ABSTRACT
Despite various reforms brought in health care service delivery there is always a gap between community and health care providers. Hence there is a need to explore the successful strategies to reorient the medical students towards public health relevant community needs. Objective: This study aimed to assess the feasibility and impact of community based field training imparted among medical undergraduates to identify problems related to infant and young child feeding practices and design appropriate interventions. Material and Methods: This study is a mixed method study where improvement of knowledge were assessed quantitatively through quasi experimental pre-post study design. Difference in cumulative score obtained after training was compared using student's t test. Perception of students and mentor's views on this approach in terms of benefits and challenges were explored during in-depth interviews. Transcripts of qualitative interviews were analysed using manual content analysis. Results: Total of 781 infant and young children from 30 villages were surveyed by 36 medical undergraduates. There was significant improvement in knowledge on feeding practices from the baseline [baseline mean (SD) score: 3.3 (1.5); post training mean (SD) score: 6.5 (1.1), p<0.001]. Mentors of the opinion that this community based approach had facilitated the students to acquire skills on management, communication, team spirit and professional attitude. Students had opportunity to assess spectrum of illness and the co-existing social conditions in their natural setting. Conclusion: Students as well as other stakeholders were more positive and overwhelmingly supporting this approach. This approach is feasible with better planning, institute cooperation and commitment.
ABSTRACT
Background: Diabetes mellitus is characterised by persistent hyperglycaemia that may be due to absolute or relative insulin deficiency. It was estimated that there would be 285 million diabetics by 2010 in the world. This estimate is projected to increase by 65% to become 438 million in the year 2030. Similarly in India it is estimated to increase by 58% from 51 million people in the year 2010 to 87 million people by the year 2030. Methods: The study was carried out as cross sectional study among 235 diabetic OPD attendants of rural health centre aged 30 years and above. TCSS was used for diagnosis diabetic peripheral neuropathy. Data was entered in MS excel 2007 and analysis was done using SPSS version 17.0. Chi square test was applied to find statistical difference in proportions and a p value of <0.05 was considered statistically significant. Results: The overall prevalence of peripheral neuropathy among the study participants was observed to be 13.2%, while none of the study subjects presented with severe form of the disease. Nearly half of the patient who participated in the study also had co existing systemic hypertension. Also 12.3% of the study subjects had a positive history of foot ulcers. Conclusions: The prevalence of DPN increased with increasing age and it is observed to be associated with duration of diabetes, physical activity, smoking habit and systemic hypertension.