Medical Outpatient Department Research Articles

A Cross Sectional Study to Assess the Sleep Disturbance and Activities of Daily Living and Their Predictors among Older Adults Visiting Medical Out Patient Department of Selected Hospitals of Bagalkot

Background of the Study: Healthy aging according to the WHO is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course. Older adults may experience mobility problems due to age-related changes in muscles, bones, and joints. Depression, anxiety, and social isolation are prevalent among older adults. Sleep disturbances can significantly impact mood and emotional well-being in older adults. Mood swings, depression, and anxiety. This may result in difficulties with mobility, self-care tasks, and overall functional independence. Hence the investigator felt the need to conduct “A cross sectional study to assess the sleep disturbance and activities of daily living and their predictors among older adults visiting medical outpatient department of selected hospitals of Bagalkot.” Aim: To assess the sleep disturbance and activities of daily living among older adults. Methods: Quantitative non-experimental approach with Cross sectional descriptive survey research design was used for the study to accomplish the objectives. Sleep Quality Scale (SQS), The Lawton Instrumental Activities of Daily Living Scale were used to collect data. A sample of 100 older adults aged above 60 years and visiting medical OPD’s of selected hospitals of Bagalkot was selected by Non probability Purposive Sampling Technique. The data collected were analyzed using descriptive and Inferential Statistics. Results: Findings shows that, there was a significant negative correlation (r= -0.546, P<0.01) between sleep disturbance and activities of daily living of older adults. Sleep disturbance was significantly associated with Religion[χ2=9.09, P<0.0026], Marital Status[χ2=6.43, P<0.0112],Number of Children[χ2=10.77, P<0.001], Family Monthly Income[χ2=15.52, P<0.0001],Residential Status[χ2=10.39, P<0.0013],Type of Family[χ2=8.42, P<0.0037],Chronic Illness[χ2=15.2, P<0.0001],Exercise Habits[χ2=9.09, ...

Quality of hypertension management and health insurance impact: an assessment of insured and uninsured patients with systemic hypertension in a teaching Hospital in Ilorin, Nigeria.

Patient satisfaction is an important indicator used to measure quality of care and the performance of healthcare services. This study assessed patient satisfaction with the quality of hypertension care received by both insured and uninsured patients with systemic hypertension. This comparative cross-sectional study was conducted among insured and uninsured patients with systemic hypertension attending the Medical Outpatient Department clinics of the University of Ilorin Teaching Hospital, Kwara State, Nigeria, from May to July, 2023. Data were collected from 95 patients from each group, selected by systematic random sampling; using an interviewer-administered, anonymous, structured close ended questionnaire. Different aspects of the healthcare services were assessed; these include patient registration process, waiting time, staff attitudes, laboratory services, availability and cost of prescribed drugs etc. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 27.0 software. The insured patients with systemic hypertension had a higher overall mean satisfaction (74.1±20.8) compared to the uninsured group (69.3±23.2), though this was not statistically significant (p value = 0.417). However, the insured patients with systemic hypertension had significant satisfaction scores compared to uninsured hypertensive group in the domains of waiting time (63.6 ± 24.9 vs 48.0 ± 25.8, p=0.000), drug cost and availability (73.9 ± 24.1 vs 56.2 ± 25.0, p=0.000), and cost of service and care (74.1±24.0 vs 59.8±26.0, p=0.000). This study concluded that both insured and uninsured patients with systemic hypertension had comparable treatment, though the insured group had some better satisfaction scores in some of the assessed healthcare domains. The healthcare policy makers should endeavour to improve health insurance coverage, and utilize identified factors in policy formulation and implementation to encourage utilization of health insurance among patients.

Depression, a Hidden Co-Morbidity in Patients of Chronic Ailments; An Outpatient-Based Study

Objective: To identify the rate of depression among patients with chronic diseases attending outpatient clinics. Methodology: This cross-sectional study was conducted at the Department of Medicine in a Tertiary care Hospital, Rawalpindi, from December 2023 to May 2024. A total of two hundred and forty-six patients visiting the outpatient department (OPD) were chosen through consecutive sampling, adhering to specific exclusion and inclusion criteria. All participants provided informed written consent. Demographic data, information on comorbidities, and clinical and laboratory details were collected. The (CESD-10) scale “Center for Epidemiologic Studies Depression” was utilized to evaluate depression. Results: Among the 246 patients with chronic ailments in the medical OPD, 115 were male, and 131 were female. Depression was prevalent in 57 (86.4%) cases of diabetes mellitus (p-value 0.014), 37 (61.7%) cases of hypertension (p-value 0.005), 40 (64.5%) cases of chronic kidney disease (p-value 0.024), and 51 (87.9%) cases of asthma (p-value 0.010). Conclusion: Patients with chronic ailments are more susceptible to depression, highlighting the importance of considering this comorbidity in their treatment plans.

Frequency of TTG Positivity in Diarrhea Predominant IBS Patients at Peshawar, Pakistan

Irritable Bowel Syndrome is abdominal discomfort and alterations in bowel habits without an identifiable organic cause. Objective: To determine the frequency of tissue transglutaminase positivity in diarrhea-predominant IBS patients. Methods: This cross-sectional study was done from 1st January 2021 to 30th July 2021 in the Medicine department of Khyber Teaching Hospital, Peshawar, Pakistan. Patients of either gender aged between 18-60 years presenting in the medical outpatient department with diarrhea-predominant irritable bowel syndrome. Diarrhea-predominant irritable bowel syndrome was defined as a patient who fulfilled the Rome-IV criteria for irritable bowel syndrome with ≥2 of the features. Tissue transglutaminase antibodies were done for all patients and tissue transglutaminase positivity was defined as anti-tissue transglutaminase IgA or IgG antibody levels ≥10 AU/ml on laboratory tests performed by the chemi-luminescence immunoassay technique. Results: In a total of 96 patients, 59 (61.5%) were male. The mean age, weight, and duration of diarrhea were 37.64 ± 6.28 years, 81.48 ± 7.70 kg, and 11.67 ± 3.81 months, respectively. The tissue transglutaminase positivity was seen in 12 (12.5%) of patients. Duration of disease above 6 weeks was found to have a significant association with tissue transglutaminase positivity (p<0.001) as all tissue transglutaminase-positive patients had a duration of disease above 6 months. Conclusions: It was concluded that the frequency of tissue transglutaminase positivity was high in diarrhea-predominant irritable bowel syndrome patients. Screening for celiac disease in irritable bowel syndrome patients can be worth considering especially in cases with relatively longer duration of irritable bowel syndrome diarrhea predominant symptoms.

Prevalence of Vitamin B12 Deficiency in Patients with Type II Diabetes Mellitus in Morang District

Introduction: Type II Diabetes Mellitus is a significant global health concern that has become prevalent worldwide, and its impact on morbidity and mortality is substantial. Metformin is a commonly prescribed medication for type II diabetes that interferes with the absorption of vitamin B12 in the gastrointestinal tract, which leads to neurological issues in patients. Objective: The aim of this study was to evaluate the vitamin B12 levels in Type II diabetic patients taking metformin at the Purbanchal University Teaching Hospital medical OPD. Method: A quantitative, descriptive cross-sectional study was done from May 2022 to April 2023 at the medical outpatient department of Purbanchal University Teaching Hospital, Gothgaun, Morang. Non-probability purposive sampling was done to select 385 Type II diabetic patients on metformin for 12 months. A structured questionnaire was used for data collection, which was validated with the consultation of experts. Result: It was found that the mean age (in years) with SD was 55.2±11.3; most of the respondents were female. The prevalence of low vitamin B12 was 21.8% among the study respondents. Diabetic patients on low vitamin B12 taking metformin were significantly associated with age over 50 years, a higher metformin dosage, a longer duration of use, and vegetarian dietary patterns. Conclusion: These findings emphasize the importance of regular monitoring of vitamin B12 levels in Type II diabetes mellitus and prolonged metformin treatment to prevent potential complications.

Medication adherence in geriatric patients attending medical outpatient department.

Adherence to medication represents a challenge in managing chronic conditions in the geriatric population. This study assessed adherence rates and factors affecting adherence of geriatric patients attending the Helen Joseph Hospital outpatient department. This was a prospective cross-sectional study of 130 patients aged 65 years and older, with at least two chronic conditions. Participants were administered a survey incorporating the Medication Adherence Rating Scale and the Adherence Barrier Questionnaire to identify medication adherence and patient-specific barriers to adherence, respectively. These instruments are reliable and valid. Descriptive statistics and logistic regression were used for analysis. Most patients were female (63%) with a mean age of 72 (67-78) years. Common comorbidities included type 2 diabetes mellitus (63%), hypertension (98%), dyslipidaemia (92%) and congestive cardiac failure (38%). Polypharmacy was prevalent, affecting 53% of the participants. Despite 96% of participants being adherent, all had at least one barrier to adherence, with the majority (65%) having more than one barrier. The main barriers were forgetfulness (59%), fear of side effects (39%), problems with taking the medications (26%) and believing medications are poisonous (22%). Although most participants accessed the pharmacy easily, only 83% reported consistent medication availability and 11% could not afford to collect their medication. Polypharmacy is common in the population. Despite high adherence rates, barriers such as believing medications are poisonous remain significant. A good patient-doctor relationship improves adherence.Contribution:Understanding the barriers to adherence in older adults with polypharmacy and multimorbidity can assist practitioners improve patient care.

Prevalence of Parasitic Disease Burden in the Adult Population Presenting With Persistent or Chronic Diarrhea.

Introduction Parasitic infection is an overlooked cause of diarrhea in adults. It can cause persistent or chronic diarrhea that contributes to a significant burden on the overall morbidity of the population. Stool sampling would aid in the diagnosis of parasitic infection in adults presenting with diarrhea. Methods A cross-sectional study was conducted from January to June 2024 at Medical Teaching Institution (MTI)-Hayatabad Medical Complex, Peshawar, Pakistan. A total of 500 stool samples were collected using non-probability consecutive sampling. All the patients presenting with complaints of persistent or chronic diarrhea to the medical outpatient department or admitted to the medical units were included in the study. Patients with bloody diarrhea and those less than 13 years of age were excluded from the study. Verbal and written informed consent was obtained from all the patients included in the study. The stool samples of all the patients were collected, reported, and verified by the microbiology department. Results Out of 500 stool samples of the patients with persistent or chronic diarrhea, 174 (34.8%) were found to be infected with cysts or trophozoites of parasites.Gender distribution of parasitic infections showed that 89 out of 245 females (36.3%) and 85 out of 255 males (33.3%) were affected. The comparison between genders yielded a p-value of 0.482. All the patients showed mono parasitism. The most common isolate was Giardia lamblia in 90 (51.72%) cases, followed by H-Nana in 49 (28.17%) isolates, Entamoeba histolytica in 16 (9.20%), Ascaris lumbricoides in 14 (8.04%), Trichuris trichura in two (1.15%), Taenia saginata in two (1.15%), and Cryptosporidium in one (0.6%) infected patient. Conclusion Parasitic intestinal infections, particularly Giardia and H-Nana, are prevalent yet overlooked causes of persistent and chronic diarrhea in adults. These findings underscore the importance of routine stool examination as a cost-effective diagnostic tool, potentially improving patient outcomes and reducing unnecessary medical interventions.​​​​​​​​​.

Association Between Body Mass Index (BMI), Vitamin D, and Testosterone Levels.

Introduction Obesity is measured scientifically by calculating body mass index (BMI). Body mass index in men is linked to various hormonal imbalances. This study aims to observe the relationships between BMI, vitamin D, and testosterone levels in patients attending the outpatient clinic at Hayatabad Medical Complex, Peshawar, Pakistan. Methods This observational cross-sectional study involved 272 patients, presenting to the medical outpatient department from January 1st, 2023, to December 31st, 2023. Body mass index, serum vitamin D, and testosterone levels were measured for each participant. Body mass index was categorized into normal, overweight, and obese. Statistical analysis was calculated, including descriptive statistics, logistic regression, and correlation analysis to evaluate associations between these variables. Results The mean BMI of the participants was 25.82 ± 7.88 kg/m². A significant inverse correlation was observed between BMI and vitamin D levels (r = -0.79, p < 0.001) and between BMI and testosterone levels (r = -0.87, p < 0.001). A positive correlation was found between vitamin D and testosterone levels (r = 0.87, p < 0.001). Logistic regression analysis revealed that higher BMI in the range of overweight or above was associated with a 2.5-fold increase in the likelihood of vitamin D deficiency (odds ratio (OR) = 2.50, 95% CI = 1.8-3.5, p < 0.001) and a 3.1-fold increase in the likelihood of low testosterone levels (OR = 3.10, 95% CI = 2.2-4.3, p < 0.001). Conclusion In this study, higher BMI is significantly associated with lower vitamin D and testosterone levels. These findings suggest that addressing obesity could help mitigate hormonal imbalances, such as vitamin D deficiency and low testosterone, which are linked to metabolic health risks. It can also be hypothesized that obesity can be a risk factor for vitamin D and testosterone deficiency.

P055 ELECTROCARDIOGRAPHIC ABNORMALITIES AND ASSOCIATED FACTORS IN NORMOTENSIVE TYPE II DIABETIC PATIENTS

Background/Objective: Type II diabetes mellitus (T2DM) is a coronary heart disease (CHD) equivalent in the presence of target organ damage or at least three cardiovascular disease (CVD) risk factors. Resting electrocardiography (ECG) is recommended in T2DM patients only in the presence of hypertension or on suspicion of CVD. ECG abnormalities occur early in T2DM, are associated with future cardiovascular events/mortality after adjustment for traditional CVD risk factors. Early screening and detection may improve long term survival in T2DM patients hence, aim of study- to assess the patterns and factors associated with ECG abnormalities in T2DM patients without co-existing hypertension. Methods: One hundred normotensive (BP&lt;130/80mmHg, not on any antihypertensive agent) T2DM patients were recruited consecutively, from the Endocrinology and Diabetes clinics of the Medical Outpatient Clinic and Family Medicine department of the University of Nigeria Teaching Hospital. Consents were obtained, before interviewers, administered questionnaire to get the biodata, T2DM history, complications and treatment. Anthropometric and blood pressure readings were taken using standard methods. A 12-hour overnight fasting blood sample was taken for biochemical assessment of blood glucose, glycated haemoglobin, lipids, urea and creatinine. A 12 lead ECG was performed and interpreted by one cardiologist using the Minnesota ECG code criteria. Descriptive statistics was used for patterns of ECG abnormalities while association between categorical variables were cross tabulated and tested using chi square. Results: Participants were majorly females 68(68.0%), overweight/obese 52(52.0%) with a mean age of 55.56±9.89 years. Duration of T2DM illness post diagnosis was 6.57±6.26years. T2DM was poorly controlled in 92(92.0%) while 93(93.0%) had dyslipidaemia. ECG was abnormal in 56(56.0%) with multiple abnormality in 12(21.4)%. Left atrial abnormality was the commonest 14(25.0%) ECG abnormality. No factor was associated with ECG abnormality. Conclusions: ECG abnormalities are common in T2DM, occurring early in the absence of co-existing hypertension. ECG should be done at diagnosis of T2DM irrespective of CVD risk factors, with frequent monitoring than recommended by guidelines. Table. Pattern of electrocardiographic abnormalities in normotensive type II diabetic patients.

Implementation of Patient-Reported Outcomes in a Medical Oncology Setting (the iPROMOS Study): Type II Hybrid Implementation Study.

Clinical trials have demonstrated that patient-reported outcome measures (PROMs) can improve mortality and morbidity outcomes when used in clinical practice. This study aimed to prospectively investigate the implementation of PROMs in routine oncology. Outcomes measured included improved symptom detection, clinical response to symptom information, and health service outcomes. Two of 12 eligible clinics were randomized to implement symptom PROMs in a medical oncology outpatient department in Australia. Randomization was carried out at the clinic level. Patients in control clinics continued with usual care; those in intervention clinics completed a symptom PROM at presentation. This was a pilot study investigating symptom detection, using binary logistic models, and clinical response to PROMs investigated using multiple regression models. A total of 461 patient encounters were included, consisting of 242 encounters in the control and 222 in the intervention condition. Patients in these clinics most commonly had head and neck, lung, prostate, breast, or colorectal cancer and were seen in the clinic for surveillance and oral or systemic treatments for curative, metastatic, or palliative cancer care pathways. Compared with control encounters, the proportion of symptoms detected increased in intervention encounters (odds ratio 1.05, 95% CI 0.99-1.11; P=.08). The odds of receiving supportive care, demonstrated by nonroutine allied health review, increased in the intervention compared with control encounters (odds ratio 3.54, 95% CI 1.26-9.90; P=.02). Implementation of PROMs in routine care did not significantly improve symptom detection but increased the likelihood of nonroutine allied health reviews for supportive care. Larger studies are needed to investigate health service outcomes. Australian New Zealand Clinical Trials Registry ACTRN12618000398202; https://tinyurl.com/3cxbemy4.

Patterns and Errors of Medication Prescription among Patients with Chronic Medical Diseases attending Medical Outpatient Department of a Tertiary Hospital in Ilorin, Nigeria

Patterns and Errors of Medication Prescription among Patients with Chronic Medical Diseases attending Medical Outpatient Department of a Tertiary Hospital in Ilorin, Nigeria

Feasibility of Provision and Vaccine Hesitancy at a Central Hospital COVID-19 Vaccination Site in South Africa after Four Waves of the Pandemic.

As mortality declined significantly during the fourth and fifth waves compared to previous waves, the question of the future role of COVID-19 vaccination arose among both experts and the public in South Africa. Turning attention away from the general public, now considered to be at very low risk of severe COVID-19 disease, a commonly held view was that the vaccination campaign should focus only on those who remain highly vulnerable to severe disease and death from COVID-19. Primary amongst this group are patients with common chronic diseases attending hospital outpatient departments. We hypothesized that providing COVID-19 vaccinations on-site at a central hospital will increase uptake for the patients with co-morbid chronic conditions who need them most in the Omicron phase of the pandemic. Evaluate the acceptability, need, and uptake of a hospital-based vaccination site for patients attending the medical hospital outpatient departments. To assess vaccination uptake, coverage, and hesitancy in people attending a central hospital, to determine factors associated with and influencing vaccination uptake, and to document implementation and assess acceptability of the vaccination project among staff and persons attending the hospital. Mixed-methods study using quantitative and qualitative methods. Of the 317 participants enrolled in the study, 229 (72%) had already received at least one dose of the COVID-19 vaccine. A total of 296 participants were eligible for a first vaccination, additional vaccination, or booster vaccination according to the South African Department of Health guidelines. Of those previously vaccinated, 65% opted for an additional dose on the day it was offered (same day). Only 13 previously unvaccinated participants (15% of vaccine naïve participants) opted for vaccination, increasing vaccine coverage with at least one dose from 72% to 76%. Approximately 24% (n = 75) of all participants refused vaccination (vaccine hesitant). Variables tested for an association with vaccination status demonstrated that age reached statistical significance. Emerging themes in the qualitative analysis included perceptions of vulnerability, vaccine safety and efficacy concerns, information gaps regarding vaccinations, the value of convenience in the decision to vaccinate, and the role of health promoters. This study has shown that it is logistically acceptable to provide a vaccination site at a large hospital targeting patients attending outpatient services for chronic medical conditions. This service also benefits accompanying persons and hospital staff. Access and convenience of the vaccination site influence decision-making, increasing the opportunity to vaccinate. However, vaccine hesitancy is widespread with just under one-quarter of all those offered vaccinations remaining unvaccinated. Strengthening health education and patient-clinician engagement about the benefits of vaccination is essential to reach highly vulnerable populations routinely attending hospital outpatient departments with an appropriate vaccination program.

Role Of Cities in NCD Prevention and Management: A Qualitative Research Study among Doctors

Background: Noncommunicable diseases (NCDs) such as diabetes, hypertension, and cardiovascular diseases are major global health concerns, surpassing the mortality rates of communicable diseases. These conditions pose significant challenges to global development, particularly in low- and middle-income countries where two-thirds of NCD-related deaths occur. In Pakistan, NCDs account for nearly 25% of all fatalities. The prevention of NCDs requires continuous lifestyle modifications, and evidence suggests that the physical environment and urban design play crucial roles in influencing health behaviors and outcomes. Objective: This study aimed to assess doctors' perspectives on the role of cities in the prevention and management of NCDs in Pakistan, and to identify barriers and enablers to the development of healthy city policies. Methods: This descriptive exploratory study employed a qualitative approach, conducted at various private hospitals in the Twin Cities. A purposive sample of approximately 20 doctors from medical units and outpatient departments participated in focus group discussions (FGDs). Data were collected using a semi-structured interview guide, and the FGDs were audio-recorded with participants' consent. Thematic analysis was performed to identify major themes and subthemes related to the role of urban environments in NCD prevention and management. Results: Participants recognized the importance of physical activity, healthy environments, and lifestyle modifications in preventing NCDs. Key barriers to physical activity included socio-cultural norms, environmental limitations, and political/legislative challenges. Facilitators included individual willpower, health-seeking behavior, supportive policies, and perceived benefits. Poor air quality and the lack of green spaces were significant contributors to the increased prevalence of NCDs. Participants emphasized the need for government intervention to improve urban infrastructure, promote physical activity, and enhance public health initiatives. Conclusion: Well-planned cities can significantly reduce the burden of NCDs by addressing modifiable risk factors. Governments must prioritize the development of infrastructure that promotes physical activity, improves air quality, and increases access to green spaces. Comprehensive multisectoral strategies are essential to combat the rising threat of NCDs, particularly in rapidly urbanizing areas.

To study the efficacy of case based learning on prescription practices in post graduate students on geriatric patients attending medical OPD

BackgroundRationalizing drugs and deprescribing potentially inappropriate medicines in elderly patients is a major challenge faced by doctors in today’s era due to the ever-increasing number of diseases, drugs, changing guidelines, and indications. The objective of this study was to study the efficacy of case-based learning on prescription practices in postgraduate students on geriatric patients attending medical outpatient department (OPD). MethodsObservation cross-sectional study done on postgraduate medicine residents working in medicine/geriatric OPD. Prescriptions were analyzed for quality by prescription quality index (PQI) score. The baseline PQI score was generated. An interactive workshop and training session on case-based learning on appropriate prescribing for the elderly was conducted. The prescribing habits and PQI scores were reassessed and compared to assess the change in PQI scores along with satisfaction levels and faculty feedback. ResultsA total of 60 prescriptions from 24 medicine residents were initially assessed for baseline PQI. A total of 41 residents participated in the workshop. Sixty fresh prescriptions were reassessed after one month of the workshop. The mean baseline PQI was 27.15 (±3.70) which increased to 31.81 (±3.60) [p < 0.001. The majority of the faculty (10/12) felt improvement in prescribing practices. Two third of residents (28/41) had a very good and excellent level of satisfaction with the case-based learning. ConclusionCase-based learning is an effective tool for enhancing the prescribing skills of postgraduates, especially in geriatric patients. There was a significant improvement in PQI score after the case-based learning workshop in the prescriptions of the postgraduate students with a p-value of < 0.001.

Incidence of Plasmodium Vivax Malaria in Patients with Pancytopenia

Background: Malaria, caused by Plasmodium vivax, is prevalent in many tropical and subtropical regions of the world, notably in South Asia and Africa. The clinical manifestation of malaria, including pancytopenia, varies widely, leading to complex challenges in diagnosis and treatment. Understanding the association between Vivax malaria and hematological abnormalities like pancytopenia is critical for improving patient outcomes in endemic regions. Objective: This study aimed to investigate the incidence of Plasmodium vivax in patients presenting with pancytopenia and to assess the demographic and hematological profiles of these patients in a high-prevalence area. Methods: A prospective cohort study was conducted at the Hayatabad Medical Complex, Peshawar, from January 2021 to January 2023. A total of 350 patients who presented at the medical outpatient department were enrolled based on inclusion and exclusion criteria. Blood samples were collected using aseptic techniques, and peripheral blood smears were prepared for analysis. Demographic data were collected through questionnaires. Statistical analysis was performed using SPSS version 25, with categorical data analyzed using Chi-square tests and continuous variables using t-tests, setting statistical significance at p &lt; 0.05. Results: Of the 350 patients studied, 71.4% were male and 28.6% were female, with a mean age of 55.1 years. The hemoglobin levels averaged 8.86 g/dl (SD ± 1.77), and the leukocyte count was 2.84×10^3/Cmm (SD ± 3.31). Platelet counts averaged 77.25×10^9/Cmm (SD ± 2.90). Overall, 52.6% of patients tested positive for P. vivax. There were no significant differences in the incidence of P. vivax infection across age groups (p = 0.36) or between genders (p = 0.41). Conclusion: The study confirmed a significant prevalence of P. vivax in patients with pancytopenia, highlighting the need for routine screening in malaria-endemic regions. Early diagnosis and treatment are essential for managing pancytopenia in patients with malaria and can lead to substantial improvements in clinical outcomes.

Thyroid and Lipid Profile Dysfunction among Obese versus Non-Obese Individuals Study Design

Obesity, a complex disorder influenced by both genetic and environmental factors, manifests through intricate interactions. Objective: To assess thyroid function tests and serum lipid profiles in obese and non-obese individuals. Methods: This cross sectional observational study was conducted over six months from July to December 2023 at the medical outpatient department of Shahida Islam Medical College, after obtaining ethical approval (IRB Ref no. SIMC/H.R./7314/23, dated May 1, 2023). A sample size of 200 was calculated, divided equally into obese (BMI &gt; 30 kg/m²) and non-obese (BMI &lt; 25 kg/m²) groups. Data were analyzed using SPSS version 23.0, employing chi-square tests for significance (p &lt; 0.05). Results: Each group comprised 100 participants, with mean ages of 42.49 ± 9.0 years for the obese and 43.83 ± 6.2 years for the non-obese group. Females constituted 62% of the obese and 51% of the non-obese group. Mean BMI was 35.8 kg/m² and 26.6 kg/m² in the obese and non-obese groups, respectively. Obese individuals exhibited higher mean total cholesterol (173 ± 40.77 mg/dl vs. 134 ± 29.62 mg/dl, p = 0.05) and significant differences in HDL, LDL, triglycerides, TSH, T3, and T4 levels (p &lt; 0.05). Conclusions: Obesity is associated with adverse thyroid and lipid profiles, with a higher prevalence among females. These findings underscore the importance of addressing these metabolic factors in obesity management.

A Study was Conducted to Evaluate the Risk Factors Associated with Stroke among Hypertensive Patients Receiving Care at the Medical Outpatient Department (OPD) of HSK Hospital &amp; Research Centre in Navanagar, Bagalkot

BACKGROUND OF THE STUDY:* Hypertension, characterized by elevated blood pressure, is a major public health concern globally. It is a leading cause of cardiovascular diseases, including stroke. Stroke, a neurological condition, is a significant cause of mortality and disability, especially in low- and middle-income countries. Hypertension is a predominant risk factor for stroke both globally and in our country. Hence, there is a critical need to enhance stroke education, particularly targeting low-income individuals at high risk, through public health campaigns and targeted health education efforts. OBJECTIVES OF THE STUDY: 1. To assess the knowledge of hypertensive patients regarding stroke risk factors and prevention. 2. To determine the association between knowledge scores and selected socio-demographic variables. HYPOTHESIS: H1: There will be a significant association between the knowledge level of hypertensive patients and their socio-demographic variables. CONCEPTUAL FRAMEWORK: This study adopts the health belief model proposed by Becker as its conceptual framework. METHODOLOGY: The research employed a descriptive survey design to assess stroke risk factors among hypertensive patients attending the medical OPD of HSK Hospital &amp; Research Centre in Bagalkot. Non-probability convenient sampling was used to select 100 hypertensive patients for the study. Data collection utilized a structured questionnaire consisting of two sections: Section I focused on socio-demographic variables, while Section II assessed stroke risk factors. RESULTS: The study revealed that hypertensive patients exhibited varying levels of knowledge regarding stroke risk factors. On average, the overall knowledge score was 55.3%. The percentage distribution of hypertensive patients based on their knowledge level showed that 24% had poor knowledge, 50% had average knowledge, and 26% had good knowledge. CONCLUSION: The study identified a significant association between the knowledge level of hypertensive patients and certain socio-demographic characteristics, particularly the source of information. However, no significant associations were found with other variables such as age, gender, education, occupation, and health history. This underscores the importance of targeted health education interventions aimed at improving awareness of stroke risk factors among hypertensive patients.

A Retrospective Study on the Effectiveness of Sulphur in Lm Potency for Dermatitis in Paediatrics Age Group

Context: Children with dermatitis often complain of eczema, neurodermatitis, stasis dermatitis, atopic dermatitis, and seborrheic dermatitis, among other conditions. The purpose of the study is to determine the effectiveness of sulfur LM potency for dermatitis complaints in the pediatric age group and to emphasize the incidence of dermatitis in children. Thirty instances of dermatitis treated with sulfur LM potency were selected from the pediatric age category and gathered from Sarada Krishna Homoeopathic Medical College's in-patient and outpatient departments in Kulasekharam. According to this study, dermatitis is more common in children aged 1 to 5; 19 cases showed a significant improvement, and 22 cases improved during follow-up visits. Ten cases have impacted females and twenty cases have affected males. Kids more people with lower socioeconomic status have been impacted. Based on the study, homoeopathic drugs may be more effective in treating cases of dermatitis. With the right dosage of the medication, more over half of them 22 patients could feel better. Eight patients' conditions have persisted, and two patients' conditions have gotten worse. This outcome is consistent with a clinical investigation that found that, out of 30 instances, 10 patients were male and that homoeopathic drugs were effective in treating dermatitis in youngsters.

Effects of Galvanic Skin Resistance Biofeedback on Perceived Stress in Individuals with High Blood Pressure: A Quasi-experimental Study

Introduction: According to the World Health Organisation (WHO), hypertension is one of the leading causes of premature morbidity and mortality, both in industrialised and developing countries. Patients with arterial hypertension are advised to make lifestyle adjustments, such as increasing physical activity and reducing stress. Nowadays, a variety of relaxation techniques are used to reduce stress and tension. The practise of Biofeedback (BF) is regarded as a successful treatment for this purpose. Aim: To investigate the effect of Galvanic Skin Resistance Biofeedback (GSRBF) on perceived stress. Materials and Methods: In present quasi-experimental study, 53 individuals with high blood pressure, including prehypertensive and hypertensive individuals {Blood Pressure (BP)&gt; 120/80 mmHg}, were included. Participants were recruited from various Medical and Physiotherapy Outpatient Departments (OPD) of private and Government hospitals and clinics in Veraval, Gujarat, India, from March 2022 to September 2022. Basic demographic data was collected, Blood Pressure (BP) was measured, and the Perceived Stress Scale (PSS) was administered. Participants were then connected to the GSRBF instrument and instructed to relax using a relaxation response technique. After 12 sessions, BP was measured again, and the PSS was administered. As the data were not normally distributed, a t-test was performed at a significance level of 95% (p&lt;0.05). Results: The analysis revealed a significant decrease in PSS scores following GSRBF sessions, with a p-value of &lt;0.05. Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) also showed a significant reduction, with a p-value of &lt;0.05. Conclusion: The GSRBF demonstrated a significant reduction in perceived stress among individuals with high blood pressure, and it also showed a significant reduction in SBP and DBP. The present study provides valuable insights into the potential of GSRBF as an adjunct therapy for managing hypertension and promoting overall well-being.

Effect of Yoga Nidra on Perceived Stress Section in Individuals with High Blood Pressure: A Quasi-experimental Study

Introduction: A persistently high level of stress can lead to a variety of diseases, such as anxiety, depression, sleeplessness, muscle discomfort, high Blood Pressure (BP) and a compromised immune system. Although 15% of adults in India suffer from hypertension, significant progress has been made in preventing and managing this condition. One alternative form of treatment that may help with stress management and BP regulation is Yoga Nidra. Aim: To assess the effect of Yoga Nidra on perceived stress in Individuals with High Blood Pressure. Materials and Methods: The present quasi-experimental study was conducted at various medical and physiotherapy Outpatient Departments (OPDs) in Veraval, Gujarat, India, from June 2021 to September 2022. A total of 49 individuals diagnosed with high BP, including both prehypertensive and hypertensive individuals (with BP &gt;120/80 mmHg), were selected. Essential demographic information was gathered from the participants, who were also asked to complete the Perceived Stress Scale (PSS) questionnaire. Participants were introduced to the concept of Yoga Nidra and provided with instructions on how to perform the Yoga Nidra technique. They engaged in 12 sessions of this technique. After completing these 12 sessions, participants once again completed the PSS questionnaire. Since the collected data did not exhibit a normal distribution, a paired t-test was conducted at a significance level of 95%. Results: Out of 49 study participants, 22 (45%) were females and 27 (55%) were males, and mean±Standard Deviation (SD) age was 47.86±10.62 years. The analysis revealed a significant reduction in PSS scores following the Yoga Nidra sessions (p-value=0.0001). Additionally, both Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) showed decrease with a p-value of 0.0001. Conclusion: Yoga Nidra has a significant effect on reducing perceived stress in individuals with high blood pressure, along with a reduction in blood pressure. This research provides valuable findings regarding the potential of Yoga Nidra as an additional relaxation therapy to help manage hypertension and enhance overall well-being.