Post-tubercular Lumbosacral Kyphotic Deformity in a 11-Year-Old Child: A Case Report.

CASE: An 11-year-old girl with intact neurology presented with a lumbosacral kyphotic deformity due to healed tuberculosis. Radiological imaging showed sagittal balanced spine with compensatory thoracic lordosis and cervical kyphosis. She underwent L4 and L5 posterior vertebral column resection (PVCR) with posterior instrumentation from L2 to pelvis. The patient demonstrated immediate correction of compensatory curves postoperatively. At 3-year follow-up, she returned to her activities of daily living with Oswestry Disability Index and Scoliosis Research Society scores of 12 and 4.8% respectively. CONCLUSION: Pediatric post-tubercular deformities in the lumbosacral region are rare. They can cause secondary changes in other regions, such as the loss of thoracic kyphosis or cervical lordosis. These deformities should be addressed at an early age to prevent structural changes in compensatory curves.

Usage of Plastic Bags and Health Hazards: A Study to Assess Awareness Level and Perception about Legislation Among a Small Population of Mangalore City.

INTRODUCTION: Plastic bag users are at risk of number of health hazards. There is paucity of data with regard to awareness of health hazards among general population in India. AIM: This study was done to find out the status of awareness of the health hazards associated with the usage of plastic bags among people and their perception towards the legislation prohibiting the usage of plastic bags. MATERIALS AND METHODS: This cross-sectional study conducted in Mangalore city in August 2013. Data was collected by interviewing any adult member (aged above 18 years) in each of the selected households using an interview schedule. RESULTS: Mean age of the 250 participants was 32.8±10.8 years. Majority 160(64%) were females educated up to undergraduate level or above 187(74.8%). Among the participants 216(86.4%) were aware of the health hazards associated with the use of plastic bags. Awareness was significantly more amongst females (p=0.027), well-educated participants (p=0.004) and among professionals and semi-professionals (p<0.001). There were 50(20%) participants reusing plastic bags for shopping after initial usage. The cloth bags were used for shopping in place of plastic bags by 13(5.2%) participants. Among the participants 213(85.2%) were aware of the legislation banning the use of plastic bags and out of which 166(77.9%) were in its favour. Semi-professionals and students favoured the ban on plastic bags whereas unskilled and semiskilled workers were against the ban (p=0.01). CONCLUSION: Most of the participants in the settings had the awareness of hazards of plastic bag usage. However, there is a need for spreading the awareness of using alternative strategies and effective implementation of legislation in order to minimize the usage of plastics in the community.

Skin diseases and conditions among students of a medical college in southern India.

INTRODUCTION: Skin diseases are a common problem among young adults. There is paucity of data about it among medical students. This study aimed to find out the pattern of skin disorders and to describe their association with various socio-demographic factors among medical students. MATERIALS AND METHODS: This cross-sectional study was conducted in June 2011 in a medical college in Mangalore, Karnataka. Two-hundred and seventy eight medical students were chosen from the 4(th), 6(th) and 8(th) semester through convenient sampling method. Data on hair and skin morbidities suffered over past 1 year and its associated factors were collected using a self-administered questionnaire. RESULTS: Most of the participants 171 (61.5%) were of the age group 20-21 years and majority were females 148 (53.2%). The most common hair/skin morbidities suffered in the past one year were acne 185 (66.6%), hair loss 165 (59.3%), and sun tan 147 (52.9%). Fungal infection (P = 0.051) and severe type of acne (P = 0.041) were seen significantly more among males while hair morbidities like hair loss (P = 0.003), split ends of hairs (P < 0.0001) and dandruff (P =0.006) were seen significantly more among female students. Patterned baldness (P = 0.018) and sun tan (P < 0.0001) were significantly more among non-Mangalorean students than native Mangaloreans. Presence of dandruff was significantly associated with hair loss (P = 0.039) and usage of sunscreen was found to protect from developing sun tans (P = 0.049). CONCLUSION: Skin disorders, particularly the cosmetic problems are very common among medical students. Gender and place of origin were found to significantly influence the development of certain morbidities.

Prevalence of bronchial asthma and its associated factors among school children in urban Puducherry, India.

BACKGROUND: Bronchial asthma is an important public health problem at the global level. There is paucity of studies on bronchial asthma among school children in Urban India. OBJECTIVE: To assess the prevalence and associated factors of bronchial asthma among school children. MATERIALS AND METHODS: A cross-sectional study was conducted among 263 children studying in the 8(th), 9(th), and 10(th) standard using the modified International Study on Allergy and Asthma in Childhood questionnaire in Urban Puducherry. Data on associated factors that include family history of asthma, type of fuel used for cooking, placement of kitchen in the house, number of windows in sleeping room, pet animals, smoking among family members, birth order, and smoke outlet were collected. Data were analyzed by univariate analysis and expressed in proportion or percentages. RESULTS: Prevalence of ever bronchial asthma was found to be 5.3%, of which 4.2% had current episode of asthma during the last 1-year period. About 72.7% of the current asthmatics had cold or rhinitis and 54.5% each had itching or rashes and nocturnal dry cough. Prevalence is more among the 12-13 years age group (6.5%) compared to the 14-16 years age group (3.6%). Boys (5.4%) and girls (5.2%) had comparable prevalence rates. The prevalence was significantly more among those with a family history of asthma, having smoking habits in any of the family members, and the absence of smoke outlet in the house (P < 0.05). CONCLUSION: Bronchial asthma is an important health problem among children in urban Puducherry. Intervention on exposure to passive smoking and provision of smoke outlets may help to reduce the burden of disease at the community level.

Pattern of seizure cases in tertiary care hospitals in Karnataka state of India.

BACKGROUND: The prevalence and incidence of epilepsy is higher in developing countries than in developed countries. Understanding pattern and risk factors of seizure cases will help in suggesting appropriate preventive measures. OBJECTIVES: This study was carried out to assess the pattern of seizure, its management and compliance with treatment. MATERIALS AND METHODS: Data from medical records of seizure cases in three tertiary care hospitals of Mangalore city in south India admitted from January 2006 to December 2011 were collected and analyzed. RESULTS: Nearly half (44.4%) of the 196 cases belonged to productive age group (15-45 years) and 2/3(rd) (60.7%) were males. Majority (>80% cases) were unskilled workers and of low socio-economic status groups. Family history of seizures was present in 8.4% cases. Mean age of onset of seizure was found to be 19.9 years. Proportion of generalized tonic clonic seizure cases was 78.1%. Secondary seizures were seen in 66 (33.7%) cases with the most common cause being trauma to the head (24.2%). Refractory seizures were present in 2.7% cases. Monotherapy was the most commonly followed treatment regimen and phenytoin was the most popular anti-epileptic drug (AED) used. Non-compliance with AEDs was seen in 18.1% cases and was more among patients on polytherapy (P = 0.032). CONCLUSION: Seizure manifestations and treatment compliance vary widely in the studied population. In depth analysis of each seizure type will give more information about the factors associated with it.

Clinical spectrum of rheumatic Fever and rheumatic heart disease: a 10 year experience in an urban area of South India.

BACKGROUND: Rheumatic fever (RF) is an important problem concerning developing countries like India. Rheumatic heart disease (RHD) is one of the most readily preventable chronic diseases. AIM: This study was done to find out the clinical profile, risk factors, compliance with treatment and outcome among RF/RHD cases so as to suggest better case management strategies. MATERIALS AND METHODS: Clinical records of 51 RF and 71 RHD cases admitted in tertiary care hospitals in Mangalore between 2001 and 2010 were reviewed retrospectively. RESULTS: Mean age of RF cases were 17.4 ± 12.1 years and RHD cases were 33.2 ± 18.6 years. More than half of RF and RHD cases were males. Commonest risk factors among RF cases were poor socioeconomic status (60.4%), history of upper respiratory tract infection before disease onset (58.8%) and undernutrition (35.3%). Commonest clinical manifestation among RF cases was fever 39 (76.5%) followed by polyarthritis 34 (66.7%). Commonest valvular lesions among RHD cases was mitral stenosis with mitral regurgitation found in 42.9% cases. Compliance of patients with prophylactic antibiotics was found to be 37 (30.3%). Mortality rate was significantly more among RHD cases (P = 0.0399). CONCLUSIONS: Improvement of socioeconomic and nutritional factors is an important task required for primary prophylaxis and of compliance for secondary prophylaxis of RF.

Prevalence of depression and its associated factors using Beck Depression Inventory among students of a medical college in Karnataka.

BACKGROUND AND OBJECTIVE: Depression among medical students is an area of increasing concern worldwide. This study aimed to assess the prevalence of depression and its associated factors among medical students. MATERIALS AND METHODS: A stratified random sample of 400 students was assessed using Beck Depression Inventory by investigators. Associations between depression and class of studying, social factors like alcohol use, drug addiction, family problems, family history of depression, and staying away from home were analyzed by univariate analysis. RESULTS: The overall prevalence of depression was found to be 71.25%. Among those with depression, a majority (80%) had mild and moderate degree of depression. The study showed that 46.3% (132) of the depressed were females and 53.7% (153) were males. According to cut-off scores, 115 students (29.8%) scored as normal (0-9), 111 (27.8%) as mild (10-18), 117 (29.3%) as moderate (19-29), 30 (7.5%) as severe (30-40), and 27 (6.7%) as very severe (>40) depression. The prevalence of depression was comparatively less among 1(st) and 2(nd) year medical students (57% and 50%, respectively) and the difference between the grade of depression and year of studying was found to be significant (χ(2)=122, P<0.001). The prevalence was significantly more among those with family problems and family history of depression. CONCLUSION: Depression is highly prevalent among medical students in this area. Our findings point to the importance of broad screening and psychiatric counseling of this vulnerable population.

Health and environmental sanitation in India: Issues for prioritizing control strategies.

Environmental sanitation is a major public health issue in India. Recent interventional studies on environmental sanitation in India highlighted the importance of prioritizing control strategies. Research related to the appropriate cost-effective intervention strategies and their implementation in Indian context is a big challenge. This paper discusses various intervention strategies related to environmental sanitation in India and emphasizes to prioritize it according to the need of country.

Pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka, India.

BACKGROUND AND OBJECTIVE: Acute poisoning is a medical emergency. It is important to know the nature, severity and outcome of acute poisoning cases in order to take up appropriate planning, prevention and management techniques. This study aimed to assess the pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka. MATERIALS AND METHODS: This is a retrospective hospital record-based study conducted in a tertiary care hospital attached to a medical institution in Karnataka. The study included 136 cases and data regarding age, sex, time elapsed after intake; circumstances of poisoning, name of the poisonous substance, chemical type, duration of hospitalization, severity and outcome were collected in the prestructured proforma. RESULTS: Incidence was more common among males (75.4%) compared to females (24.3). Most cases of acute poisoning presented among 20- to 29-year age group (31.2%) followed by 12- to 19-year age group (30.2%). A majority of poisoning cases (36.0%) were due to organophosphorus compound (OPC). Total mortality was found to be 15.4%. Mortality rate due to corrosives was significantly high compared with OPC poisoning (chi(2) = 4.12, P = 0.04). Of the 56 patients of OPC and carbamate poisoning, 13 patients (23.2%) had respiratory arrest and required respiratory support. Time lapse had a significant role on the mortality in cases of acute poisoning (chi(2) = 10.9, P = 0.01). CONCLUSION: Poisoning is more common in young males. The overall mortality is substantially high, mainly contributed by self-poisoning with insecticides and corrosives. Early care in a tertiary care center may help to reduce mortality in India.

Perception, Practices Towards Research and Predictors of Research Career Among UG Medical Students from Coastal South India: A Cross-Sectional Study.

BACKGROUND: The number of physician scientists worldwide is decreasing. A review of literature suggests paucity of information examining perceptions and practices towards research among medical undergraduate students in India. Hence, this study was undertaken. OBJECTIVES: To understand (a) the awareness, skills, perceptions and practices among undergraduate (UG) medical students towards research, (b) the factors responsible for willingness to take up research as a career among the undergraduates. MATERIAL AND METHODS: This is a questionnaire-based qualitative study. This study was conducted in Kasturba Medical College, Mangalore. A pre-tested questionnaire examining their awareness, perceptions and practices towards research in medical field was used. Consent was obtained from the Dean of the College and student participation was voluntary. ANALYSIS: The information was analyzed using SPSS version 11. Univariate and Multivariate analyses were done to know the willingness to consider research as a career. RESULTS: A total of 471 students responded giving a response rate of 55.41%. Nearly 70% were aware about research though their level of awareness varied. Various skills of conducting research were known to 47% of the students. Most (76%) were part of a research team mainly as a part of the medical curriculum, a few (8.3%) were confident of research as a career option. The multivariate reveals that those with good skill and students who involved in research in addition to curriculum were more likely to take up research as career option/would continue to do research in future. CONCLUSIONS: Good training and student support programs exclusively for research would motivate students to opt for research careers.