Navodaya Medical College Research Articles

PHARMACOECONOMIC EVALUATION OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT A TERTIARY CARE TEACHING HOSPITAL IN NORTH KARNATAKA, INDIA

Objective: The objective of the study was to evaluate the burden of cost in patients of acute exacerbations of chronic obstructive lung disease (COPD).Methods: A prospective, observational study was conducted in COPD patients over a period of 6 months in general medicine and pulmonary wards of Navodaya Medical College Hospital and Research Centre, Raichur, Karnataka, India. Direct medical and non-medical cost were included in the burden of cost. From the drug rate manual of hospital, cost for drugs and investigation were calculated.Results: Overall 100 COPD patients were enrolled in which 92 were male and 8 were female with a mean age of 60.33±10.98. The patients participated in this study were stayed in the hospital with mean±standard deviation (SD) value of 9±3. Minimum total direct medical cost was Rs. 1149.00 and maximum was Rs. 13,510.00 with a mean±SD 3297.48±1634.226, in which medicine cost was high (mean 2746.63). Minimum total direct non-medical cost was Rs. 100.00 and maximum was Rs. 3470.00 with a mean±SD 700.7±487.121, in which food expenses was high (mean 549.55). Maximum total direct cost was Rs.16,980.00 and minimum was 1349.00 with a mean± SD 3998.18±1921.47. Direct medical cost contributes 79.56% and direct non-medical cost contribute 20.44% of total direct cost.Conclusion: COPD has a substantial impact on health-care costs particularly for hospitalization. Exacerbation prevention resulting in reduced need for inpatient care could lower costs. The development of pharmacoeconomic is at an infancy stage in India at the moment, despite the rapid growth of clinical research. In a country with scarce resources and an ever-growing population with diverse health-care needs, health economics (Pharmacoeconomic evaluation) plays a pivotal role in determining the delivery of equitable and cost-effective health services.

Effect of cigarette smoking on erythrocyte sedimentation rate and total leukocyte count

Background: Cigarette smoking is one of the major lifestyle factors which influence the health of human beings. Erythrocyte sedimentation rate (ESR) is a certain biomarker of inflammation. It was a significant predictor of heart failure. Aims and Objectives: This study was conducted to find the effect of cigarette smoking on ESR and total leukocyte count (TLC). Materials and Methods: A total of 120 healthy male smokers and 120 healthy male non-smokers among hospital employees and people from surrounding areas of Navodaya Medical College, Raichur (India), were studied. The TLC was done using Beckman Coulter Automatic Analyzer; ESR estimation was done by Westergren’s method. Results: The mean ESR for smokers is 11.74 mm/h and for non-smokers 7.38 mm/h. The mean TLC for smokers is 8050 per mm3 and for non-smokers 6858 per mm3. The difference between mean ESR and TLC of smokers and non-smokers was statistically significant (P < 0.0001). Conclusion: We concluded that, in smokers, ESR and TLC increased significantly. Regular monitoring of these two parameters in smokers is advised.

Outcome in the small for gestational age neonates in their early neonatal period in relation with the cord blood nucleated RBC’s

Background: NRBCs are physiologically found only in the peripheral blood of the fetus and neonates. Under all other conditions, NRBC is an indicator of pathology, either increase in erythroid activity or damage to the bone marrow has been suggested that the presence of elevated NRBC in the umbilical cord blood is a sign of fetal hypoxia.1-12. Elevated NRBC is a sign of fetal hypoxia in newborns of mothers with preeclampsia even with well controlled hypertension.Methods: The study period is 1 year from November 2015 to October 2016 on Term SGA babies delivered in Navodaya Medical College Hospital and Research Centre. Inclusion criteria all term SGA and healthy term AGA Newborns. Exclusion criteria were mothers with the following condition: maternal diabetes mellitus, hypertension, preeclampsia, chorioamnionitis and babies with the following conditions meconium stained amniotic fluid, congenital anomalies, twin-to-twin transfusion, severe anemia, cyanotic heart disease.Results: The mean gestational age among control and study group was 18.96 and 19.08 respectively. Low APGAR score (≤5) was seen in 3 cases in the study group. No newborn in control group had low APGAR. Out of 50 babies included in this study,24 babies were delivered by LSCS and 26 babies by normal vaginal delivery. the NRBC count was found to be significantly higher in the SGA babies group as compared to the AGA group and this was statistically significant [p,0.005].Conclusions: My study showed that NRBC count was higher in SGA babies than term AGA babies but there was no correlation of NRBC count with the outcome in SGA babies.

Late presenting lateral condyle fracture of the humerus in children - clinical outcome of surgical fixation

Aim: To assess the surgical outcome of Late presenting lateral condyle fracture of the humerus in children with open reduction k-wire/cancellous screw fixation. Material and Methods: After obtaining approval of the ethics committee, a prospective study was conducted in the department of orthopedics Navodaya Medical College and research center, Raichur from March 2015 to August 2016. 13 cases of Late presenting lateral condyle fracture of the humerus in children underwent surgery with k-wire/cancellous screw fixation. We evaluated scoring system proposed by Dhillon et al. to determine the outcomes. Results: There were 9 males and 4 females with a mean age of 7 years and 3 months (range 4-13 years). The average time interval between injury and internal fixation was 4.1 weeks. (Range 3 weeks to 7 weeks). In our study 5 patients got Excellent; 6 patients Good; 2 patients Fair; and 1 patient got Poor results. We encountered major complication in 1 patient who devolved AVN lateral condyle of humerus. Minor complications were noted in total 5 patients. Pin tract infection was the most common in 3 patients and one patient had residual flexion deformity of 15 degree with ROM of 110 degree and another patient had stiffness of elbow. Conclusion: We conclude from our study that late presenting fracture of lateral condyle of humerus needs surgical intervention which can be reasonably reduced and union achieved obtaining satisfactory functional outcome.

Adverse Drug Reaction Monitoring of Antipsychotic Drugs and Mood Stabilizers in a Teaching Hospital

International Journal of Pharmacology and Clinical Sciences,2016,5,4,118-121.DOI:10.5530/ijpcs.5.4.5Published:December 2016Type:Research ArticleAuthors:Swetha Munoli, and Soumya B Patil Author(s) affiliations:Swetha Munoli1, Soumya B Patil2* 1Department of Pharmacology, ESIC-MC and PGIMSR, Bangalore, Karnataka, INDIA. 2Department of Pharmacology, Navodaya Medical College, Raichur, Karnataka, INDIA. Abstract:Background: Antipsychotics and mood stabilizers are associated with adverse effects which can affect the compliance and course of treatment in mental disorders. The present study was therefore undertaken to monitor the adverse drug reactions (ADRs) of the antipsychotics and mood stabilizers in the psychiatric outpatient unit of our hospital. Methods: Study was conducted from December 2011 to November 2012, the patients on antipsychotic drugs from psychiatry outpatient department (OPD) of Raichur Institute of Medical Sciences were considered for analysis. The patients were diagnosed by consultant psychiatrist. Data was collected in standard questionnaire format. All patients diagnosed with psychiatric disorder as per ICD 10 criteria and receiving treatment with antipsychotic or mood stabilizer were included. Assessment of causality and severity of recorded adverse events was done using WHO assessment scale and modified Siegel and Hartwig Scale respectively. Results: 45 ADRs were recorded among 778 patients. Extra pyramidal symptoms, anticholinergic side effects and Weight gain were the most common ADRs. Risperidone, chlorpromazine and olanzapine were the drugs causing maximum ADRs. Assessment of causality and severity of recorded adverse events showed possible to probable and mild to moderately severe respectively. Conclusion: Extrapyramidal symptoms were most common ADRs in our study followed by anticholinergic side effects. Risperidone was most commonly prescribed drug followed by chlorpromazine. Risperidone and chlorpromazine accounted for most of ADRs. Assessment of causality of recorded adverse events showed no certain cause and Assessment of severity of recorded adverse events showed no severe cases. Keywords:Antipsychotics, Extrapyramidal Symptoms, Haloperidol, Lithium, Olanzapine, RisperidoneView:PDF (288.48 KB) PDFClick here to download the PDF file. Images Incidence rate of adverse effects with various anti psychotic drugs

Metacarpal shaft fracture fixation with intramedullary k-wire: Surgical and Clinical outcomes

Background: Metacarpal fractures are among the most common fractures. The majority of metacarpal shaft fractures can be treated conservatively. There are numerous indications for operative treatment and various fixation techniques. The purpose of this prospective study was to assess the surgical and clinical outcomes of metacarpal shaft fractures using intramedullary fixation by K-wire (Kirschner wire). Materials and Methods: 15 cases of Metacarpal shaft fractures underwent surgery with Intra medullary fixation by K-wire. The study was conducted from March 2015 to February 2016 admitted to Navodaya Medical College and research center, Raichur. We evaluated the DASH score to determine the outcomes. Results: All fractures got united in our study and all patients were available for follow up. Two superficial wound (pin site) infections noted which healed with intravenous antibiotic treatment and regular pin site dressing. There were no major complications noted. All patients regained full flexion at the MCP and IP joints but two patients had a mild extensor lag of about 10°. At final follow up the mean DASH score in our study was 4.3 (range: 0-7.2). Conclusion: Closed or minimally invasive fixation with Kirschner wire (k-wire) is a safe method and can be performed with minimal complications. It can be seen as good choice in selective metacarpal shaft fractures.

Umbilical coiling index as a marker of perinatal outcome: An analytical study at Navodaya Medical College, Raichur

Objectives: To measure the umbilical coiling index (UCI) postnatally and to study its association with adverse antenatal and perinatal outcome. Materials and Methods: This prospective study was carried out in the department of pediatrics at Navodaya Medical College, Raichur, Karnataka, from June to July 2016. 200 patients who were in active labor irrespective of their parities, who had singleton pregnancies with live babies who were either delivered by vaginal, instrumental, or lower segmental cesarean section were included in the study and multiple pregnancies, malpresentations, previously diagnosed intrauterine device, and elective cesarean section were excluded. UCI was calculated at the time of delivery by dividing the total number of coils by the total umbilical cord length in centimeters. Its association with various maternal and perinatal risk factors was noted. The statistical tests were the Chi-square test and assessed with EPI Info Version 12.0 software and statistically analyzed. Results: The mean UCI was 0.25±0.03. Hypocoiling or UCI &lt;10th percentile (&lt;0.11) was found to be significantly associated with low APGAR at 1 min and 5 min, meconium stained liquor (MSL), abruption, abnormal fetal heart rate (FHR), neonatal intensive care unit (NICU) admission, low birth weight, and intrauterine growth restriction. Hypercoiling or UCI &gt;90th percentile (&gt;0.37) was found to be associated withpregnancy-induced hypertension, preterm, diabetes mellitus, postpartum hemorrhage, polyhydramnios, NICU admission, abnormal FHR, MSL, and low APGAR at 1 min. Conclusion: Abnormal UCI is associated with several antenatal and perinatal adverse features.

Visual Outcome in Posterior Polar Cataract after Small Incision Cataract Surgery at Navodaya Medical College, Raichur

Visual Outcome in Posterior Polar Cataract after Small Incision Cataract Surgery at Navodaya Medical College, Raichur

Prevalence of Depression among Elderly People in the Place of their Residency, in the Urban Field Practice Area of Navodaya Medical College, Raichur

Prevalence of Depression among Elderly People in the Place of their Residency, in the Urban Field Practice Area of Navodaya Medical College, Raichur

Serum sodium as a prognostic marker in dengue fever cases admitted to PICU in Navodaya hospital, Raichur, India

Background: Dengue fever is an arboviral infection which is mosquito transmitted, most common in tropical and subtropical countries. Worldwide around 2.5 billion population are at the risk of developing dengue infection.Methods: The study was carried out in a 5 bedded (high dependency unit) PICU of Navodaya Medical College and Hospital, Raichur, Karnataka, India. The study was approved by the ethical committee of the hospital. The study was performed over a period of 12 months from August 2015 - August 2016. The study group included individuals from the age group of 1 month to 18 years, who were diagnosed with dengue fever. Results: Out of the total 99 cases, 36 cases had no variation in serum sodium levels, 33 cases were mild hyponatremic, 12 cases were moderate hyponatremic and 18 cases were severely hyponatremic. Out of the 36 cases with normal serum sodium levels, only 1 case progressed to bleeding complications. Out of the 33 cases with mild serum sodium levels, 2 cases progressed to complications out of which 1 case having bleeding manifestations and 1 case having both bleeding and central nervous system (CNS) complications.Conclusions: Hyponatremia is the most common electrolyte disturbance in dengue fever as well as dengue associated complications. The lower the serum sodium levels the higher is the incidence of complications associated with dengue fever. The incidence of CNS and bleeding complications is more as compared to the RS and hepatobiliary complications. The incidence of RS and hepatobiliary complications is high with moderate and severe hyponatremia. Thus serum sodium plays a most important role in the prognosis of dengue fever and associated complications.

Prevalence of hypertension and its risk factors among adults in urban field practice area NMC, Raichur, Karnataka, India

Background: Hypertension is the commonest cardiovascular disorder, posting a major public health problem of the world and especially to population in socio-economic and epidemiological transition. It is one of the major and independent risk factors for non-communicable diseases like cerebrovascular disease, coronary heart diseases, and cardiac and renal failure. The recent WHO report states that considering the prevalence of any diseases, hypertension ranks fourth in the world. As it is hidden beneath an outwardly asymptomatic appearance, the disease does immense harm to the body in the form of ‘Target organ’ damage hence the WHO is named it the “silent killer”. The objectives were to estimate prevalence of hypertension among adults in urban population and to estimate the risk factors associated.Methods: A cross sectional, community based study over a period of one year from January 2013 - December 2013, in Urban field Practice area of Navodaya Medical College. Diagnostic criteria (based on JNC VII guidelines) includes SBP ≥140mmHg and/or DBP ≥90mmHg and persons already on anti-hypertensive treatment. Study Population includes people aged 18-65 years residing in the urban field practice area of NMC. Systematic random sampling method is used. Statistical Analysis was done by Chi Square Test by using SPSS version 17.Results: The hypertension prevalence was 33.6%. The prevalence increased with age. Males have shown higher prevalence of HTN (49.4%) compared to females (23%). Family history of hypertension was present in 36.9% of hypertensives. Majority were taking &gt;6 grams salt per day. Prevalence of hypertension was more in past smokers (82.4%) followed by current smokers (51.5%) when compared to non-smokers (27.6%). 45.4% of hypertensives had stress.Conclusions: Prevalence of hypertension among adults in urban field practice area is 33.6%.There is significant association of hypertension with age, smoking tobacco, high salt intake, stress.

Endoscopic dacryocystorhinostomy: our experience

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The purpose of the study was to determine the outcome and safety of endoscopic dacryocystorhinostomy (ENDO-DCR) with the use of silicon stents in nasolacrimal duct obstruction.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was done in the department of otorhinolaryngology and head and neck surgery, Navodaya Medical College and Research Centre, Raichur, from January 2013 to June 2015, with a total of 82cases (10 cases with bilateral disease) underwent a standardized procedure, with an endonasal approach to the lacrimal sac, surgical removal of nasal mucosa, lacrimal bone, and a fragment of the frontal process of the maxilla. The medial wall of the lacrimal sac was removed completely and canalicular silicone intubation tube was placed for six weeks post operatively. Main outcome measures were resolution of epiphora, absence of discharge, and patency of the ostium confirmed by irrigation and endoscopic evaluation of neo osteum at 6 weeks.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;The ENDO-DCR procedure with adjunctive canalicular silicon intubation tube was successful in 78 (95%) cases. No significant complications were encountered during or after operative period&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Endoscopic dacryocystorhinostomy with canalicular silicon intubation for shorter duration (6 weeks) is a safe and successful procedure for the treatment of nasolacrimal duct obstruction in adults as well as in children with a success rate of 95%.&lt;/p&gt;

DRUG USE EVALUATION OF THIRD GENERATION CEPHALOSPORINS IN A TERTIARY CARE TEACHING HOSPITAL

Background: Inappropriate use of antibiotics specifically, the broad spectrum antibiotics in hospital results in resistance to antibiotics. Assessment of antimicrobial use can be performed by evaluating their use . Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. Objective: The present work was undertaken to study the drug utilization evaluation of third generation cephalosporins in the inpatient department of various wards of Navodaya Medical College & Hospital , Raichur Materials & Methods: This is a prospective observational study conducted in Navodaya Medical College & Hospital from November 2015 to April 2016. A total of 100 case records of inpatients in medicine, surgery and pediatric wards were reviewed. Relevant information was recorded in a structured proforma & data was evaluated. Results: Prescriptions of 100 patients containing third generation cephalosporins were collected and the utilization pattern were analyzed by using WHO drug core indicators. The average number of drugs per prescription was found to be 8.62. Only 2.43% of drugs were prescribed by generic name. The percentage of total prescrip tions for antibiotics was 13.92%, for injections were 12.06% and drugs prescribed from EDL was 53.82%. Ceftriaxone was most frequently prescribed (64%) third generation cephalosporins in parenteral form, followed by cefoperazone(15%). Gender analysis revealed that male (56%) patients prescribed with third generation cephalosporins were more compared to female (44%). With regard to age, 73.33% of males were in above 60 years age group while 66.66% of females were in 11-20 years age group. Conclusion: Our study concludes that, awareness about the drug-drug interactions among health care professionals, computerized systems for prescription and drug information, as well as collaborative drug selection and pharmaceutical care are some of the possible solutions to the drug usage related problems. Hence, the involvement of clinical pharmacists in clinical practice helps to increase proper usage of cephalosporins and optimum outcome.

Study of prehilar branching pattern of renal artery in human cadaveric kidneys

Abstract Background and aims: Kidneys are the pair of excretory organs situated retroperitoneally in the lumbar region on either side of vertebral column. Classically there is a single renal artery supplying each kidney which arises from abdominal aorta. Understanding the anatomy of vascular pattern of kidney is important for clinicians to perform renal transplantation, interventional radiological stodies. The present stody was undertaken for studying the prehilar vascular pattern of renal artery. Material and methods: Kidneys were collected from the department of Anatomy, Navodaya Medical College and Hospital, Raichur, Karnataka. Totally 84 kidneys were collected, the kidney containing full renal arteries from aorta were selected. The abnormal shaped kidneys were excluded from the stody. The blunt dissection was done to remove fat, loose connective tissue at the hilum and the artery was coloured with fabric red colour and photographed. Results: Out of 84 kidneys, single renal artery was seen in 72 cases and 12 kidney specimens showed double renal arteries. The single renal artery divided into anterior and posterior divisions. The anterior division was classified into three types of which, type I showed 43.06% incidence, type II showed 33.33% and type III showed 23.61% incidence. The posterior division was classified into two types of which type I showed 69.44% and type II showed 30.56%. Superior polar arteries were seen in 13.09% and inferior polar artery was seen in 5.95% cases. Conclusion : A sound knowledge of branching pattern of renal artery is important for urologists and radiologists for giving proper diagnosis and treatment. The present study mainly aims for prehilar vascular pattern of renal artery which may be usefull for renal transplantation and microvascular surgeries of kidneys.

Fungal Profile of Occular Infection in Patients Attending In a Tertiary Care Hospital

Aim and objective: To identify the fungal etiology of Ocular infections in patients attending Ophthalmology department from the period Nov 2010 to Sep 2011 at Navodaya Medical College Hospital and Research Centre, Raichur. Methods: 102 patients attending Ophthalmology OPD/IPD in Navodaya Medical College Hospital and Research Centre were analysed from Nov 2010 to Sep 2011. Using predefined inclusion and exclusion criteria, samples were collected according to the standard protocol. These were cultured for microorganisms (fungal) and were identified. Results: Out of 102 samples studied, 75 samples had growth and the isolation rate. only 23(26%) was fungal growth. KOH wet mount examination showed high specificity of 98.73% and PPV of 90.91% with very significant p value of < 0.0001. The most common fungal isolate were Fusarium spp (30.43%) followed by Aspergillus spp (26.04%). Conclusion: Fungal etiology was mostly associated with corneal infections. Direct microscopic examination is an essential tool in the diagnosis of fungal infections. A simple and rapid KOH wet mount examination early during the disease result in significant progress of the disease in initiating early and specific therapy.

Comparative Study of Atorvastatin and Rosuvastatin in Combination with Fenofibrate in mixed Hyperlipidemia

International Journal of Pharmacology and Clinical Sciences,2016,5,1,25-31.DOI:10.5530/ijpcs.5.1.5Published:March 2016Type:Research ArticlesAuthors:Rohit Dixit, and Shankar Jagan Author(s) affiliations:Rohit Dixit1 and Shankar Jagan2 1Department of Pharmacology, Navodaya Medical College, INDIA. 2Medical Review Safety Physician, Accenture, Chennai, INDIA. Abstract:Aim: To compare the effects of Atorvastatin and Rosuvastatin in combination with fenofibrate in patients with mixed Hyperlipidemia. Materials and Methods: It was an open label, randomized, parallel group, comparative, prospective clinical study. A total of 70 subjects diagnosed with mixed hyperlipidemia were screened and were randomly allocated into two groups of thirty each. Initial readings of lipid levels like TC, TG, HDL, LDL and VLDL for both the groups were taken as baseline values. Then, Group I received Tab Atorvastatin 10 mg + Fenofibrate 160 mg and Group II received Tab Rosuvastatin 10 mg+ Fenofibrate 160 mg once a day at night for 12 weeks. Patients were assessed after 12 weeks and their Lipid profile was done. Results: Patients who received a combination of atorvastatin with fenofibrate had a reduction of Total cholesterol by 39%, Triglycerides by 47%, LDL-C by 50% and VLDL-C by 35% respectively. In group treated with combination of rosuvastatin with fenofibrate there was a decrease in TC by 54%, TGs by 58%, LDL-C by 52% and VLDL-C by 56% respectively. At the same time, HDL-C levels were increased by 14% in the group treated with rosuvastatin with fenofibrate as compared to atorvastatin with fenofibrate treated group which increased the HDL-C levels by 6%. Conclusion: Both the treatment regimens significantly decreased TC, TG, LDL‑C, VLDL‑C, but the reduction was more and statistically significant in Rosuvastatin and fenofibrate combination group when compared with atorvastatin and fenofibrate treated group at the end of 12 weeks. Keywords:Atherosclerosis, Cholesterol, Heart, Lipoprotein, StatinsView:PDF (464.7 KB) PDFClick here to download the PDF file. Images Study design

A Prospective Study on Medication Prescribing Pattern for Geriatric Patients in aTertiary Care Teaching Hospital

Background: Polypharmacy and inappropriate prescriptions are prominent prescribing issues with elderly patients. Beer’s criteria and other guidelines have been developed to assist in the reduction of potentially inappropriate medications prescribed to elderly patients. Objective: The present work was undertaken to study prescribing pattern of various drugs in elderly patients and also to evaluate inappropriate prescribing with the help of Beers criteria. Materials & Methods: This is a prospective observational study conducted in Navodaya Medical College & Hospital from November 2014 to April 2015. A total of 400 case records of inpatients ≥65years in medical, surgery and orthopaedic wards were reviewed. Relevant information was recorded in a structured proforma & data was evaluated. Results: Most of the cases were from respiratory system (28%), followed by cardiovascular system (18.75%). The most commonly prescribed drugs were antimicrobials (19.106%). Polypharmacy was observed in 344(83.5%) patients. According to Beers criteria, 256 drugs were prescribed inappropriately & all these drugs were to be generally avoided in older adults. Conclusion: This study has shown the patterns of diseases prevalent in geriatric patients, drug use among them and also suggests that drugs to be avoided in elderly. Prevalence of polypharmacy was high which is usually unavoidable in the elderly.

OTFS-A pathological menace leading to double trouble in women

Background: OTFS are a heterogenous group of tumors with varying stromal activity and produce hormones such as estrogen, androgen or progesterone. These tumors are of due importance as they have widespread clinical, biochemical or pathological effects on various tissues and organs and are commonly observed in female genital tract manifesting as hyperplasias or carcinomas. It is thus important to study OTFS and analyse the associated changes in the endometrium. Objectives: The aims of present study are: 1. Age distribution and clinical features of OTFS. 2. Histopathological spectra of OTFS. 3. Study of functional status of these tumors and associated endo-myometrial changes. Methods: Present study of 2 years (2014-2015) analysed 48 cases of OTFS and their corresponding endo-myometrial changes in hysterectomised patients, at department of pathology, Navodaya Medical College, Raichur, Karnataka. Specimens were examined, processed and stained using Hematoxylin and Eosin. Results: Majority of cases were in reproductive age group (83.3%) compared to postmenopausal (16.7%) category. Most were asymptomatic and few (12%) were symptomatic with menorrhagia and postmenopausal bleeding. Histopathological categories included: surface epithelial tumors (44), dermoid cysts (2), metastatic EOPPC (1) and combined tumor (1). OTFS with active stroma (64.5%) was commonly observed among total cases and the associated endo-myometrial changes, most frequently observed was endometrial polyp (29%) followed by cystoglandular hyperplasia (25.8%), adenomatous polyp (19.4%), adenomatous hyperplasia (16.1%), adenomyosis (8.7%) and leiomyoma (6.5%). Conclusion: As OTFS with active stroma can have ill effects on endo-myometrium, an appropriate screening of the cases clinically and histopathologically would reduce morbidity and mortality, thus helping in better patient outcome. Keywords: Ovarian tumors with functioning stroma, Endocrine manifestations, Active stroma, Endo-myometrial changes

Opinion of doctors about unmet needs of rural diabetics

Background: India is home to nearly 62 million diabetics - second only to China which has over 92 million diabetics. The main challenges for screening for diabetes and its complications in rural India are inadequate health care resources, lack of awareness and illiteracy among patients, limited physicians and paramedical staff trained in diabetes, lack of awareness among doctors as to who can legally practice diabetes in India. The present study was undertaken to explore the opinion of various doctors regarding diabetic care in rural India. Methods: The present study was conducted in Navodaya Medical College, Raichur and Mamata Medical College, Khammam. A cross-sectional study design was used to perform a multicentre survey from April 2015 to September 2015. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS). Content and construct validation of the questionnaire was done by a panel containing subject experts, epidemiologists and a statistician. Following which the questionnaires were sent to different set doctors by print outs, email and via online survey tools. Results: All the doctors who were involved in the study had different opinion. MBBS doctors are more aware than BHMS/BAMS/BUMS doctors about the minimum degree required doing a diabetic practice legally in India. Both the group of doctors believed that the needs of diabetic population in rural India are not properly addressed; the reason behind this was lack of qualified doctors (according to majority of BHMS/BAMS/BUMS doctors) and lack of awareness among the rural patients (according to MBBS doctors). Both the doctors believe that MBBS doctors with some fellowship courses in diabetes can manage diabetes effectively (except serious complications). Conclusions: Both the doctors believe that MBBS doctors with some fellowship courses in diabetes can manage diabetes effectively (except serious complications). In India only MD (general medicine) and endocrinologists are technically qualified to treat diabetes. MCI should come forward and recognize the fellowship courses by regularizing them with proper guidelines and protocol set up for the institution providing such courses and allow those doctors to practice in rural areas, so that diabetics’ needs are addressed properly.

Prevalence of alcohol consumption among adults in urban field practice area NMC, Raichur, Karnataka, India

Background: According to world health report, at least 10 thousand million people throughout the world regularly use alcohol. A WHO report indicates that alcohol use accounts for 3.2% of all global deaths and 4% of all global burden of diseases; it also accounts for 3.5% of all DALYs lost due to all causes. Profile of clients in addiction treatment centers in 23 states showed that alcohol was the first or second major drug of abuse in most of the states of India. Habitual alcohol use is another major lifestyle factor associated with ill health and a large number of serious diseases. Objectives of the study were to estimate the prevalence of alcohol consumption among adults in urban population. Methods: A cross sectional, community based study was undertaken over a period of one year from January 2013 – December 2013, in urban field Practice area of Navodaya Medical College. Study population was people aged 18-65 years residing in the urban field practice area of NMC. Sampling method was systematic random sampling. Statistical Analysis: Chi Square Test by using SPSS version 17. Results: Total participants in the study were 1751, comprised of 964 males and 787 females. current alcohol use 33.6% (male- 49.2%, female-14.4%). 32.78% of males and 12.57% females consumed alcohol since 20 years. 18.56% males and 1.90% females consumed for more than 20years. Majority 33.6% belonged to Class I, followed by 37.8% Class III and 36.0% Class IV. Conclusions: Nearly one third of subjects use alcohol among them nearly half of the men consumed alcohol. Usage of alcohol is more common in middle aged men.