Role of Non Stress Test in Monitoring High Risk Pregnancy.

Background : Heart rate variations in fetus subjected to adverse environment provides assessment of health status. Aim : The present study is conducted to assess the efficacy of this tool in selecting high risk mother with compromised fetus at an early stage. Methods and Material : Hospital based case control study. High risk pregnancies attending hospital over a period of one year were considered for purpose of test. Normal patient were served as control. 80 high risk and 20 normal patient were considered for the study. The subjects were explained the test, need of the test, done after 28 wks. of gestation. Statistical Analysis : Sensitivity, specificity, negative predictive and positive predictive value, false positive and false negative rate were assessed. Result : Test has high sensitivity and specificity with high negative predictive value.

Benefits of Telemedicine and Barriers to its Effective Implementation in Rural India: A Multicentric E- Survey.

Introduction: Telemedicine has become an accepted concept in health care worldwide. The practice of health care using interactive audio, visual and data communications is the need of the hour. This includes health care delivery, diagnosis, consultation and treatment, as well as education and transfer of medical data. Objectives: 1) To estimate the benefits of telemedicine in health care system in rural Maharashtra. 2) To identify the barriers in effective implementation of telemedicine in rural Maharashtra. Materials and Methods: Study Type: E-survey using a validated structured questionnaire. Locus of Study: Department of Pharmacology, Jawaharlal Nehru Medical College, Wardha. Duration of Study: 3 months. Study Design:The questionnaire was sent to doctors of all specialities through email. A total of 300 completed questionnaires were evaluated and statistically analyzed using SPSS software. Results: The results showed a significant association (p < 0.001) of high acceptance of telemedicine in doctors of teaching hospitals as compared to doctors from non-teaching hospitals and private practitioners. Preoperative services, discharge, referral, follow-up and obtaining second opinions are other facilities that can be offered through telemedicine to patients in rural areas. The benefits of telemedicine acknowledged by doctors through this survey include obtaining laboratory results; making appointments; transmission of ECG, X rays and still images; telephonic consultation for patients, health education, monitoring patients at home (follow up), preoperative services, obtaining second opinions and referral of patients for tertiary care. The important barriers to the effective implementation of telemedicine in rural areas, indentified through this study include heavy investments in equipments, technical difficulties, lack of staff educated in information technology and concern about legal responsibility. 48% doctors strongly agreed that telemedicine should be implemented in all hospitals with internet facility. 31% of the doctors strongly disagreed that telemedicine will increase the access of health care services for rural patients. 42% of the doctors strongly agreed that telemedicine will help to save the time and money of patients. 30% of the patients strongly agreed that drug information centers should be run through telemedicine. Conclusions: Web enabled telemedicine system can help in easy flow and better delivery of health care consultation to patients in remote areas who do not get access to a super specialized health care delivery system. However, good access to poor patients in remote areas has to be ensured.