Health insurance coverage and out-of pocket expenditure: A study among rural and urban households of Faridabad, Haryana

Introduction: Catastrophic health spending is one of the major factors pushing people into poverty. Reducing “out-of-pocket expenditure (OOPE)” on health through health insurance coverage is an effective approach. The objectives of this study are (1) to estimate health insurance coverage among rural and urban households (HHs) and (2) to determine the proportion of income spent on health as OOPE among the selected HHs. Material and Methods: A cross-sectional study was conducted in rural and urban parts of district Faridabad, Haryana. A sample of 374 were taken from rural and urban areas. The unit of the study was HHs in both the areas. The proportion of income spent on health care (both direct and indirect expenses included) as OOPE was taken as outcome variable. Results: Health insurance coverage was higher among urban HHs (58.0%) as compared to the rural (38.5%). The rural population was availing of private consultation, laboratory, and pharmacy services to a greater extent than the urban; hence, they were spending a substantial proportion of their income on health-care services. The majority of the HHs in the rural and urban areas spent up to 20% of their income on health care. Conclusion: Universal health coverage without health insurance is unlikely.

Prevalence of hypertension amongst employee’s state insurance beneficiaries of four districts in Haryana

Background: Raised blood pressure (hypertension) caused an estimated 9.4 million deaths in 2010. 22% of adults aged 18 years and over around the world had raised blood pressure in 2014 In India prevalence of Hypertension is 22.4% (13.5% in Haryana, district Faridabad) according to National Family Health Survey 2015-2016. A number of studies have estimated the prevalence of hypertension in general population in our country but data regarding the prevalence of hypertension in industrial workers has not been documented in the recent past. The objectives of the study were to calculate the prevalence of hypertension and its associated risk factors in employee’s state insurance (ESI) beneficiaries in four districts in Haryana.Methods: Cross-sectional study was done on 365 ESI beneficiaries working in industries in four districts of Haryana. Predesigned structured self-administered questionnaire was used for interview. Blood pressure measurement and all the anthropometric measurements were done by the following standardized technique.Results: The overall prevalence of hypertension was found to be 17.26%. The severity of hypertension increased significantly with age (p=0.006). Overweight and obese participants had higher proportion of hypertensive, however, history of shift duty, drug abuse, tobacco and alcohol intake did not show a significant trend of severity of HTN.Conclusions: From the results of the present study, it can be concluded that there are a large number of undiagnosed cases of hypertension amongst employee’s state insurance corporation (ESIC) beneficiaries. It is, therefore recommended that health check-up and awareness camps should be conducted on regular basis for early detection and timely treatment of hypertension.

Epidemiological study of obesity and overweight among adolescents in schools in district Ghaziabad

Background: Developing countries are experiencing an epidemic of obesity and overweight. Adolescence is the stage when the lifestyle behavior sets in and decides the future pattern of health. The objective was to study the prevalence and correlates of overweight and obesity among school going adolescents of district Ghaziabad.Methods: A school based cross sectional survey was conducted in district Ghaziabad. Adolescents (10-19 years) from both urban and rural government and private schools were included. Multistage sampling technique was used to study 1128 study population. Anthropometry and a structured questionnaire were used as study tool.Results: In urban area, the proportion of underweight students in government schools (20.9%) was significantly more than the private school (13.8%) whereas the number of overweight students in private school (18.2%) was significantly more than the government schools (10.3%). In rural area underweight students in government school (30.5%) was significantly more than the private school (21.3%) whereas the number of overweight students in private school (11.3%) was significantly more than the government school (3.2%). Obesity was significantly associated with the area of residence, type of school, consumption of carbonated drinks, fast foods and decreased physical activity.Conclusions: An overall higher prevalence of overweight and obesity among adolescents in urban areas and increasing trend in rural areas too alarm us to focus on the modifiable risk factors

A Prospective Randomised Study To Evaluate The Feasibility And Safety of Laparoscopic Cholecystectomy Under Spinal Anaesthesia

Background: Laparoscopic cholecystectomy is the gold standard for the surgical treatment of symptomatic gall-stones The aim of this prospective randomized study was to compare the surgical outcome of LC performed with the patient under spinal anaesthesia with that of LC performed with the patient under general anaesthesia in the management of symptomatic uncomplicated gallstone disease. Methods: An Observational Descriptive Study was done on total 100 cases. Outcome Measures noted were a) Conversion rate of laparoscopic cholecystectomy under spinal anaesthesia to general anaesthesia, b) Hypotension and c) Bradycardia. Results: Spinal anaesthesia is a feasible, safe and effective alternative to general anaesthesia for laparoscopic cholecystectomy. Intraoperative hypotension, and bradycardia need to be addressed during laparoscopic cholecystectomy under spinal anaesthesia. Provided with good patient selection laparoscopic cholecystectomy under spinal anaesthesia can substitute that under general anaesthesia. Conclusion: Laparoscopic cholecystectomy under spinal anaesthesia is a better option for selected group of patients while anticipating fast track surgery or day care surgery

A Comparative Study of Efficacy of Local Corticosteroid Injection Versus Ultrasound Therapy in the Treatment of Planter Fasciitis

Background: Plantar Fasciitis is a frequent disorder involving the plantar fascia. Usually, syndromes that involvemanifestation of the typical heel pain are called plantar fasciitis. Common treatments can be divided into noninvasive and and invasive treatments, such as corticosteroid injection (CSI), botulinum toxin injection, platelet-rich plasma (PRP) injection and surgery. Methods: Total 80 patients were taken up for the study that completed the follow-up. Patients by random sampling were divided in two groups. Patients were divided in Conservative ultrasound therapy and Local Steroid Injections group of 40 patients each. Results: Treatment outcome was found almost similar in both treatment group, the betterment was found better with ultrasound with more duration of treatment but this is not statistically significant. Conclusion: Findings of our study suggest that As both treatment modalities are at par on comparison of their treatment outcome it is better to go for conservative approach.

Use of social networking sites among medical undergraduates of a medical college in north-west India.

Introduction: Use of Internet for communication has become a very important part of young people's life. Social networking sites are virtual communities that allow users to create a profile and interact with friends. One area of interest in this field is regarding the activities of medical students on social networking sites and how these activities affect their academic performances. Objective: To assess the use of social networking sites and its impact on academic performance among medical undergraduates of a rural medical College. Methodology: It was a cross sectional study conducted over a period of three weeks in December 2013 among undergraduate students of Dr RPGMC Kangra at Tanda. A self-administered questionnaire was used to conduct the study. Data was entered in Microsoft excel sheet and analysed.Result: A total of 150 participants were enrolled of which only 141 agreed to participate. Among these 74 (52%) were males and 68 (48%) females. The mean age of the subjects was 20.2 ± 1.5 years. Majority 123 (87.2 %) used multiple networking sites, 45 % (60/123) had joined communities related to medicine. More than half 52.7 % (65/123) of subjects used these multiple sites to remain connected with their friends.81.7% (49/60) visited medical communities daily and 93.9% (46/49) among them said that these communities has helped increase their knowledge. Average time spent per session was 10-30 minutes among 26.8 % (33/ 123) participants.Conclusion: The results of the study showed that role of social networking sites among undergraduate students pursuing a professional course is important while communicating with friends and people of their own field. It helps them in broadening their knowledge and they feel it has helped them positively in their academic performance.