A Study of Reversal Reactions in Leprosy | Author : Shyam Shrivastava, Meenakshi Sidhar | Abstract | Full Text | Abstract :Reversal reactions (RRs) are the leading cause of deformities and disabilities in leprosy. A comprehensive data on the magnitude of RR is crucial in implementing and evaluating the leprosy control strategy. Therefore, we had undertaken this study to find out the rate of reversal reaction (RR) and the key features associated with it, so that a comprehensive strategy could be adopted for their early detection and management.
In this prospective study, all untreated newly diagnosed cases of leprosy that attended a tertiary level urban hospital from April 2012–March 2017, were examined for RR at the time of diagnoses as well as during the course of their treatment.
RR was recorded in 13.61% (84/617) of patients, of these 73.80% (62/84) presented in RR at the time of the first visit (at the time of diagnoses) to the hospital, while the remaining 26.20% (22/84) developed it during the course of multidrug therapy (MDT). Majority of RR were seen in multi-bacillary (MB) cases (78/84, 92.85%), in comparison to pauci-bacillary (PB), where it was seen only in 7.15% (6/84). Another important finding was the declining trend of RR, from 21.15% (22/104) in 2012-13 to 2.34% (3/128) in 2016-17. MB cases and MDT were found to be the two key features associated with reversal reactions.
Although a significant declining trend of RR was recorded in the study, yet they are still prevalent, particularly in the MB cases, and most of them were detected at the time of the patient’s first visit. Therefore, a strategy to further augment the public awareness program regarding the features of RR, as well as explaining these features to patients before starting treatment should be emphasized. |
| Morbidity Pattern Among The Geriatric Population In South India: An Observational Study | Author : Divyamol K Sasidharan, Jishnu Sathees Lalu, Priya Vijayakumar, Sumi Soman, Manu Raj, George Paul | Abstract | Full Text | Abstract :Introduction: India, the second most populous country in the world is expected to have an increase in geriatric population of 37% by 2051.Along with the rise in geriatric population there is also a rise in geriatric related morbidity which requires special attention and care.
Methods: This was a community-based study, consisting of house to house survey of all people aged 65 years and above in Ernakulam district. Residents of Ernakulam district who are ambulant and above the age of 65 years formed the study population of this study. Subjects aged 65 years and above were selected for the study using multi stage stratified random cluster sampling method. A total of 1000 samples were collected.
Results: Among the 1000 study subjects, 342(34.2%) were diabetic 768(76.8%) were hypertensive and 248(24.8%) were suffering from dyslipidemia. Hypertension (76.8%) followed by visual impairment (59.4%)
and knee pain (56.5%) were the most common comorbidities in the present study population.
Conclusion: The incidence of all the study parameters among the elderly population was very high in comparison with studies from other parts of India. A substantial impact on this burden, unique preventive health care strategies specific to the elderly need to be clearly formulated and tested. |
| Hospitalization Patterns of Diabetic Patients in a Tertiary Care Hospital in Bangalore | Author : Aruna Tubachi, Shaik Riyaz Ameer, Swapnil Paunikar | Abstract | Full Text | Abstract :Background: Hospitalization occurs more often in diabetic than non-diabetic patients and is associated with increased morbidity and mortality. Data on these issues is limited. It is well recognized elsewhere that patients with diabetes are admitted more often and stay longer in the hospital.
Objectives: 1) Documentation of the contribution of diabetes to the inpatient work load in a tertiary hospital; (2) Identification of the departments involved in diabetic patient care; and 3) Assessment of the acute hyperglycemic/ hypoglycemic emergencies, complications and “crude” outcome.
Study Setting: MS Ramaiah Teaching Hospital which is a multispecialty teaching hospital.
Inclusion Criteria: In-patients admitted with type 1 and type 2 diabetes.
Study Design: Descriptive, retrospective, record-based study.
Sampling Design: Complete enumeration of all the patients admitted in the ward during September month.
Study Period: October to November 2012.
Statistical Analysis: Proportion of diabetics was calculated. Chi-square test of significance was employed. Results are summarized as mean +standard deviation and/or median (range) for the normally distributed and non-normally distributed data.
Materials and Methods: The data relevant to the study was accessed from in-patient files at medical records department. Information pertaining to age of the patient, diagnosis for which the patient was admitted, type of ward admitted, associated co-morbidities, type of diabetes, duration of stay, episode of
uncontrolled hyperglycemia, and associated complications was collected.
Results: 59% of diabetic patients were male. Majority of the patients were in the age group of 50–70 years. 42.9% of the diabetics had duration of diabetes varying between 1 and 5 years. Mean duration of stay was 6.86 days. 45.2% were on oral hypogycemics. 47.6% of the diabetics had hypertension. 4.8% had
hypothyroidism. 9.5% had cardiac disorder. 40.5% of the patients were admitted for one of the microvacular or macrovascular complications. 16.7% of them had uncontrolled glycemic levels. All the patients treated were discharged to home.
Conclusion: The study shows 18.33% prevalence of SCH in T2DM patients with good glycemic control. This finding indicates that SCH was common in T2DM patients and a need for screening for the same in them |
| Examining Population Structure of Rajasthan with Implications for Public Health Planning and rate Standardization to support Eye and Vision Care Public Health Programming | Author : Gregory Fant | Abstract | Full Text | Abstract :Introduction: Scientific thinking and methods are necessary in order to make valid comparisons of the distribution of health outcomes within and across populations. To date, no prior report has been identified as examining the population structure of Rajasthan and its implication for public health planning applied to eye health and vision care service utilization. In this report, the population structure of Rajasthan was examined based on official projections. A brief discussion was offered for the use of population structure data in public health planning, specifically to support eye health and vision care public health programming in Rajasthan.
Methods: Using an ecological design, secondary data were used to examine the projected population structures of Rajasthan and India from 2016 to 2026. The data were abstracted from publically-available reports and organized by age group and sex for 2016, 2021, and 2026. Population pyramids were constructed
for the data from each of the three aforementioned years for both the population of Rajasthan and the corresponding data for the population of India.
Results: The projected population of Rajasthan is expected to rise from 2016 to 2026. During this tenyear time span, the proportion of individuals in the younger age groups (birth to 34 years) will represent a sizable number of individuals compared to those in the older age groups. A comparison of the projected population structures, by age-group strata and sex, showed differences in population pyramids.
Discussion: These findings suggest that, when making public health planning decisions for Rajasthan, public health planners concerned with eye conditions and vision care service utilization might consider the distribution of population by age grouping. Furthermore, it might be appropriate to establish a “standard
reference population” for Rajasthan in order to compare age-standardized rates of eye conditions and vision care utilization through 2026.
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