ABSTRACT
Background. Availability of doctors at primary health centres (PHCs) is a major concern. We measured the operational availability of doctors in PHCs and examined the effect of residential distance and private practice. Methods. Thirty-six health centres, consisting of six randomly selected PHCs from six purposively chosen districts in Andhra Pradesh were studied. Cross-sectional data on residential distance, private practice and attendance pattern of 38 operationally available medical officers were analysed. Results. About 80% of doctors residing within 20 km attended their PHC on all 6 days of a week, compared with only 33% for those staying >40 km away. Among those staying >20 km away from their PHC, the odds of absenteeism by privately practising doctors was 3–24 times more than for those not practising privately. Conclusion. Residential distance seems to affect the operational availability of doctors. Private practice by doctors living within 20 km from the PHC does not seem to affect their operational availability. However, private practice by doctors staying >20 km away from their PHC may affect their availability.
Subject(s)
Absenteeism , Ambulatory Care Facilities , Cross-Sectional Studies , Humans , India , Physicians/supply & distribution , Primary Health Care , Private Practice , Residence CharacteristicsABSTRACT
Penetrating neck wounds are potentially dangerous and require emergency management because of the presence of vital structures in the neck. Organic foreign bodies further carries a risk of wound infection. We present a case of penetrating broken branch of a tree traversing from zone II to zone III without any neurovascular injury. Neck exploration was done with midline mandibulotomy approach and foreign body was removed without any complication.
Subject(s)
Accidental Falls , Child , Female , Foreign Bodies/surgery , Humans , Neck Injuries/surgery , Plants , Wounds, Penetrating/surgeryABSTRACT
A 9 years old patient presented with swelling and severe pain in right eye with diplopia; with normal visual acuity. CT scan of paranasal sinus revealed right eye axial proptosis and dehiscence in lamina papyracia. After thorough investigation, patient was posted for surgical drainage and decompression of the right orbit. Patient, improved after surgery and followed regularly for last 2 months.