To Study Association of Sociodemographic Factors with Awareness and Practices Pertaining to Complementary Feeding in Six Months to Two Years old Child Attending Immunization Clinic in a Tertiary Care Hospital of a Medical College in Urban Area

National Guidelines on Infant and Young Child Feeding should become an integral part of nation-wide Integrated child development Services (ICDS) and the Reproductive and Child Health (RCH) Programme. These need to be effectively operationalized through the programme managers and field functionaries of these on-going programmes. This can happen only when they are practically oriented to the correct norms of IYCF. Methods: A cross sectional study of complementary feeding practices amongst mothers of children aged six months to two years in an urban setting. The place of study is an immunization clinic in a tertiary care hospital of a medical college located in urban area. Study population comprised of mothers of children aged six months to two years attending an immunization clinic. Study was approved by college Institutional Ethics Committee. Mothers who met the inclusion criteria, attending the immunization clinic, from the selected tertiary care hospital of a medical college were selected by systematic random sampling and interviewed. Data analysis done with the using Microsoft excel. Results: Out of 154 mothers, 51.3% of the mothers were in the age group of 25-34 years followed by 47.4% of the mothers in the age group less than 25 years and only 1.3 % of the mothers were more than 35 years of age. Mean age ± SD of the mothers was 25.26 ± 3.73 with the youngest and the oldest mother being 19 and 39 years old respectively. Among the respondents by religion, majority (80.5%) were Hindus followed by 15.6 % Muslims and only 3.9% were Christians. Conclusion: Time of complementary feeding initiation varied according child’s gender, predominant caregiver of the child, mother’s parity and socio economic status of the family, which were found to be statistically significant.

Study of Renal Functions in People Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (PLHA): An Observational Study of Tertiary Care Hospital in North India.

Aims: The aim of this study was to find out the involvement of renal dysfunction in people living with human immunodeficiency virus/acquired immune deficiency syndrome (PLHA) in India. Study Design: Observational study. Place and Duration of Study: Total (n=150) consecutive HIV positive patients between November 2012 - April 2014, who were attending the ART Clinic or were admitted in Department of Medicine at University College of Medical Sciences and Guru TegBahadur Hospital, Delhi, India were recruited for the study. Methodology: Estimated glomerular filtration rate (eGFR) was calculated by using Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Morning spot urine samples were collected for urine albumin and urine creatinine test. Albumin/creatinine ratio (ACR) was calculated by using urine albumin and urine creatinine and were expressed in mg/g creatinine. Results: The mean eGFR (MDRD) of the study subjects was found 106.8±20.72 mL/min/1.73 m2 and a statistically significant difference was observed between male and female subjects (p = 0.039). The mean eGFR (CKD-EPI) of the study subjects was found 107.53±18.50 mL/min/1.73 m2, however, no significant difference was observed between male and female subjects (p = 0.745). The micro/macro-albuminuria (urinary ACR ≥ 30 mg/g creatinine) was found in 18 (12%) patients and leucocyturia and hematuria was found in 12.7% and 5% patients respectively. The median CD4 counts of the study subjects was 341 (222-467) cells/ mm3 and 141 (94%) were taking highly active anti-retroviral therapy (HAART). The most common HAART regimens were zidovudin/ lamivudine/nevirapine (ZLN) and tenofovir/ lamivudine/ nevirapine (TLN); 60.7% & 26.0% respectively. Hepatitis B and C co-infection rate found among subjects was 4% and 3.3% respectively. Conclusions: In conclusion, the prevalence of deranged renal functions as indicated by eGFR and urinary ACR is common in PLHA in North India. All HIV infected patients must undergo renal function tests including urinary ACR to detect the renal involvement at early stage.

Visceral ischemia: could it be segmental arterial mediolysis.

We present two cases of segmental arterial mediolysis, which can present with dissecting aneurysms or thrombosis of the visceral branches of the abdominal aorta. Segmental arterial mediolysis (SAM) causes ischemic bowel disease and has characteristic CT and angiographic features.

A 10-year experience of managing acute limb ischaemia in India.

Background. Acute limb ischaemia is threatening to both limb and life. There is little information about this disease entity from India. Methods. We did a retrospective analysis of the clinical profile of patients presenting with non-traumatic acute limb ischaemia to our department (a tertiary care centre in India) from January 1998 to December 2007. The demography, risk factors, time taken to present to the emergency from the onset of symptoms, time taken to administer the first dose of heparin upon arrival to the emergency, primary interventions and outcomes in terms of amputation rates and in-hospital mortality were studied. Results. The mean (SD) age of the 84 patients was 48.9 (14.3) years. Only one patient died (1.2%) and 24 patients had an amputation (28.6%). Among the predisposing risk factors a significant association was found between smoking and the rate of amputation. Early presentation to emergency and early administration of heparin was associated with lower amputation rates though this did not achieve statistical significance. Conclusion. Acute limb ischaemia is a catastrophic event. Smoking is a risk factor associated with poorer outcomes. Early arrival to the emergency and early administration of heparin was associated with lower amputation rates.

Multidimensional health status of HIV-infected outpatients at a tertiary care center in north India.

Background : Quality of life (QOL) scores inform researchers acquainted with such tools about patients' perception of various domains of their health. The scores provide a useful denominator for clinical trials, especially in chronic diseases with therapeutic side effects, such as HIV. However, in clinical settings, there is a felt need of description of problems commonly perceived by patients. Aim : This study describes the multidimensional health-related issues of HIV-positive patients. Settings and Design : Cross-sectional design with convenient sampling was used to recruit 138 HIV-positive patients at the outpatient section of the Department of Medicine of a tertiary care hospital in north India. Materials and Methods : A structured questionnaire was used to collect information about health-related problems. Identified problems were assessed using a Likert scale for severity. Results : Out of the 20 assessed problems, the patients reported positive for an average of 12.01 +/- 3.78 problems. The most prevalent problems were those related to emotions (98.6%), lack of energy (96.4%), and health perception (92.0%). The most distressing problems were 'feeling that health was not good' (77.5%) and 'health was bad' (75.4%). The number of problems reported was significantly related to weight loss ( P = 0.006) and clinical category ( P = 0.023). A significant correlation was observed between weight loss and problems in social activities ( P P P P = 0.002).Conclusion : Many patients have significant problems in dimensions other than physical. A physician's awareness about these problems is important for a holistic patient management.

The impact of HIV/AIDS on the quality of life: a cross sectional study in north India.

OBJECTIVE: To determine the impact of Human Deficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) on the quality of life (QOL) on such patients in North India. DESIGN: A cross sectional study. SETTING: Outpatient setting and wards, Department of Medicine at a premier tertiary health care center, North India. PARTICIPANTS: Sixty-eight consecutive HIV/AIDS patients attending Medicine out patient department and/or admitted to the wards of All India Institute of Medical Sciences were administered a structured questionnaire by the HIV nurse coordinator. QOL was evaluated using the WHOQOL-Bref (Hindi) instrument. ANALYSIS: One way Analysis of Variance (ANOVA) was performed to find out significant difference between the clinical categories and socio-demographic variables on QOL domains. RESULTS: The overall QOL mean score on a scale of 0-100 was found to be 25.8. Similarly, on the scale of 0-100 the mean scores in the four domains of QOL in descending order were social (80.9); psychological (27.5); physical (17.7) and environmental domain (11.65). There was a significant difference of quality of life in the physical domain between asymptomatic patients (14.6) and patients with AIDS (10.43) defining illnesses (p< 0.001) and asymptomatic and early symptomatic (12) patients (p=0.014). QOL in the psychological domain was significantly poorer in early symptomatic (12.1) (p< 0.05) and AIDS patients (12.4) (p< 0.006) as compared to asymptomatic individuals (14.2). A significant difference in QOL scores in the psychological domain was observed with respect to the educational status (p< 0.037) and income of patients (p< 0.048). Significantly better QOL scores in the physical (p< 0.040) and environmental domain (p< 0.017) were present with respect to the occupation of the patients. Patients with family support had better QOL scores in environmental domain. CONCLUSIONS: In our study, QOL is associated with education, income, occupation, family support and clinical categories of the patients.

Traction as a cause of gallbladder avulsion.

Following isolated blunt trauma to the abdomen, a 25-year-old man developed peritonitis. Laparotomy revealed a band between the transverse colon and gallbladder, with partial avulsion of the latter. Avulsion of the gallbladder is a rare injury and, to the best of our knowledge traction has not been described as a mechanism of injury.

Ectopic pancreas mimicking superior mesenteric artery syndrome.

Ectopic pancreas rarely produces symptoms and often goes undetected. We report a 28-year-old man with ectopic pancreas presenting with symptoms and radiological findings mimicking superior mesenteric artery syndrome. Excision of the lesion and duodeno-jejunostomy led to relief.