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Background : Acute Kidney Injury (AKI) is a common complication Post Cardiac Surgery with reported incidence of 20-70%. Various studies have been conducted worldwide on risk factors contributing to the etiology of AKI in Cardiac surgery patients. We undertook similar study to understand the etiology and risk factors associated with AKI at Goa Medical College hence we undertook this study. Methodology : A retrospective record based observational study was conducted at Goa Medical College; wherein records of 419 patients who underwent Cardiac Surgery during the study period were analyzed for pre-operative, intra-operative and postoperative variables. Kidney Disease Improving Global Outcomes criteria were used to study the incidence of AKI. The Data was entered in Microsoft Excel and analysed using SPSS version 22.0. Chi-square test and Student t test were used as a test of significance. Results : Out of 419 patient records reviewed; 40.3% patients developed AKI after Cardiac Surgery. Age, Sex, h/o previous Cardiac Surgery, CPB duration, Aortic Cross Clamp Time, addition of vasopressor etc. were some of the significant risk factors associated. AKI associated with Cardiac Surgery was associated with a mortality of 8.3%. Mean duration of ventilation 38.48�.27 hrs. and ICU stay 6.12�15 days was comparatively longer than patients without AKI (P<0.001). Conclusion : We concur that AKI is a serious complication in patients undergoing Cardiac Surgery and has significant impact on the outcome of the patients in terms of duration of ICU stay, duration of ventilation and mortality. There is need to identify modifiable risk factors at the earliest and develop approaches to improve the outcome and decrease the AKI associated morbidity and mortality
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Introduction: Since the discovery of HIV in the 1980's,there has been an alarming upsurge of Tuberculosis acrossthe globe. TB is the most common and usually the firstopportunistic infection in people living with HIV. BothHIV and TB together form the cursed duet, each one fastforwarding the progression of the other. Aims & Objectives:To study the epidemiology & various determinants of HIV-TBco-infection in HIV positive patients attending ART center atGoa Medical College (GMC), Goa. To study the prevalence ofHIV- TB co-infection. Settings and Design: It was a three yearrecord based retrospective observational study carried out atthe antiretroviral therapy center of a tertiary care Hospital inthe state of Goa.Material and methods: Study group comprised of 342 casesof HIV-TB co-infected patients above 15 years of age, and thecontrol group was formed by equal number of non TB, HIVinfected patients diagnosed during the same period. Variousdeterminants like age, gender, occupation, educational status,mode of transmission of HIV, addictions, CD4 counts etcwere compared. Statistical analysis: was done by calculatingpercentages and proportion by SPSS 14.0 version and Chisquare test was used for statistical significance, with P valuesless than 0.05 considered as statistically significant.Results: The prevalence of HIV-TB co-infection during thestudy period was found to be 26.6%. The incidence of coinfection was found to be higher in males (60.8%), in thosewho were semiskilled workers and with level of education upto secondary school and all these were found to be statisticallysignificant. Alcohol consumption, low CD4 counts and Comorbid illness like anemia were also found to be statisticallysignificant.Conclusions: Higher HIV-TB co-infection prevalence ratein the state warrants upgradation of disease control programswith efforts to increase awareness about the prevention andspread of both the diseases and their effective management.
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Introduction: Reproductive tract infections (RTIs) are a universal public health problem among young women in developingcountries and occupy the second position in public health problems. RTIs lead to 17% of economic losses in these countries.According to the WHO estimates in 2008, globally, 499 million new cases of RTIs occurred annually among women in thereproductive age group. In India, one among four women in the reproductive age group has any one type of RTIs and the annualincidence of RTI estimated is about 5%. Consequently, the prevalence rate of RTIs in various states of India is 19%–71%. Thereare about 40% of women estimated to have RTIs/sexually transmitted infections (RTI/STI) at any given point of time, but only1% complete the full course of treatment of both partners. The present study was conducted to know about the knowledge,attitude, and practices about the RTI/STIs among the antenatal mothers attending outpatient departments in Goa MedicalCollege as part of needs assessment for formulating educational and preventive strategies.Materials and Methods: This cross-sectional descriptive study was conducted at Goa Medical College, a Tertiary Care Hospital atBambolim-Goa, from December 2018 until February 2019. Institutional Ethics Committee (IEC) approval was taken from the IEC ofthe Goa Medical College. Data were collected by interviewing mothers using a semi-structured questionnaire. Additive scores weredeveloped for awareness, knowledge, and perceptions in specific areas of transmission, prevention, and treatment of RTI/STI. Thescores were characterized as poor, average, and good. Data were entered in EpiData Manager and analyzed using SPSS 22 version.Categorical variables were expressed in percentages and proportions and quantitative variables in mean ± SD. The associationbetween dependent and independent variables was assessed using bivariate analysis. P < 0.05 was taken as statistically significant.Aims and Objectives: The aims of the study were (1) to study the level of awareness regarding RTIs/STIs among antenatalmothers, (2) to study their knowledge regarding symptoms and modes of transmission of RTI/STI, (3) to study awarenessregarding preventive strategies for transmission of RTI/STIs, and (4) to study their attitudes and perceptions toward STIs.Results: The mean age of the study participants was 27.5 years. The majority of antenatal mothers, i.e., 64% were aware of RTI/STIsin our study. There was poor awareness in 46% of study subjects and good awareness in 28% of study subjects. On bivariate analysis,awareness was significantly related to education level (P = 0.000), occupation (P = 0.002), socioeconomic status (P = 0.000), andlocation (P = 0.000). About 59% antenatal mothers knew whitish discharge per vaginum as the most common symptom of STI/RTI.The other symptoms identified were lower abdominal pain by 56%, itching in perineal region by 40%, weakness by 50%, and lossof weight by 22%. The mode of spread of RTI/STIs was identified as a sexual route by 56% and blood transfusion by 35% and 31%and 30% were of the opinion that unhygienic conditions and unsafe deliveries were the modes of spread of RTI/STIs, respectively.About 50% antenatal mothers were aware that safe sexual practices can prevent STI/RTIs, 36% felt that the use of condoms helpsin preventing STI/RTIs, 22% opined that good personal hygiene is the mode of preventing RTI/STIs, and 31% were ignorant aboutits prevention. Thus, 67% subjects had poor knowledge, 24%average knowledge and good knowledge was present in only9% study subjects. On bivariate analysis, knowledge wassignificantly related to age (P = 0.04), education (P = 0.03),occupation (P = 0.002), and location (P = 0.015). Socioeconomicstatus shows significant linear by linear relation trends. About74% study, subjects felt that RTI should be treated to avoidcomplications, while 23% did not want to express themselves.Similarly, 20% subjects refused to talk about STIs. Half of the study participants (48%) had a poor score with respect to perception about STI/RTI. Only 19% had good scores which were significantlyrelated to education (P = 0.012), occupation (P = 0.001), and location (P = 0.000).Conclusion: The study findings show that although there is 64% awareness of STI/RTI, there is a lack of requisite knowledgewith respect to RTIs. The attitude, knowledge, and perception are significantly related to education, occupation, and location.Therefore, the knowledge has to be spread in society through educational programs so as to increase awareness of this problem,thereby curbing the spread of RTI/ STIs and their complications.
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Introduction: Every year around 5,00,000 individuals losesight as a result of work related eye injuries. The followingstudy was conducted to study the profile of work relatedocular injuries presenting at a tertiary care hospital inGoa.Material and methods: A longitudinal hospital-basedstudy was conducted at the Department of Ophthalmologyat Goa Medical College and Hospital in the one year timeperiod between September 2014- August 2015; whereby 54consecutive patients who presented with work-related eyeinjuries were included in the study. Detailed history and clinicalexamination findings were entered in a pretested proforma.SPSS version 22 and expressed as simple percentages andproportions.Results: the incidence of work-related eye injuries in ourstudy during a one year period was 10.8%, most commonvictims were males in the productive age group of 21-40years. Most patients were industrial workers (50%) followedby agricultural workers (25.92%), construction workers(18.51%), carpenters (3.70%) and fishermen (1.85%). Mostcommon injury that was observed among the study participantswas a conjunctival or corneal foreign body (44.44%) followedby open globe injuries (31.48%) and closed globe injuries(14.81%). 9.25% participants sustained chemical injuries.90.74% participants did not reportedly wear any protectivedevice at the time of injury.Conclusion: work related eye injuries were most commonamong males in the productive age group. Majority of thevictims were not wearing protective eye-wear at the timeof the injury. Hence there is a need to create awarenessabout the need for protective devices at work placealong with proper lighting and training programs for theworkers.
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Background: Mobile Phones can be considered as one of the essential socio-personal utility with diverse features but its overuse may have negative consequences on health. The objective of the present study was to assess the prevalence of mobile phone problematic usage among the medical students and to study the association of health related symptoms and problematic mobile phone usage.Methods: A total of 250 medical students were included in this study. Data regarding the sociodemographic factors and perceived health symptoms related to mobile phone use was collected on a predesigned, structured and self-administered questionnaire. Mobile phone problem use scale (MPPUS) was employed to assess the problematic usage of mobile phone and students were classified into following four categories - casual users (<74), regular users (75-143), at risk users (>143-<179) and problematic users (>179).Results: The total prevalence of problematic users was 22% (17.2% at risk, 4.8% problematic users). Eye strain, concentration difficulties, memory disturbances, morning tiredness, headache, sleep disturbances, painful fingers and restlessness were significantly associated with at risk and problematic users.Conclusions: Multiple health symptoms were associated with problematic use of mobile phones among the medical students. MPPUS is a useful tool which can be used to identify problematic usage of mobile phones.
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Background: Diabetic retinopathy is one of the most common complication of diabetes with a prevalence of 7.3-25%. There have been several studies done in India to assess the knowledge and awareness on diabetes and diabetic retinopathy among patients with diabetes, however very few studies assessed knowledge, awareness and practices amongst patients with diabetic retinopathy.4-7 Besides, no such study was undertaken at Goa Medical College.Methods: A cross-sectional study was conducted among 100 consecutive diabetic retinopathy patients attending ophthalmology out-patient department (OPD) at Goa Medical College and Hospital. The patients were administered a pre-tested proforma to assess their level of awareness and attitudes and practices towards diabetes and diabetic retinopathy. Data was entered in Microsoft excel 2010; analysed using the SPSS version 22. Chi-square test was used as test of significance.Results: In our study, 58% were aware of the symptoms of diabetes. 15% were aware of the multiple complications. 35% had knowledge about only one test for detecting diabetes i.e. fasting blood sugar level. 22% had never heard about HbA1c. 49% were not aware that they had diabetic retinopathy. 76% felt it is important to continue medications even if blood sugar levels were normal. 62% were aware of the importance of exercise. 71% took their medications regularly, 72% checked their blood sugar regularly. There was a significant association between educational status and awareness and practices towards diabetes.Conclusions: The diabetic retinopathy patients in our study had a fair knowledge about diabetes and diabetic retinopathy
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Background: Gestational Diabetes Mellitus (GDM) accounts for almost 90% of all pregnancies complicated by diabetes. Its prevalence in the Indian population ranges from 5.5% to 11.5 %.Methods: The present study was undertaken to assess the incidence of GDM among antenatal mothers admitted in Goa Medical College for a period of 18 months and also to study the risk factors associated with GDM amongst such cases.Results: Present study revealed that among 7717 antenatal mothers who were admitted and delivered in our Hospital, 424 women were diagnosed with GDM. Of these women diagnosed with GDM, almost one third were in the age group of 31- 35 years (35.8%); 56.2 % of these women were multigravidas. Advancing maternal age, rising parity, obesity, family history of Diabetes Mellitus (DM) and past history of GDM were among the risk factors found to be significantly associated with GDM.Conclusions: The incidence of GDM in present study population was 5.49%. Advancing maternal age, maternal obesity, family history of DM and past history of GDM were found to be important determinants of GDM.