Factors Influencing Oral Anti-diabetic Medication Adherence among Type 2 Diabetes Mellitus in Urban Health Training Centre, Bengaluru.

Background: Medication adherence is a major challenge in treatment of type 2 diabetes. Hence the pre-sent study was undertaken to assess the factors influencing drug adherence in Type 2 diabetes Benga-luru. Methods: A descriptive study was conducted in urban health training centre Bengaluru for a period of 9 months. A total of 70 type 2 Diabetes patients only on oral drugs willing to give informed consent were included. Institutional Ethical Committee clearance was obtained and pre-tested semi structured proforma was administered and the probable factors that affect adherence was included. Data was en-tered in Microsoft excel and analyzed in SPSS-21. Descriptive statistics and inferential statistics like Bi-nary logistic regression was used to assess the factors influencing drugs. Results: Around 92.8% consumed ?2 drugs and consumed single or combination of drugs. Most com-mon anti-diabetic drug consumed was Biguanides in 64(91.4%). Good adherence (0-2 score) to oral anti-diabetic drugs was observed in 43 (61%) study subjects the factor significantly associated with poor ad-herence in Binary Logistic Regression Model is sometimes forgetting to consume the medication. Conclusion: The factors that influenced oral anti-diabetic drugs good adherence is consuming the medi-cations without forgetting. Efforts are needed to improve adherence and self-management techniques to prevent complications.

Assessment of health education on knowledge regarding oral antidiabetic drug adherence in urban area, Bengaluru

Background: Diabetes mellitus is a chronic disease with a high mortality and morbidity. Knowledge regarding the disease is required for the management of drug adherence in diabetes, hence the present study was taken to assess the effectiveness of health education on knowledge regarding oral anti-diabetic drug adherence.Methods: The study was conducted at urban health training centre of a medical college, Bengaluru from October 2015 to July 2016. A total of 70 type 2 diabetes mellitus patients were involved in this descriptive and interventional study. The study subjects included only on oral anti-diabetic drugs and willing to give informed consent. A pre-tested semi-structured proforma was administered and information about socio-demographic profile, and impact of health education intervention on knowledge was obtained.Results: Most of the subjects were female (80%), in the age group of 35-45 years (34%), illiterate (40%), unemployed (67%) with class IV (78%) socio-economic status according to Modified Kuppuswamy classification 2014. The mean±SD age was 52.47±11.06 years. Significant improvement in knowledge regarding adherence to oral anti-diabetic medication was found in study subjects following health education intervention.Conclusions: The study revealed that health education regarding the importance of drug adherence is needed in study subjects and there was significant improvement in knowledge after health education.

Assessment of knowledge on non-communicable diseases and their screening tests among elderly population in an urban area of Bengaluru

Background: Non-communicable diseases (NCDs) are the leading cause of morbidity and premature mortality in most low and middle income countries (LMIC) around the world. Recent estimates shown that about 80% of NCDs deaths occur in LMIC and nearly three fourth of global NCDs related deaths take place after the age of 60. The knowledge of NCDs and their related screening tests among elderly is essential for early detection which reduces further development of the disease and its complications, thereby reducing the burden of health care cost. Hence, the present study was undertaken.Methods: A descriptive study was conducted among 245 study subject after obtaining informed consent. Using pre-tested structured questionnaire, information was collected regarding knowledge on NCDs and their screening tests. Results were entered in Microsoft excel and analyzed using descriptive statistics.Results: 81.6% of study subjects were aware of common NCDs. Off which only 02% were aware of 6 NCDs (out of 12 NCDs considered in this study). Regarding individual diseases, about 61.6% subjects were aware of Hypertension and 52.7% about DM. About knowledge of screening test, 69% were aware about any screening test and 58.8% were aware of screening test for hypertension and 41.6% for diabetes mellitus.Conclusions: The overall knowledge regarding NCDs and their screening tests is poor among elderly population.

Myocardial FFR (Fractional Flow Reserve) in patients with angiographically intermediate coronary artery stenosis - an initial institutional experience.

RESEARCH ARTICLE January-March 2013 | Volume 1 | Issue 1 | Page: 4-11 Myocardial FFR (Fractional Flow Reserve) in patients with angiographically intermediate coronary artery stenosis - an initial institutional experience Jagadish H. Ramaiah*, Raghu T. Ramegowda, Srinivas B. Chikkaswamy, Manjunath C. Nanjappa Sri Jayadeva Institute of Cardiovascular Sciences & Research, Jaya Nagar 9th Block, BG Road, Bangalore - 560069, Karnataka, INDIA Correspondence to: Dr. Jagadish H. Ramaiah, Email: jagadishhr@rediffmail.com Background: The clinical significance of coronary artery stenosis of intermediate severity can be difficult to determine. The management of intermediate coronary lesions, defined by a diameter stenosis of ≥40% to ≤70%, continues to be a therapeutic dilemma for cardiologists. The 2-dimensional representation of the arterial lesion provided by angiography is limited in distinguishing intermediate lesions that require stenting from those that simply need appropriate medical therapy. In the era of drug-eluting stents, some might propose that stenting all intermediate coronary lesions is an appropriate solution. However, the possibility of procedural complications such as coronary dissection, no reflow phenomenon, in-stent restenosis, and stent thrombosis requires accurate stratification of patients with intermediate coronary lesions to appropriate therapy. Myocardial fractional flow reserve (FFR) is an index of the functional severity of coronary stenosis that is calculated from pressure measurements made during coronary angiography. The objective of the study is to evaluate the usefulness of FFR in patients with angiographically intermediate coronary artery stenosis. Methods: 20 patients with intermediate coronary stenosis and chest pain of uncertain origin. The Exercise Electrocardiography (TMT), Myocardial Perfusion Imaging study (MPI), Quantitative Coronary Angiography (QCA) were compared with the results of FFR measurements. Results: 20 patients were undergone FFR measurement during the study period. With the mean age of 57.25±11.2 and male patients were 16 (80%), female patients 4 (20%), in all 13 patients with an FFR of <0.75, reversible myocardial ischemia was demonstrated unequivocally on at least one noninvasive test. In contrast, 5 of 7 patients with an FFR of >0.75 tested negative for reversible myocardial ischemia on TMT and MPI study. No revascularization procedures were performed in 7 (35%) patients, and no adverse cardiovascular events were noted in all these patients during 6 months of follow-up. Conclusions: In patients with coronary stenosis of intermediate severity, FFR appears to be a useful index of the functional severity of the stenosis and the need for coronary revascularization

Assessment of noise levels of the equipments used in the dental teaching institution, Bangalore.

Context: In dental practical classes, the acoustic environment is characterized by high noise levels in relation to other teaching areas, due to the exaggerated noise produced by some of these devices and use of dental equipment by many users at the same time. Aims: To measure, analyze and compare noise levels of equipments among dental learning areas under different working conditions and also to measure and compare noise levels between used and brand new handpieces under different working conditions. Materials and Methods: Noise levels were measured and analyzed in different dental learning areas that included clinical, pre-clinical areas and laboratories selected as representatives of a variety of learning-teaching activities. The noise levels were determined using a precision noise level meter (CENTER® 325 IEC 651 TYPE II) with a microphone. The mean of the maxima was determined. The data were collected, tabulated, and statistically analyzed using t tests. Results: The noise levels measured varied between 64 and 97 dB(A).The differences in sound levels when the equipment was merely turned on and during cutting operations and also between used and brand new equipments were recorded. The laboratory engines had the highest noise levels, whereas the noise levels in high-speed turbine handpieces and the low-speed contra angle handpieces were decreased. Conclusion: The noise levels detected in this study are considered to be close to the limit of risk of hearing loss.

Missense mutation G296S in GATA4 is not responsible for cardiac septal defects.

BACKGROUND: The most common type of congenital heart disease is the cardiac septal defects, which has reported to be caused by a missense mutation (G296S) in exon 3 of the GATA4 gene. AIMS: The present study was undertaken to find out whether GATA4 gene is the prime cause of the septal defects in Mysore population. MATERIALS AND METHODS: GATA4 gene analyses were undertaken on 21 confirmed CHD cases by PCR and DNA sequencing. RESULTS AND CONCLUSION: Analysis of this particular mutation in 21 septal defect patients revealed that none of the patients had the mutation, indicating that this mutation is population specific or septal defect in Mysore population is caused due to mutations in other regions of the GATA4 gene.

Evolution of phenylthiocarbamide taster trait in Mysore, South India.

BACKGROUND: The ability to taste phenylthiocarbamide (PTC), a bitter chemical has long been known to be a heritable trait, which is being widely used for both genetic and anthropological studies. The frequency of taster and non-taster allele is found to vary in different populations. AIMS AND OBJECTIVE: To investigate the frequency of taster trait in Mysore, South India. MATERIALS AND METHODS: The present investigation was conducted in Mysore, South India during 2002 - 2003. About 3282 subjects irrespective of age, sex, religion, food habits, socio-economic status were randomly selected from various parts of the city and a total of 180 families, which included Christian (50), Hindu (61) and Muslim (69) were screened from different localities of the city. Harris and Kalmus method was used to assess the PTC taster and nontaster phenotype. RESULTS: It was found that tasters were significantly more frequent than nontasters in all the four categories. The incidence of tasters was more in unbiased category (85%) and less in Muslim category (58%). Investigations on PTC tasting in the families of three different religious groups revealed that the tasters were significantly more frequent than nontasters. It was also found that heterozygous father or mother for the taster genes with nontaster partner had taster and nontaster progenies in the ratio 1.0: 1.54 indicating the deviation in the segregation pattern of test cross. CONCLUSION: In Mysore, tasters are more frequent than nontasters. Variation in the frequency of nontaster allele in the religious groups could be due to inbreeding.

An understanding the genetic basis of congenital heart disease.

The recent exponential increase in the knowledge of genetics has revolutionized the understanding of congenital heart diseases (CHDs) during the past few decades. Prior studies have reported the influence of Mendelian disorders on CHDs to be very small, when compared to the polygenic inheritance, which constituted a higher percentage. The recent findings of candidate genes responsible for CHDs have provided new insights into the genetic basis of heart malformation. Here we reviewed the understandings of different types of heart lesions associated with syndromes for which genetic etiologies are apparent, as well as the recent developments involving the molecular pathways involved in CHDs in case of human beings. The similar mutations, which are the devastating events of molecular mechanism, may be the cause of different types of CHDs indicating single gene defects as the cause of different apparent phenotypes. An integrated simple model will explain the causes of presently well known CHDs. This review provides updated information on the genetic basis for cardiac defects which helps to understand, identify, prevent and treat individuals who might be at risk at an early stage. There is a need to find heart defects as early as possible so that they can be treated while the heart is still forming.

Effect of Cr in irrigation water on germination and growth of French beans (Dolichos lablab L.).

The waters containing chromium (Cr) mainly from industries enter into the sewers, municipal treatment plant, streams and lakes that are used for irrigation purposes. The effect of Cr in irrigation water on seed germination and growth of French bean (Dolichos lablab L.) was investigated. Germination studies were conducted in the lab and field conditions. Seeds were treated with different concentrations (0 to 25 mg/1) of Cr in irrigation water. The percentage germination of seeds and plant growth showed a gradual decrease with increase in Cr concentration. Stimulatory effect in growth of plant was observed at lower concentration (1 to 2 mg/l). Accumulation of Cr was in the order of Root > Leaf > Stem > Pod. There was an increase in the total concentration of Cr content of soil with increase in Cr concentration in irrigation water.