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Abstract Introduction Selective neck dissection inclinically node-negative neckisconsidered the standard of care for oral squamous cell carcinomas (SCCs). Controversy still prevailsinnode-positive disease regarding the extent of neck dissection. In our part of the world, comprehensive neck dissection is mostly considered to be the minimal optimal treatment for palpable neck disease. Objective To compare regional control and disease-specific survival between clinically node-positive and node-negative patients undergoing selective neck dissection for oral SCC. Methods This was a retrospective cohort study conducted in the department of ENT, Head and Neck surgery at a tertiary care hospital. All patients with biopsy-proven oral and lip SCC, with or without nodal disease, who underwent selective neck dissection between April 2006 and July 2015 were included in the study. Results During the study period, 111 patients with oral SCC underwent selective neck dissection, of whom 71 (62%) were clinically node-negative and 40 (38%) patients had clinically positive nodes in the neck. The mean follow-up was 16.62 months (standard deviation [SD]: 17.03). The overall regional control rates were 95 versus 96% for clinical negative versus positive nodes, respectively (p = 0.589). The disease-specific survival was 84.5% in the node negative group versus 82.5% in the node-positive group (p = 0.703). Conclusion Selective neck dissection in node-positive neck oral SCC has similar regional control rates when compared with node-negative neck SCC. The difference in disease-specific survival between the two groups is also not significant.
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Background: Primary percutaneous coronary intervention (PCI) is a recommended management strategy for patients with de novo ST-segment elevation myocardial infarction (STEMI). Still, the efficacy of primary PCI in-stent thrombosis (ST) induced STEMI is unclear. The aim was to assess the clinical characteristics and the in-hospital outcomes of patients undergoing primary PCI for STEMI caused by acute, sub-acute, or late ST. Methods: A sample of hundred consecutive patients who presented with STEMI due to ST were included in this study. The angiographic evidence of a flow-limiting thrombus or total vessel occlusion (thrombolysis in myocardial infarction (TIMI) flow grade 0 to II) at the site of the previous stent implant was taken as ST. Primary PCI was performed, and all enrolled patients and in-hospital mortality were observed. Results: Male patients were 69, and the mean age was 58.9 ± 7.78 years. ST was categorized as acute in 40 patients, sub-acute in 53, and late in the remaining seven patients. Killip class III/IV was observed in 45 patients. Dissection was observed in 25, under deployment in 74, and/or malposition in 24 patients. Thrombus aspiration was performed in 97, plain old balloon angioplasty in 76, and stenting in 22 patients. Final TIMI III flow was achieved in 32 patients. During a mean hospital stay of 4.93 ± 2.46 days, the mortality rate was 27%. Conclusion: In-hospital mortality after primary PCI was observed in more than 1/4th of the patients with STEMI due to ST undergoing primary PCI
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Background: One of the most widely performed surgical procedures nowadays is cataract surgery combined with monofocal intraocular lens implantation (IOL). Monofocal IOLs can compensate for the spherical refractive error but not astigmatism. Thus, patients with astigmatism are unable to see well after surgery without spectacles. A new generation of IOLs called toric IOLs, improve uncorrected visual acuity in eyes with high astigmatism due to a specific lens design. This study aimed to present a practical method of toric intraocular lens (IOL) implantation based on a refractive power analyzer system and slit-lamp observation.Material & Methods:This prospective study comprised 30 patients who underwent toric IOL implantation with cataract extraction at the Department of Ophthalmology, National Institute of Ophthalmology, Dhaka, Bangladesh. This study was conducted from Jan 2021 to Dec 2021. Approval from the local ethical committee was obtained.Results:The study included 45 eyes of 30 patients. The sex distribution of the study patients where the male was 18(60%) and the female was 12(40%). In the age distribution of the study, 5(16.67%) patients were from the 60-69 range, 10(33.33%) patients were from the 70-79 range, and 15(50.00%) patients were from the 80-89 range. The patients’ demographic variables consequently. Changes in visual acuity and refraction are shown in table-4 thorough preoperative and postoperative. Postoperative IOL alignment methods are shown in table-5, the mean±SD of the slit-lamp target was 2.55±2.76 and in the range, of 0.0 to 12.0, the mean±SD of the corneal analyzer target was 2.55±1.98 and range was 0.0 to 11.0, and the mean±SD of the slit-lamp corneal analyzer was 3.27±2.98 and range was 0.0 to 16.0.Conclusions:We studied 2 methods of assessing toric IOL alignment postoperatively and found no significant difference between them. Both were reliable and predictable. In addition, we found that the simple preoperative marking technique we used yielded toric IOL alignment that was as accurate as that obtained with other commonly used techniques and that was within a clinically acceptable level.
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To compare global endothelial function assessed by pulse wave analysis (PWA) using the ratio of endothelium dependent vasodilatation (EDV) to endothelium independent vasodilatation (EIV) in patients with hypercholesterolemia and controls. 92 subjects [46 hypercholesterolemics, 46 controls] were studied at standardized conditions. Baseline augmentation index (AIx) was assessed followed by the administration of 0.5 mg sublingual nitroglycerine, an endothelium independent vasodilator. AIx was assessed and the maximum change in AIx after nitroglycerine was recorded as EIV. After a washout period of 30 minutes, 400 µg of inhaled salbutamol, an endothelium dependent vasodilator was administered. AIx was assessed again and the maximum change in AIx after salbutamol was recorded as EDV. Global endothelial function was calculated as EDV:EIV ratio. EDV and EIV in patients with hypercholesterolemia compared to controls were 2.97 ± 3.95 and 6.65 ± 3.80 (p<0.001); and 13.41 ± 4.57 and 15.88 ± 4.78 (p=0.01) respectively. EDV:EIV ratio was significantly reduced in patients with hypercholesterolemia compared to controls; 0.21 ± 0.38 and 0.44 ± 0.24 (p<0.001) respectively. EDV:EIV ratio was significantly reduced in patients with hypercholesterolemia compared to controls. PWA is a potential clinical tool to assess global endothelial function in patients with hypercholesterole
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Humans , Male , Female , Adult , Endothelium/metabolism , Pulse Wave Analysis/methods , Hypercholesterolemia , Patients , Vasodilator Agents/adverse effectsABSTRACT
@#Introduction: Vascular dysregulation is postulated to be involved in the pathogenesis of primary open angle glaucoma (POAG). Systemic arterial stiffness may accelerate the pre-existing damage. The purpose of this study was to determine the association of arterial stiffness with severity and progression of visual field in Malay patients with POAG. Methods: A cross-sectional study was conducted with 55 patients with POAG and 55 age- and sex-matched control subjects. The patients with POAG were further divided in accordance with their Advanced Glaucoma Intervention Study (AGIS) scores on their visual fields (VFs) (mild in 23 patients, moderate in 18, and severe in 14). Progression was defined as the worsening of the VF defect quantified as an increase in AGIS score of 4 points from the baseline. Arterial stiffness was measured using SphygmoCor and quantified as pulse wave analysis (PWA) and pulse wave velocity (PWV). Results: No significant differences in PWA and PWV were found between the patients with POAG and the control subjects (p=0.333 and p=0.443, respectively). The mean follow-up duration for the patients with POAG was 4.7±3.1 years. PWA and PWV showed no significant association with POAG severity after the confounding factors were controlled for. Ten patients with progression of VF were identified. In the analysis of covariance, a significantly higher PWV was found in the patients with disease progression (p=0.036). Conclusion: VF severity and progression were not associated with systemic arterial stiffness. The probable reason is that other factors affecting retinal microcirculation may play a larger role in the severity and progression of POAG.
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@#Introduction: Substance abuse is a major social and health bane worldwide, including Malaysia, inflicting extensive morbidity and mortality. Our study aims to review the request and results of urine drugs of abuse testing conducted at the Pharmacology Laboratory of Hospital Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia, over a period of 11 years. Methods: Data for urine drugs of abuse testing requested and their results performed at the Pharmacology Laboratory between January 2009 and December 2019 was retrospectively extracted. Data on patient demographics, types of drugs requested, and types of drugs tested positive were analysed. Testing was performed using the enzyme multiplied immunoassay technique. Results: The absolute number and percentage of positive cases for amphetamine type stimulant (ATS) drugs has steadily risen over the past decade making it the current drug of abuse of most concern. Opiate abuse, although still seen, remained static. The peak age range for abusing drugs falls between 25–34 years with a male predominance; an alarming finding was of positive cases observed among neonates and children below the age of 12. Majority of requests came from the Psychiatric and Emergency Departments. Conclusion: Over the past eleven years, ATS abuse has superseded opiate in being the most abused drug type, detected even at young ages. Therefore, societal awareness and education on the dangers of ATS abuse, and intensive detection of ATS use must be implemented.
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@#Introduction: Vitamin D deficiency has been implicated as one of the factors involved in endothelial dysfunction associated with diabetes. This study aimed to evaluate the effects of active vitamin D (alphacalcidol) supplementation on aortic endothelial function in diabetic rats receiving vitamin D-deficient diet. Methods: Streptozotocin-induced diabetic rats were fed with standard diet (D) or vitamin D-deficient diet (DD and DDS) for 10 weeks. Group DDS was then supplemented with 0.2 μg/kg alphacalcidol at the last four weeks of the study duration. Non-diabetic rats were fed with standard diet (N) or vitamin-D deficient diet (ND). At the end of the experiment, the rats were sacrificed, and their aortic rings were harvested for endothelial functional study. Results: Acetylcholine-induced relaxation in aorta of diabetic rats (D and DD) were significantly lower compared to non-diabetic rats (N). In the presence of endothelial nitric oxide synthase blocker (L-NAME), maximal relaxation induced by acetylcholine in aorta of D and DD groups were significantly higher compared to N, ND and DDS groups, indicating involvement of non-nitric oxide (NO) relaxation pathways in diabetes. Four weeks supplementation with alphacalcidol in DDS group significantly improved acetylcholine-induced relaxation and reduced the reliance on non-NO relaxation pathways. Conclusion: The present study suggests that impairment of acetylcholine-induced relaxation in aorta of diabetes and diabetes with vitamin D-deficient diet was largely due to a decrease in NO related pathways, and this was compensated by non-NO pathways. Supplementation with alphacalcidol alleviated endothelial impairment in aorta of diabetic rats with vitamin D-deficient diet.
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Background@#Misconceptions regarding activities after pacemaker implantation can result in restrictions in daily life. This study aims at measuring the correction of misconceptions following an educational intervention utilizing a picture based brochure and personal counseling. @*Methods@#One hundred and twenty-eight patients were enrolled in a quasi experimental study on the day after pacemaker implantation. Patients’ perceptions about safety of various daily activities, medical procedures, and usage of appliances, in the presence of pacemaker was assessed using a questionnaire before and ten days after an educational intervention using a pictorial brochure. The number of correct responses before and after the intervention was compared to assess the change in patients’ perception. @*Results@#A total of 128 patients were interviewed at baseline, of which 115 followed-up at 10 days. Mean age of patients was 60.31 ± 12.81 years. In total, 76 (59.4%) were male and 61(47.7%) were illiterate. Mean correct responses increased from 64.47 ± 29.48% to 92.29 ± 14.42% (p < 0.001). Percent of questions answered correctly improved in all three categories after the intervention. Correct answers increased from 74.57 ± 24.94% to 95.65 ± 11.48% (p < 0.001) for routine daily activities, 51.09 ± 33.9% to 84.78 ± 20.86% (p < 0.001) for medical procedures and 64.03 ± 37.36% to 92.57 ± 18.79% (p < 0.001) for domestic appliance usage. @*Conclusion@#Misconception that can adversely affect pacemaker patient’s quality of life can be corrected by counseling with pictorial based brochures regardless of the patient’s baseline knowledge or education.
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Introduction: Indigenous people in a far-flung mountainous area without basic facilities, mainly rely on medicinal plants to cope with various veterinary health problems. Objective: The present study was carried out to explore the traditional knowledge of ethnoveterinary practices in Kaghan Valley, district Mansehra, Western Himalayas-Pakistan. Method: Ethnoveterinary data were collected between February to October 2014 from nine villages of the Kaghan Valley by involving 80 local people include traditional healers using a semi-structured interview. Results: A sum of 41 plant taxa of ethnoveterinary medicinal plants was documented for treating livestock ailments. Out of which, herbaceous plants were recorded with high percentage (27 species, 65.8 %). Most of the species were used to treat gastrointestinal diseases (12 taxa), followed by health improvement (7 taxa). The widely used part of plants for livestock aliments was the whole plant (9 species) followed by leaves (7 species), and preparation were paste (18 species) followed by powder with 10 species. The highest used values were recorded for Arisaema costatum (0.82), Primula denticulata (0.76), and high relative frequency citations for Berberis lyceum and Dryopteris ramosa with 0.37 each. Among the plant species Skimmia laureola, Thymus linearis and Phytolacca latbenia were among the taxa with cent fidelity level. Conclusion: The flora used in traditional remedies of the valley was found mostly endemic due to excessive utilization. Thus, further chemical investigation, better utilization and conservation of indigenous use of the reported species should be considered for future work.
Introducción: Los pueblos indígenas de zonas montañosas lejanas sin facilidades básicas dependen principalmente de las plantas medicinales para afrontar problemas de salud de tipo veterinario. Objetivo: Explorar el conocimiento tradicional en las prácticas etnoveterinarias en el valle de Kaghan, distrito de Mansehra, Himalaya occidental-Pakistán. Métodos: Se recopilaron datos etnoveterinarios mediante una entrevista semiestructurada entre febrero y octubre de 2014 en nueve aldeas del valle de Kaghan, con la participación de 80 habitantes locales, incluidos curanderos tradicionales. Resultados: Se documentó un total de 41 taxones de plantas medicinales etnoveterinarias para el tratamiento de enfermedades del ganado. Se registró un alto porcentaje de plantas herbáceas (27 especies, 65.8 %). La mayoría de las especies utilizadas han sido para tratar enfermedades gastrointestinales (12 taxones), y mejora de la salud (7 taxones). Para el tratamiento de enfermedades del ganado, lo más usual fue utilizar la planta entera (9 especies), seguida de las hojas (7 especies), con preparación en pasta (18 especies) y en polvo (10 especies). Las especies registradas con más uso fueron: Arisaema costatum (0.82), Primula denticulata (0.76) y Berberis lyceum y Dryopteris ramosa con la misma alta frecuencia relativa (0.37 cada una). Las especies Skimmia laureola, Thymus linearis y Phytolacca latbenia se reportaron entre los taxones con mayor nivel de fidelidad porcentual. Conclusión: La flora utilizada en los remedios tradicionales del valle de Kaghan fue mayoritariamente endémica. Se propone para trabajos futuros mayor investigación química, y mayor utilización y conservación en las especies de plantas reportadas por los indígenas.
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Animals , Cattle , Cattle Diseases/therapy , Medicine, Traditional/methods , PakistanABSTRACT
Background@#Misconceptions regarding activities after pacemaker implantation can result in restrictions in daily life. This study aims at measuring the correction of misconceptions following an educational intervention utilizing a picture based brochure and personal counseling. @*Methods@#One hundred and twenty-eight patients were enrolled in a quasi experimental study on the day after pacemaker implantation. Patients’ perceptions about safety of various daily activities, medical procedures, and usage of appliances, in the presence of pacemaker was assessed using a questionnaire before and ten days after an educational intervention using a pictorial brochure. The number of correct responses before and after the intervention was compared to assess the change in patients’ perception. @*Results@#A total of 128 patients were interviewed at baseline, of which 115 followed-up at 10 days. Mean age of patients was 60.31 ± 12.81 years. In total, 76 (59.4%) were male and 61(47.7%) were illiterate. Mean correct responses increased from 64.47 ± 29.48% to 92.29 ± 14.42% (p < 0.001). Percent of questions answered correctly improved in all three categories after the intervention. Correct answers increased from 74.57 ± 24.94% to 95.65 ± 11.48% (p < 0.001) for routine daily activities, 51.09 ± 33.9% to 84.78 ± 20.86% (p < 0.001) for medical procedures and 64.03 ± 37.36% to 92.57 ± 18.79% (p < 0.001) for domestic appliance usage. @*Conclusion@#Misconception that can adversely affect pacemaker patient’s quality of life can be corrected by counseling with pictorial based brochures regardless of the patient’s baseline knowledge or education.
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During the traumatic brain injury (TBI), improved expression of circulatory miR-21 serves as a diagnostic feature. Low levels of exosome-miR-21 in the brain can effectively improve neuroinflammation and blood-brain barrier (BBB) permeability, reduce nerve apoptosis, restore neural function and ameliorate TBI. We evaluated the role of macrophage derived exosomes-miR-21 (M-Exos-miR-21) in disrupting BBB, deteriorating TBI, and Rg1 interventions. IL-1
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Objective: To determine the anti-hyperglycemic effects of interleukin-1 inhibitor (diacerein) in alloxan induced diabetic albino wistar rats. This experimental study was performed at the Department of Animal Husbandry and Veterinary Sciences, Sindh Agriculture University, Tando Jam within 6 months from April 2016 to September 2016. Total of 160 adult Albino Wistar Rats having an average of 200 to 300 grams body weights were selected. Animals were categorized into 4 groups as; Group A (n=15): Control rats – receive 0.9% normal saline as placebo Experimental Groups Group B (n=15): Experimental Control (Diabetic rats) - Alloxan50 mg/kg body weight intraperitoneal. Group C (n=15): Diabetic rats + Diacerein (30 mg/kg/day) orally daily. Group D (n=15): Diabetic rats + Diacerein (50 mg/kg/day) orally daily. Animals were kept and treated as per the NIH Guideline for Use and Care of Laboratory Animals. Diabetes mellitus was induced via a single intraperitoneal injection of 50 milligram/kg alloxan monohydrated dissolved in aseptic 0.9% saline. After 72 hours, blood specimens were taken from the caudal vein of the rats and glucose level>200 mg/dL was taken as diabetes. Experimental rats were given diacerein approximately 30 and 50 mg orally for 6 weeks. At the completion of experiment the body weight was measured of each animal by electronic measuring balance and blood sample was taken from each animal of all groups to assess the blood glucose level and HbA1c level. Data were recorded via self-made proforma and analysis was done by using SPSS version 20. Results: Average body weight of Diabetic control (Group B) was 193.33±22.50 grams, which was lower in contrast to Diacerein treated group C 202.47±25.70 grams and significantly lower as compared to Diacerein treated group D as 212.6±23.43 grams. A significant increase in blood glucose levels 182.07±10.63 mg/dl was noted in the Diabetic control (Group B) compared to Diacerein treated group C (110.13± 8.54 mg/dl) and group D (85.87±8.41 mg/dl) (P=0.001). HbA1c was markedly raised in the Group B- diabetic controls, while diacerein treated diabetic rats (groups C and D) showed a significant decrease in HbA1c (P=0.001). Conclusion: It was concluded that Diacerein achieves the Euglycemic state by reducing the levels of blood glucose and glycated hemoglobin (HbA1c) in Alloxan-Induced diabetes mellitus in Wistar Albino Rats
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Background: Thalassemia, an inherited blood disorder represents a significant burden for many countries across the globe and the knowledge related to this illness is very limited. The preventive practices, among people especially from developing countries. In Pakistan, Thalassemia is a serious health problem bearing 5 to 8% frequency of beta-Thalassemia gene without discrimination of ethnic groups. Objective: To assess the awareness level regarding Thalassemia in general population of Rahim Yar Khan, a district of Southern Punjab, Pakistan. Methodology: Study Design: Cross sectional study. A total of 400 adults of 18 years and above age, were selected randomly, from the households of the Rahim Yar Khan City and one Rural Union council. Out of 400 subjects, only 131, reported that they had heard the name ”Thalassemia”, hence for analysis of awareness, the data of only these 131 was used. A structured questionnaire was designed which included information on; gender, age and 24 questions about awareness of Thalassemia disease. Level of Awareness was ascertained by response of these 24 questions and was categorized as poor, average and good. The persons answering less than 12 questions correctly were considered to have poor knowledge, answers of 13-18 questions were labeled as possessing average knowledge and the persons were included in category of having good knowledge who answered more than 18 questions correctly. Data was analyzed by using SPSS 20. Results: Out of 131 study subjects , who reported to have ever heard of word Thalassemia, level of awareness about Thalassemia was found to be “Good” among 7 (5.4%) persons, 27 (20.6%) persons have an average knowledge about Thalassemia and a large number of people 97 (74%) have poor knowledge about Thalassemia disease. Conclusion: Public knowledge regarding Thalassemia was found to be poor among general population of Rahim Yar Khan, Pakistan.
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Background: Primary headache disorders including migraine and tension-type headache (TTH) are of great importance to global public health due to its high prevalence, but very few studies have been conducted to know its prevalence and pain severity of different types of primary headache. Aim of this study was to investigate the subtypes and pain severity of different types of primary headache in hospital setting.Methods: This study is a cross-sectional study with 200 sample size. Includes patients with Primary headache in department of Psychiatry, MGMMC, Indore. Patient aged between 18-65 years, both gender. Diagnosis of headache was done clinically in accordance with International Classification of Headache disorders (ICHD- 3). Semi-structured headache questionnaire, Comparative pain scale were used for assessment of samples.Results: Among 200 patients, Tension type headache was 73.5%, Migraine was 22%, Mixed headache was in 4.5% patients. Majority of migraine and mixed headache cases had severe pain at 93.2% & 55.6% respectively. Majority of TTH cases had moderate pain in 42.2% patients.Conclusions: Study has shown assessments of severity of pain, can be used to assess the impact of Primary headache on patient’s quality of life.
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Diabetes is an independent risk factor for the development of cardiovascular disease, with approximately 80% of cardiovascular mortality and morbidity linked to vascular complications such as atherosclerosis. It has been estimated that up to one-third of patients with diabetes mellitus use some form of complementary and/or alternative medicine. One plant that has received attention from diabetic patients for its perceived antidiabetic properties is Clinacanthus nutans, a member of the Acanthaceae family that is known as snake grass. Ethnomedical applications of this herb have been identified for the treatment of certain conditions, including fever, diabetes, skin rashes, and insect bites. This review aims to assess the potential of C. nutans to be used in the prevention and/or treatment of diabetic vasculopathy. Evidence for antidiabetic, anti-inflammatory, and dyslipidemic properties of C. nutans, as shown from experimental studies, is presented and discussed. Diabetes, inflammation, and hyperlipidemia are known to play significant roles in the initiation and severity of diabetic cardiovascular disease; thus, targeting these factors might be beneficial for preventing and/or treating diabetic vasculopathy.
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Plants, Medicinal/adverse effects , Acanthaceae/classification , Diabetic Angiopathies/pathology , Complementary Therapies/trends , Cardiovascular Diseases/pathology , Risk Factors , Diabetes Mellitus/pathologyABSTRACT
Background/Aims@#This study aimed to study the endoscopic yield, appropriateness, and complications of pediatric endoscopy performed by adult gastroenterologists in an adult endoscopic suite. @*Methods@#This a retrospective study in which records of all the patients less than 18 years of age who underwent endoscopy in the last 5 years were studied. The indications of endoscopy in children were categorized as appropriate or inappropriate per the latest guidelines by American Society for Gastrointestinal Endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Positive endoscopic yield was defined as the presence of any abnormality on endoscopy. @*Results@#Among the total of 822 children (age <18 years), the most common indications were variceal surveillance/eradication in 157 (19.1%), followed by dyspepsia in 143 (17.4%), upper gastrointestinal (UGI) bleeding in 136 (16.5%), recurrent abdominal pain in 94 (11.4%), unexplained anemia in 74 (9%), recurrent vomiting in 50 (6.08%), chronic refractory gastroesophageal reflux disease in 34 (4.1%) and others; 780 out of 822 endoscopic procedures (94.9%) done in children were appropriate as per the guidelines. The endoscopic yield was 45.8%, highest in patients with UGI bleeding (71.3%), followed by variceal surveillance (54.8%), recurrent vomiting (38%), dyspepsia (37.8%), and recurrent abdominal pain (36%). Minor adverse events occurred in 7.3% of children. @*Conclusions@#Pediatric endoscopy performed by an experienced adult gastroenterologist may be acceptable if done in cooperation with a pediatrician.
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Background: Health insurance is a widely recognized and preferable mechanism to finance the health care expenditure of the individuals. It is an important mechanism in the modern world to save the individuals from the huge health shock but only a small percentage of people even from educated higher income groups are covered under any health insurance policy. This study was undertaken to know the pattern of health insurance utilization in Uttar Kannada and Udupi districts of Karnataka.Methods: A descriptive study was conducted among 550 household of Uttar Kannada and Udupi districts. Household were selected using multistage sampling technique.Results: Of the 550 study participants, 348 (63.27%) were aware and also subscribed for any type of the health insurance and of these only 89 (25.57%) utilized them. 190 (34.55%) had availed Rashtriya Swastya Bima Yojana, 42 (7.64%) for Yashasvini, 6 (1.09%) forESI, 12 (2.18%) for Sampoorna Suraksha and 15 (27.27%) had private insurances. Reasons for not availing health insurances other than being unaware were complicated process 85 (42.08%) and provides only partial coverage 49 (24.26%). The main reasons for not using the health insurance were non availability of empaneled hospital 84 (74.34%), disease not being under the scope of scheme 60 (23.17%) and 32 (12.36%) were unaware about the process of availing.Conclusions: Health insurances being are the best way to help people reduce their financial burden has to be made aware and the drawbacks have to be addressed.
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Background: Health insurance is an important mechanism in the modern world to save the individuals from the huge health shock, even then very high percentage of people even from educated higher income groups are not covered under any health insurance policy. This study was undertaken to know the knowledge, attitude and practice regarding health insurance.Methods: A community based cross sectional study was conducted among 550 household of Uttar Kannada and Udupi districts. Multistage sampling technique was used.Results: Of the 550 study participants, 384 (69.8%) were BPL card holders. 348 (63.27%) were aware and also subscribed for any type of the health insurance, 115 (20.91%) were aware but did not subscribe while 87 (15.82%) were not aware about it. The main source of information were health workers 185 (39.74%), friends and family 178 (38.44%) and media 99 (21.38%). Of the 348 who had health insurance, only 89 (25.57%) utilized them. Reasons for not availing health insurances other than being unaware were complicated process 85 (42.08%) and provides only partial coverage 49 (24.26%). The main reasons for not using the health insurance were non availability of empanelled hospital 84 (74.34%), disease not being under the scope of scheme 60 (23.17%) and 32 (12.36%) were unaware about the process of availing.Conclusions: Health insurances are the best way to help people reduce their financial burden. Hence it is very important to educate the community regarding the best health insurance available so that they can take the maximum benefits from
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Background: Health is one of the most important components of an effective poverty reduction strategy. However, use of health services is sometimes associated with out-of-pocket (OOP) payments. Urology disorders are often chronic and affect individuals not by shortening survival, but by impairing quality of life hence posing a substantial economic impact for patients. A well-planned health finance systems protects population against the financial risks of ill-health. This study addressed concerns over high levels of out-of-pocket payments even by those who have insurance coverage.Methods: Descriptive study was conducted among 160 patients admitted in Urology Department who are covered under various health schemes for the duration of 6 months.Results: Of the 160 study participants studied, 129 (80.62%) were males, 37 (23.13%), 64 (40%) were illiterates and most of the families 127 (79.38%) were from rural area. Various health schemes availed were, 120 (75%) Arogya Karnataka, 8 (11.25%) RBSY Kerala and 6 (3.75%) Sampoorna Suraksha. Expenses other than medical included home care assistance, adaptations to home and cost of parallel treatment. The main source for out of pocket expenditure was borrowing money from relatives or friends 70 (43.8%), self-finance 46 (28.7%) and selling valuables 28 (17.5%). Prevalence of catastrophic health expenditure in our study was 8.75%.Conclusions: The government should increase the public health spending to reduce the out of pocket expenditure by the families and the public must be educated about the availability of insurance scheme and their efficient/optimum utilization.