ABSTRACT
Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortatlity worldwide. Malnourishment in COPD patients is very common and is a prognostic factor in its treatment. The present study has been conducted to assess nutritional status in COPD patients and its correlation with severity of disease. Methods: This institutional based analytical cross sectional study was conducted in the Department of Pulmonary Medicine at tertiary care hospital in Himachal Pradesh (India) from 1 Dec 2017 to 31st May 2018. A total of 52 COPD participants attending the pulmonary Medicine OPD and fulfilling the inclusion criteria were enrolled. Results: All participants reported being smoker since long with the mean years of smoking since 31 years and about 13.6 cigarettes being smoked per day. 22 (42%) of the participants were undernourished as per BMI criteria But when compared with MUAC criteria, a large number 38 (73%) came out to be undernourished. haemoglobin and cholesterol levels were less in patients with severe diseases than mild and moderate category (76.9%). Conclusions: The malnourishment and severity of the disease has direct correlation. More the severity of COPD, more is the malnourishment. Biochemical parameters, although not deranged significantly in any group, but more on the lower side in patients with severe COPD. There is a need for regular nutritional assessment of every COPD patient and recommendation of supplementary food for them.
ABSTRACT
The Government of India initiated a cash incentive scheme—Janani Suraksha Yojana (JSY)—to promote institutional deliveries with an aim to reduce maternal mortality ratio (MMR). An observational study was conducted in a tertiary-care hospital of Madhya Pradesh, India, before and after implementation of JSY, with a sample of women presenting for institutional delivery. The objectives of this study were to: (i) determine the total number of institutional deliveries before and after implementation of JSY, (ii) determine the MMR, and (iii) compare factors associated with maternal mortality and morbidity. The data were analyzed for two years before implementation of JSY (2003-2005) and compared with two years following implementation of JSY (2005-2007). Overall, institutional deliveries increased by 42.6% after implementation, including those among rural, illiterate and primary-literate persons of lower socioeconomic strata. The main causes of maternal mortality were eclampsia, pre-eclampsia and severe anaemia both before and after implementation of JSY. Anaemia was the most common morbidity factor observed in this study. Among those who had institutional deliveries, there were significant increases in cases of eclampsia, pre-eclampsia, polyhydramnios, oligohydramnios, antepartum haemorrhage (APH), postpartum haemorrhage (PPH), and malaria after implementation of JSY. The scheme appeared to increase institutional delivery by at-risk mothers, which has the potential to reduce maternal morbidity and mortality, improve child survival, and ensure equity in maternal healthcare in India. The lessons from this study and other available sources should be utilized to improve the performance and implementation of JSY scheme in India.
ABSTRACT
Every year, several students across India attempt suicide or just drop out of college, unable to face the humiliation that goes by the name of ragging. Student hostels are citadels of such cruelty in many educational institutes in the country. Medical colleges are included in this list. In 2009, Aman Kachroo, a medical student in Himachal Pradesh, died after an assault by his seniors in the name of “ragging”.
ABSTRACT
Ragging is any disorderly conduct that has the effect of teasing or handling with rudeness any student, which causes or is likely to cause annoyance, harm or to raise fear in a junior so as to adversely affect the psyche of the junior. Ragging is practiced all over the world, with different nomenclature like hazing, fagging; bapteme in French; doop in Dutch; and Mopokaste in Finnish. The first recorded cases of ragging were in the 8 th century BC during the Olympics in Greece. Ragging has been frequently associated with a broad spectrum of physical, behavioral, emotional and social problems among the victims. It independently increases suicide risks. Some of the reasons given by students for ragging are they were also ragged by their seniors; sense of superiority; and introduction. Other factors perpetuating ragging are use of alcohol in hostels and lack of implementation of serious anti-ragging measures by college authorities. Various practical steps to control ragging must include strict role of authorities, ban on alcohol within college and hostels, surprise raids in hostels at night, postings (with accommodation) of wardens in hostels, separate hostels for juniors, presence of college "disciplinary committee" and "cultural committee," strict punishments for those involved in ragging, actions by Medical Council of India (MCI) and University Grants Commission (UGC) against the erring colleges and universities and formulation of anti-ragging laws. Ragging should be declared a public health problem because it involves the physical, mental and social exploitation of not only an individual but also of his/her family and the society as a whole.