Doctor-patient interactions with respect to type of practice

Background: The doctor-patient relationship is the core foundation for healing, care, establishment of trust and an essential part of modern-day medical ethics. The last few decades have seen an exponential growth in the scientific component of the medical field which has led to a strain on doctor-patient relationship. With the growing trend of patients wanting more information from their doctor in order to have a more active role in their health-care, active communication from the physician’s end is needed. Present study aims to find out what doctors over various fields expect out of this relationship.Methods: A cross sectional prospective study was conducted among a total of 49 urban and rural doctors of various specialities in an urban area of Maharashtra using a pre-structured questionnaire. The statistical tools used to analyse the data was by using Microsoft excel software.Results: It was also noted that time spent with patients was less by the specialists as compared with other doctors for all aspects of consultation. On evaluating experience with the duration of consultation, we noted that doctors having more than 30 years of experience gave lesser time for all aspects of consultation as compared to those with lesser experience. A close range, between 45%-57% of all physicians, admitted to answering phone calls during consultations.Conclusions:It is imperative to study doctor-patient interactions since a better relationship results in a more satisfied patient with better treatment outcome.

Determinants of pesticide exposure among workers in floriculture industry in rural Maharashtra

Background: Pesticides are extensively used in floriculture where workers are mostly unskilled and may not have appropriate knowledge about safety. Acute accidents during spraying are reported, chronic exposure goes unnoticed. There are not many Indian studies regarding health risks and safety practices among floriculture workers in India. Hence this study to assess pesticide exposure, to find their determinants and suggest appropriate preventive measures.Methods: Study was cross sectional in Floriculture Park, Talegaon (D), Pune, Maharashtra, India using cluster sampling from February 2018 to July 2019. Prevalence of morbidities being 63% sample size was calculated as 111 (allowable error 15%). Socio-demographic, work and health related variables were recorded using a pretested structured questionnaire. Clinical examination and laboratory investigations were done by medical experts.Results: A total of 118 workers participated. Only half (51.2%) were using personal protective devices. None were following reentry guidelines. 13.3% males and 4.1% females had low serum cholinesterase level which is a biomarker of pesticide exposure. Sprayers had significantly high risk of low serum cholinesterase levels (OR=3.31) as compared to others. With exposed subjects which included both sprayers as well as polyhouse workers the association increased with OR=4.27. However association was not significant when working in polyhouse alone was considered as a risk factor (OR=1.256).Conclusions: Presence of exposure was the only factor that had a statistically significant association with low Serum Cholinesterase levels. Safe occupational practices like use of personal protective devices, rotation of exposed workers, monitoring of serum cholinesterase levels and health education of workers should be undertaken.

Screening for diabetes using Indian diabetic risk score in the field practice area of tertiary care hospital, Maharashtra

Background: Globally, people living with diabetes were estimated to be 422 million in year 2014. In India, an estimated 7.8% have diabetes. Early detection and prompt treatment for diabetes is key to achieve sustained control and prevent complications. The Indian diabetic risk score (IDRS) is one of simple screening tool to find the risk for diabetes in the community of filed practice area of teaching hospital.Methods: A community based cross sectional study was conducted in urban and rural field practice area during the period of 1st January to 30th September 2018. As per global health report on diabetes, World Health Organization 2016, prevalence of diabetes in India was found to be 7.8%. Considering allowable error as 20% sample size was 1183 which was rounded up to 1200 with 600 each in urban and rural field practice area. The data was collected with bio- data and IDRS questionnaire which includes age, physical exercise, waist circumference and family history of diabetes.Results: Total 1200 Study participants were included in the study. It was observed that 821 (68.41%) were female participants and 379 (31.59%) were male participants. High risk for diabetes was observed in 329 (27.42%) participants. Among the high-risk participants, 194 (58.96%) were from the urban area and 135 (41.04%) were from the rural area. The association between increasing BMI with high IDRS was observed and found statistically significant. High blood pressure was observed among the participants having high IDRS and findings were statistically significant.Conclusions: This simplified IDRS is cost-effective tool to screen the community on large scale.