Rural Health Care Centers Research Articles

Serum amylase or serum lipase, a comparison in acute pancreatitis

Abstract Background More and more samples are received by the laboratories each day for the simultaneous measurement of serum amylase and lipase in the diagnosis of acute pancreatitis. Objectives This study is an effort to find which of the two analytes, serum amylase or lipase, is a better marker. Methods This is a retrospective study from a tertiary care hospital in which radiologically diagnosed patients of acute pancreatitis, in whom blood samples for the estimation of serum amylase and lipase were collected within 12–72 h after the onset of abdominal pain were taken up for the study. All the relevant data and imaging details were collected. Results We analyzed 100 such cases and in our study we found that 74 out of 100 patients had raised serum amylase and 93 out of 100 had raised serum lipase levels. Conclusion In rural health care centers, in smaller hospitals, or in set ups where resources are limited and in situations where patients cannot afford, serum lipase will be a better choice over serum amylase in the diagnosis of acute pancreatitis.

Nurses Communication Barriers in Healthcare Centers: Patients’ Perspectives

While community health nurses in different healthcare settings, provide competent and qualified services, they have been confronted by numerous types of communication barriers that hindering their necessary functions. The nurse as a community servant should have fitting communication skills to maintain excellent care provision and overcoming the barriers that may hinder these targets. Thus, the current study aims to identify and describe patients’ perceptions about nurses' communication barriers in healthcare centers in KSA.  Cross-sectional, descriptive exploratory design is used in three health care centers in the rural governor of Afif in the Riyadh city, KSA. 300 patients were selected by a stratified proportionate random sampling technique in the three healthcare centers, and for each center, systemic random sampling approach was implemented. The Health Communication Feedback questionnaire (HCFQ) was used for data collection which was developed by Yorkshire Cancer Network in 2006 and modified by Fathi A et al., in 2015. The present research study found that patients in rural healthcare centers have accepted views regarding nurses’ communication behaviors in healthcare centers. While, they perceived some barriers in this communication, such as: 1- Barriers in the side of the patients which including; the disease process, language difficulties, physical and psychological complaints like pain, fever, anxiety, and graving. 2- Barriers in the side of the nurses which involving; limited communication skills and insufficient time. 3- Barriers regarding staff and health care center environment which containing; work crowdedness, noise and uncooperative routine system of management. The last type of barriers is 4-Barries in dealing with health messages which representing that nurses’ health messages may be not related to clients’ need and it may involve terminology which hinders their communication. On the other hand, the study participants provided some suggestions to overcome the previous barriers, for examples: increasing of patient-nurse cooperation, training of nurses on communications skills in health centers and considering that in nursing curricula, and decreasing nurses’ workload. Conclusion: Patient’s views are very effective indicators for healthcare professional work. Community health nurses in healthcare centers have some communication barriers which may negatively affect their performance. Moreover, patients illustrated some solutions which should be taken into considerations among stakeholders and nursing curricula planners in KSA. Recommendations: In-serve training programs about communication skills, culture, religious norms and role models should be taken by the nurses in simulated virtual environments or reality. The further major study needed in the light of the current study is, develop and implement nursing curricula included real scenarios about nurses-patient communication skills.

Clinicopathological study of cervical lymphadenopathy at rural tertiary health care centre

Background: The term lymphadenopathy refers to nodes that are abnormal in size, consistency or number. Cervical lymphadenothy is one of the common and important presentations of the underlying pathology of the head and neck region which has large number of differential diagnosis like neoplasms, infections (specific and non-specific) and in immune deficiency disorders and also, the rare disorders like Inflammatory pseudotumour (Plasma cell granuloma) and Kikuchi-Fujimoto diseases. Etiological profile of cervical Lymphadenopathy varies from region to region, in developing countries like India, acute respiratory infection, suppurative skin infection and tuberculosis are the main causes for cervical lymphadenopathy while in developed countries secondary carcinoma are the most frequent causes for cervical lymphadenopathy.Methods: This hospital based cross sectional study was carried out in the Department of Otorhinolaryngology in Rural Tertiary Health Care Centre. The period of the study was from January 2014 to June 2016.Results: In our study of 176 patients the youngest patient was 13year of age and oldest patient was 68 years old. The majority of patients affected were in the age group of 21 to 30 years (30.68%) followed by 13 to 20 years (23.86%). The least affected age group was 60 to 70 years (5.8%). There were 80 men and 96 women. The male to female ratio in present study was 1:1.2 The frequently affected age group was 21 to 30 years in men (26.25%) as well as women (34.38%). In our study Neck swelling was present in all cases (100%). fever was the second most common symptom in 54 cases (30.68%) followed by cough in 45 cases (25.56%). In our study most frequently involved lymph node group was posterior cervical in 68 cases (38.39%), followed by upper deep cervical in 66 cases (37.50%).Conclusions: In the present study it was found that tuberculosis was the most frequent cause of cervical Lymphadenopathy in 48.29% of patients, followed by reactive Lymphadenopathy in 17.34%, metastatic lymphadenopathy in 15.34% chronic nonspecific Lymphadenopathy in 14.77% and primary lymphoreticular malignancy in 4.35%. In our study out of 176 cases of cervical lymphadenopathy 141 cases (80.11%) were non neoplastic and 35 cases (19.88 %) were neoplastic.

The relationship of married women's marriage duration with their reproductive practices

Background: Low fertility rate is currently a serious health problem both in developed and developing countries. Objective: The objective of this study was to assess the women's reproductive practices based on their marriage duration. Methods: This cross-sectional study was completed in urban and in rural healthcare centers in Babol, Iran. A sample of 880 married women aged 15-49 was recruited through the cluster sampling. Data on participants' reproductive practices were collected and analyzed through the one-way analysis of variance and the Chi-squared tests. Results: Women with different marriage durations significantly differed from each other respecting their age at the first pregnancy, the time interval between their marriage and their first pregnancy, the number of their children, the interval between their first and second pregnancies, their contraceptive use before the first pregnancy, a history of abortion, and a history of unwanted pregnancy ( P Conclusions: While the rate of fertility and the duration of reproductive life have decreased among women, the rates of unwanted pregnancy, induced abortion, and unreliable contraceptive method use are still high among them. Health-care providers, particularly midwives, are recommended to provide women with educations about the best contraceptive methods, the best marriage-pregnancy interval, and ideal spacing between pregnancies to reduce the rates of unwanted pregnancy and induced abortion.

The emergence of Mupirocin resistance among the clinical isolates of Staphylococci in a rural tertiary health-care centre of South India

INTRODUCTION: Mupirocin is mainly used for decolonisation of Methicillin-resistant Staphylococcus aureus among patients and health-care workers. However resistance originates from coagulase negative staphylococci (CoNS) and spreads to S. aureus by horizontal gene transfer. Hence, the present study was done to determine the overall prevalence of high- and low-level Mupirocin resistance among S. aureus and CoNS and correlate with the occurrence of Methicillin and inducible Clindamycin resistance. MATERIALS AND METHODS: A total of 100 consecutive, non-repetitive, clinical isolates of Staphylococci were obtained from various samples in a rural tertiary care hospital of Karnataka between August and September 2016. Antibiotic susceptibility testing was done according to the Clinical and Laboratory Standards Institute (M100-S25, 2015) guidelines. Low- and high-level Mupirocin resistance was screened using 5 μg and 200 μg discs, respectively. RESULTS: Of 100 staphylococcal isolates, high-level Mupirocin resistance (MupRH) was detected in 13 isolates and low-level Mupirocin resistance (MupRL) was found in 4 isolates. Of 13 HLMR isolates, majority were CoNS (12 out of 13, 92.31%). Even in LLMR isolates, 75% (3 out of 4) were CoNS. All the HLMR and LLMR isolates were Methicillin resistant (P < 0.05). CONCLUSION: High prevalence of Mupirocin resistance was found in the present study. Hence, screening for Mupirocin resistance should be routinely done and the drug must be used judiciously.

Epidemiology of lip and palate clefts in northwest of Iran: Prevalence, surgery complications and unrepaired patients younger than 18 years old

BackgroundThis study investigated the prevalence of lip and palate clefts, need for reoperation and primary surgery in unrepaired patients younger than 18 years old in Zanjan province, northwest of Iran. MethodsAll urban and rural healthcare centers and the education department of Zanjan province were informed about this project. After identifying all patients with cleft lip and palate, they were sent to the plastic surgery clinic of our hospital. Their data were gathered, including sex, age, clinical classification, surgical modality, complications, surgery satisfaction and un-repaired patients. ResultsA total of 87,356 people were examined by social workers. Among them 120 children and adolescents had cleft lip and palate (1.37 per 1000). 59 (49.1%) patients had cleft lip and palate, 35 (29.1%) patients had only cleft lip and 26 (21.6%) patients had only cleft palate. 25 patients (20.8%) had not done surgery (detection rate was 2.86 per 10,000). Secondary surgery was done in 39 patients (41.05%). In spite of a referral health system in Iran, 25 children with cleft lip had not been operated. ConclusionAlthough most of the identified patients had been operated before, almost half of them had to undergo surgery again. Given the lack of studies on this topic in Iran, our findings can form the basis for further studies to precisely identify the roots of cleft lip and palate and properly plan to decrease its risk factors. Further studies are needed to identify reasons of missed detections and why primary surgeries are not satisfying.

Applications of Data Envelope Analysis Using Efficient or Inefficient Frontiers in Evaluating the Efficiency of Rural Healthcare Centers (Case Study: Langroud County)

Objective: This study was conducted to examine the efficiency of rural healthcare centers (Health Houses) including output-oriented efficiency, input-oriented efficiency, optimistic efficiency, pessimistic efficiency and efficiency range in Langerud County in Guilan province. Method: This study is a descriptive-analytical one whose data is cross-sectional collected through field works in 2016 from 45 rural healthcare centers in Langerud County. The required data were obtained from available documents and statistics, and were analyzed using Windeap and GAMS software packages. In this paper, to evaluate the performance of rural healthcare centers from March 2015 to March 2016, two inputs and three outputs were determined. The input included the costs and the number of health workers, and the outputs included family health clients, outpatients, and the clients who needed wound dressings. Findings: The results showed that nine out of 45 rural healthcare centers, with an efficiency score of 1, have efficient performance. Rural healthcare centers in villages of Garask, Koru Roud Khaneh, and Malat are respectively the first three villages with the highest efficiency score. The study results showed that the average optimistic efficiency at output-oriented and input-oriented efficiencies are 1.645 and 0.688, respectively, and 15.5% of rural healthcare centers are pessimistically inefficient. Besides, 64% of the units are between the efficient and inefficient frontiers, and are not pessimistically inefficient; meanwhile, those units are not on pessimistic lines of efficiency which demonstrates indulgence in input consumption or a potential ability in increased offered services or decreased input consumption. According to the results, maximum optimistic efficiency is 3.87 and its minimum is one. Maximum pessimistic efficiency is one and its minimum is 0.29. Practical Implications: As the results show, it is suggested that efficient healthcare units be used as paragons and that assessing educational requirements of inefficient rural healthcare centers would provide useful information for planners and policy makers.

Usefulness of WOMAC index as a screening tool for knee osteoarthritis among patients attending a rural health care center in Tamil Nadu

Background: Osteoarthritis is the eighth leading cause of disability and a degenerative disease that worsens over time. Hence, early diagnosis and treatment remains the key in the management of Osteoarthritis. The aim and objective of the study was to evaluate the usefulness of WOMAC index for screening Osteoarthritis among the patients older than 50 years of age attending a Rural Health Centre.Methods: A cross sectional study was done among patients complaining of knee pain who visited a rural centre between June-August 2016. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was applied to all participants with knee pain to assess risk for OA. Also, American College of Rheumatology criteria (ACR) was used as a standard. Descriptive statistics were used. Chi-square test with Odds Ratio was calculated to find out of the strength of association. To test the agreement of WOMAC score with ACR Clinical Criteria, McNemar’s test analysis was done.Results: Out of 103 study subjects 45 were males and 58 were females. According to WOMAC Index Scores, 20 (19.4%) subjects belonged to high risk (score ≥81) and 38 (39.6%) subjects belonged to moderate risk (score 60 - 80). The Mean±SD WOMAC Score was 64.40±15.2. Age group [OR 2.85; 95% CI 1.25-6.48) and gender [OR 2.29; 95% CI 1.01-5.24) were significantly associated with WOMAC score percentage. Comparing WOMAC score percentages with ACR criteria for knee OA revealed statistically significant agreement (p-value, 0.009) which indicated the diagnostic accuracy of WOMAC index.Conclusions: WOMAC Index can be a useful screening tool for people at risk for Osteoarthritis and will help in identifying the disease early.

Correlation of Histopathological Study of Breast Lesions with cytology and mammography as a measure of internal quality and diagnostic accuracy

Background: Breast cancer is the one of the leading causes death in women. Triple test approach has been widely accepted in asymptomatic women for the preoperative diagnosis of the breast lesions. Triple test includes clinical examination, mammography and Fine Needle Aspiration Cytology (FNAC) to differentiate between neoplastic and non-neoplastic lesions, histopathological confirmation being the gold standard for neoplasticlesions and best management plan for the patient. The aim was to study the histopathological spectrum of breast lesions and correlate the cytological and radiological findings with histopathological examination and to determine sensitivity, specificity and diagnostic accuracy of FNACand mammography in the diagnosis of the breast lesions. Methods: The study comprised of 552 casesofhistopathologically diagnosed breast lesions over the period of twelve years in a rural tertiary health care centre catering rural population. Results: Of the 552 cases examinedhistopathologically, 375 cases (67.9%) were benign lesions, 177 cases (32.1%) were malignant. Fibroadenoma was the commonest benign lesion, whereas infiltrating ductal carcinoma was the commonest malignant tumour. Incidence of phyllodes tumour was significantly higher compared to other studies. Overall sensitivity, specificity and diagnostic accuracy of FNAC and mammography were 95.9%, 98%, 96.6% and 84.7%, 78.5%,81.1% respectively. Conclusion: Histopathology plays an important role in diagnostic and therapeutic management of neoplastic breast lesionswith preoperative Triple test being an important supportive investigation in rapid diagnosis withfairly good sensitivity,specificity and diagnostic accuracyin neoplastic lesions. Significantly higher incidence of phyllodes tumor needs further investigation for causative mechanism. DOI: 10.21276/APALM.1427

Impact of fortified versus unfortified lipid-based supplements on morbidity and nutritional status: A randomised double-blind placebo-controlled trial in ill Gambian children.

BackgroundMultiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed.Methods and findingsWe undertook a double-blind randomised controlled trial of small-quantity lipid-based nutrient supplements (SQ-LNS) fortified with 23 micronutrients in children aged 6 months (mo) to 5 years (y) presenting with an illness at a rural primary healthcare centre in The Gambia. Primary outcomes were repeat clinic presentations and growth over 24 wk. Participants were randomly assigned to receive 1 of 3 interventions: (1) supplementation with micronutrient-fortified SQ-LNS for 12 wk (MMN-12), (2) supplementation with micronutrient-fortified SQ-LNS for 6 wk followed by unfortified SQ-LNS for 6 wk (MMN-6), or (3) supplementation with unfortified SQ-LNS for 12 wk (MMN-0) to be consumed in daily portions. Treatment masking used 16 letters per 6-wk block in the randomisation process. Blinded intention-to-treat analysis based on a prespecified statistical analysis plan included all participants eligible and correctly enrolled.Between December 2009 and June 2011, 1,101 children (age 6–60 mo, mean 25.5 mo) were enrolled, and 1,085 were assessed (MMN-0 = 361, MMN-6 = 362, MMN-12 = 362). MMN supplementation was associated with a small increase in height-for-age z-scores 24 wk after recruitment (effect size for MMN groups combined: 0.084 SD/24 wk, 95% CI: 0.005, 0.168; p = 0.037; equivalent to 2–5 mm depending on age). No significant difference in frequency of morbidity measured by the number of visits to the clinic within 24 wk follow-up was detected with 0.09 presentations per wk for all groups (MMN-0 versus MMN-6: adjusted incidence rate ratio [IRR] 1.03, 95% CI: 0.92, 1.16; MMN-0 versus MMN-12: 1.05, 95% CI: 0.93, 1.18). In post hoc analysis, clinic visits significantly increased by 43% over the first 3 wk of fortified versus unfortified SQ-LNS (adjusted IRR 1.43; 95% CI: 1.07, 1.92; p = 0.016), with respiratory presentations increasing by 52% with fortified SQ-LNS (adjusted IRR 1.52; 95% CI: 1.01, 2.30; p = 0.046). The number of severe adverse events during supplementation were similar between groups (MMN-0 = 20 [1 death]; MMN-6 = 21 [1 death]; MMN-12 = 20 [0 death]). No participant withdrew due to adverse effects. Study limitations included the lack of supervision of daily supplementation.ConclusionPrescribing micronutrient-fortified SQ-LNS to ill children presenting for primary care in rural Gambia had a very small effect on linear growth and did not reduce morbidity compared to unfortified SQ-LNS. An early increase in repeat visits indicates a need for the establishment of evidence-based guidelines and caution with systematic prescribing of MMN. Future research should be directed at understanding the mechanisms behind the lack of effect of MMN supplementation on morbidity measures and limited effect on growth.Trial registrationISRCTN 73571031.

Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

BackgroundRural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service...

Undiagnosed diabetes among adult attendants of a rural primary healthcare center in Menoufia Governorate

Objective The present study aimed to estimate the prevalence of undiagnosed diabetes in adult attendants of a primary healthcare center in a rural area. Background The prevalence of diabetes is rapidly increasing worldwide. T2DM may remain undetected for many years, leading to severe complications and healthcare costs. Patients and methods We carried out a cross-sectional study on 1255 cases, with a mean age of 38.9±11.16 years. All participants were subjected to history taking, complete medical examination, and laboratory investigations (measurement of fasting blood glucose level and 2-h postprandial blood glucose level). We then compared our findings between the diabetic group and the normal group. Results The prevalence of undiagnosed diabetes in adults was 4.2%. Undiagnosed diabetes was significantly associated with age ( P P P P P Conclusion The prevalence of undiagnosed diabetes in adult attendants of the rural primary healthcare center was 4.2%.

Cervical cancer screening in rural Bhutan with the careHPV test on self-collected samples: an ongoing cross-sectional, population-based study (REACH-Bhutan)

ObjectivesThe Bhutanese Screening Programme recommends a Pap smear every 3 years for women aged 25–65 years, and coverage ranges from 20% to 60%, being especially challenging in rural settings. The...

Cognitive screening tools for primary care settings: examining the ‘Test Your Memory’ and ‘General Practitioner assessment of Cognition’ tools in a rural aging population in Greece

Background: Under conditions of high demand for primary care services in a setting of low financial resources, there is need for brief, easily administered cognitive screening tools for use in the primary care setting, especially in rural areas. However, interpretation of these cognitive tests’ results requires knowledge on their susceptibility to cultural, educational and demographic patient characteristics.Objectives: To assess the clinical validity of the ‘Test Your Memory’ (TYM) and ‘General Practitioner assessment of Cognition’ (GPCog) which was specifically designed for primary care practice, in a rural primary care setting in Greece, utilizing the ‘Mini Mental State Examination’ (MMSE) as a reference standard.Methods: The MMSE, TYM, and GPCog were administered to a random sample of 319 community dwelling Greek adults aged 60 to 89 years in 11 rural Primary Healthcare Centres of the Prefecture of Heraklion on the island of Crete, Greece. Analyses examined (a) The association of each instrument with demographic factors and MMSE and (b) optimal cut-off scores, sensitivity and specificity against MMSE-based cognitive impairment risk using ROC analyses with the MMSE 23/24 point cut-off as a reference standard.Results: We found a sensitivity of 80% and a specificity of 77% for TYM (35/36 or 38/39 cut-off, depending on education). Corresponding values were 89% and 61% for GPCog (7/8 cut-off), respectively.Conclusion: The TYM and GPCog instruments appear to be suitable for routine use in the primary care setting as tools for cognitive impairment risk detection in elderly rural populations.

Complete Blood Count Reference Ranges from a Rural Haitian Ambulatory Care Clinic.

At rural healthcare centers in developing countries, it is difficult to recruit healthy individuals for reference range studies. So, in this study, I evaluated complete blood count (CBC) data to determine reference ranges for a rural Haitian population. A convenience sample of laboratory records was reviewed to obtain CBC results for 157 adult patients with normal screening examination results. Central 95% reference ranges were determined for male and female subjects. Relative to reference ranges obtained with United States (US)-based subjects, the hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and absolute neutrophil count (ANC) ranges were lower in subjects who resided in rural Haiti. The upper reference limit of the red blood cell distribution width-coefficient of variation (RDW-CV) was higher than the reference range for the US-based group. Locally derived CBC reference ranges were established using data from subjects who resided in rural Haiti. Ranges for Hgb, Hct, MCV, MCH, RDW-CV, and ANC differed from those established using data from US-based subjects.

The Burden of Movement Disorders in Cameroon: A Rural and Urban-Based Inpatient/Outpatient Study.

Because of rapid demographic changes, the prevalence of movement disorders (MDs) is expected to increase in Africa. The objective of this study was to estimate the prevalence of MDs in an inpatient/outpatient-based study of rural and urban health care centers in Cameroon. In this retrospective medical chart review, the inpatient/outpatients settings covered an urban population (3,000,000) and a rural population (380,276). Neurological diseases were classified according to the International Statistical Classification of Diseases-Related Health Problems, 10th revision (ICD-10). Crude prevalence was calculated per 100 with 95% confidence intervals (CIs). Of 20,131 medical charts reviewed (13% from the rural area), 4187 patients (20.8%) with neurological complaints were identified. MDs were diagnosed exclusively from urban centers in 134 patients (3.2%): the mean patient age was 48.6 ± 18.6 years, and 54.7% were women. The most prevalent MDs were hyperkinetic movements (tremor, myoclonus, and drug-induced MDs [ICD-10 code G25]; prevalence, 1.19%; 95% CI, 1.192-1.194%), Parkinson's disease (ICD-10 code G20; prevalence, 0.78%; 95% CI, 0.785-0.787%), dystonia (ICD-10 code G24; prevalence, 0.61%; 95% CI, 0.612-0.613%), secondary parkinsonism (ICD-10 code G21; prevalence, 0.56%; 95% CI, 0.564-0.565%), Huntington's disease (ICD-10 code G10; prevalence, 0.09%; 95% CI, 0.091-0.092%), and ataxia (ICD-10 code R29; prevalence, 0.04%; 95% CI, 0.0451-0.0456). Although the burden of MDs is expected to increase, MDs are likely underdiagnosed in rural areas. High-quality movement disorder training is essential to tackle this need.

Impact of acne and psoriasis on patient's quality of life: A multicentre study from health-care centers in Wardha district

Background: Acne and psoriasis are important chronic skin diseases which may impair quality of life (QOL) of a patient. The dermatology life quality index (DLQI) is a questionnaire specially designed to assess the QOL in the patients with skin diseases. Aims and Objectives: This study was designed to analyze the DLQI for acne and psoriasis in rural health care centers. Materials and Methods: A multicenter, questionnaire-based prospective study was conducted with patients attending the outpatient department of 32 Health-Care Centers of Wardha District. 148 patients of acne and 38 patients of psoriasis were screened, out of which 120 patients of acne and 35 patients of psoriasis were analyzed for DLQI. Results: The mean DLQI score in psoriasis was 13.11, and DLQI score in acne was 7.17. In acne patients, question 2 which concerned embarrassment had the highest DLQI score while question 9, about sexual difficulties had the lowest mean DLQI score. In psoriasis patients, the highest DLQI scores were seen in Question 1(physical symptoms) and lowest DLQI scores in Question 7 (working or studying). Conclusion: Acne has a moderate effect on QOL while psoriasis has very large effect on QOL.

The prevalence of squamous cell carcinoma in different sites of oral cavity at our Rural Health Care Centre in Loni, Maharashtra - a retrospective 10-year study.

Aim of the studyOral cancer ranks in the top three of all cancers in India and is quickly becoming a global health priority. More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma. The purpose of this study was to document its incidence depending upon the involvement of different sites of oral cavity, and its variation with age and gender.Material and methodsHistopathologically proven oral squamous cell carcinoma cases were collected from the department of oral and maxillofacial surgery RDC, PIMS. The cases were systematically grouped under three headings: anatomical sub-site of oral cavity, age group, and gender, which were analysed to calculate the prevalence of oral cancer. The study was undertaken after obtaining approval from the institutional Ethical Committee board.ResultsAmong the different sites of oral cavity, the highest incidence (31.47%) of oral squamous cell carcinoma was seen for buccal mucosa in our study. The most affected age group (39.50%) were patients above 50 years old, predominantly involving males.ConclusionsThe population in this study were mostly from remote areas, among which a high rate of occurrence of oral cancer was encountered because the people were of low socio-economic class, had a casual attitude towards their health, high rate of tobacco consumption, and limited health care facilities. This study provides valuable data of the prevalence of oral cancer among the rural population.

Socioeconomic determinants affecting the quality of life among diabetic and hypertensive patients in a rural area, Egypt.

Background:Diabetes mellitus and hypertension have a high prevalence of growth in all countries threatening to become a global epidemic risk, thus the quality of life this category of patients is extremely important. The aim of this study was to assess the socioeconomic determinants affecting the quality of life among diabetic and hypertensive patients.Patient and Methods:A descriptive cross-sectional study was conducted in a rural family health care center in El-Batanon village, in the delta region of Menoufia, Egypt. The recruited sample population was 401 participants over six month's context time frame (diabetic and hypertensive participants were 224 and 117 respectively). All participants were interviewed using a questionnaire to assess the demographic characteristics, socioeconomic status, type, duration and treatments of illness and the 36-Item Short Form Health Survey.Results:Patients with Diabetes presented a poorer health related quality of life than those with hypertension in perceived health in the areas of role-physical (RP) (P < 0.05), bodily pain (BP) (P < 0.001), general health (GH) (P < 0.05), vitality (VT) (P < 0.05), social functioning (SF) (P < 0.001) and role-emotional (RE) (P < 0.001). Age, Sex, Family size, socioeconomic score and occupation were the main Socioeconomic Determinants affecting the quality of life among diabetic and hypertensive patients.Conclusion:Diabetes and hypertension seem to comparably impair the health-related quality of life. There is a need to develop and implement effective targeted intervention to help the patients to cope with their life in a better way.

Psychosocial Status and Economic Dependence for Healthcare and Nonhealthcare among Elderly Population in Rural Coastal Karnataka.

Introduction:The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS) among elderly patients.Materials and Methods:The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September–December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent.Results:Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%), whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them.Conclusion:The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.