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Introduction: The medical curriculum, the medium of instruction and evaluation in India, is primarily English. While it has the advantage of preparing Indian medical graduates to represent and interact globally, it also translates into learning difficulties for a substantial population of Indian medical students. Hindi is the common language of communication among majority of the population in Uttar Pradesh.Madhya Pradesh Government in India has already started the option of pursuing the allopathic graduate medical course in Hindi. There is paucity of data regarding opinion of medical professionals about implementation of Medical Education in Hindi in Uttar Pradesh and nearby states. Objective: To assess the attitude and opinion of medical students and medical professionals towards using Hindi in Medical Education. Method: A cross-st stsectional web-based online survey was conducted between 1 December 2022 and 31 January 2023. Undergraduate medical students, interns, residents and faculty from medical colleges, hospitals of Uttar Pradesh and neighbouring states (Uttarakhand and Bihar) were contacted to participate in this survey using pretested structured questionnaire. Results: A total of 1606 participants responded and answered the questionnaire and 1575 responses were found complete and used in analysis.Most participants (52.8%) believed that Medical Education in Hindi would attract more students from Hindi backgrounds to join the medical field. Similarly, 58.9% of participants were of the opinion that Medical Education in Hindi would improve communication with patients. However, about half of the participants (49.5%) perceived teaching in Hindi as a hurdle in acquiring higher education. Conclusion: More than half of the participants thought that medical education in Hindi will attract more students from Hindi backgrounds to join the medical field. Similarly, Medical Education in Hindi was perceived to improve communication skills with patients, at least where Hindi is a vernacular language by majority of the participants.
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Introduction : Depression is the leading cause of disease-related disability among women in the world today. Depression is a serious condition that can impact every area of women’s life. It affects social life, family relationships, career, and one’s sense of selfworth and purpose. To determine the prevalence andObjective: associated risk factors of depression among rural housewives aged 18–59 years. A community basedMethod: cross sectional study was carried out among 414 housewives in rural field practice area of Department of Community Medicine, Jhalawar Medical College, Jhalawar, Rajasthan. Participants were selected by simple random sampling technique. A pre designed semi structured proforma was used for collecting information on socio-demographic characteristics, medical history, family problems, personal history and obstetrical and gynecological history. Assessment of depression was done by using self-reported instrument Patient Health Questionnaire-9 (PHQ-9) Out of 414 Housewives, 63 (15.2%) were found to have depression. WithResults: increasing education level, there was a declining trend toward depression. Significantly higher rates of depression were observed among housewives reporting any debilitating ailments in one or more family members (31.2%), some unusual events occurred in family in past (56.2%), presence of any addiction in family members (22.7%) and debt on family (58.8%). Marriage at early age, having first pregnancy at early age, more than two children, menstrual irregularities and suffering from unable to conceive or infertility were the biological factors significantly associated with depression. Prevalence of depression was highConclusion: among housewives in rural community. Many social and biological factors were contributing towards high rate of depression among housewives
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Pain has always been a distressing feeling or the unpleasant sensory and emotional experience. A pain free life is longing of everyone and this is the biggest challenge for the medical science practitioners nowadays as how to provide efficient pain management. In modern medicine we have variety of pain-relieving medications that works brilliantly for short period of time and when used for longer duration they come up with various side effects. So there is a need to find a way to relieve pain without much suffering to the patient and Agnikarma is one of the sound ways to do so. It is therapeutic burning with special tools on specific sites according to the disease. It is a parasurgical procedure that is utilized as curative procedure, or as postoperative procedure or in hemostatic manner. Agnikarma is derived from Ayurveda, a renowned Indian system of medicine, which is procedure used generally for the management of pain and also for curing various disorders. In Ayurveda Vata Dosha is responsible mainly for various types of Ruja or pain in the body and Agnikarma is one of the best method to pacifying Vata and Kapha Dosha and hence relieves pain. Acharya Sushruta, a renowned Vedic Indian surgeon has very well explained the eminence of Agnikarma by saying that the recurrence of disease will not be there if once they are treated with Agnikarma. He in his text mentioned various Dravyas according to the diseases through which Agnikarma can be performed. Also several Dahanaupkarana are mentioned in the classics that provide practitioner abundant methods to perform Agnikarma without much limitations
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INTRODUCTION: Obesity is generally considered to play a key role in the metabolic syndrome, including hypertension. Metabolic syndrome is defined as a cluster of as a combination of obesity, insulin resistance, hyperinsulinemia, dyslipidaemia and hypertension. Other measures of obesity apart from Body Mass Index (BMI) are Waist Circumference (WC) and Height Weight Ratio (HWtR) and are efficient risk factors for prediction of CVD in children. BMI is calculated as person's weight (kg) 2 divided by height in meters (m ). Correlation between BMI and lipid profile were studi MATERIAL & METHODS: ed in a sample of 270 people (154 males & 116 females). In our study, we found that Mean total cholest RESULT: erol of Group I and Group II patients was 163.88±50.17 mg/dl and 184.02±36.31 mg/dl respectively. Total mean total cholesterol of the patients was 173.95±44.86 mg/dl. Triglycerides in Group I and Group II patients was 152.84±58.82 mg/dl and 157.28±73.29 mg/dl respectively. Total mean total cholesterol of the patients was 155.06±66.37 mg/dl. HDL in Group I and Group II patients was 48.55±16.76 and 47.03±9.06 respectively. Total mean total cholesterol of the patients was 47.79±13.47 mg/dl. The mean LDL of Group I and Group II patients was 85.04±36.13 mg/dl and 113.1926±24.35 mg/dl respectively. Total mean LDL of the patients was 99.11±33.83 mg/dl. Total Chol CONCLUSION: esterol and LDL of the studied patients have shown significant correlation in both groups (p<0.05). Triglycerides and HDL of the studied patients have shown non-significant correlation in both groups. (p>0.05)
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Purpose@#Studies objectively comparing lithotomy and prone positions regarding surgeon comfort, ergonomics, patient comfort, and position related complications are scarce. @*Methods@#The patients posted for surgery of either fistula in ano, hemorrhoids, or were included in this study. Subjective Mental Effort Questionnaire (SMEQ) and Local Experienced Discomfort (LED) scale were used to score the level of mental and physical stress among the operating surgeon, assistants, and the scrub nurse. Other parameters studied were the exposure of the operative site, patient comfort level, and position-related complications. @*Results@#Thirty patients were operated in each position. Mean±standard deviation of jackknife prone vs. lithotomy surgeon SMEQ score (15.6±10.4 vs. 107.0±11.5, P<0.05) and LED score (1.8±1.5 vs. 6.7±0.5, P<0.05) were found to be statistically significant. Prone vs. lithotomy assistant SMEQ score (29.1±13.1 vs. 100.6±8.7, P<0.05) and LED score (4.6±1.1 vs. 7.4±0.8, P<0.05) were also found to be statistically significant. SMEQ (10.0±0.0 vs. 20.6±2.5, P<0.05) and LED scores (1.1±0.3 vs. 3.3±0.5, P<0.05) of scrub nurses and LED scores (2.5±0.5 vs. 6.3±0.7, P<0.05) of patients were also statistically significant. Exposure of the operative site was significantly better in the prone position (5.0 vs. 2.1, P<0.05). @*Conclusion@#Significantly better SMEQ, LED, and exposure score suggests the superiority of jackknife prone position over the lithotomy in terms of significantly less mental and physical stress to the operating surgeon, assistant, and scrub nurse; better ergonomics, and excellent exposure.
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Objectives@#The quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women. @*Methods@#This community-based cross-sectional study included menopausal women aged 45–55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews. @*Results@#A total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase. @*Conclusions@#This study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage.Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.
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The purpose of this extension study was to assess the long-term efficacy and safety of gemigliptin 50 mg in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who had completed the initial 24-week study comparing gemigliptin monotherapy with placebo were eligible to enrol. In the open-label, 28-week extension study, all enrolled patients received gemigliptin, regardless of the treatment received during the initial 24-week study period. The mean reduction±standard deviation (SD) in glycosylated hemoglobin (HbA1c) observed after 24 weeks of treatment (–0.6%±1.1%) was further decreased for the gemi-gemi group and the mean change in HbA1c at week 52 from baseline was –0.9%±1.2% (P<0.0001). For the pbo-gemi group, HbA1c decreased after they were switched to gemigliptin, and the mean change in HbA1c at week 52 from baseline was –0.7%±1.2% (P<0.0001). Furthermore, the overall incidence of adverse events demonstrated that gemigliptin was safe and well tolerated up to 52 weeks.
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Objectives@#The quality of life declines gradually as women enter menopause, owing to the various problems associated with estrogen deficiency and aging, which adds to their morbidities. This study aimed to investigate the patterns of morbidity among rural menopausal women and compare the morbidity patterns among menopausal transition group and post-menopausal women. @*Methods@#This community-based cross-sectional study included menopausal women aged 45–55 years from rural areas of the Etawah district, Uttar Pradesh, India. To select blocks and villages of the district, multistage random sampling was performed. According to a pretested, semistructured schedule, data were collected through interviews. @*Results@#A total of 315 women participated in the study. The most frequent complaints among the participants were of feeling tired and worn out (85.1%) and of muscle and joint pains (67.6%). Poor memory (P = 0.046) and diabetes (P = 0.024) were more common in women who were in the menopause transition phase than in those who were in the postmenopausal phase. @*Conclusions@#This study showed that majority of the menopausal women suffered from physical problems. Lifestyle modification and awareness programs will be beneficial among women in menopausal transition, to reduce the morbidity later in post-menopausal stage.Behaviour change communication, family and community support are essential in post-menopausal women, to help them cope with various morbid conditions.
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The purpose of this extension study was to assess the long-term efficacy and safety of gemigliptin 50 mg in patients with type 2 diabetes mellitus (T2DM). Patients with T2DM who had completed the initial 24-week study comparing gemigliptin monotherapy with placebo were eligible to enrol. In the open-label, 28-week extension study, all enrolled patients received gemigliptin, regardless of the treatment received during the initial 24-week study period. The mean reduction±standard deviation (SD) in glycosylated hemoglobin (HbA1c) observed after 24 weeks of treatment (–0.6%±1.1%) was further decreased for the gemi-gemi group and the mean change in HbA1c at week 52 from baseline was –0.9%±1.2% (P<0.0001). For the pbo-gemi group, HbA1c decreased after they were switched to gemigliptin, and the mean change in HbA1c at week 52 from baseline was –0.7%±1.2% (P<0.0001). Furthermore, the overall incidence of adverse events demonstrated that gemigliptin was safe and well tolerated up to 52 weeks.
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Context: Health-related quality of life (HRQOL) assessment plays an important role in the decision-making process in oncology. Aims: The aim of the study was to translate European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) OES18 and OG25 in Punjabi language for HRQOL assessment of patients diagnosed with esophagus and esophagogastric malignancies. Subjects and Methods: The EORTC translation guidelines were duly followed to translate QLQ-OES18 and OG25 into Punjabi language. Each set of questionnaire was independently translated by two forward translators, followed by backward translation of the reconciled version by two independent translators. The final version was submitted to the EORTC Translation Team and served to the patients for the pilot testing. Results: The questionnaire was administered to ten patients each of esophagus and esophagogastric malignancies who were evaluated and treated at our hospital. Every patient underwent an interview to check if any of the questions was difficult, uncomfortable, or upsetting to answer. Their concerns were recorded as per the template provided by the EORTC team and due changes done if required. Conclusions: The EORTC QLQ-OES18 and OG25 questionnaire has been translated to Punjabi language and subsequently approved for usage.
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Context: The fluctuations of proteins in multiple myeloma (MM) are well-known markers for checking the status of the patients. Aims: The objective of this study was to examine three proteins that have an important role in disease progression. Subjects and Methods: The study was performed with two groups: 30 MM stage I patients' (14 females/16 males; aged 60.83 ± 12.38 years) as case group and 40 healthy individuals (18 females/22 males; aged 57.65 ± 6.43 years) as control group. Both groups have been matched in gender and age. Bone sialoprotein (BSP), osteopontin (OPN), and β2-microglobulin (β2M) were measured with an enzyme-linked immunosorbent assay. Results: Serum BSP levels of MM-I patients was significantly higher than that of healthy controls (29.24 ± 5.57 vs. 20.89 ± 3.67, P = 0.001). OPN levels of MM-I patients were significantly lower than that of healthy individuals (12.03 ± 3.45 vs. 19.35 ± 4.67, P = 0.001). β2M levels of patients and controls were similar (1.49 ± 0.67 vs. 1.29 ± 0.55, P = 0.193). Conclusions: The results suggested that myeloma cells may affect the production of BSP and OPN, which possibly contributes to osteoclastic bone resorption in MM-I patients. Their levels may be a useful biomarker for assessing bone destruction in MM-I patients and distinguishing MM-I from healthy individuals
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Background: Stroke is the most common neurological condition causing long term disabilities in various ways.Post-stroke shoulder subluxation, mainly the Gleno-humeral Subluxation (GHS) of the affected side is oftendetected as a complication. Numerous theories exist to explain the pathomechanics of developing GHS,butstudies regarding its relationship with the sensori-motor recovery of the affected limb is still controversial.Aim of Study: To ascertain the correlation between Gleno-humeral subluxation with sensori-motor recovery ofthe affected upper limb following stroke.Method: This correlation study was conducted on 30 patients of both sexes within the age group of 45-65 yearswith post-stroke (duration < 6weeks) Gleno-humeral subluxation( GHS). Screening of GHS was done by palpationand degree of GHS was quantified by High resolution USG by measuring the Acromion - Greater TuberosityDistance difference (AGTDD) between two shoulders. Sensorimotor recovey of the affected limb was assessed byFugl - Meyer Assessment Scale of Upper Extremity (FMA-UE). Data collected at the baseline (visit1), at 6 weeks(visit 2), 12 weeks (visit 3) and at the end of the study i.e 24 weeks (visit 4).Results: Pearson Correlation (r) in all visits (V1: r=-0.926, p=0.000. V2: r=- 0.947, p=0.000. V3: r=- 0.912, p=0.000.V4: r=- 0.924, p=0.000) established a statistically significant negative correlation between degree of shouldersubluxation and sensory-motor recovery.Conclusion: Post-stroke GHS is a significant complication which undoubtedly plays a cardinal negative roleduring sensori-motor recovery of the affected upper limb.KEY WORDS: Gleno-humeral subluxation (GHS), Acromion-Greater Tuberosity Distance difference (AGTDD),
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Background: The utilization of social services, including health services, has never been equitably distributed in the society. Cost, distance, attitude of health providers, and other factors put the secondary care and private sector facilities out of reach of most of the poor residents. The socioeconomic factors also have a complex relationship with some of the supply factors, and often in the scarcity of good data, it is very difficult to explain the poor utilization of reproductive and child health (RCH) services.Methods: A cross sectional study conducted on 80 recently delivered women at home in the villages covered under the selected subcentre to interview all recently delivered women to find out the reasons for non-utilization of RCH services. The data was collected by using pre designed semi-structured questionnaire.Results: Most of the participants belong to age group of 20 to 24 (55%) and joint family (51.3%). Main reason for not having institutional delivery was found to be long waiting time in hospital/lack of proper facilities (50%) followed by non-cooperative hospital staff (36.2%). The study showed that most common reason for not getting money under JSY was found to be non-issuance of JSY card (33.3%) and non-cooperative hospital staff (33.3%). It was found that non utilisation of contraceptive services was mainly due to objection by husband (45.5%).Conclusions: This study revealed lack of knowledge, no felt need and financial constraints as the most common reason for not utilizing the different RCH services.
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Background: More than 1.2 million deaths occur each year on the world's roads. In India, the number of motor vehicles on the road is increasing with the population and economic growth. It has been estimated that if effective and immediate action is not taken, deaths due to road traffic accidents will become the fifth leading cause of deaths by 2020. Objectives was to assess the level of awareness and behavior regarding road safety rules among undergraduate medical students.Methods: The present cross-sectional study was conducted in a Medical College of western Uttar Pradesh. In the present study 200 final and pre-final year, undergraduate medical students were selected with the help of simple random selection, who drive/use vehicles either of their own or others. The study period was from June 2019 to August 2019.Results: About 29 percent of participants responded that they do not follow lane rules while driving. Study showed that 72.1% and 42.0% were aware that what documents to be carried with them while driving among those who attend and did not attend any program on road safety measures respectively. About 58.1 % and 38.2% were aware that penalty for driving without a helmet can be imposed among those who attend and did not attend any program on road safety measures.Conclusions: Awareness of road safety measures among participants was satisfactory, but the gap was also seen between awareness and behavior patterns regarding road safety measures.
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Background: Vaccine potency can be lost when exposed to non-recommended temperatures. Hence for the proper running of the universal immunization programme (UIP) factors like vaccine cold chain and vaccine management wants great focus and attention skills and knowledge of the vaccine cold chain handlers so for good implementation of UIP vaccine cold chain handlers are important.Methods: This was an observational cross-sectional study. Study duration was carried out from October 2017 to March 2018. All the 16 cold chain handlers of district Etawah were interviewed.Results: All 16 (100.0%) were male and 1 (6.3%), 2 (12.5%), 8 (50.0%) and 5 (31.3%) of the respondents were high schools, intermediate, graduate, and post-graduate respectively. It had been observed that the hundred percent of the cold chain handlers with the knowledge of vaccine cold chain. It has been observed from the study that 15 (93.7%) cold chain handlers had knowledge of temperature range for vaccine storage.Conclusions: Quality of immunization program depends upon cold chain management at peripheral health institutions. In our study, we have found that most of the vaccine handlers were reported to have appropriate knowledge regarding the cold chain.
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Background: Neonatal death is defined as no. of deaths during the first 28 completed days of life per 1000 live births in a given year or period. Around 2.6 million deaths or roughly 46% of all under five deaths had occurred during this period in 2016 which means that 7000 newborn deaths occur each day. Most of the neonatal deaths occur on the first day and week accounting to about 1 million dying on the 1st day. Objective of this study was to ascertain various causes of neonatal mortality using verbal autopsy in Etawah district.Methods: The present study was a retrospective cross-sectional study carried out for a period of 1 year (July 17 to June 2018) using WHO verbal autopsy questionnaire by finding out the study subjects from medical information system of UPUMS, Saifai and district hospital, Etawah. A total of 89 neonatal deaths were found out of which 87 were interviewed by going to their residences to get the relevant information regarding the causes of deaths.Results: Most common cause of neonatal mortality came out to be low birth weight with prematurity 44 of 87 (50.6%), followed by birth asphyxia 23 of 87 (26.4%) and sepsis 8 of 87 (9.2%).Conclusions: Effective interventions should be incorporated into policy decisions to reduce neonatal mortality due to these causes.
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Neutrophils play as major phagocytes that participate in the various effector phase of immunity. Mannosebinding lectin (MBL) assisted priming of neutrophils could trigger various processes including modulationof endocytosis rate, reactive oxygen production, chemotaxis, etc., through interactions with cell surfacereceptors. The physiological receptor for MBL on neutrophil's surface is still unreported. Macromoleculardocking could be attempted to determine the protein-protein interactions which are important forunderstanding cellular function and organization. The study was performed to identify the interacting partnerof MBL present on neutrophils surface which leads to the activation of various cell processes. Protein networkanalysis, homology modeling, and Rigid docking were performed to explore structural features and bindingmechanism of MBL with its cellular receptors. The results indicates that CR1 interact with the MBL and mayact as MBL receptor.
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Objective: Present study was conducted to evaluateeffectiveness of lumbar epidural and spinal anaesthesia inelective caesarean section.Methods: This experimental study is conducted at tertiarymedical college hospital, Gopalgong. Written informed consentfrom 100 patients were obtained for this experimental study.Purposive sampling technique was used.Results: During the study, where in group-A 52.02% womenwere in their first pregnancy followed by 28.28% were 2ndpregnancy, 19.7% were multi gravid women. where in group-A,35% had hypotension where as in group-B it was 11%. groupA, 30% patients were Highly satisfied where as in group-B itwas 65%. The patients selected for the study was divided intotwo groups: Group – I (Spinal): 50 Patients selected, Group – II(Epidural): 50 patients selected.Conclusion: From our result and study we can conclude that,continuous epidural technique which allowed mother earlybreastfeeding and ambulation. Further studies are needed forbetter outcome.
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Background: According to William Osler, a great feature which distinguishes man from animals is the desire to take medicine. Self-medication is an age old practice. According to World Health Organization guidelines “self-medication is defined as use of medicinal products by the individuals to treat self-recognized disorders or symptoms, or the intermittent or continuous use of a medication prescribed by a physician for chronic or recurring diseases or symptoms.Methods: It was a cross sectional study, which was conducted among residents of urban and rural areas of Etawah district, Uttar Pradesh by using 40×5 cluster sampling. The data was collected by using pre designed, semi-structured questionnaire. Proforma included socio- demographic profile, practice of self- medication and pattern of self-medication.Results: Most of the participants who indulged in self-medication in urban areas 69.5% and rural areas 65% belong to the age group 20-39 years. Majority of the participants (51.0%) in urban areas belonged to the nuclear family while most of the participants (50%) belonged to joint family followed by nuclear family (40%) in rural areas. most common reason for self-medication in urban area was the availability of old prescription which is present in 30.0% (60) of subjects but in rural area most common reason for self-medication was high fee of doctor which was 29.0% (58).Conclusions: Most common age group indulged in self-medication was 20-39 years. Most common reason for self-medication was availability of old prescription at home while in rural area, high fees of doctor was the common reason for self-medicatio
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Objective@#To standardize the technique; evaluate resources requirements and analyze our early experience of total marrow and lymphoid irradiation (TMLI) as part of the conditioning regimen before allogenic bone marrow transplantation using helical tomotherapy. @*Methods@#Computed tomography (CT) scanning and treatment were performed in head first supine (HFS) and feet first supine (FFS) orientations with an overlap at mid-thigh. Patients along with the immobilization device were manually rotated by 180° to change the orientation after the delivery of HFS plan. The dose at the junction was contributed by a complementary dose gradient from each of the plans. Plan was to deliver 95% of 12 Gy to 98% of clinical target volume with dose heterogeneity <10% and pre-specified organs-at-risk dose constraints. Megavoltage-CT was used for position verification before each fraction. Patient specific quality assurance and in vivo film dosimetry to verify junction dose were performed in all patients. @*Results@#Treatment was delivered in two daily fractions of 2 Gy each for 3 days with at least 8-hour gap between each fraction. The target coverage goals were met in all the patients. The average person-hours per patient were 16.5, 21.5, and 25.75 for radiation oncologist, radiation therapist, and medical physicist, respectively. Average in-room time per patient was 9.25 hours with an average beam-on time of 3.32 hours for all the 6 fractions. @*Conclusion@#This report comprehensively describes technique and resource requirements for TMLI and would serve as a practical guide for departments keen to start this service. Despite being time and labor intensive, it can be implemented safely and robustly.