Socio-demographic characteristics of cancer patients: Hospital based cancer registry in a tertiary care hospital of India.

AIM: To determine the socio-demographic characteristics of cancer patients. MATERIALS AND METHODS: Review of the Cancer registry, and patient interview. Information on socio-demographic profile, medical history, family history and previous treatment, if any, was retrieved from the patient. If the patient couldn’t be contacted then information was taken from pathology/radiotherapy or medical records department. RESULTS: A total of 684 patients participated in the study. More than 40% of males and 53.7% of females were illiterate, P < 0.05. The majority (33.5%) of participants were of low socioeconomic status. The most frequently reported cancer (ca) in males it was ca lung (40.9) and ca oesophagus (9.8). In females most common cancer were ca breast (23.9) followed by ca cervix (11.7).

Pulse polio immunization in district Panipat: a process evaluation.

OBJECTIVE: To evaluate all steps of pulse polio immunization on special sub national immunization day. METHODS: On a sub-national immunization day (SNID), 120 booths were randomly selected from 662 booths by probability proportionate to size (PPS) sampling technique. RESULTS: It was observed that attendance in the district level meeting was thin (30%). 34% workers were doing this work for the first time without any training. 40% of the vaccinators were neither working according to micro plan nor were same as mentioned in the micro plan. Supervision too was found deficient. CONCLUSION: In a sustained and long drawn programme like IPPI, sustaining the interest and motivation of health personnel is paramount. This paper emphasises the importance of continued re-orientation training to keep them motivated and updated.

Gap between awareness and practices regarding maternal and child health among women in an urban slum community.

OBJECTIVE: To investigate the knowledge of ever-married women regarding maternal and child health and to assess existing gap between awareness and practice levels of lactating mothers. METHODS: Community based cross sectional study with 283 ever-married women in the reproductive age. RESULTS: Low levels of awareness and practice of TT immunization (74.2% awareness, 58.1% practice), five-cleans (31.9% awareness and 14.4% practice), trained birth attendant (69.6% awareness 39.1% practice), and post-natal care (75.4% awareness and 51.0% practice) among lactating mothers. Knowledge regarding optimal infant and young child feeding practices was very poor: initiation of breast-feeding within six hours (17.4%), colostrum feeding (34.8%), exclusive breastfeeding (5.8%) and significant gaps between knowledge and practice were observed. Highly significant difference (P<0.001) between proportions of women aware of ICDS (59.4%) and of beneficiaries (21.7%). High levels of awareness regarding reproductive health parameters except for contraception: desire for two children (81.6%), legal ages at marriages for girls (84.5%), desired birth interval of three or more years (71.7%). CONCLUSION: Wide gaps exist between awareness and practices related with MCH due to non-adoption of knowledge into actual practice, except some selected components lacking in both knowledge as well as practice. Need for bridging the existing gaps avoiding socio-cultural barriers and misconceptions prevailing in the community and by promoting and protecting healthy MCH care practices.

Status of cold-chain maintenance in Chandigarh.

An effective cold chain maintenance system is the backbone of success of any immunization program. This study compares the state of cold chain maintenance during intensive pulse polio immunization campaign in union territory of Chandigarh in the year 2001 with that of 2006. The study was conducted during pulse polio rounds of December 2001 and January 2002 and another in April and May 2006 by Department of Community Medicine, Govt. Medical College, Chandigarh. Data was collected from different levels of cold chain maintenance; OPV vials were also collected and sent for potency testing at Central Research Institute, Kasauli in all the rounds. Cold chain sickness rate has decreased from 9.8% in year 2001 to 6% in year 2006. Icepacks were neatly stacked in all the deep freezers (DF) and ice-lined refrigerators (ILR). 94.71% DF's & ILR's were defrosted periodically, 95.36% temperature charts were up-to-date and signed by supervisors and no day carriers were being used in 2006 round. Whereas in 2001, the periodicity of defrosting ILR & DFs was 76.9%, vaccines were stacked neatly in only 38.46% and day carriers were being used. All the randomly selected vaccine samples were reported potent.

Rhinosporidiosis in Raipur, Chhattisgarh: a report of 462 cases.

Rhinosporidiosis is endemic in the state of Chhattisgarh. 462 cases were encountered during the period of 12 years from January 1994 to December 2005. Maximum incidence was seen in men in the age group of 21-30 years. Nose and nasopharynx were the commonest site (81.1%), followed by ocular tissue (14.2%). Many rare sites of involvement were encountered. Seven cases of generalized rhinosporidiosis were seen. Rhinosporidium seeberi could be easily identified in Haematoxylin and eosin stained sections. Sporangias and spores are better delineated by periodic Acid Schiff, Mayer's mucicarmine, Verhoff's vonGieson and Grocott Gomori methamine silver stain.

Surveillance of communicable diseases in tertiary health care system in Chandigarh, UT.

BACKGROUND: Communicable disease surveillance is to have baseline data which will be helpful for planning and also for identifying epidemics under non-evident conditions. OBJECTIVE: To delineate the pattern of occurrence of communicable diseases so as to enable early identification, followed by appropriate and timely response to outbreaks. MATERIALS AND METHODS: Reports of listed communicable diseases from various departments and centers of Government Medical College, Chandigarh, involved in clinical care and laboratory diagnosis, were collected by the Department of Community Medicine on a weekly basis. Analysis of surveillance data was done for a period of 1 year--including reports from March 2005 to February 2006. STATISTICAL ANALYSIS: Percentage, normal test of proportions, time series analysis. RESULTS: Out of 19,378 cases of various communicable diseases, 11,575, i.e, more than half, were dealt with by health centers. Thus maximum cases of acute respiratory infections (ARIs) [8,278 (71.87%)] and acute diarrheal diseases (ADDs) [3,148 (54.4%)] were dealt with by health centers. Of 19,378 cases, 11,518 (59.44%) were of ARIs, 5,786 (29.86%) of ADDs and 550 (2.84%) of pulmonary tuberculosis. There was no significant difference in the incidence of either disease between two sexes. Most, i.e, 4,413 (38.31%), cases of ARIs and 512 (86.49%) cases of pneumonia were reported in winter; ADDs--2,607 (45.05%) in summer; and typhoid--94 (41.04%) in the monsoon season. CONCLUSION: Maximum workload of common communicable diseases was borne by health centers. The most common morbidity was ARIs, followed by ADDs and pulmonary tuberculosis. No significant gender predilection was seen. Overall reporting of communicable diseases observed in three different seasons was found to show a gradual increase from winter to summer through monsoon. Some specific seasonal trends were demonstrated by various morbidities.

Influence of infant-feeding practices on nutritional status of under-five children.

OBJECTIVES: To study the nutritional status of under-five children and to assess whether infant feeding practices are associated with the undernutrition in anganwari (AW) areas of urban Allahabad. METHODS: Under-five-years children and their mothers in selected four anganwari areas of urban Allahbad (UP) participated in the study. Nutritional assessment by WHO criterion (SD- classification) using summary indices of nutritional status: weight-for-age, height-for-age and weight-for-height was done. Normal test of proportions, Chi-square test for testing association of nutritional status with different characteristics and risk analysis using odds ratios with 95% confidence intervals was also done. RESULTS: Among all under five children surveyed, 36.4% underweight (< 2SD weight- for -age), 51.6% stunted (< 2SD height- for- age) and 10.6% wasted (< 2SD weight- for- height). Proportions of underweight (45.5%) and stunting (81.8%) were found maximum among children aged 13-24 months. Wasting was most prevalent (18.2%) among children aged 37-48 months. Initiation of breast-feeding after six hours of birth, deprivation from colostrum and improper complementary feeding were found significant (P< 0.05) risk factors for underweight. Wasting was not significantly associated (P>0.10) with any infant feeding practice studied. ICDS benefits received by children failed to improve the nutritional status of children. CONCLUSION: Delayed initiation of breast-feeding, deprivation from colostrum and improper weaning are significant risk factors for undernutrition among under-fives. There is need for promotion and protection of optimal infant feeding practices for improving nutritional status of children.

Operationalisation of surveillance of communicable diseases in Chandigarh.

Weekly reports of listed communicable diseases from various departments and centres of Government Medical College, Chandigarh, involved in clinical care and laboratory diagnosis, compiled and forwarded by Department of Community Medicine, sub-nodal centre under National Surveillance Programme for Communicable Diseases (NSPCD), to Anti- Malaria-cum-Nodal Officer, NSPCD were analysed for a period of one year Out of 14,082 cases of various communicable diseases 9166 (64.62%) were of Acute Respiratory Infections (ARI), 3586 (25.78%) of Acute Diarrhoeal Diseases (ADDs) and 576 (4.10%) of Pulmonary Tuberculosis. The proportion of ARI appeared higher among females while that of other diseases was higher among males. Most cases of ARI (76.5%) and Pneumonia (3.09%) reported in winter, ADDs (38.89%) and Pulmonary Tuberculosis (4.68%) in summer and Typhoid (1.57%) and Viral Hepatitis (1.23%) in monsoon season. No significant gender predilection was seen. Overall reporting of communicable diseases seen to be significantly more during winter and summer compared to monsoon season, with specific seasonal trends demonstrated by various morbidities.

Evaluation of cold chain system in Chandigarh during PPI campaign 2001-2002.

OBJECTIVE: To evaluate the maintenance of cold chain system (CCS) in intensified pulse polio immunization (IPPI) programme, during December 2001 and January 2002 in Union Territory (UT) Chandigarh. MATERIALS & METHODS: A Cross sectional time bound study was conducted in seven centres, where OPV vials were stored prior to IPPI and 20 IPPI Booths in UT, Chandigarh. Booths were selected by stratified random sampling technique. The status of cold chain equipments was assessed at headquarter of IPPI, 6 regional (distribution) centres, 20 IPPI posts and 5 house to house teams. RESULTS: The cold chain sickness rate was found to be 9.7% in January, 2002. There were reports of breakdown of cold chain maintenance due to defective plugs and sockets, faults in thermostat, leakage of gas. But all vaccine samples picked up randomly were reported potent, as per the test reports provided by Central Research Institute (CRI), Kasauli during the period of study. OBSERVATION & DISCUSSION: Temperature charting and cold chain maintenance was found satisfactory, but necessity of improvement, specially regarding the handling of vaccines by the female health worker. Lids of vaccine carriers not closed tightly, frequent opening of lids during immunization, direct exposure of vaccine to atmospheric temperature, keeping the vaccine vial in hand or pocket. More emphasis is to be given on maintenance of cold chain system in orientation training programme of all Health functionaries before the Intensified Pulse Polio Immunization (IPPI) programme.

Prescribing patterns and cost of antihypertensive drugs in an internal medicine clinic.

BACKGROUND: Antihypertensive agents are selected primarily for their ability to prevent morbidity and mortality related to hypertension. METHODS AND RESULTS: Prescribing trends and the cost of antihypertensive drugs were studied in 300 patients attending an internal medicine clinic. Beta-blockers were the most frequently used group of drugs (46.7%), followed by calcium-channel antagonists (34.3%) and angiotensin-converting enzyme inhibitors (30%). Diuretics were used in only 13.2% of the prescriptions. Atenolol (36%), amlodipine (29.3%) and enalapril (19%) were the most frequently used individual drugs. Propranolol, furosemide, amlodipine and atenolol were the least expensive drugs used, with annual drug acquisition costs of Rs 80, 102, 182 and 318, respectively. Benazepril (Rs 1778), diltiazem SR (Rs 1777), lisinopril (Rs 1660), prazosin (Rs 1416) and losartan (Rs 1365) were the most expensive drugs in terms of annual drug acquisition costs. CONCLUSIONS: The results of our study emphasize the need to encourage frequent use of diuretics. Since the costs of different antihypertensives vary considerably, newer and relatively expensive antihypertensives should be prescribed only when clearly indicated.

Dr. P.C. Sen Memorial Award--1994. Role of various risk factors in the epidemiology of hypertension in a rural community of Varanasi district.

1572 persons above 30 years were screened for hypertension in a rural community of Varanasi district. 113 persons were diagnosed as hypertensive giving an overall prevalence of 7.19%. Prevalence rates among males and females were found 5.57% and 8.82% respectively. 203 controls, age and sex matched, were selected. Various risk factors including intake of salt, fat, socio-economic status were studied. On doing analysis by logistic regression, salt consumption and obesity were found significant predictor of hypertension.

Study of root canals configuration in mandibular first permanent molar.

The number and configuration of root canals in mandibular first permanent molar, studied by radiographic method, on 60 teeth revealed (1) one canal in the mesial root in 5 percent, two in 78.3 percent, three in 13.3 percent and four in 3.3 percent. In distal root, one canal was observed in 58.3 percent, two in 40 percent and three in 1.7 percent of the cases; (2) transverse anastomosis existed in about half of the mesial roots; whereas in distal root, it was only 21.7 percent; (3) biconvex canal curvature was seen in 18.3 percent of mesial and 1.7 percent of distal roots (4) apical foramina: in mesial root two apical foramina were observed in 60 percent of specimens, three in 6.7 percent and four in 3.3 percent. In distal root, two apical foramina were seen in 25 percent and three in 1.7 percent cases; (5) type of root canal: type 2-1 was the most common feature of mesial as well as distal roots; (6) the mesial root canals tended to be curved in 51.7 percent, while distal root canal straight in 58.3 percent.

Modification of the toxicity of acetylcholine by prior atropinization in mice.

The potentiation of acetylcholine (Ach) toxicity in mice with prior atropinization was tested. The experiments were carried out with three doses of 200 mg, 300 mg, and 400 mg/kg of Ach administered ip. Prior atropinization was observed to potentiate the Ach toxicity at all dose levels of atropine except the highest in the group that received Ach 200 mg/kg and the results were variable in the other two groups.