High Fear & Stress in the Quarantine Population of COVID-19 in Southern Rajasthan : A Survey

Background : The advent of the COVID-19 pandemic has caused a significant psychological impact on the General Public, Health Care Workers, Elderly, High-risk groups, etc. Higher fear is likely among the quarantine population. Aim of this study : To evaluate the fear and stress of individuals in quarantine; to determine the possible factors that are influencing the Psychological reactions of the individuals in quarantine compared to the general population; to provide a basis for future Government policies. Methods : A semi-structured questionnaire that included a pre-tested, 7-item Fear of COVID-19 Scale (FCV-19S) was used for data collection. A total of 245 responses were received. Through random sampling, 50 participants each were chosen from the general and quarantine populations. p-value <0.05 was considered significant. Results : Individuals in quarantine had a greater fear of COVID-19 compared to the general population (p=0.0059). Symptomatic fears like clammy hands (p=0.032), sleep disturbance (p=0.00026) and heart palpitations (p=0.000034) were commoner in the quarantine population. The younger age group in the quarantine population was comparatively more affected by News and Social media (p=0.00018). Getting a negative screening test resulted in lesser fear both in the quarantine (p=0.017) and general populations (p=0.002). Conclusion : The individuals under quarantine have greater fear possibly due to stressors like transmitting the infection to family, working on the frontlines, being in high-risk groups, losing jobs, and exposure to social media. However, negative screening tests were shown to reduce the fear.

Acute pancreatitis as first presentation of primary hyperparathyroidism: an observational study attertiary care centreJammu and Kashmir, India

Metabolic causes of acute pancreatitis though uncommon, are important as early recognition helps in the management and prevention of recurrent episodes. Among the uncommon etiologies, Primary hyperparathyroidism (PHPT) is one of the important causes of acute pancreatitis. We studied nine patients with acute or recurrent acute pancreatitis with etiology of PHPT. All patients had elevated serum calcium on admission and high levels of circulating parathyroid hormone. Ultrasonography, 4D CT and Sestamibi scan was used to localize parathyroid adenoma. These patients underwent parathyroidectomy and post-operative histology was consistent with parathyroid adenoma.

Prevalence and risk factors associated with overweight and obesity in age group between 8 to 19 years in North India, a school based cross-sectional study

Background:The objective of this study was to observe association of demographic, lifestyle factors and Socio cultural and economic factors among children抯 and adolescents with overweight and obesity.Methods:Our study was cross sectional study, carried out in age group between 8 to 19 years of age from June to October 2019 in nine schools of district Baramulla, Jammu and Kashmir, North India. Body mass index (weight in kg/height in m2) was assessed to identify participants with (overweight/obese), CDC sex and age specific growth charts were used for assessment. Structured questionnaire was usedto collect information regarding socio-demographics and respondent抯 exposure to various risk factors.Results:In our study, among 354 participants study showed that 44.1% were boys and 55.9% were girls. Among these15.5% were overweight and 5.9% were obese in females, while as 7.9% were overweight and 2.5% were obese in males, thus showing female preponderance. Besides this physical activity, consumption of junk/fast foods along with watching TV and video games along with mother education and occupation were significantly associated with overweight and obesity in children抯 and adolescents.Conclusions:Having overweight parents along with limited exercise and Sedentary activities along with physical inactivity compounded by erratic eating habits with overweight parents are main risk factors leading to overweight and obesity in school going children抯 and adolescents in north Kashmir, India.

Etiology and clinical spectrumofacuteundifferentiated fever illness in patients in atertiary care hospital Sheri Kashmir institute of medicalscience Soura, Jammu and Kashmir

Background:Current study aimed at s to delineate the etiology and clinical parameters associated with AUFIpresenting toemergency department in atertiary care hospital.Methods:This wasa prospectivehospital based study carried out atemergency medicine, SKIMS hospital, SouraKashmir, IndiaJuly2017 toaugust 2018. Patients with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean盨D for continuous variables like age of the patients and duration of fever, Frequency and percentage were used to analyse categorical variables such as causes of fever and gender, while as descriptive analysis was calculated in terms of mean盨D for continuous variables like ageof the patients and duration of fever.Results:Totalnumbers of patients included were 174, among these 112 (64.3%) were males and 62 (35.6%) were females. Most patientswere diagnosedenteric fever (N=59, 33.9%)followed byUTI (N=25, 14.3%) dengue (N=12, 6.8%) and malaria (N=8, 4.5%)while rest of cases were associated with other viral illnesses (N=70, 40.5%)based on clinicalbasisand inconclusive laboratory results.Conclusions:Enteric fever was found to be the most commoncause of acute undifferentiated fever followed by dengue andother viral illnesses, althoughcauses and clinic spectrumof AUFI is varied.

Biomedical Waste Management: A Study of Knowledge, Attitude, and Practice Among Medical, Dental and Nursing Students in a Teaching College

Background: Bio-medical waste is perilous and can be a health hazard. Medical, dental and nursing graduatesspend maximum time during their clinical posting with the patients which increases their chance of exposureand risk related to biomedical waste. Therefore, they need to be aware about biomedical waste management.Purpose: To assess the Knowledge, Attitude and Practices (KAP) regarding biomedical waste managementamong medical, dental and nursing students. Material and Methods: This cross-sectional study was carriedout to access the knowledge and awareness about biomedical waste. The structured self-administeredquestionnaires were used for data collection. Results: Out of the total 300 students enrolled in this study(Group I: Medical, Group 2: Dental, Group 3: Nursing students), 20 medical 13 dental and 23 nursing failed torespond to the questionnaire. MBBS students had more knowledge but better attitude towards BMWmanagement guidelines were seen in nursing students (p<0.001). 86% of the participating candidates hadcorrect knowledge about definition of BMW. Only around 38% of candidates had knowledge of segregationof waste but none had knowledge of correct colour coding. 88% of candidates confirmed that recordmaintenance was essential but they did lack to answer what kinds of records are important to maintain forbiomedical waste management. 94% of the participating candidates said that BMW is teamwork. Conclusion:There is a need for rigorous training programme and monitoring for medical students

Study Of Prevalence Of Hypothyroidism In Type 2 Diabetes Mellitus Patients Of Lucknow And Surrounding Areas

Diabetes mellitus and thyroid hormone dysfunction are two common endocrinopathies seen in adult population. Insulin and thyroid hormones are intimately involved in cellular metabolism, so excess or deficit of any of them can derange the function of another. To see the prevalence of hypothyroidism in type 2 Diabetes Mellitus patients. Atotal of 235 patients with diagnosed Type 2 Diabetes Mellitus of either sex, aged >20 years were included in the study. Analysis of serum TSH by ELISAwas done in all patients of the study. Atotal of 235(107 males and 128 females) Type 2 Diabetes Mellitus patients were included in the study. Hypothyroidism was seen in 48(20.4%) patients. Hyperthyroidism was seen in 17(7.2%) patients. Euthyroid patients were 170(72.3%). Out of 128 females 27(11.4%) had hypothyroidism whereas out of 107 males 21(8.9%) had hypothyroidism. We conclude that prevalence of hypothyroidism was 20.4% and seen more in female Type 2 Diabetic patients as compared with male patients

Risk of metabolic syndrome in the first degree relatives of women with polycystic ovarian syndrome.

Background: Poly cystic ovarian syndrome (PCOS) is a common disorder, affecting approximately 4 – 8% of women in the reproductive age group. First degree relatives (FDRs) of women with PCOS are at high risk developing endocrine and metabolic co-morbidities of PCOS such as obesity, insulin resistance (IR), and impaired insulin sensitivity, hyperlipidemia and metabolic syndrome (MBS). Present study was conducted with the objectives to evaluate the risk of metabolic syndrome in FDRs of women with PCOS and to compare the risk of metabolic syndrome in FDRs of women with PCOS with age, sex and relation matched FDRs of women with no PCOS. To give suitable recommendations based on the findings of the study. Methods: Hospital based cross sectional analytical study was carried out. 50 FDRs of women with PCOS were compared against same number of age, sex and relation matched FDRs of women with no PCOS. Results: The prevalence of MBS was significantly higher i.e. 34% among FDRsPCOS compared to FDRsControls (8%) (p < 0.05). The FDRsPCOS were 5.92 times more at risk of MBS than FDRsControls (p < 0.05). Relation wise it was found that the fatherPCOS and motherPCOS were 1.5 times at risk, brotherPCOS were 14.26 and sisterPCOS were 12.43 times at risk of MBS than their counterparts. Conclusions: Thus it is concluded that the FDRsPCOS are at high risk of MBS than FDRsControls.

Adherence to acute otitis media treatment guidelines among primary health care providers in Israel

AIMS: To determine the appropriateness of the acute otitis media antibiotic treatment prescribed in the community in relation to the therapeutic guidelines. METHODS: Children aged 3 months-3 years diagnosed with simple uncomplicated acute otitis media in 6 community primary care clinics were enrolled. Data on the antibiotic treatment were collected using computerized medical files. RESULTS: 689 simple uncomplicated acute otitis media patients were enrolled; 597 (86.9%) were treated with antibiotics by 38 family medicine practitioners, 12 pediatricians and 7 general practitioners. 461 (77.2%) patients were <2 years of age. Amoxicillin was administered to 540 (90.5%) patients, with no differences between the various medical specialties. 127/540 (23.5%) patients did not receive the appropriate dosage; 140/413 (33.9%) patients treated with appropriate dosage did not receive the treatment for the appropriate duration of time. 258/357 (72.3%) evaluable patients <2 years of age received an antibiotic considered inappropriate to guidelines (38 not treated with amoxicillin, 94 received inappropriate dosage and 126 not treated for 10 days); 53/100 (53%) evaluable children >2 years of age received an inappropriate antibiotic treatment. CONCLUSIONS: The majority of primary care physicians treat simple uncomplicated acute otitis media with the recommended antibiotic drug. However, incorrect dosage and shorter than recommended duration of therapy may jeopardize the quality of care in children with simple uncomplicated acute otitis media. .

Triple X syndrome with rare phenotypic presentation.

Triple X syndrome is a rare numerical chromosomal anomaly, occurring as a result of non dysjunction in meiosis I. Most cases have neurodevelopmental defects and functional problems. We report two cases diagnosed in our centre. The first was a fetus with cleft lip and palate, 47, XXX was identified by Fetal Blood Sampling. The second was a child with multisystem anomaly including cleft lip and palate, whose karyotype also revealed 47, XXX. Though isolated cases of associated abnormalities have been reported there have not been consistent phenotypic changes reported with this condition.

Maternal death and its causes - a challenge for achieving millennium goals

Maternal death is not the only death of a leady but it is in fact a death of a family. one of the millennium goal of WHO is to reduce maternal mortality by three quarters up to 2015. In order to achieve the role it is essential to have basic figure from worldwide. District head quarter women and children hospital DHQ [W and C], Dera Ismail Khan situated in southern areas of NWFP is providing as emergency obstetric care to this area and peripheral areas of Punjab and Bulochistan. Maternal mortality ratio and and its causes in Distt Headquarter setting of D.I Khan can serve as a baseline figures for planning the strategies for achieving millennium goals. The study was carried out in District Headquarter for women in Dera Ismail Khan. It was a seven year study starting from 15t January 1999- 31st December 2005. It is a descriptive retrospective hospital based study. The record was collected from admission Register, Labour Register. and maternal mortality register. In the seven years period total No of live birth were 11811 and there were 131 maternal deaths. Maternal mortality ratio was 1109/ 100,000 live births. Direct causes of maternal death contributed to 94.5% and indirect causes contributed to 5.35%. Hemorrhage, the leading cause of maternal death was responsible for 57.5% of maternal deaths. Antepartum [APH] and post partum [PPH] contributed equally. Obstructed labour killed 13.9% of the mothers, eclampsia killed 16.74% while infections killed 5.35% of the mothers. Indirect maternal deaths were hepatic coma, sever anaemia and cardiac failure. The challenge for achieving millennium goals is very high. The leading cause of death of the mothers is haemorrhage. The three delays i.e delayed decision, delayed transport, and delayed management are the virtual causes. To achieve the millenium goal we need to improve the first level health care facilities. We also need public awareness, rising the self determination and women's right and women empowerment and her role and decision maker

Intestinal parasitic infection among children and neonatus admitted to Ibn-Sina hospital, Sirt, Libya

A total of 350 stool samples from 196 males and 154 female children and neonatus admitted in Ibn-Sina hospital, Sirt, were examined from June 2001 to May 2002, to determine the prevalence of intestinal parasites. Intestinal parasitic infections were identified in 196 [56%] of children and neonates. No intestinal helminthic parasites were detected but 13 intestinal protozoan parasites were detected. The most prevalent protozoan was Entamoeba histolytica /E.dispar [36.57%]; Blastocystis hominis [12.57%], Giardia lamblia [10.29%], Isospora belli [3.14%] and Balantidium coli [0.86%], the latter was detected in non-Libyan children. The non-pathogenic ones were Entamoeba coli [15.14%], Endolimax nana [13.71%], Entamoeba hartmanni [4.29%], Chilomastix mesnilli [4.29%], Re-tortamonas intestinalis [3.43%], Dientamoeba fragilis [2%], lodamoeba butschlii [0.86%] and Trichomonas hominis [0.86%]. The result showed a significant difference exists between the prevalence of pathogenic and non-pathogenic protozoan parasites [P<0.05]. High prevalence of E. histolytica/ E. dispar followed by E. coli, E. nana, B. hominis and G. lamblia in both sexes of children, while the prevalence of other intestinal parasites were low in both sexes, significantly different existed in the prevalence of intestinal parasites between males and females children [t= 24.68; P<0.05]. Age groups had no effect on the prevalence of intestinal parasites [F= 0.66; P<0.05]. Significant differences existed in the prevalence between single and multiple infections with pathogenic protozoa. The socio-economic status of children parents revealed that highprevalence in children from medium socioeconomic status. The family size had no significant effect on the prevalence of the intestinal parasites

Prevalence of intestinal parasites among primary schollchildren in Derna district, Libya

The prevalence of intestinal parasites and some hygienic factors was evaluated in primary schoolchildren in Derna District. A total of 1039 stool specimens were examined by direct smear and formaline-ether concentration methods. The results showed that 31% of the children were infected with at least one or two parasites. These parasites were Giardia lamblia [12.7%], Blastocystis hominis [6.7%], Entamoeba histolytica/ Entamoeba dispar [6.6%], Entamoeba coli [3.2%], E. hartmanni [1.0%], Enterobius vermicularis [0.6%], Ascaris lumbricoides [0.1%] and Hymenolepis nana [0.1%]. A significant difference was between infection rate and parent's education [P= 0.000], socio-economic status of the family [P= 0.000], family size and number of rooms in houses [P=0.000]. Also, there was a significant differences between infection rate and source of water for human consumption [P=0.05]

PAP smear screening for precancerous conditions of the cervical cancer

To find the presence of cervical cancer in PAP smears taken from Pakistani women of different age groups. Department of Cytology, Public Health Laboratory Division. National Institute of Health, Islamabad. Data of all cervical smears sent to the cytology department of NIH between 1st January 2001 to 31st December 2004 was retrospectively analysed to see the presence of malignancy. A total of 546 smears were assessed during the study period. Of these, 302[55.31%] showed inflammatory changes, 124[22.71%] were normal, 40[7.33%] were atrophic, 17[3.12%] showed dysplastic changes, in which 10 cases were of low grade squamous intraepithelial lesion [LSIL], and 07 cases were of high grade squamous intraepithelial lesion [HSIL]. Carcinoma in situ, was seen in 11 [2.02%]. Inadequate sample was reported in 52 [9.52%] cases with an advise to repeat the test. Awareness campaigns and screening program for cervical cancer in women of reproductive age is recommended especially in those having prolonged symptoms

Hormonal therapy in metastatic prostate carcinoma

To control metastatic prostate carcinoma by inducing hormonal changes in the male body is a longstanding procedure, well known in medical practice. The new concept includes a knowledge of the "how and why" this hormonal change induces a clinical response. New methods of induction of this hormone change are in common use with less side effects and toxicity. Lowering of serum testosterone level in man is the cornerstone of this maneuver. Most of prostate cancer cells have a hormone receptor which makes them go dormant when serum hormone level is diminished to very low or nil levels

Endoscopic removal of a swallowed razor blade from the esophagus

A 23 year old patient was admitted because of dysphagia after swallowing a complete razor blade. Removal was successful by breaking it in situ through a rigid oesphagoscope