Pradeep Kumar Kasar

Prevalence of hypertension and associated cardiovascular risk factors in Central India

Objectives: To study the difference in the prevalence of hypertension and associated risk factors in urban and rural populations and the association of hypertension with various determinants. Materials and Methods: A community-based cross-sectional study was conducted in 48 villages and 15 urban wards of Jabalpur District of Central India. Nine hundred and thirty-nine individuals aged 20 years and above (624 from rural areas and 315 from urban areas) were included in the study. The prevalence of hypertension and associated cardiovascular risk factors was assessed in the urban and rural populations. A pretested questionnaire was used to collect data on socio-demographic, behavioral, and dietary factors. Anthropometric measurements of weight, height, waist and hip circumference, and blood pressure measurements were taken using the standard methodology. The glucose oxidase–peroxidase and cholesterol oxidase–cholesterol peroxidase methods were used to measure plasma glucose and serum cholesterol, respectively. Bivariate analysis was followed by multivariate analysis to detect the odds of getting hypertension with various risk factors for the urban and rural populations separately. Hypertension was defined as per Joint National Committee (JNC) - VII criteria. Results: The response rate was 97%. Overall prevalence of hypertension was 17%, with 21.4% in the urban population and 14.8% in the rural population. Significantly higher mean values of weight, height, body mass index (BMI), hip circumference (HC), waist circumference (WC), waist hip ratio (WHR), systolic blood pressure (SBP), fasting blood sugar (FBS), and serum cholesterol levels were mapped in the urban population in comparison with the rural population. Multivariate logistic regression analysis identified increasing age, parental history of hypertension, tobacco smoking, tobacco chewing, physical inactivity, high estimated per capita salt consumption, and BMI ≥27.5 kg/m2 as independent predictors for hypertension in the urban population, while in the rural population, increasing age, physical inactivity, central obesity, tobacco chewing and tobacco smoking were independent predictors for hypertension. Conclusion: The prevalence of hypertension and other cardiovascular risk factors was high in both urban and rural communities. Therefore, there is a need for comprehensive health promotion programs to encourage lifestyle modification.

Validation of Indian diabetic risk score in diagnosing type 2 diabetes mellitus against high fasting blood sugar levels among adult population of central India.

Globally the increasing prevalence of diabetes mellitus (DM) is major public health concern. The Indian Diabetes Risk Score (IDRS) was developed by Madras Diabetes Research Foundation (MDRF) as a simple tool to help detect undiagnosed type 2 DM (T2DM) in the community. We conducted a study among 911 adults of Jabalpur District to validate the IDRS score against increased fasting blood sugar levels in diagnosing T2DM. T2DM was confirmed either by history of previously known disease or fasting plasma glucose ≥126 mg/dl on two occasions. Sensitivity, specificity, positive predictive value, negative predictive value, Youden index (sensitivity + specificity −1), likelihood ratio for positive test, and likelihood ratio for negative test were calculated for IDRS cut-offs of ≥20, ≥40, ≥60, and ≥80 against the presence of T2DM (either known diabetic or fasting plasma glucose >126 mg/dl on two occasions). The overall prevalence of T2DM was 9.99% (95% confidence interval, 8.04-11.94%). In the Receiver operating characteristic analysis, IDRS had an area under the curve of 0.736 (P < 0.001). The best cut-off was IDRS 40 with a sensitivity, specificity, and Youden index of 60.4%, 70.7%, and 0.31, respectively. The findings of our study indicate that IDRS has excellent predictive value for detecting undiagnosed diabetes in the community and IDRS is also a much stronger risk indicator than examining individual risk factors like age, family history, obesity, or physical activity.

Prevalence of self-medication practices among the residents of urban slums located near govt. medical college, Jabalpur

Self-medication is defined as medication taken on the patient’s own initiative or on the advice of pharmacist or any other lay person. The World Health Organization (WHO) has defined self-medication as the practice whereby individuals treat their ailments and conditions with medicines that are approved and available without prescription, and which are safe and effective when used as directed. 1 But self-medication can be described as a double edged sword for its users, because it has both beneficial and harmful effects. 2 Antibiotic resistance is rising to dangerously high levels in all parts of the world. New resistance mechanisms are emerging and spreading ABSTRACT

A cross sectional study to assess knowledge, attitude and practice regarding voluntary blood donation among medical students of Jabalpur, central India

Background: Blood transfusion is a crucial and an essential part of any nation’s health care delivery system for a lifesaving Interventions. Positive attitude towards blood donation practices among the younger generation would play a crucial role in improving health care structure. Objectives of the study were to assess knowledge, attitude, and practice towards blood donation and its associated factors among undergraduate medical students. Methods: It was a descriptive cross sectional study conducted on the 322 under graduate medical students of different professional years during September to December 2016 at Netaji Subash Chandra Bose medical college Jabalpur (M.P.). A pretested, self administered, structured questionnaire was used to collect data on knowledge, attitude and practice regarding voluntary blood donation. Scores for three domains i.e. knowledge, attitude, practice was calculated. Data on Socio demographic details and reason behind non donation of blood were also collected. Results: On correlation between the scores of attitude and practice with knowledge. Attitude has a positive statistically significant correlation with the increase in knowledge and vice versa. On the other hand Increase in attitude shows a negative statistically significant correlation with practice and vice versa. Students belongs to >20 years of age group has significantly more knowledge and good attitude regarding blood donation (p<0.001). Female students when compared with male have more knowledge and good attitude regarding blood donation. But in case of practice of blood donation female significantly lag behind male students (p<0.001). Conclusions: Opportunities for blood donations should be created regularly by conducting blood donation camps this will not only increase the Sense of social responsibility among medical students through positive attitude but will also narrowed down the gap between the demand and the supply of the country.

Association of severe acute malnutrition with infections in under-five children admitted to Nutritional Rehabilitation Center—study from central India -

Background: Infectious disease is the foremost reason of illness and death in developing countries, especially in children with severe acute malnutrition (SAM). Protein energy malnutrition is the basic reason for the heightened vulnerability to infections that can lead to a vicious cycle. Objective: To study the association of SAM with infection, cause of delay in admission, and action taken by health worker in under-five children admitted to Nutritional Rehabilitation Center (NRC). Materials and Methods: This was a case–control study design conducted at Nutritional Rehabilitation Center of NSCB Medical College, Jabalpur, Madhya Pradesh, India, and neighbourhood control subjects were selected from affected community. The X2-test, Student’s t-test, and qualitative analysis were done for data analysis using SPSS software, version 17. Result: A total of 700 subjects were taken for the study, of which 350 were severely malnourished children and 350 well-nourished control subjects. Severe malnourished children on an average present most commonly with fever (2.8 episodes, 11 days in last 3 months), followed by diarrhea (2.7 episodes, 10 days illness in last 3 months) and acute respiratory infection (ARI) (1.6 episodes, 7 days illness in last 3 months). There is a significant difference in illness owing to fever, diarrhea, and ARI between the severe malnourished children and normal nourished children. The average time between identification of child as severe malnourished and their admission was 4.38 months. The most important cause of delay in admission to NRC was because no information regarding NRC was given by health worker in early stage of disease, care of other sibling, and work at home in severe malnourished children. Conclusion: There is strong association of SAM and infections. SAM and infections should be treated urgently to decrease morbidity and mortality.

Study of oral hygienic practices and oral health status among school children in Jabalpur, Madhya Pradesh: a cross-sectional study

Background: Oral hygiene should be educated and practiced at early age as it is one of the determinants of the health state later in one’s life. Considering the fact that there is the rise in the number of dental problems in school going children, the present study was undertaken to find out the oral hygienic practices among school going children and assess their oral health status. Methods: A cross sectional study carried out in 150 school children from two schools near medical area Jabalpur (75 from each school)between the age group of 10-15 years. A p-value of <0.05 was considered statistically significant for applied statistical tests. Results: The present study showed that only 34 % children had habit of brushing both time morning and at night before going to bed. Only 22% of children used correct brushing technique. Most common malpractice among children was eating chalk 12%. Regarding oral health status of school children dental caries 54.7% followed by dental cavities (52.7%) were most common problems found. Conclusions: Oral hygienic practices were poor needs educational motivation regarding duration of brushing, appropriate way to brush the teeth, and use of mouthwash.

Assessment of patient satisfaction: a descriptive study at outpatient department of a tertiary care public hospital in Jabalpur

Background: Patients satisfaction has always been important issue for physicians and hospital administrators. A patient is the ultimate consumer of the hospital. He is the person in distress and expects comfort, care and cure from hospital. He can better judge the performance of a hospital. Aims & Objectives: The present study was conducted with the objective to assess the level of satisfaction in patients attending the OPD of NSCB MC Hospital, Jabalpur, regarding waiting time, professional care and facilities available at OPDs. Materials and Methods: This cross sectional study was carried out at Out Patient Departments of NSCB Medical College, Jabalpur. A total of 422 patients or their attendants >15 year, were chosen as respondents by systemic random sampling, in the period of 62 days from 9 OPDs. A 30- item questionnaire was administered, and responses were noted in term of excellent, good, fair and poor. Results: A total of 400 forms were analyzed out of 422. Mean age of the respondents was 39.08 years. 33% were illiterate and 43% were working on daily wages. The mean waiting time for OPD registration was 25.13 minute, and for consultation, it was 33.04 minutes. A total of 82% respondents were satisfied with examination of doctor, and 70% were satisfied that doctor explained well their queries, but most of them were unsatisfied with public facility and signage available at OPDs. Conclusion: An assessment of the level of patient satisfaction related to different OPD care reminded us of certain areas that need improvements, to improve hospital’s services - like waiting area, appropriate signboards, availability of public facility, like drinking water, and cleanliness.

A longitudinal observational study of user’s perspective of use of Copper-T-380-A inserted in immediate post partum period at a tertiary health care centre in Central India -

Background: The study aims to understand user’s perspective & complaints due to Copper-T-380A inserted during the immediate postpartum period and to assess the expulsion rate, voluntary removal & mean duration of use. The study also aims to find out reasons for voluntary removal of the IUD. Methods: A longitudinal observational was conducted in tertiary health care center in central India during July-2009 to June 2010. A total of 360 women were enrolled who had immediate post partum IUD insertion. They were interviewed within 48 hours of IUD insertion using a preformed pre tested questionnaire & followed after 1.5, 3 & 6 months in field visits. Results: Of all 74.51% users continued using it upto 22.04±2.66 weeks. The cumulative expulsion rate at the end of 6 months was 16.62%. Most common interval of expulsion was after 3.6±1.5 weeks of IUD insertion. Almost 24.58% users had voluntary removal of IUD after a mean duration of 9.34±3.54 weeks following insertion. The most common reason for voluntary removal of IUD is lower abdominal pain in 13.5%. No instance of uterine perforation, sepsis or hyperpyrexia was noted. Conclusion: Immediate postpartum IUD insertion is safe means of contraception. There is a gradual decline in the discomfort caused by an IUD with time. But there is high expulsion rate.