Mz Idris

Study on patient satisfaction in the government allopathic health facilities of Lucknow district, India.

Background: The outcome of any disease is influenced by the decisions to seek care, timely arrival at appropriate diagnostic and treatment services and the receipt of adequate care from service providers. Satisfaction in service provision is increasingly being used as a measure of health system performance. Satisfaction manifests itself in the distribution, access and utilization of health services. Objectives: To determine the areas and causes of low satisfaction among the patients and suggest methods for improvement. Materials and Methods: Multistage stratified random sampling was used to select the government allopathic health facilities of Lucknow district and systematic random sampling for the selection of the patients for the interview. Results: The accessibility was difficult in 42% patients and waiting time more than 30 min for 62.5% of those attending the tertiary level health facility. The satisfaction with the duration of the outpatient department (OPD) (64.6%) and the presence of signboards (46.6%) was also found to be low. The overall satisfaction regarding the doctor-patient communication was more than 60% at all the levels of health care facilities but that with the examination and consultation was less than 60% at the primary level as compared to more than 80% elsewhere. The most important motivating factor for the visit to the tertiary (48.2%) and secondary level (71.9%, 67.1%) of health facilities was the faith on doctors or health facility. Conclusions: The level of patient satisfaction is severely deficient in several areas and needs improvement for the achievement of optimal health of the people.

Assessment of prescription pattern at the public health facilities of Lucknow district

Objectives: To study the prescription pattern at the different levels of public health facilities of Lucknow district and to assess the average cost of drugs prescribed. Methods: Multi-stage stratified random sampling was done to select 1625 prescriptions of the patients attending the different level of public health facilities in Lucknow district, from August 2005 to September 2006, which was used for the development of study tools, collection of data and analysis. Results: The important components of prescription viz. examination findings, weight of the child, follow up visit and the signatures of the prescribers were absent in the prescriptions at the primary level. Polypharmacy was common (3.1 ± 1.6 drugs per prescription). The prescription of drugs by generic name was low (27.1%). The prescriptions at the secondary level health facilities were incomplete with respect to mentioning the suffix/prefix of the drug, full name, dose, frequency and strength of the drugs, and directions specifying the route and duration of the treatment. The average cost of drugs/prescription/day in US

Lipoprotein (a) levels in relation to severity of coronary artery disease in north Indian patients

(Mean, SD) was found to be the highest at the tertiary level (0.34, 0.43), which decreased significantly at the primary level health facilities. Conclusion: The pattern of prescription in terms of completeness and rationality was poor. There is an urgent need to improve the standards of drug prescription.

Isolated systolic hypertension and its determinants - A cross-sectional study in the adult population of Lucknow district in North India

Background: Lipoprotein (a) [Lp (a)] is an established risk marker of coronary artery disease which is independent from other risk factors. Objective: The aim was to address the association between Lp (a) and CAD risk in North Indians. To evaluate whether high levels of lipoprotein (a) [Lp (a)] is a predictor of risk and is related to the severity of CAD. Materials and Methods: This was a cross-sectional study done on 360 patients presenting with chest pain. Coronary angiography revealed CAD in 270 patients and 90 patients without CAD. Lipoprotein (a) level, lipid profile, fasting blood glucose, anthropometric and clinical parameters were analyzed. Results: Lipoprotein (a) 21.0 mg/dL is associated with the presence of coronary lesions (P = 0.0001). A highly significant difference in Lp (a) levels was observed between normal coronaries vs. single-vessel disease, double-and triple-vessel disease ( P < 0.0001). Body mass index (BMI) was significantly raised in CAD group compared to normal coronary. Conclusion: Multivariate analysis found that Lp (a) was considered an independent predictor for severity of CAD and Lp (a) levels 21.0 mg/dL are associated with severe patterns of coronary atherosclerosis.

UMBILICAL CORD BLOOD NUTRIENTS AMONG LOW BIRTH WEIGHT AND NORMAL BIRTH WEIGHT BABIES IN PRIMARY HEALTH CARE SETUP IN LUCKNOW , INDIA

Objectives: 1) To determine the prevalence of isolated systolic hypertension (ISH) in the adult population of Lucknow district. 2) To study the determinants of ISH especially the relationship with age. Materials and Methods: A community-based cross-sectional study was conducted in four randomly selected areas of Lucknow district. A total of 800 subjects, aged 20 years and above, 400 from urban and 400 from rural area of Lucknow district were included in the study. The statistical tools used for analysis were Pearsons Chi-square test and multiple logistic regression. Results: The prevalence of ISH according to JNC-7 criteria was 4.3%, which was 5.1% in men and 3.6% in women. A significant increase in the prevalence of ISH was seen with an increase in age. Multivariate logistic regression analysis of the determinants showed that age, BMI and smoking were significant independent risk factors of ISH. Conclusions: Given the risk of cardiovascular disease associated with ISH, the findings of this study emphasize the need for further research to document the impact of modifiable risk factors of ISH and the effect of hypertension screening and specific health promotion in bringing down the burden of ISH and related cardiovascular morbidity.

Utilization of public health care facilities in Lucknow district

Materna l factors have an effect on the birth weight. As a result of which, there is a high prevalence of low birth weight (LBW) babies. LBW babies have less nutrient reserve. Protein and iron are the key elements for neonatal growth and development. Deficiency of trace elements during intrauterine period is closely related to morbidity and mortality of the newborn. To assess the umbilical cord blood nutrients in low birth weight and normal birth weight babies. The present cross section study was conducted from 201 1 to 2012 at Sarojni Nagar PHC, Lucknow, Uttar Pradesh, India. Study subjects included pregnant women who were registered in the third trimester of pregnancy at PHC Sarojni Nagar and followed up till delivery. Maternal biosocial characteristics like age, p arity, height, weight and haemoglobin were recorded. Cord blood was collected from 42 LBW and 67 NBW babies delivered at the PHC Sarojni Nagar. In cord blood, serum iron, TIBC, serum protein and serum albumin were investigated. As evident from results s. p rotein, s. albumin and s. iron were significantly low in LBW babies than normal birth weight babies. In low birth weight group, serum protein, albumin and iron were insignificantly low in preterm than term LBW. TIBC showed inverse relationship, level of TI BC was high in LBW than NBW. In low birth weight group TIBC was also significantly high in preterm. LBW babies are born with significant lower nutrition reserve at birth. Finally this study can be integrated with existing health programme for better develo pment of low birth weight babies and accordingly to provide supplementary nutrition to the pregnant women and low birth weight babies.

PREVALENCE OF NOSOCOMIAL INFECTIONS IN SURGICAL WARDS OF TERTIARY CARE HOSPITAL AT LUCKNOW

Health has been declared a fundamental human right. This implies that the state has a responsibility towards the health of its people. Governments all over the world are striving to expand and improve their health care services. Health is on one hand a highly personal responsibility and on the other hand a major public concern. It thus involves the joint effort of the whole social community and the state to protect and promote health. Health is no longer accepted as charity or privilege of the few but demanded as a right for all.