A comparative study on treatment seeking behaviour of geriatric population in rural and urban areas of district Kanpur, Uttar Pradesh

Background: Aging is a complex and universal life process. Treatment seeking behaviour in elderly is affected by socioeconomic factors and by affordability, availability and accessibility of healthcare. Objectives: To study treatment-seeking behaviour of the study subjects. To compare treatment seeking behaviour among rural and urban study subjects. Methods: This was a cross-sectional study conducted in the Kanpur district. Selection of villages in rural and mohallas in urban areas was done using a multistage random sampling technique. A total of 600 subjects were studied, including 400 from urban areas and 200 from rural areas. Elderly persons>60 years of age, both males and females were included in the study. Results: Overall, out of 600 study subjects, 59.8% were taking treatment in rural areas and in urban areas 77.6% were taking treatment. In urban areas, more females availed treatment compared to rural areas. Majority of study subjects (56.5%) sought treatment from a government hospital. Only 36% subjects had health insurance. Conclusion: In Urban areas more subjects availed treatment as compared to rural areas. Majority of subjects sought treatment from government health facilities. Lack of financial support and long waiting time were major reasons for not availing health care.

Effect of Prenatal Dietary Pattern on Maternal Anemia and Low Birth Weight in Rural Areas of Kanpur

Background: In India, the dietary pattern of women from low socioeconomic status are almost same during pre-pregnant, pregnant and lactating periods. Additional foods are required to improve weight gain in pregnancy and birth weight of infants. Aim & Objective: To identify the impact of prenatal dietary pattern on maternal anemia and low birth weight in rural areas of Kanpur Nagar. Methods: This study was a cross sectional study conducted amongst mothers who recently delivered (RDW) in rural blocks of District Kanpur Nagar. Data was collected by interviewing study subjects using a semi-structured interview schedule after applying multistage random sampling technique. Results: Out of 102 women studied, 39.2% women had consumed >90 IFA tablets, 49.1% of mothers had practiced MMF and 47.1% of women practiced MDD during their prenatal period and 40.1% babies of current pregnancy were born as LBW. IFA consumption during pregnancy was significantly associated with maternal anemia. MMF during pregnancy was significantly associated with LBW. Conclusions: In our study it was found that IFA consumption, MMF and MDD during antenatal is a key preventive measure to reduce anemia status in pregnant females and birth weight of baby during prenatal period.

Malignant nasal paraganglioma: a case report and review of the literature.

A rare case of malignant nasal paraganglioma is described. A 30 year old female patient presented with a one year history of bilateralnasal obstruction, nasal deformity and recurrent epistaxis. CT scan demonstrated an enhancing mass occupying both nasal cavities, right maxillary antrum and anterior ethmoid sinus. Histopathologic diagnosis was malignant paraganglioma. A total maxillectomy with excision of growth was performed. Post-operative radiotherapy and chemotherapy was given but patient expired before the completion of therapy. Nose being a rare site for paragangliomas, these lesions present a diagnostic challenge to histopathologists and clinicians alike. A review of the four previously described malignant nasal paragangliomas is also presented.

Clinical, hematological and histomorphological profile of myelodysplastic syndrome.

AIM: The present study was designed to analyse clinical, haematological and histomorphogical features in 37 cases of myelodysplasic syndrome (MDS). MATERIAL AND METHODS: FAB criteria was used to diagnose MDS in 37 patients. Clinical details, peripheral blood findings, bone marrow aspirate and biopsy were reviewed. RESULTS: Of 37 cases, there were 25 females and 12 males in age range of 2 years to 75 years. There were three children. There were nine cases of refractory anaemia (RA), 18 of refractory anaemia with excess blasts (RAEB), nine of refractory anaemia with excess blasts in transformation (RAEB-t) and one of chronic myelomonocytic leukemia (CMML). All were denovo MDS. All patients had pallor. Hepato and/or splenomegaly was seen in 15 cases. Anemia, leukopenia and thrombocytopenia was seen in 37, 6 and 23 cases respectively. Bone marrow aspiration (BMA) was hyper to normo cellular in 35 cases. Dyshemopoiesis was seen in one or more cell lines in all cases. Bone marrow biopsy (BMB) was available in 16 cases. Abnormal localisation of immature precursors (ALIP) was seen in 11/12 biopsies of RAEB and 3/4 of RAEB-t. BMB was helpful in diagnosis of 3 doubtful cases (one RAEB and two RAEB-t), and upgrading of 2 cases of RAEB to RAEB-t. On follow up, 1 case of RA, 3 of RAEB, 1 of RAEB-t developed AML. One case of RAEB developed ALL and 2 progressed to RAEB-t. CONCLUSION: Primary MDS is seen in all age groups. Pallor is commonest presentation. RAEB was commonest subgroup seen. BMB is helpful in diagnosis of doubtful cases. ALIP is a reliable diagnostic feature of MDS. BMB is a diagnostic as well as prognostic tool in MDS cases which should be taken as a mandatory investigation.

Inflammatory pseudotumour of lung.

Inflammatory pseudotumour of lung is a rare benign lung tumour of uncertain aetiology. It is difficult to distinguish clinically as well as histologically from inflammatory lesions, hamartomas and neoplasms. Only two such cases have been reported from India earlier. We report one such case, that was clinically misdiagnosed as neuroblastoma.

A study of electroencephalogram in meditators.

Electroencephalographic patterns were studied in 30 normal healthy individuals practicing meditation and compared with 10 normal healthy controls not practicing meditation. In this study, we found prominent alpha wave activity and increase it its voltage in meditators as compared to controls. Meditators had significantly more alpha rhythm as compared to control group. Percentage of alpha waves were higher in persons performing meditation with good coherence which suggested good homogenicity, uniformity and increased orderliness of brain.

Humoral immunological profile of workers exposed to asbestos in asbestos mines.

Humoral immunological profile including immunoglobulins IgG, IgA, IgM, C-reactive protein, rheumatoid factor, antinuclear antibodies and circulating immune complexes were studied in a representative sample of 36 workers suffering from asbestosis (group A), 35 workers who are exposed to asbestos but not having evidence of asbestosis (group B) and 28 control workers (group C). Mean IgG and IgA levels were found to be significantly higher in the two exposed groups than in the controls. Circulating immune complexes of IgG, IgA and IgM class were detected in a significant percentage of cases in exposed groups than in controls. In groups A and B, the percentage of positive ANF cases was much higher than in the controls. The results suggest that immunological changes are associated with exposure to asbestos and these may play an important role in the pathogenesis of the disease process.

Humoral immunologic dysfunction in silicosis.

Immunoglobulins may play an important role in the evolution of silicosis, and their determination may serve as a helpful criterion in the diagnosis of silicosis. Serum immunoglobulin levels were studied in slate pencil workers (130) exposed to high concentrations of silica dusts and non-exposed controls (50). Significantly higher levels of immunoglobulins were observed in the silica exposed individuals. A rising trend in the serum IgG from a mean of 1373 mg/dl in control group to 2193.68 mg/dl in exposed group (conglomerate) and IgM from 140.51 mg/dl in control to 201.19 mg/dl in exposed group (conglomerate silicosis) was observed with increase in the duration of dust exposure. Highest mean levels of IgG (2193.60 mg/dl) and IgM (201.19 mg/dl) were observed in the workers having conglomerate silicosis. The results indicate that though, the levels of immunoglobulins were raised in subjects exposed to silica, this parameter may be of limited value for determining progressive of silicosis.