Effect of COVID 19 pandemic on time to care, use of ambulance, admission characteristics, demography, injury characteristics, management and outcome of Paediatric Orthopaedic trauma patients admitted to the trauma centre

Background: Lockdown imposed to limit the spread of COVID 19 may have had a significant effect on the time to care, demography, injury causation, injury characteristics, volume and nature of admission, management and outcome of paediatric orthopaedic trauma patients. Objective: To document the effect of lockdown on the time to care at KGMU, use of ambulance, volume and type of admissions, demography, injury causation, injury characteristics, management and outcome of paediatric orthopaedic trauma patients. Methods:. This record review compared age, sex, type of admission, mechanism of injury, injury characteristics, type of treatment, vehicle used for transport, and outcome among patients admitted in prelockdown, lockdown and post lockdown. Results: Lockdown was associated with decrease in the number of cases (p<0.01), increase in the time since injury to reception (p<0.040), a rise in the share of referred admission (p<0.040), time since reception at KGMU, time to definitive care (p<0.001), high energy falls (p<0.001), injuries at home (p<0.001), higher ISS (p<0.001), non operative treatment (p=0.038) and greater use of ambulance (p=0.003). Conclusion: Lockdown resulted in a significant change in the causation and management of injury, significant delays in timeliness of care, reduction in the volume of admissions, an increase in injury severity and share of referral admissions.

Prevailing Marketing Practices and Consumer Preference for Pork in Bareilly City

Present study was conducted using purposive sampling technique to identify prevailing marketing practices and consumer preference for pork in Bareilly city. The study revealed that majority of retailers come under middle age group and belong to lower socio-economic strata. Facilities of chiller, deep freezer, disinfectant and packaging and labeling were not available at any retail shops. Majority of respondent sold 30-35kg pork/day with higher frequency of selling at morning within 4-5 hrs of slaughter. Problems faced by retailers were poor financial conditions and lack of marketing chain. Pork retailers required training and aids related to pork business from government. Majority of consumers at Bareilly city belongs to the lower socio-economic strata. Majority of individuals purchased pork at least 1-2 times per week, most of them purchased at morning time. Most of consumer preferred ham cut, purchased meat from road side stalls immediately after slaughter for preparing dishes from pork and preferred stewing. Finally, it can be concluded that pork was sold through unorganized sector, both consumers and retailers were not aware about quality and safety of pork and meager value chain exist for pork business at Bareilly city

Socio-economic & household risk factors of malaria in tribal areas of Madhya Pradesh, central India.

Background & objectives: Malaria is a major public health problem in many states of the country, particularly, in Madhya Pradesh where both Plasmodium vivax and P. falciparum are endemic. Although many studies have been conducted to investigate risk factors for malaria, but only a few have examined household and socio-economic risk factors. The present study was, therefore, undertaken to explore the relationship of different socio-demographic, socio-economic and behavioural risk factors with malaria prevalence in tribal areas of Madhya Pradesh, India. Methods: This study was undertaken in all 62 villages of Bargi Primary Health Centre from May 2005 to June 2008. These villages comprised 7117 households with an average family size of five members. fortnightly fever surveys were conducted in all villages to assess prevalence of malaria infection in the community. The distinct univariate and multivariate logistic regression models were fitted on the data set. Results: The important socio-demographic risk factors like age of household head, social group, occupation and family size; socio-economic factors like type of walls of house, place of drinking water source, irrigated land, cash crop; and behavioural variables like place of sleeping, use of bed nets, etc. were found significantly associated with malaria in univariate analyses. in multivariate analyses only social groups, family size, type of walls of house, and place of sleeping had strong significant association with prevalence of malaria. Interpretation & conclusions: The study shows that in tribal areas where people are living in poor quality of houses with no proper use of preventive measures, malaria is firmly established. We conclude that community based interventions which bring improvement in standard of living, access to healthcare facilities and health awareness, will have a significant impact on malaria prevention in these areas.

Retrospective study of chikungunya outbreak in urban areas of India.

Background & objectives: A retrospective study on chikungunya outbreak in India in five States viz. Delhi, Madhya Pradesh, Orissa, Maharashtra and Kerala was conducted in 2007-2008 to know the distribution and determinants of chikungunya fever outbreak in India. Methods: On the basis of high and low incidence of chikungunya fever, two districts from each State and two wards from the selected district were taken for random selection of 1000 households from 10 districts and 5 States. Semi-structured questionnaires were administered to individuals, patients, qualified health professionals and to stakeholders for collecting information. Results: The educational background and occupation of the respondents showed variations across the study States. Only in high incidence ward of Maharashtra, water storage period for 3-6 days and emptying, drying of water containers on weekly basis was noted. The study through knowledge, attitude, belief, practice (KABP) obtained individual's perception of chikungunya fever, its prevention and control. Patients’ expenditure on treatment was mainly recorded less than Rs 500 across study States. Health facility survey obtained an overview of the capacity of local health facilities. Stakeholders’ perception regarding chikungunya fever was also noted. Interpretation & Conclusions: The study revealed differences in awareness of chikungunya, cause of the disease, vector responsible, mode of transmission, biting time and elimination of breeding of mosquitoes statistically significant among high and low incidence wards of all the States. Expenditure on treatment was independent of economically active status and loss of man-days across all the States. Education and occupation did not have any relation with emptying/drying of water containers in high incidence wards. Strengthening of surveillance, information, education and communication (IEC) activities along with case management facilities may be provided by the State health department for prevention of chikungunya outbreaks in future. Stakeholders should be more involved in outbreak management and future planning.

Effect of Antihypertensive drugs on Quality of Life in elderly patients.

The use of drugs to increase human happiness and to improve the quality of life physically, mentally and socioeconomically is a serious matter of concern. Chronic disabling conditions become common in old age and affect the quality of life. Quality of life (QOL) is an important measure of health care, which measures the gap between expectations and achievements. Effect of Drug use on quality of life in elderly Indian population with hypertension was studied using Mc Master Health Index. The study population was divided into test group (hypertensive patients on regular treatment) and control group (Not on any treatment or on treatment for less than 3 months). All three parameters of QOL namely physical, emotional and social were studied using Mc Master Health Index questionnaire. The results were statistically compared using ANOVA and chi square. Our results point toward better overall QOL in patients on regular treatment

Studies on malaria during pregnancy in a tribal area of central India (Madhya Pradesh).

In tribal villages of central India where malaria is highly prevalent (mesoendemic), this preliminary study was undertaken to determine the effects of malaria infection in a group of 456 pregnant women with or without fever. Only 96 women were found infected with malaria, of which Plasmodium falciparum accounted for 64% of the detected parasites, while P. vivax for the remaining 36%. There were no instances of cerebral malaria or death however, one abortion and four still births were recorded among 38 primigravid women. Only one neonate was found infected with P. falciparum on day 21 though parasitemia was not high. Anemia was commonly present in most of the women (80%). Failure to clear P. falciparum parasitemia after a chloroquine regimen (25 mg/kg of body weight) was commonly observed. Persistent P. falciparum parasitemia was recorded in 8% cases. Poor response to chloroquine suggests the need to change the drug policy.

Isolation of NADH from Saccharomyces cerevisiae by ether permeabilization and its purification by affinity ultrafiltration.

Cells of Saccharomyces cerevisiae were permeabilized by ether for the isolation of coenzyme NADH. A 4-fold increase in the ether fraction to aqueous fraction resulted in the recovery of 80% of total NADH present in the cell. NADH was separated and purified by affinity ultrafiltration using yeast alcohol dehydrogenase as an affinity ligand. The binding characteristics of the enzyme and coenzyme were established at different pH and ionic strengths using gel filtration. The number of moles of NADH bound per mole of alcohol dehydrogenase (r) was found to be 5.7 at pH 8 and ionic strength (I) 0.1 M. The binary complex of NADH and alcohol dehydrogenase was cleaved by lowering the pH to 6.0. The crude cell permeate on purification by ultrafiltration with 2-fold dilution, gave NADH with an absorbance ratio (A260/A340) of 2.3 and overall yield of 68%. Alcohol dehydrogenase was recovered as retentate with 93% recovery and 15% loss in activity.

Rational drug use--evaluation of a training programme for interns.

A workshop covering various aspects of rational drug use was conducted for interns of Christian Medical College, Ludhiana. Evaluation of the workshop revealed that it was able to bring about an attitudinal change regarding rational drug use. The methodology and evaluation procedures have been described. It is suggested that similar attempts should be made at all medical colleges so that every graduate enters medical practice with a positive attitude towards rational drug use.

Cervical spine injury: how easy to miss!

Acute injuries of the cervical spine are not uncommonly missed on the initial examination. In a study of 48 patients of acute injury of the cervical spine, the diagnosis was missed initially in 8 patients. The common reasons for missed diagnosis had been, head injury in 3 patients, polytrauma in 2, inadequate or improper radiologic examination in 2 and erroneous diagnosis in one case. Neurologic status was worsened in one patient because of delayed diagnosis.

Treatment of intractable spasticity in spinal cord injured patients.

Spasticity and flexor spasms can be most incapacitating in SCI victims. Muscle relaxants, physiotherapy and elimination of triggering factors must be tried before opting for peripheral surgery or alcohol block. The choice of alcohol block or peripheral surgery depends in whether damage to the spinal cord is complete or incomplete. Results of both the procedures are satisfactory in rightly chosen patients. Alcohol block is a simple, safe and effective method of treating spasticity in the patients of complete paraplegia. The effect is immediate and almost permanent. However, alcohol block is contra-indicated in the patients of incomplete paraplegia where peripheral surgery is a better choice.

Mesenchymal chondrosarcoma of the paraspinal region: a case report.

Mesenchymal chondrosarcoma is a very uncommon tumor. An extremely rare presentation of the tumor i.e. arising from the paraspinal region is being presented.

Prevalence of Wuchereria bancrofti infection in some coastal villages of Ganjam, Orissa.

The endemicity of filariasis was assessed in 42 villages of coastal Keluapalli PHC in Ganjam District of Orissa. Prevalence was found to vary greatly between extreme coastal and subcoastal villages. The infection was non existent in 12 coastal villages. Age and sexwise distribution of filariasis cases have been analysed and presented.