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.

Occupational and social hazards among domestic solid waste collectors: a cross sectional study

Background: Domestic solid waste collectors play important role in maintain hygiene of a community, especially in developing countries. Yet not many efforts are done to identify their health needs. The main objective of this study is to identify the morbidity pattern and social problems of solid waste collectors in urban Maharashtra.Methods: It was a cross sectional study. Study population consisted of domestic solid waste collectors who are registered under municipal corporation. Sampling was purposive. All the domestic solid waste collectors who came for specially arranged health check-up were included in the sample. Social and demographic information along with clinical history was collected using a structured questionnaire. General physical exam, eye checkup, skin examination and lab investigations were done in a specially organized camp, after obtaining prior consent of the participants. Data was analyzed using SPSS 19 software.Results: More than 90% of 98 solid waste collectors, who participated in the study had frequent cough, fever and diarrhea. Over 85% had back or/and leg pain. More than half of the study population had dryness of skin and 47% of them complained of itching. 15 solid waste collectors were discriminated in marriages.Conclusions: High prevalence of common frequent symptoms such as fever, cough and diarrhea can be controlled by conducting regular health checkups for this community. The need is to reach them rather than waiting for them to come to health facility. Sensitization of community towards importance of work done by the solid waste collectors is also required.

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.