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Background: Geriatric patients are at a greater risk of developing adverse drug reaction (ADR) because of changed metabolic activity and renal status associated with aging. As most of the elderly patients suffer from multiple chronic diseases (Diabetes, Hypertension, Arthritis, constipation, peptic ulcer disease, etc.), they are under polypharmacy and the risk of ADRs is exacerbated by multiple medications. Metabolic ADRs include weight gain, hypoglycemia, hyponatremia, hypokalemia, and the endocrinal abnormality are the frequent cause of hospital admission in geriatric patients. Most metabolic ADRs due to drugs are treatable. There are few such studies conducted in India regarding metabolic ADR in geriatric patients. Hence, this study aims to evaluate the metabolic ADRs encountered in geriatric patients with the following objectives in Odisha. Aim and Objectives: The prevalence and spectrum of metabolic ADRs in geriatric population were studied. The causality assessment, severity assessment, and preventability were done using standard scales. Materials and Method: This was a prospective and observational study conducted from September 2016 to September 2018 in Department of Pharmacology in collaboration with Department of Geriatric Medicine and Department of Medicine of SCB Medical College and Hospital. All geriatric patients (?60 years) with ADR, reporting to the above departments, were included in the study. The detailed information of type of ADRs and its characteristics was filled up in Suspected ADR Reporting Form designed by Indian pharmacopeia commission version 1.3. The incidence and spectrum of metabolic ADRs were observed. Their causality, severity, and preventability were evaluated by the WHO-UMC System, Hartwig’s Severity Scale, and Schumock Thornton Preventability Scale, respectively. Result: A total of 236 ADRs were reported in 2 years, out of which 28.8% were metabolic ADRs. Metabolic ADRs were more reported in young old patients and often encountered ADR was hypoglycemia 73.5% due to use of oral anti diabetics. About 29% of the metabolic ADRs had a causal relation of probable association. About 94.2% were moderate in severity and 89.7% metabolic ADRs could be probably preventable. Conclusion: There was a probable causal association of metabolic ADR with the drug used and they were moderate verity. The metabolic ADRs found in our study can be preventable with appropriate means.
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Erythema nodosum leprosum (ENL) is a serious, often recurring and disabling, immunologically mediated reaction occurring in leprosy which often requires hospitalization. There are published several studies of ENL, but systematic studies regarding the risk factors associated with ENL in the post elimination era are few. The aim of the study was to determine the risk factors associated with ENL in a tertiary care centre in Western Odisha. This is a case control study involving 292 patients of leprosy who attended the Dermatology OPD of this tertiary care centre. These constituted 97 patients with ENL and 195 patients without ENL who attended the OPD during this period. Detailed history, clinical examination, slit skin smears were done. These included gender details, age, area of residence (rural/urban), education and socioeconomic status. The most common subtype of leprosy observed in ENL was lepromatous leprosy followed by borderline lepromatous type. Patients diagnosed with initial high BI and lepromatous leprosy were found to be significant risk factors for development of ENL. Skin diseases, Anaemia and Diabetes Mellitus were found to be more prevalent in ENL patients
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The tribal music is passed down from one generation to next generations. In Odisha every tribal community has its own cultural values, which guide their socio-economic life. Odishan tribal music with its closed-group form of ethnicity is remarkable in the sense that it can never be studied in isolation from the social and ritual contexts of the people concerned. Odishan tribal music possesses a well-built community basis. The fact can be comprehended in the domains of musical-socialization, kinds of ownership, levels of participation and nature of specialization. The tribes-folk and their inbuilt artistic instincts, and intricate engineering skills passed down hundreds of generations, come together to create layered musical magic in a single instrument, using tools and materials that grew, or were found on their lands and forests. Odishan tribes have also possessed a variety of sub-cultures, racial and linguistics variations, which on their part; spill over beyond the administrative boundaries of the state of Odisha into the neighboring states
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Objective : To find out the status of Malaria in Odisha. Methods : By studying the most recent data available on the National Vector Borne Disease Control Programme (NVBDCP) website. Results : Out of the 30 districts of Odisha, Malaria is highly concentrated in mainly Malkangiri District. Conclusions : If an approach of universal diagnosis and radical treatment like that which was used in the “Malaria-mukt Bastar” campaigns of Chhattisgarh is adopted in Malkangiri District, it is possible that the Annual Parasite Incidence (API) may come down there quickly
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Background: Worldwide, around 1.28 billion adults, aged 30–79 years have hypertension (HTN) and most (two?thirds) of them living in low? and middle?income countries like India. While only less than half of adults (42%) with HTN are diagnosed and treated. This study is an effort to estimate the prevalence and determine the determinants of HTN among the rural elderly population in Tigira block, Cuttack district of Odisha. Methodology: This cross?sectional study was carried out among 725 rural elderly (>60 years) people using probability proportionate to sample (PPS) sampling in the year 2019–2020. Previous medical history of HTN diagnosed by medical professional was taken as positive for HTN. Bivariate analysis was performed using the Chi?square test. The binary logistic regression model was used to find out the predictors of HTN. Results: This cross?sectional study found an HTN prevalence of 34.75% (n = 252) among rural older adults. Factors found to be significantly associated with HTN were female gender (adjusted odds ratio [AOR] = 1.73, confidence interval [CI] = 1.129–2.666), elderly aged ?80 years (AOR = 1.98, CI = 1.170–3.379), not working elderly (AOR = 2.14, CI = 1.178–3.89), lower?middle socioeconomic status (SES) (AOR = 1.61, CI = 1.093–2.372), overweight elderly (AOR = 2.01, CI = 1.309–3.098) and diabetics (AOR = 4.56, CI = 2.704–7.718), respectively. Conclusion: HTN prevalence was found to be high in the rural area, and the factors such as female gender, elderly aged ?80 years, not working elderly, lower?middle SES, overweight elderly, and diabetes were found to be the determinants of HTN in the rural elderly population of Odisha.
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Background: Several factors cause mental stress during a pandemic where academic life is uncertain. This stress may cause a change in healthy behavior. Sleep is one of the important aspects and is deranged with physical or mental stress. Aim and Objectives: With this background, we conducted this study with university students to know the level of stress and sleep pattern and to find any correlation between them. Materials and Methods: This cross-sectional observational online survey study was conducted in Bhubaneswar, Odisha with 100 university students during the second wave of the COVID-19 pandemic. The stress was assessed with the COVID-19 Student Stress Questionnaire (CSSQ) and subjective sleep was assessed by Pittsburgh Sleep Quality Inventory (PSQI). Both the questionnaires were in English and were having Likert-type response options. The survey data were analyzed by Statistical test by GraphPad Prism 6.01 software package. Results: Among the participants, 66% had high stress, 24% had moderate stress, and 10% had low stress. The sleep quality analysis showed that 76% of students were having poor sleep and 24% had good sleep. There was a positive correlation between the CSSQ and PSQI score (r = 0.45, P < 0.0001). This indicates a strong correlation between stress and sleep quality. Conclusion: During a pandemic like the current COVID-19 pandemic, university students suffer from a high level of stress and disturbed sleep. Hence, to restore the wellbeing of the students, a proper sleep hygiene practice should be promoted that may eventually help reduce stress. On the other hand, proper information regarding academic progress and defined assessment methods may help reduce academic stress and promote good sleep.
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Background: Security guards/protective inspectors are a group of professional gray collar workers responsible for safety and security of general public. In healthcare institutions, they play a pivotal role in streamlining the movement of patients, healthcare workers as well as other people as well as keeping a check upon the law-breaking activities within the premises. These professionals are constantly overburdened with responsibility and many of them are under the verge of physical, mental, and emotional crisis leading to various health issues. Aim and Objective: To assess the influence of changing work patterns on the overall physical health of security guards working in the hospital. Materials and Methods: A cross-sectional study was carried out in a tertiary care hospital in the Eastern part of Odisha involving all the security personnel currently working. Universal sampling was opted and 465 personnel participated in this study. Results: Of the total, 213 (45.8%) were between 30 and 40 years of age and 398 (85.5%) were male. 179 (38.4%) were overweight and 52.2% had a waist-hip ratio above normal range for their gender. Prevalence of anemia and Conjunctival xerosis was significantly higher among night shift workers with P < 0.001 whereas hypertension (P = 0.08) and rheumatoid arthritis (P = 0.006) was significantly higher among morning shift workers. Conclusion: Being a distinctive member of the hospital, it is high time that regular health check-ups and social security measures should be made available to them in order to provide quality life which will in turn ensure better hospital safety and security.
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Background & objectives: Serial national level serosurveys in India have provided valuable information regarding the spread of COVID-19 pandemic in the general population, but the impact of the ongoing pandemic on the tribal population in India is not well understood. In this study, we evaluated the seroprevalence of COVID-19 antibodies in the tribal population of Odisha post-second wave (September 2021). Methods: A population-based, age-stratified, cross-sectional study design was adopted for the survey, carried out in seven tribal districts of Odisha from 30th August to 16th September 2021. A multistage random sampling method was used where serum samples were tested for antibodies against the SARS-CoV-2 nucleocapsid (N) protein in each district, and a weighted seroprevalence with 95 per cent confidence interval (CI) was estimated for each district. Results: A total of 2855 study participants were included from the seven tribal districts of Odisha in the final analysis. The overall weighted seroprevalence was 72.8 per cent (95% CI: 70.1-75.3). Serological prevalence was the highest among 18-44 yr (74.4%, 95% CI: 71.3-77.3) and from Sambalpur district [75.90% (66.90-83.10)]. Among participants, 41.93 per cent had received at least one dose of any COVID-19 vaccine. Kandhamal district had the highest number of fully immunized participants (24.78%), and in Sundergarh district, most of the study participants (58.1%) were unimmunized.Interpretation & conclusions: This study found high seroprevalence against SARS-CoV-2 in the tribal population of Odisha. The vaccination coverage is at par with the general population, and efforts to address some knowledge gaps may be needed to improve the coverage in the future
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Background & objectives: Financing healthcare services through out-of-pocket payments is common in India. Household impoverishments due to health expenditure can be daunting, especially among the economically vulnerable households. This study investigated hospitalization and patient’s health expenditure in Odisha State in India. Methods: The national sample survey data were used to assess hospitalization and patient’s health expenditure over two time periods (1995 and 2014). Disease classification was made following International Classification of Diseases 10th revision (ICD-10). The hospitalization rate and health expenditure were estimated for infectious, cardiovascular, non-communicable, disability and other diseases. Andersen model was used to examine the determinants of healthcare expenditure. Results: Findings of the study revealed that hospitalization in Odisha increased nearly three folds and health expenditure by more than two times between 1995 to 2014. While the hospitalization for other diseases remained consistently higher, health expenditure for disability was the highest and it increased three times within the last two decades. The socio-economic and demographic divides in the hospitalization rate and health expenditure were evident. Interpretation & conclusions: Our analysis indicated that predisposing factors such as age and marital status played an important role in hospitalization whereas, enabling factors likely determined the health expenditure. There is a need to recognize the unique vulnerabilities of older population, widowed and health financial mechanism for disability-related illness.
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Acute encephalitis syndrome (AES) is a major public health challenge in India. We report here the epidemiology of sporadics and outbreaks of Japanese Encephalitis (JE) in Odisha state during 2012–2018. A total of 4235 AES cases (sporadics – 3394, outbreak cases – 841) recorded including 42 outbreaks; majority (n = 18) of which were during 2016. Overall JE virus (JEV) positivity was 11.78% (outbreak cases – 24.5%, sporadic cases – 8.6%). Age ≤15 years were largely affected during outbreaks, while 16–60 years population was dominant among sporadics. The major outbreak (2016) involved 336 patients from a tribal dominated district, spread over 173 villages. JEV seropositivity was high (43.45%) with 28.57% mortality. Epidemiological linkage with pig rearing was documented through JEV neutralizing antibodies in 50% of pig serum samples. Although the postvaccination period (2017–18) showed increase in AES case reporting but low JE proportion. Ongoing surveillance and preparedness of the health system would be of importance, especially in tribal‑dominated districts.
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Purpose: To describe and validate the eye health program protocol of Dongria tribal community, a particularly vulnerable tribal group (PVTG) in Rayagada district, Odisha, India. Methods: The program would consist of three segments. At people抯 residences, trained community health workers (CHWs) will measure the vision and collect demographic data. In addition, vision technicians (VTs) will refract using a hand?held device and prescribe spectacles to people who improve to >6/12, N8. Others would be referred to the vision center (VC). At VC, the VT will perform a slit?lamp examination and re?refract. They would refer people with vision ?6/12 to the secondary center (SC). At SC, referred people will receive a comprehensive eye examination and treatment. The ophthalmologist will assign the cause of blindness and visual impairment for people with visual acuity <6/12. The entire process was rehearsed in a pilot study. Results: The target population is approximately 10,000 people residing in 101 hutments on the hills of Rayagada district. The pilot study included 126 people. The mean age was 44 � 18 years; 70% of the people were illiterate, and in this cohort, 97.6% (n = 123) had never worn spectacles. In the pilot study, 41% of the people had cataract, and 12% had pterygium. The agreements between optometrist versus VTs and between optometrist versus CHWs were good (k = ~0.8�0) in all eye conditions except for strabismus (k = ~0.56�65). Conclusion: The pilot study confirms the program modality, and when completed, it would help in the planning and resource allocation of Odisha PVTG eye care
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Purpose: To estimate seeing and other disabilities in a population cohort in a tribal district, Rayagada, in the Indian state of Orissa. Methods: A door?to?door survey was conducted to identify the disabilities. The vision was measured at the residence of the subject, and other disabilities were documented from the history obtained from the subject/household/neighbor. All people with seeing disabilities were reexamined in the community eye center (primary or secondary), and required treatment was given at no cost to the patients. People with other disabilities were transported to the public health facility for appropriate care and disability certification. The results were compared with the 2011 national census data. Results: A total of 147,699 people were enumerated, and 106,339 (72%) were examined over one year period, 2016–17. In this cohort, 47.3% (n = 50,320) were male and 27.5% (n = 29,215) were 40 years or older. We recorded systemic disease in 0.6% (n = 689) people; hypertension was two times higher than diabetes mellitus. Disability was identified in 2.8% (n = 3022). Common disabilities were seeing (46.7%; n = 1411), hearing (36.8%; n = 1112), mobility (10.4%; n = 315), and mental retardation (3.2%; n = 98). Dual sensory disability (seeing and hearing) was seen in 6.4% (n = 251), and it was higher in the older age group. Seeing and hearing disabilities were higher than the 2011 state (P =< 0.001) and national (P =< 0.001) disability census. Conclusion: The first population?based survey in Rayagada, Odisha (India) in 2017 showed a higher proportion of people with seeing and hearing disabilities. It calls for an appropriate service strategy.
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The prevalence of Bacterial Vaginosis (BV) and candidiasis is high in Indian women in the reproductive age groups. Poor menstrual hygiene management (MHM) practices and low socio-demographic features are the major risk factors associated with BV and candidiasis. The aim of the study was to access the MHM practices in association with BV and Candida infection in the population of western Odisha.METHODSThis cross-sectional study was carried out in the outpatient department of O & G, VIMSAR, Burla, Odisha, from December 2016 to November 2018. Vaginal swabs were collected from the posterior vaginal fornix for analysis. BV was diagnosed by using Nugent’s laboratory diagnostic criteria and identification of Candida was done by Albi QuickTM rapid test. A pre-coded questionnaire was used to collect demographic, clinical, and behavioural (MHM practices) features from the study participants. All data were double-entered into Epi Info 7 software and analysed using Stata 11.0.RESULTSIn 352 women, the prevalence of BV and candidiasis was found in 38.92% (137/352) and 32.67% (115/352) of women respectively. Women were divided into three groups on the basis of age i.e. 18-25 years: 87 (24.72%); 26-35 years: 194 (55.11%); and 36-45 years: 71 (20.17%). Both BV and candidiasis were significantly high in women of 36-45 years age group compared to 18-25 years age group (p<0.05). Women of 36-45 years age group had more number of cases with low education (19.72%), housewife (67.61%), and living in rural villages (61.97%) compared to younger women (p<0.05). Regarding MHM practices, women in the higher age groups used more reusable cloths as absorbent materials (p<0.002), changed absorbent material less frequently (p=0.042) and changed their absorbents somewhere other than in a toilet facility (p<0.018) compared to younger women.CONCLUSIONSThe higher prevalence of BV and candidiasis in higher age groups of women may be due to the poor MHM practices, lack of higher education and other low socio-demographic conditions compared to younger age women. An increased awareness for MHM practices is important to combat the associated morbidities related to BV and candidiasis.
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The outcome of a retinopathy of prematurity (ROP) program initiated in five districts of Odisha over 3 years with partnerships between the government and non-government organizations was prospectively analyzed. The mentoring partners trained the district ophthalmologists and neonatal care providers; the program was handed over when the trainees were considered competent enough to diagnose and treat babies with ROP. During the project period (July 2016–June 2019), 3058 babies were examined; ROP was detected in 33.81% (n = 1034) and 5.06% (n = 159) babies required treatment. At the end of the project, ROP screening was possible in all five districts, and treatment was possible in three districts. ROP care nodal centers were built in one government medical college. To strengthen the initial gain, we recommend creating an Odisha Retinopathy of Prematurity (OD-ROP) steering committee with private–public partnerships to support the program and monitor its progress in other districts of Odisha.
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Purpose: To explore the possibility of vitamin A deficiency (VAD) detection through School Sight Program (SSP) in a tribal district of Odisha, India. Methods: In a cross-sectional observational study, we tracked school children with ocular signs/symptoms of VAD to their villages. The ophthalmologist examined their under-5 siblings and other under-5 children in the village. Information pertaining to family belief and practices of food, water, sanitation, and the socioeconomic status of the family were collected. Results: The ocular features of VAD were detected in 207 of 4801 (4.3%) examined children. This included 70 children (mean age 11 ± 2.6 years) detected in the school, 22 siblings (mean age 3.2 ± 1.2 years) of these children detected at their home, and 115 children (mean age 3 ± 1.5 years) detected in their habitat. The average family size was 5.8 ± 2.02 and the birth order of the child with VAD was 2.3 ± 1.25. Most parents were farmer, living in asbestos-roofed house, depended on public underground water, and practiced open-air defecation. The distribution of VAD in 207 children was conjunctival xerosis (X1A = 207; 100% of VAD and 4.3% of all children), Bitot's spot (X1B = 169; 81.6% of VAD and 3.5% of all children), corneal scar (XS = 3; 1.4% of VAD and 0.06% of all children), and night blindness (XN = 35; 16.9% of VAD and 0.72% of all children). Conclusion: An opportunistic screening for detection of VAD through a SSP could be cost-effective and complement the existing strategy.
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Background: Gestational Diabetes Mellitus (GDM) is usually diagnosed between 24th and 28th gestational week using the 75-g Oral Glucose Tolerance Test (OGTT). It is controversial that if FPG ?92 mg/dL before 24th gestational week should be intervened or not. The aim of this study was to evaluate the value of FPG to screen GDM before 24th gestational week in women with different pre-pregnancy Body Mass Index (BMI).Methods: This was a hospital based retrospective cohort study done at CHC Balipatna, Khurdha, Odisha. Women who had a singleton live birth between June 20, 2016 and June 30, 2019, resided in Balipatna block area and received prenatal care in the Community Health Centre, were included in this study. Pre-pregnancy BMI, FPG before the 24th gestational week, and one-step GDM screening with 75 g-OGTT at the 24th to 28th gestational weeks were extracted from medical records and analyzed. The pregnant women were classified into four groups based on pre-pregnancy BMI: Group A (underweight), Group B (normal), Group C (overweight) and Group D (obesity). Statistical analysis using independent sample t-test, Analysis of Variance (ANOVA) and Pearson Chi-square test was done.Results: The prevalence of GDM was 20.0% (68/341) in the study population. FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. The incidence of GDM in women with FPG ?92 mg/dL in the 19th to 24th gestational weeks and pre-pregnancy overweight or obesity was significantly higher than that in women with FPG ?92 mg/dL and pre-pregnancy BMI <24.0 kg/m2.Conclusions: FPG decreased gradually as the gestational age increased in all pre-pregnancy BMI groups until the 19th gestational week. Pre-pregnancy overweight or obesity was associated with an increased FPG value before the 24th gestational week. FPG ?92 mg/dL between 19 and 24 gestational weeks should be treated as GDM in women with pre-pregnancy overweight and obesity.
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Scrub typhus is a vector borne Rickettsial disease caused by Orientia tsutsugamushi and has been reported from tsutsugamushi triangle which includes India. It is a re-emerging pathogen in India including the state of Odisha. This study was conducted to determine seropositivity of scrub typhus in patients attending a tertiary care hospital of Western Odisha.METHODSFifty febrile patients who were negative for Malaria, Dengue and Leptospira attending a tertiary care hospital of Western Odisha were enrolled in the study. 3 ml of blood was collected, and serum was separated. IgM SD Bioline Tsutsugamushi lateral flow immunochromatography test was performed as per manufacturer instruction. Positive samples were confirmed by PCR method (Geno-Sen’s ST Real Time PCR).RESULTS20% of patients were positive for IgM SD Bioline Tsutsugamushi card test. 60% of positive patients were male. 20% of positive patients were having pathognomonic eschar. 60 % of infected patients were in the age group of 10 - 30.CONCLUSIONSIn this study, 20% of febrile patients were positive for Scrub typhus infection. So, it should be included in the differential diagnosis of a febrile patient in Western Odisha.
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Introduction: Campylobacter-mediated diarrhoea is one of the major causes of gastroenteritis globally. A majority of the Campylobacter spp. that cause disease in humans have been isolated from animals. Faecal contamination of food and water is the identified frequent cause of human campylobacteriosis. Methodology: In the present study, faecal samples from patients with symptoms of acute diarrhoea (n = 310) and domestic animals including cows (n = 60), sheep (n = 45) and goats (n = 45) were collected from the same localities in the peri-urban Bhubaneswar city. Genomic DNA isolation followed by polymerase chain reaction and sequencing was employed to analyse Campylobacter spp.-positive samples. Results: Of the 460 faecal samples, 16.77% of human samples and 25.33% of animal samples were found to be positive for Campylobacter spp. Among animals, the isolation rate was highest in sheep followed by cows and goats with 9.33%, 8.66% and 7.33%, respectively. The highest number of Campylobacter-positive cases was diagnosed in infants of 2–5 years age. Concurrent infection of other pathogens in addition to Campylobacter spp. was frequently detected in the samples. Conclusion: The present study showed the incidence of Campylobacter infections in human and different animal species in and around Bhubaneswar, Odisha. The analysis suggested that domestic animals can be the potential sources for human campylobacteriosis in the region.
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Melioidosis is an emerging infectious disease in India mostly reported from South-western coastal Karnataka and North-eastern Tamil Nadu. We speculate the existence of another major hidden focus in Odisha, one of the eastern coastal states. The clinico-epidemiological features of 47 culture-confirmed melioidosis at a tertiary care teaching hospital over a period of 2 years are reported. Septicaemia was the most common clinical presentation. Diabetes mellitus (DM) was present in 72.3% of our cases. The geo-climatic conditions of Odisha and other coastal states of India and the rise in the incidence of DM demand a nationwide surveillance of melioidosis and creation of melioidosis registry.
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Background: Worldwide, cerebrovascular accidents (stroke) are the second leading cause of death and the third leading cause of disability. According to WHO estimation, by 2050 nearly 80% of stroke cases may occur in low and middle-income countries like China and India. It is critical that we understand the etiology causing the stroke so that appropriate treatment can be initiated in a timely fashion. Furthermore, understanding the risk factors associated with stroke is important before primary and secondary preventive measures can be prescribed to the patient.Methods: This observational study was carried out amongst 481 acute ischemic stroke patients that fulfils the inclusion and exclusion criteria and admitted in medicine ward of Pandit Raghunath Murmu Medical College and Hospital, Baripada, Dist. Mayurbhanj, Odisha, India from June 2018 to January 2019. Results: In our study, 481(60.43%) patients had ischemic stroke and 315 (39.57%) patients had hemorrhagic stroke. The incidence of stroke is maximum in 51-70 years of age group which comprises of 59.46% of total patients. The average age + SD were 61.4±13.1 in our study. The most common risk factor was hypertension with 69.85% followed by dyslipidemia 51.77%. Most common clinical presentation was hemiplegia (72.35%) followed by speech involvement (59.46%). Most common site of infarct was parietal (22.25%), followed by periventricular (12.68%).Conclusions: Most of the patients had ischemic stroke as compared to hemorrhagic stroke. It was more common in males. The study contributes to understanding of demographic characteristics, risk factors, and stroke subtypes in acute ischemic stroke. The importance of various risk factors among ischemic stroke subtypes should be stressed for prompt preventive strategies and treatment.