Malaria or typhoid co-infection in a tertiary care hospital of Bareilly, Uttar Pradesh, India

Background: Malaria is a protozoal disease caused by infection with parasite of genus Plasmodium. Typhoid is common with malarial infection.Methods: A cross sectional study was done to find out co-infection of typhoid and malaria. Study was done in central pathological lab of department of pathology, RMCH, Bareilly. Blood samples were collected in EDTA vial and plain vial. Blood smear was examined for malaria parasite within RBCs. Malaria rapid test was done for detection of Plasmodium species and Widal test was done for typhoid.Results: In this study found co-infection of malaria with typhoid was 15.64%. In malarial cases 54.50% were males, while maximum cases (26.92%) were in 21-30 yrs age group. Cases of P. vivax was maximum (86.28%) and maximum cases of P. vivax (29.42 %) was in 11-20 yrs age group while that of P. falciparum (22.22%) was in 11-20, 21-30, 41-50 yrs age group and maximum number (23.60%) of mixed malarial infection was in 31-40 yrs age group, While co-infection of malaria with typhoid was maximum (24.59%) was in 11-20 yrs age group and maximum (53.28%) in females. Maximum (79.51%) cases of typhoid were of P. vivax.Conclusions: Malaria and typhoid co-infection still remain a major public health problem in many developing countries. Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for the treating physician.

A Study of Psychological Stress and Burden on Caregivers of Schizophrenic Patients

Introduction: Schizophrenia is a chronic severe mental illnesswhich not only affects patients but also causes significantburden and stress to the caregivers. There is definite lack ofstudies in India exploring caregiver burden and psychologicalstress. Study objective was to assess psychological stress andburden on caregivers of schizophrenic patients.Material and methods: The study sample included 52patients with a diagnosis of schizophrenia and their caregivers,randomly selected from the patients coming to the OPD of twotertiary care centres in Bareilly, as per inclusion and exclusioncriteria. Burden Assessment Schedule and General healthquestionnaire-12 were used for the study.Results: Our study also shows that 42.31% caregiversexperienced severe burden. Caregivers of patients with lowlevels of education reported greater burden. Parents andspouses reported moderately higher level of burden, butsiblings reported highest level of burden. Parents had greaterpsychological stress as compared to spouses and siblings.Caregivers with higher psychological stress found to haveheavier caregiving burden.Conclusion: Caregivers of schizophrenic patients sufferedfrom significant burden. It thus becomes important to planinterventions that would reduce their burden of care and thusimproving their psychological well-being.

Impacts of transfusion in β-thalassemia major patients receiving multiple blood transfusions

Background: Beta-thalassemia major is one of major public health problems in India. Thalassemia major is a transfusion-dependent severe anemia and these children experience various problems if the transfusion is inadequate but at the same time repeated blood transfusions are associated with hazards like iron overload.Methods: This study was conducted at thalassemia ward of S.M.S Hospital and J.K.LON paediatrics Hospital, Jaipur from April 2012 to Nov. 2013. 145 thalassemia patients on transfusion therapy attending outdoor or being admitted were assessed after obtaining due permission from the authorities and consent from the guardian or parents of patients.Results: Present study comprised 145 beta-thalassemia major patients with 51 (35%) females and 94 (65%) males in which youngest patient is 3 years old and the oldest 33 years. 104 (72%) were Hindus and 41 (28%) were Muslims. Consanguinity was found in a significant proportion 16% (23) of the parents of the patients. 137 (94%) patients had serum ferritin ³1000ng/ml. Out 145 thalassemic patients, 108 (74.5%) have total serum bilirubin >1(mg/dl), 103 (71%) have SGPT level >35IU, 103 (71%) have SGOT level >40IU), 38 (26.2%) have serum alkaline phosphatase level >390 IU, 35 (24.1%) have serum creatinine level >1.6mg/dl, 42 (29%) have serum urea level >45mg/dl, 28 (19.3%) have serum uric acid level >6mg/dl.Conclusions: It is suggested to revise and devise suitable transfusion regime so that a balance between adequate transfusion and minimum side effects of multiple transfusions is maintained. Systemic effects of multiple transfusions should be rigorously and meticulously studied.

Comparative Study of Serum Lipid Profile in Normotensive Pregnant Women and in Patients with Pre-Eclampsia- A Case Control Study.

Background: The objective of the present study was to compare the changes in serum lipid profile in normal pregnant women with those in patients with pre-eclampsia. Methods: In this study total 140 study subjects were evaluated, 70 normotensive pregnant women as a control group and 70 pre-eclamptic patients as a study group. Study Subjects were between the age group of 20-35 years and in the second and third trimester of pregnancy. Fasting blood samples were collected and serum level of Triglycerides (TG), Total Cholesterol (TC), High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), and Very Low Density Lipoprotein (VLDL) were measured by enzymatic colorimetric method. Results: There was a significant rise in TC, TG, LDL and VLDL and significant decrease in HDL level in pre-eclamptic group as compared to normal pregnant women.Conclusion: The findings of the present study are consistent with previous studies suggesting an altered lipid profile has a potential role in the genesis of endothelial dysfunction and expression of pre-eclampsia.

Outcome of caesarean section under spinal versus epidural for women with pre-eclampsia.

Background: Pre-eclampsia is a major cause of maternal and perinatal mortality worldwide. Women with pre-eclampsia have an increased rate of cesarean section consequent upon the high incidence of intrauterine growth restriction, fetal distress and prematurity. Objective: To compared the outcome of Cesarean section for pre-eclampsia using sub-arachnoid block and epidural anesthesia Methods: The present retrospective study was carried out in one of the tertiary care hospital of Bareilly district from Jan.2011 to July 2013. Unit of study were all the women with preeclampsia who underwent caesarean section for delivery under spinal or epidural anaesthesia and their babies. chi squire test and student t-test test were applied for statistical analysis. Results: There was no significant difference between two groups in overall maternal mortality (0.0% vs 2.4%, p>0.05), perinatal mortality (5% vs 7.1%, p>0.05), Apgar score less than 7 at 1 minute (25% vs 21%, p,0.05)and Apgar score less than 7 at 5 minute (5% vs 14.3%). Conclusion: no significant difference in the maternal and perinatal mortality outcome of cesarean delivery between women with preeclampsia who had epidural and those that had spinal anaesthesia.

A retrospective study of the outcome of cesarean section for women with pre-eclampsia under spinal versus epidural anaesthesia in hospital of Northern India.

Back ground: Pre-eclampsia is a major cause of maternal and perinatal mortality worldwide. Women with pre-eclampsia have an increased rate of cesarean section consequent upon the high incidence of intrauterine growth restriction, fetal distress and prematurity. Objective: To compared the outcome of Cesarean section for pre-eclampsia using sub-arachnoid block and epidural anesthesia Methods: The present retrospective study was carried out in one of the tertiary care hospital of Bareilly district from Jan.2011 to July 2013. Unit of study were all the women with preeclampsia who underwent caesarean section for delivery under spinal or epidural anaesthesia and their babies. chi squire test and student t-test test were applied for statistical analysis. Results: There was no significant difference between two groups in overall maternal mortality (0.0% vs 2.4%, p>0.05), perinatal mortality (5% vs 7.1%, p>0.05), Apgar score less than 7 at 1 minute (25% vs 21%, p,0.05)and Apgar score less than 7 at 5 minute (5% vs 14.3%). Conclusion: no significant difference in the maternal and perinatal mortality outcome of cesarean delivery between women with preeclampsia who had epidural and those that had spinal anaesthesia.

Prevalence and determinants of anemia in pregnancy at private hospital of Bareilly District.

Back ground: Anemia in pregnancy continues to be the major public health problem in the world & is the commonest medical disorder in pregnancy that has a varied prevalence, etiology and degree of severity in different populations. Objective: To find out the prevalence of anemia amongst pregnant women and socio-demographic factors associated with anemia in pregnancy. Methods: The present cross sectional study was carried out in obstetric and gynae OPD of one of the private hospital of Bareilly district during the month of Jan.2010 to May2010. Chi square test was applied for statistical analysis. Results: prevalence of anemia was 43.38% Anemia was found to be more prevalent in women age more than 30 years (80.39%), illiterate (49.53%), working (83.82%) & those belonging to Muslim community. Multiparous women (45%), women with poor personal hygiene (48%) and non-vegetarian diet were slightly more anemic as compare to their contrary one. Conclusion: Despite the measures taken to control anemia in pregnancy in the last two decades, the severity of nutritional anemia continues to remain a public health issue of great magnitude, suggesting that these measures have been largely ineffective.

Perception of RTIs/STDs among women of reproductive age group in a District of Uttar Pradesh.

A cross sectional study was conducted during May-June 2010 among woman of reproductive age group (15-45 years) in the urban and the rural areas of Bareilly District to asses the level of awareness regarding RTIs/STDs. The two stage cluster sampling technique was adopted. A structured questionnaire was used to interview the study participants during the house to house surveys. Each woman of reproductive age of selected household was interviewed in private about her reproductive history, current knowledge, source of information and modes of transmission of RTIs/STDs. Statistical analysis was done with Epi Info computer software. Standard Normal Variate (SNV) Test for comparison of two groups’ proportion was done; z and p were calculated to know the significance of the proportions of two groups for comparison. Most of the women were aware of RTIs/STDs (80.32%) in urban areas whereas only 27.41% in rural areas were aware of these diseases. The television and radio was the main source of information in both rural (41.17% & 32.94%) and urban areas (TV-90.36%, Radio-48.19%).

Awareness, perception and myths towards swine flu in school children of Bareilly, Uttar Pradesh.

The deadly disease swine flu is, without a speck of doubt, causing a massive havoc among the common people of India and has created fear across the various strata of the society. The objective was to find out the awareness, perception, and myths of school going children of class 9 th to 12 th toward swine flu. The present cross-sectional study was carried out in two randomly selected (using random number table) senior secondary schools of Bareilly among 400 students of class 9 th to 12 th . A total of 200 students were selected from each school. Chi-square test was applied for statistical analysis. Almost all the students (97.75%) have heard about of swine flu and are aware of it as a disease entity. Fever was found to be the main symptom while coughing and sneezing were main way of spread of swine flu known to them. About 97% of the students mention use of mask as most effective way to prevent them from swine flu. Knowledge of availability of medicine was present in less than half of the students. TV was found to be the main source from which they get knowledge (79%), and they are trying to get knowledge (53.2%) of swine flu. Among them, 74% students were taking precaution against swine flu.