A comparative study on the use of holmium laser and pneumatic lithotripser for intracorporeal lithotripsy of upper ureteric stones

Background: In the last decade different minimally invasive modalities for management of urolithiasis have been available requiring an intelligent decision by the urologist to choose one as per patients need and preferences.Methods: The present cross sectional study was conducted among patients who underwent ureterorenoscopic lithotripsy for proximal ureteric stones in the Department of Urology. Using consecutive sampling technique, patients were randomly allocated to two groups for treatment with either pneumatic lithotripser (group A) or Holmium laser lithotripser for fragmentation of calculi (group B) and the comparison of both these techniques was done.Results: 117 patients were included (57 and 60 in group A and group B respectively) in the study. The difference in age in the two groups was found to be statistically significant (p=0.03). The total operative time, length of stay in hospital and complications were more in group A patients. The difference in two groups for total operative time and length of stay in hospital was statistically significant (p=0.00 and 0.00 respectively).Conclusions: Holmium laser lithotripser has better safety profile when compared to pneumatic lithotripser especially in stone clearance rate and retropulsion rates and could be used as modality of choice in proximal ureteric stones.

Awareness about cigarettes and other tobacco products act and impact of health warnings on smokers in a North Indian city

Background: Tobacco use is a major preventable cause of morbidity as well as mortality worldwide. To combat the increasing trend of this problem, Government of India formulated the COTPA (Cigarettes and Other Tobacco Products Act) in 2003. The study aimed to assess the awareness about COTPA and impact of pictorial warnings among smokers attending outpatient services in a tertiary care hospital in Jammu.Method: The present study was conducted among 320 patients attending the outpatient department of Internal Medicine, Government Medical College, Jammu who happened to be cigarette smokers. The questionnaire was developed by authors with the help of literature review and pilot tested before its final use. Information was elicited about demographic details, awareness about COTPA and impact of pictorial warnings on quitting of smoking.Results: More than half of the respondents were in 30-50-year age group and were urban residents. Awareness about COTPA was good on some parameters but was relatively low on other parameters. Despite all, the respondents noticing pictorial warnings on tobacco packages, only 69.37% of them were contemplating to quit. About half of them were of the view that warning statements preferably be written in local languages.Conclusion: Health and pictorial warnings on tobacco packages remain an important pillar in filling the gap of knowledge and communicating the health risks of tobacco use to the consumers. Only 69.3% of the respondents were planning to quit and awareness levels about COTPA were mixed.

Climate change: what people living in Jammu city of India know?

Background: Climate change has emerged as one of the greatest challenges of the present century. The current study explores the knowledge, attitudes and practices about climate change of the adults aged 18 years and above in Jammu city of North India.Methods: A cross-sectional study was conducted among attendants of the patients visiting medical OPD of a tertiary care teaching hospital. A pilot tested questionnaire eliciting information on knowledge, attitudes and practices about climate change was administered to those who were willing to participate.  The data collected was presented in proportions.Results: Majority (95%) of the respondents had heard of the term climate change, and 43.9% of them related it to changes in the weather pattern. Plastic use as a major cause of climate change was agreed upon by 95% of the respondents. About half of the respondents were very much concerned about climate change and 80% of them were very much interested in knowing more about climate change and its impact. Only 24.8% of the respondents read/watch stories on climate change.Conclusions: Knowledge levels of the respondents were found to be reasonably good but the same cannot be said about their attitude and practices. Role of NGOs, social communities and media is of utmost importance to make people aware of the harmful effects of climate change on both the environment as well as the health of the people.

Prevalence of respiratory morbidity among brick kiln workers: a cross sectional study from rural north India

Background: Fired clay bricks, an important construction material, are manufactured in non-mechanized, labour intensive brick kilns which mostly employ unskilled men and women. The workers, as an occupational hazard, are exposed to dust and air pollution leading to respiratory diseases.Methods: This cross sectional study was conducted among brick kiln workers in RS Pura block of Jammu district. The workers were assessed regarding respiratory symptoms and illnesses using translated version of American Thoracic Society Division of Lung Disease questionnaire (ATS-DLD-78A).Results: 692 brick kiln workers were interviewed during the course of survey and 58.8%of them were males. 45% of the respondents were working since last less than three years. Among the respiratory symptoms chronic cough, was present in 23.55% and phlegm in 22.83% of the respondents. Chronic bronchitis was present in 20.52% of the respondents. Association of respiratory symptoms in relation to sex of the respondents was found to be statistically significant (p<0.05).Conclusions: Respiratory symptoms and illness were found to be quite prevalent in the brick kiln workers. More research needs to be conducted to assess other health risks besides respiratory morbidity. Health planners need to plan for their basic sanitation facilities and periodic check ups.

Association of microvascular complications of type 2 diabetes mellitus with ABO blood group

Background: Micro vascular complications are the major outcome of Type 2 Diabetes Mellitus progression, which reduces the quality of life and increases diabetic morbidity & mortality. As the incidence of type 2 diabetes is growing day by day; our search for its aetiology and pathogenesis is also ever growing to predict its risk factors and early screening for better care and prevention of its complications. Many studies have tried to link susceptibility of type 2 diabetes with ABO blood group though results have been inconsistent. The present study aims to analyse association of micro vascular complication with different blood groups if any.Methods: A cross sectional study was conducted among patients of type 2 diabetes Mellitus in a tertiary care hospital. Determination of ABO and Rh status was done by standard slide method of agglutination. Detailed information about age, gender, BMI, duration of diabetes, age of onset of diabetes was noted with the help of a proforma. The records (clinical examination and investigations done by physician) were screened for type of micro vascular complications.Results: Out of a total of 319 patients suffering from type 2 diabetes, 209 subjects (65.15%) had one or the other complications. A statistically significant (p=0.00) difference was observed between the presence or absence of complications in different blood groups. In patients with Blood group B, 76.14% presented with complications. Though Nephropathy was the most common complication observed among different blood groups, none of the type of micro vascular complication was found to be significantly associated with different blood groups.Conclusions: The findings in our study suggest that although there was a significant association between presence or absence of complications and different blood groups, but this association was not significant for different types of complications.

Risk Factors For Chronic Respiratory Diseases Among Rural Adults in Northwest India

Chronic respiratory diseases(CRD) remain a formidable challenge for public health experts acrossthe world due to their ever increasing morbidity and mortality. This study investigated various riskfactors for CRD among rural adults aged 20 years and above. The study was conducted in fourvillages under sub-health centre Domana in Kot Balwal health block and these villages wereselected randomly. For this cross-sectional population based study, a pre-tested respiratory healthquestionnaire was used. Those respondents who were found to be diagnosed cases of CRD werefurther enquired in detail about various risk factors for CRD. Out of 2018 respondents surveyed,177confirmed cases of CRD were detected.Various risk factors like being male, smoking, overcrowding,recurrent chest infections and use of non-clean fuel (wood, cow dung) were found to bestatistically significant. Among other risk factors, ventilation and history of allergy were found tobe highly significant statistically (p< 0.000). Smoking, recurrent chest infections, use of biomass fuel,ventilation and history of allergy were risk factors for CRD in rural adults aged 20 years andabove.

Cervical cancer: a hospital based KAP study among women aged 18 years and above in Northern India

Background: Cervical cancer is known for its late detection due to a variety of reasons chiefly lack of knowledge, undesirable attitudes and poor practices. Early screening and adequate knowledge about the disease remains the important safe guards against this disease. The study aimed to assess the knowledge, attitudes and practices of the women aged 18 years and above regarding cervical cancer visiting a tertiary care teaching hospital.Methods: The present cross sectional hospital based study was conducted in Jammu city, Jammu and Kashmir, India. All the women aged 18 years and above visiting OPD of gynaecology-obstetrics department of Government Medical College Jammu and willing to participate were administered a pretested questionnaire to collect the relevant data.Results: It was found that 91.56% of the respondents had heard of cervical cancer with 83% reporting that it was both preventable as well as curable. Multiple sex partners were the most important risk factor identified. Among the attitudes, 62% agreed that screening was harmless to the client. Only one third knew about the availability of preventive vaccine. About 83.6% of them had never been screened by Pap smear. However willingness to get HPV vaccination was found to be high.Conclusions: Though knowledge among the respondents was found to be adequate but it lacked transformation into attitudes and practices. In this connection, authors recommend health promotion campaigns to educate women and the community about cervical cancer and its preventability through screening.

Domestic Violence: A Community based cross sectional study among rural married females in North West India

Violence against women a social evil in the society despite a lot of talk of women empowerment. Assessmentof burden in terms of prevalence will go a long way in planning the services for those affected bydomestic violence. To find the prevalence of domestic violence and associated risk factors among marriedfemales in a rural area of Jammu. This community based cross-sectional study was conducted amongrural married females using a structured and pretested questionnaire. Data was analysed using simpleproportions, chi-square test and logistic regression. 171/301(56.6%) of the respondents reported someform of the domestic violence. Psychological, physical and sexual violence rates were found to be32.16%, 9.9% and 2.33% respectively. A statistically significant association was found with variables likeliteracy, type of family, family income, sex of children etc. Relatively high levels of domestic violence inthis rural setting calls for a multidisciplinary approach involving improvement of literacy levels amongfemales, creating awareness about legal aid and screening the victims at primary health centres to mitigatethis problem.

Gender Based Knowledge, Attitude and Practices About Swine Flu in a Rural Indian Population.

During recent Influenza A H1N1(swine flu) outbreak the current study was undertaken to assess knowledge, attitude and practices (KAP) of rural population of Jammu region regarding swine flu. 270 participants were administered a pre-designed and pre-tested questionnaire consisting of 26 questions evaluating KAP. Overall knowledge score was 62.9%. More than 90% had heard of swine flu, knew prevalent season and had knowledge of disease symptoms. However, knowledge about preventing vaccine was low (27.7%). Overall attitude score was 79.5%. Higher number of the participants expressed willingness to seek more knowledge about disease prevention , though half of them were not satisfied with health authorities efforts. The total practice rate was 60%.Preference for nutritious diet and willingness to use tissue/handkerchief was over 80% ,but only 40% expressed willingness to use mask. On most of the parameters of KAP, there was no difference on gender basis except for swine flu treatment ,panic reaction and preference for herbal medication in females. The current study found good KAP regarding swine flu in the rural area of Jammu. However, unwillingness to use mask, dissatisfaction with health agencies and lack of knowledge about population at risk is a matter of concern.