Role of information sources in carrying government reproductive health scheme to tribal women in India: A case study among women belonging to Koraga community.

Context: To improve the health status of its people irrespective of their socio and economic status, the government will design various schemes. In taking the government schemes effectively to the target group, the role of information sources is crucial. For the study purpose, Koraga community residing in and around Udupi-a district of Karnataka State, which has earned a name not only for its mythological significance but also for its culture of having their women empowered is considered. In the present study, role of information sources in taking the Janani Shishu Kalyan Yojana planned towards improving the pre- and post-natal health of women to reduce maternal death is considered. The results of the study enable us to understand the preference and dependency of the target group on various sources regarding the information received. Since the government-proposed health schemes should reach the target group to bring in a better health index which is one of the SDGs set for 2030, this study gains importance. Aims: The study intends to examine the role of information sources in educating the women, particularly those belonging to Koraga community, who fall under the particularly vulnerable tribal groups (PVTG) category among the tribals of India about the government schemes earmarked for safe motherhood. Settings and Design: It was conducted in the colonies designated for Koraga community near Udupi of Karnataka using a questionnaire. Materials and Methods: Based on the results obtained from the pilot study, a final questionnaire was prepared and was personally demonstrated among Koraga women during the month of January 2020. Data were collected from 117 women belonging to Koraga community. SPSS version 17.0 software, Microsoft Word and Excel were used in data handling and analysis. Results: The results obtained out of the study reveal that among the sources, the respondents consider doctors as dependable sources followed by ASHA/Anganwadi workers. The target group is not aware of the nomenclature of the scheme nor the benefits to expect, but they are receiving medical support during their pre- and post-natal period. Conclusion: The governments may initiate schemes for the benefit of the public, but the schemes will become successful only when the desired information reaches the target group. The study intended to examine the role of information sources in educating the women particularly those belonging to Koraga community and found that the dependency of the target group on various sources of information regarding government projects is evident and should be further strengthened.

Correlation of serum HDL level with HRV indices using multiple linear regression analysis in patients with type 2 diabetes mellitus.

AIMS/OBJECTIVES: To determine the correlation between serum HDL levels with HRV indices in patients with T2DM. MATERIALS AND METHODS: The study included 120 type 2 DM patients aged 35-65 years of either sex by simple random sampling. One-minute HRV was analyzed during deep breathing and fasting serum HDL levels was estimated in all patients. Data were analyzed using SPSS 20.0. Karl Pearson's correlation coefficient for relationship and Multiple linear regression analysis was applied for assessment of the influence of independent variables (HRV Indices) on a dependent variable (serum HDL levels). P < 0.05 was considered statistically significant. RESULTS: Significant negative correlation was observed between serum HDL levels with Mean HR (r = 0.7422, p < 0.001)), LFnu (r = -0.6172, p < 0.001) and ratio of LF/HF (r = 0.5333, p < 0.001). But significant positive correlation was observed between serum HDL levels with HFnu (r = 0.6438, p < 0.001), SDNN, (r = 0.7495, p < 0.001)), RMSSD (r = 0.6348, p < 0.001) and pNN50 % (r = 0.8187, p < 0.001). CONCLUSIONS: Our findings suggest that HDL-C level and all other HRV indices are dependent on each other in patients with T2DM. Most of these patients with low HDL-C level might be associated with autonomic imbalance; this in turn is detected by a simple bedside test of 1-minute HRV during deep breathing.

Effectiveness of the game-based learning over traditional teaching-learning strategy to instruct pharmacology for Phase II medical students.

BACKGROUND: Game-based education is fast becoming an innovative teaching approach in the field of medical education. Traditional review sessions (tutorials) are mainly focused on instructor-based learning and they help to review concepts previously taught in the lecture class. The primary objective was to evaluate the cognitive learning of students in game based learning (GBL) as compared to the conventional review sessions. The secondary objectives were to assess the perception and feedback of students regarding GBL and conventional review sessions. MATERIALS AND METHODS: An interventional GBL study was designed for 2nd year MBBS students. The enrolled students were randomly assigned to either tutorial (Group A) or GBL (Group B), and informed consent was obtained. Group B students were further divided into smaller groups, and for Group A, the traditional tutorial method was followed. For both the groups, a multiple choice question (MCQ) pre-test and post-test was conducted on the selected topics. A total of 15 MCQs with gradually increasing difficulty were used in the GBL. For each group of students, one student would be on hot seat by answering the questions and then continued the game. Lifelines were provided. RESULTS: From the pretest and posttest scores, students performed better in Group B (39.53%) than Group A (18.43%) with respect to the knowledge score, and the difference was statistically significant. Students' perception and feedback regarding GBL were very enthusiastic and promising than the tutorial group. Largely, students commented that GBL was unique, active participation, fun, and novel learning style. CONCLUSIONS: GBL is a student-centered learning and showed more effective than the traditional tutorials in understanding the topic and was more enjoyable by students.

Sensitivity towards patient's presence to avoid violent situations in hospitals: An observatory study.

CONTEXT: The process of communication includes intense observation based on which opinions are formed or situations are created. A patient whose is in state of panic due to the health conditions feels neglected and becomes skeptical about the treatment hi/she is going to receive. AIMS: The aim of the study is to understand the need for being sensitive towards patient's presence while communicating. SETTINGS AND DESIGN: It was conducted in the outpatient wing of clinics at three different cities of Karnataka using a Sequential Observatory Study design. MATERIALS AND METHODS: Based on the results obtained from the pilot study a final schedule was prepared and sent to people using google drive during the month of Dec 2019. Out of 200 filled forms only 55 patients/relatives were qualified for analysis. SPSS version 17.0 software, Microsoft word and Excel were used in data handling and analysis. Textual analysis was used for presenting interview data. RESULTS: The qualitative analysis of the questionnaires found four emerging themes that disturbed the patients psychologically and such situations could lead to violence. The results prove that patients/relatives observe both verbal and nonverbal communication in the hospital from the time of their entry to exit. CONCLUSION: The communication intended or unintended made some impact on the perceptions of the patients about the way they are going to be treated. This indicates that the workforce should be conscious of their behaviour.

Inferior Turbinate Reduction: Diode LASER or Conventional Partial Turbinectomy?

Hypertrophy of inferior nasal turbinate is one of the most common causes for nasal obstruction (NO). As diode laser has proven to be as effective as any other lasers, our objective was to study various primary outcomes of its use of diode laser like improvement in NO, intraoperative bleeding, postoperative pain, and rapidity of healing. The study was undertaken to compare the various outcomes by diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT). A nonrandomized controlled trial was conducted on 2 groups: One group (30 cases) underwent LTR and PIT was performed in the other group (30 cases). The improvement in NO was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to fifth postoperative day. Lastly, rapidity of healing was evaluated until 6 months. Subjective relief of NO was 90.8% in LTR group, whereas it was 65% in PIT group at 6-month follow-up, which was statistically significant (P < .05). Pain scores were higher until 5 days in PIT group compared to LTR group (P = .0001). Intraoperative bleeding mean scores (milliliters) were 8.03 in LTR group compared to 23.29 in PIT group (P = .00001). Rapidity of healing was faster in LTR group with mean scores of 3.03 weeks in comparison to PIT group where it was 6.33 weeks (P = .00001). Compared to the conventional technique, the outcomes were better with diode laser and caused less morbidity.

Inferior turbinate reduction: Diode laser or conventional partial turbinectomy?

Hypertrophy of the inferior nasal turbinate is one of the most common causes of nasal obstruction. The diode laser has proven to be as effective as other lasers for this indication. Our objective was to study various outcomes associated with the use of the diode laser, such as improvements in nasal obstruction and postoperative pain, reduction in intraoperative bleeding, and rapidity of healing. A nonrandomized, controlled trial was conducted in which outcomes were compared between diode laser turbinate reduction (LTR) and conventional partial inferior turbinectomy (PIT) in 60 patients, 30 who underwent LTR and 30 who underwent PIT. The improvement in nasal obstruction was measured postoperatively up to 6 months. Intraoperative bleeding was measured and postoperative pain scores were assessed each day up to the fifth postoperative day. Rapidity of healing was evaluated until 6 months postoperatively. Subjective relief of nasal obstruction occurred in 90.8% of the LTR group and 65% of the PIT group at 6 months (p < 0.05). Pain scores were significantly higher until 5 days postoperatively in the PIT group compared with the LTR group (p = 0.0001). Intraoperative bleeding mean scores (ml) were 8.03 in the LTR group and 23.29 in the PIT group (p = 0.00001). Healing was faster in the LTR group at a mean of 3.03 weeks compared with 6.33 weeks in the PIT group (p = 0.00001). Outcomes with the diode laser were better and diode LTR caused less morbidity compared with the conventional technique.

School teachers' knowledge of oral disease prevention: a survey from Dharwad, India.

AIM: To assess knowledge and the associated factors among Indian school teachers towards oral disease. METHODS: A cross-sectional design was employed using a self-administered questionnaire. A total of 215 school teachers were selected, with a response rate of 95.3% (n = 205). RESULTS: A total of 35.6% of school teachers had "good" knowledge, while 42.4% had "medium" knowledge of the prevention of oral disease. Knowledge of dental caries was highest, as opposed to oral cancer, which was lowest. School teachers aged >50 years and those with postgraduate degrees had greater knowledge. A significant association was observed between teachers' levels of knowledge and their age groups (χ(2) = 20.9950, P < 0.05) and education level (χ(2) = 13.9740, P < 0.05). However, the multivariate stepwise regression analysis showed that education, age group, sex, and type of institutional funding (public/private) was significantly correlated to knowledge (R(2) = 0.1250, P < 0.05). CONCLUSIONS: The study revealed that school teachers, in particular younger teachers and those with only basic educational qualifications, need to be further motivated to improve their awareness and knowledge about oral diseases. Therefore, the establishment of school-based oral health promotion programs in India with immediate effects is essential.

Removal of dental plaque from different regions of the mouth after a 1-minute episode of mechanical oral hygiene.

PURPOSE: To assess dental plaque on different regions of the dentition prior to and immediately after toothbrushing. METHODS: Subjects refrained from oral hygiene for 22-26 hours prior to baseline whole mouth plaque assessments by the Turesky modification of the Quigley-Hein Index (TMQH). All subjects brushed with a marketed soft-bristled toothbrush and a fluoride dentifrice for 1 minute prior to post-brushing plaque assessments similar to baseline. One calibrated clinical examiner conducted all measurements. RESULTS: 30 subjects (mean age 23 years) completed the study. Irrespective of arch, posterior teeth harbored higher frequencies for scores of 3-5 than corresponding anterior teeth prior to brushing. In comparison to the pre-brushing examination, scores of 0-1 were more common in the post-brushing evaluation, however, greater frequencies of higher plaque were observed on posterior than on anterior regions. Irrespective of gender, subject or arch, anterior teeth harbored lower mean amounts of plaque than posterior teeth by ANOVA at both clinical examinations (P < 0.0001). Additionally, irrespective of arch, lower mean scores for plaque were observed on anterior teeth than from posterior teeth or the whole mouth at both examinations (P < 0.001). Lingual and molar surfaces consistently harbored large densities of plaque and represented areas with the least plaque removal after toothbrushing. Mid-vestibular sites represented the areas with the highest percent removal of plaque at 65% and harbored significantly lower levels of plaque than proximal sites during all phases of the study (P < 0.0059).

Using zero inflated models to analyze dental caries with many zeroes.

AIM: The study aimed to analyze and determine the factors associated with dental caries experience contains many zeros by zero inflated models. DESIGN: A cross sectional design was employed using clinical examination and questionnaire with interview method. MATERIALS AND METHODS: A study was conducted during March-August 2007 in Dharwad, Karnataka, India, involved a systematic random samples of 1760 individuals aged 18-40 years. The dental caries examination was carried out by using DMFT index (i.e. Decayed (D), Missing (M), Filled (F)). The DMFT index data contains many zeros were analyzed with Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. RESULTS: The study findings indicated, the variables such as family size, frequency of brushing and duration of change of toothbrush were positively associated with dental caries. But the variable the frequency of sweet consumption is negatively associated with dental caries experience in Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. CONCLUSIONS: The ZIP model is a very good fit over the standard Poisson model and the ZINB is the better statistical fit compared to the Negative Binomial model. The Zero Inflated Negative Binomial model is better fit over the Zero Inflated Poisson model for modeling the DMF count data.

A comparison of ordinal regression models in an analysis of factors associated with periodontal disease.

AIM: The study aimed to determine the factors associated with periodontal disease (different levels of severity) by using different regression models for ordinal data. DESIGN: A cross-sectional design was employed using clinical examination and 'questionnaire with interview' method. MATERIALS AND METHODS: The study was conducted during June 2008 to October 2008 in Dharwad, Karnataka, India. It involved a systematic random sample of 1760 individuals aged 18-40 years. The periodontal disease examination was conducted by using Community Periodontal Index for Treatment Needs (CPITN). STATISTICAL ANALYSIS USED: Regression models for ordinal data with different built-in link functions were used in determination of factors associated with periodontal disease. RESULTS: The study findings indicated that, the ordinal regression models with four built-in link functions (logit, probit, Clog-log and nlog-log) displayed similar results with negligible differences in significant factors associated with periodontal disease. The factors such as religion, caste, sources of drinking water, Timings for sweet consumption, Timings for cleaning or brushing the teeth and materials used for brushing teeth were significantly associated with periodontal disease in all ordinal models. CONCLUSIONS: The ordinal regression model with Clog-log is a better fit in determination of significant factors associated with periodontal disease as compared to models with logit, probit and nlog-log built-in link functions. The factors such as caste and time for sweet consumption are negatively associated with periodontal disease. But religion, sources of drinking water, Timings for cleaning or brushing the teeth and materials used for brushing teeth are significantly and positively associated with periodontal disease.