Rural Hospital In Central India Research Articles

Impact of COVID 19 Pandemic on Tuerculosis

Covid19 or SARS COV 2 is the most dreaded pandemic of the century, causing widespread mortality and morbidity. On the other hand, tuberculosis is an age-old disease killing billions around the globe every year. Both the diseases have caused a significant loss of human lives along with socio-economic constraints. While SARS Cov 2 is a very new disease, tuberculosis is known to humanity for thousands of years. Tuberculosis is an airborne infection while Covid spreads via droplet spread and through fomite as well. Tuberculosis and complications related to it may lead to increased mortality due to poor lung compliance. Moreover, Tuberculosis control programmed may get affected due to the ongoing pandemic. To decrease the adverse outcome of Covid19 on Tb strict measures like proper social distancing, hand hygiene, compliance to Anti Tubercular drugs, domiciliary Tb care and strengthening immune system may prove important. Measures like the use of masks, proper cough hygiene and repeated washing of hands may play a role in decreasing the spread of tuberculosis as well and might also play a role in the elimination of tuberculosis. The article also highlights the measures taken in a rural hospital in central India for the management of COVID 19 and Tuberculosis and the possible difficulties faced in the management of tuberculosis during the Covid pandemic.

Depression, Anxiety and Stress among the general population in the time of COVID-19 lockdown: A cross-sectional study protocol

The incidence of Depression, Anxiety and stress among the general population is steadily increasing due to outbreak of COVID-19 across the globe. Beyond the risks of COVID-19, concerns have been expressed to have mental effect on the general population due to COVID-19 lock down. The emotional impact is more among individuals with pre-existing medical diseases like hypertension, Coronary Artery Disease, Diabetes (DM) and psychiatric illness. The lockdown results in health anxiety, this can manifest as maladaptive behaviours (repeated medical consultations, avoiding health care even if genuinely ill, hoarding particular items); at a broader societal level, it can lead to mistrust of public authorities and scapegoating of particular populations or groups. There are very few data from India studying mental impact of lockdown due to COVID 19 among general population. In our study, we will assess DAS among rural population who are accompanying the Non-COVID 19 patients at a tertiary care rural hospital of central India in the era of lock down.

Transvaginal laparoscopic appendectomy using innovative submucosal tunnels: a conducive modification for improving hybrid NOTES access and its critical appraisal.

Currently, transvaginal natural orifice transluminal endoscopic surgery (NOTES), the most minimally invasive option for laparoscopic surgery, suffers various technological restraints limiting its implementation. We discuss a simple modification for vaginal access to improve the existing hybrid NOTES technique. We retrospectively studied 18 women at our rural hospital in central India, who, under defined criteria, underwent transvaginal appendicectomy using innovative strategically designed submucosal tunnels. The procedure was successfully completed in all but the first three cases. None required additional abdominal trocar or analgesia beyond the first 6 h. The mean operative and hospitalisation times were 27.5 min and 18.5 h, respectively. We had no intraoperative complications and only one patient experienced postoperative self-limiting vaginal spotting. All patients were very pleased with the cosmetic results and sexual life as assessed by locally devised scales. On regular follow-up, all were progressing well. We recommend the method presented, as it is not only feasible and safe but has the potential to improve overall results. Clearly, a larger volume randomised trial would be optimal to confirm our conclusion.

Evaluation of the evan's and bicaudate index for rural population in central india using computed tomography

Introduction:Evans index (EI) and Bicaudate index (BCI) are practical markers of ventricular volume and are helpful radiological markers in the diagnosis of normal pressure hydrocephalus. Worldwide, variation exists in normative studies for both these indices. Most of the studies conducted for EI and BCI are based on the Western population data. No study has been performed on the rural population of Central India. The purpose of this study is to develop normative data on EI and BCI that can be extrapolated for future reference.Materials and Methods:This was a retrospective study conducted from December 2018 to May 2019 in MGIMS Hospital, Sevagram, Maharashtra, India, which is a rural hospital in Central India. All patients with either a head injury or neurological complaints although with normal computed tomography (CT) brain were included in the study. Patients with diagnosed neurological disorder, clinical features suggesting hydrocephalus, or intracranial pathology on CT brain were excluded from the study. Five hundred and eleven patients were selected for this study, and EI and BCI was calculated for them.Results:The mean value of EI and BCI in our study was 0.2707 and 0.1121, respectively. Both indices showed a statistically significant difference between males and females. The value of both indices increased with age.Conclusion:Although our study is in agreement with the cutoff value of EI to diagnose dilated lateral ventricles as 0.3 for age <70 years, cutoff value of EI for the older population should be reconsidered to 0.34.

Descriptive epidemiology of central nervous system tumors in rural hospital of central India : 5-year experience

Descriptive epidemiology of central nervous system tumors in rural hospital of central India : 5-year experience - IJN- Print ISSN No: - 2581-8236 Online ISSN No:- 2581-916X Article DOI No:- 10.18231/j.ijn.2019.023, IP Indian Journal of Neurosciences-IP Indian J Neurosci

Role of B-Mode ultrasound in the evaluation of orbital masses.

Introduction: Blindness and Vision impairment cause significant morbidity amongst Indian population. According to WHO estimates, about 20.5 % people in India are categorized as blind while 22.2 % people have low vision. The orbital masses owing to the small anatomical volume of orbit can cause devastating consequences. Ultrasound and colour doppler are useful in analysis of orbital masses with real time evaluation, excellent soft tissue resolution, localisation, and benign or malignant nature of masses. This study evaluates the role of ultrasound in orbital masses. Aim: To study the role of ultrasound in evaluation and identification of orbital masses. Study design &amp; settings: Prospective observational study in ultrasound unit of a rural hospital in central India. Materials and methods: A total of 316 consenting patients were studied for 1 year using high frequency linear and curved probes. Statistical analysis was done using SPSS software (IBM Inc.) Results: Out of the 316 patients, total 15 cases were identified to have orbital masses. Most common orbital mass lesions observed were lacrimal gland tumours. Most of the masses were extraconal in location and most common ultrasound appearance of the lesions was solid with most of the malignant masses showing vascularity on colour doppler imaging. Conclusion: Ultrasound can identify and characterize orbital masses based on appearance and echotexture with accurate localisation. It is cheap and easily available with no radiation hazards Pre-operative ultrasound and Colour Doppler evaluation of orbit can help in predicting prognosis of the disease

Diaphyseal fractures in pediatric age group in rural area: A demographic study

Introduction: Fractures in children are a common occurrence. Fractures have a considerable impact on daily living and activities of affected children and thus are an important topic of public health. The present study aims to study the demographic aspects of diaphyseal fractures in children. Materials and Methods: This is a prospective study conducted in a tertiary care rural hospital in Central India on children in the age group of 3–15 years between June 2017 and April 2019. A total of 38 fractures in 25 children were included in the study. Results: The incidence of fractures was found more common in boys (60%). Most of the fractures were seen in the age group of 11–15 years (68%). Fall from level ground while playing was reported to be the most common mode of trauma (56%), followed by road traffic accident. Twenty-eight percent of the patients presented to the hospital on the day of trauma. Among the bones fractured, both bone forearms were the most common (52%). Overall, left-sided fractures were more common (56%) than right sided (44%). Middle one-third shaft was the most commonly fractured level.Conclusions: Both bone forearms are the most common diaphyseal fractures in children and middle one-third is the most common level. Injury prevention programs will help in decreasing the incidence and morbidity associated with pediatric fractures.

Keyhole surgery in intertrochanteric femur fracture of elderly population in rural hospital of central India

Background: More than 90% of hip fractures in patients after the 5th decade of age are intertrochanteric fractures with 20-30% of these cases experiencing complications and a mortality rate of approximately 17%. Dynamic Hip screw is gold standard for fixation but to minimize intra-operative complications keyhole surgeries are getting popular. Objective: To evaluate intraoperative and immediate post-operative outcome amongst intertrochanteric fracture patients operated with keyhole surgery. Material & Methods: Prospective study conducted amongst elderly population with inter-trochanteric femur fracture admitted in rural hospital from central India. Duration of surgery, intra-operative blood loss and healing of wound was noted. Results: Total 16 patients were operated with male to female ratio of 1.6:1. Conclusion: Keyhole surgery reduces surgical duration and blood loss due to minimum tissue handling. It can be a procedure of choice in patient with co-morbidities and illness.

Distribution of ABO and Rhesus (D) Blood Groups among Blood Donors in Tertiary Care Rural Hospital of Central India: A Retrospective Study

Distribution of ABO and Rhesus (D) Blood Groups among Blood Donors in Tertiary Care Rural Hospital of Central India: A Retrospective Study

To observe the proportion of amblyopia among children presenting in a rural hospital in Central India

Objectives: • To screen the children attending the ophthalmology OPD • To know the profile and cause of amblyopia. Materials and Methods: A Cross-sectional study was conducted between August 2017 to February 2018. Children aged 5-20 years were recruited in the study. Children

Clinical and endoscopic profile of the patients with upper gastrointestinal bleeding in central rural India: A hospital-based cross-sectional study

Introduction: Acute Upper Gastrointestinal bleeding (UGIB) is one of the common causes with which the patients present to emergency. The upper gastrointestinal (UGI) endoscopy remains a crucial tool in identification of UGIB. The aim of the present study was to determine the endoscopic profile of UGIB in adult population of rural central India admitted with history of UGIB (hemetemesis and/or malena). Methods: This prospective, cross sectional study was conducted in rural hospital in central India and we enrolled all consecutive patients aged 18 years and above who were admitted in the hospital ward with the history of UGIB. After obtaining the demographic data, all patients underwent clinical examination, laboratory investigations and video-endoscopy. We used Student's t test to compare means, Chi-square test to compare proportions and Mann-Whitney test to compare medians. P value

Seroprevalence of Common Transfusion Transmitted Infections among Blood Donors in Tertiary Care Rural Hospital of Central India: A Six Years Study

Seroprevalence of Common Transfusion Transmitted Infections among Blood Donors in Tertiary Care Rural Hospital of Central India: A Six Years Study

Tinea Capitis Among Primary School Children: A Clinicomycological Study in a Rural Hospital in Central India

Tinea Capitis Among Primary School Children: A Clinicomycological Study in a Rural Hospital in Central India

Paediatric Ocular Disoders in a Tertiary Care Rural Hospital of Central India (Birth to 15 Years)

Paediatric Ocular Disoders in a Tertiary Care Rural Hospital of Central India (Birth to 15 Years)

Pattern of refractive error in paediatric patients coming to rural tertiary care hospital of Central India

Background: Refractive error is a important cause of low vision in paediatric age group. If uncorrected it can lead to severe visual impairment in paediatric age group. Around 12.8 million children in age group range of 5-15 years have undiagnosed refractive error or under corrected refractive error. In India, refractive error as social health problem not yet defined. The untreated refractive error can cause amblyopia and poor school performance, which in long run can lead to financial and social loss for the rest of life. The purpose of the present study is to know the different types of refractive errors in a tertiary care rural hospital. Materials and methods: A cross sectional study to know the different types of refractive error in paediatric patients in a tertiary care rural hospital of central India from January 2015 to June 2015. The patients of birth to upto the age of 15 years were included. The patient particular were noted. The patient name, age, sex ,residence, visual acuity, refractive error were noted. Results: The total number of 848 patients enrolled in the present study from eye OPD of UPRIMS &R, Saifai, UP from January 2015 to June 2015. The age of patients ranges from birth to 15 years of age. Out of these refractive error is seen in 260 patients (31.37%, 168 male, 92 female). So, refractive error was the cause of hospital consultation in around 1/3rd of the patients.The most common refractive error noted was myopia in 160 patients (61.53%, 95 males, 65 females), followed by astigmatism in 40 patients (23.85%, 32 males, 6 females) and hypermetropia in 38 patients (14.61%, 32males, 6 females). The common age of presentation was from 11-15 years ( 130 patients, 50%), followed by 6-10 years age( 70 patients, 26.92%) and lastly less than 5 years age group (60 patients.23.08%). Conclusion: In India, refractive error as public health problem is not yet defined. The untreated refractive error can cause amblyopia and poor school performance, which in lon

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Correlation of severity of chronic obstructive pulmonary disease with health-related quality of life and six-minute walk test in a rural hospital of central India.

Background:Chronic obstructive pulmonary disease (COPD) patients experience a progressive deterioration and disability leading to worsening of their health-related quality of life (HRQoL) and functional exercise capacity. We performed this study to identify the correlation of HRQoL assessed by St George's Respiratory Questionnaire (SGRQ) and the functional exercise capacity assessed by the six-minute walk test (6MWT) with severity of COPD defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria among spirometry-confirmed COPD patients, admitted in a tertiary care rural hospital.Materials and Methods:The study included 129 spirometry-confirmed COPD patients defined by the GOLD criteria from a tertiary care hospital in central India. They underwent HRQoL measurement using the disease-specific (SGRQ). Functional exercise capacity was measured by 6MWT, as per the American Thoracic Society (ATS) guidelines.Statistical Analysis:We analyzed the various SGRQ scores and six-minute walk distance (6MWD) percentage predicted with various stages of COPD using the Student's t-test. The Pearson's correlation coefficient (r) was used to assess the relationships between various SGRQ scores and 6MWD with FEV1 % predicted.Results:We found that COPD patients with GOLD III and IV, but not GOLD II, had significantly poor HRQoL measured by SGRQ, as compared to patients with mild COPD (GOLD I). An inverse linear relation was found between 6MWD and the severity of COPD. Correlation of FEV1 % predicted with various SGRQ scores varied from - 0.40 to - 0.53, with a maximum correlation of FEV1 % predicted with an SGRQ symptom score (- 0.53) and SGRQ total score (- 0.50). A strong positive correlation was found between 6MWD and FEV1 % predicted (0.57).Conclusions:Staging COPD according to the GOLD guidelines does correspond to important differences in the HRQoL of COPD patients having severe disease, but not for mild disease, whereas, the functional exercise capacity of COPD patients deteriorates in a linear fashion with the severity of disease assessed by the GOLD staging criteria.

Study of Risk Factor for Congenital Heart Diseases in Children at Rural Hospital of Central India

Introduction: Congenital heart disease is the most common congenital problem that accounts for up to 25% of all congenital malformations. Hence this study was aimed at improving the knowledge related to risk factors associated with CHD in a rural Indian scenario. It was a hospital- based case control study. Materials and Methods: The children up to twelve year of age with clinical suspicion of CHD were subjected to chest x-ray and electrocardiography, and final diagnosis was confirmed by echocardiography (n=209) as cases. The control group (n=418) were randomly selected from children without CHD who were admitted during the same period. The etiological factors like environmental, infections, drugs, and maternal factors were analyzed by using EPI 6 version. Results: In cases group, 56% were male and 44% female children. 82% cases presented at age of less than 5 years and 18% after 5 year. Exposure to smoking (OR=10.45), tobacco intake by mother (OR=8.28) and family history of CHD (OR=7.21) were the significant risk factor present in cases. Conclusion: The risk factors for CHD child identified were exposure to smoking and tobacco intake by mother, family history of CHD, antenatal infection in 1st trimester and history of diabetic mother. DOI: http://dx.doi.org/10.3126/jnps.v33i2.8254 J Nepal Paediatr Soc. 2013; 33(2):121-124

AETIOLOGY OF PERINATAL MORTALITY- A STUDY IN A RURAL SETTING

Background : Each year, an estimated six million perinatal deaths occur worldwide and 98% of them occur in low and middle-income countries. Perinatal deaths are the leading burden of disease among children aged less than five years worldwide. Globally there are 3 major causes of neonatal death: infections (36%) ,prematurity (28%) and asphyxia (23%). Of the remaining, 7% are due to congenital malformations. Objectives : Analysis of risk factors associated with perinatal mortality and to determine the most common causes of early neonatal deaths. Material and method : The study was carried out at a tertiary care rural hospital of central India. Data were collected on 5,856 births over a one year period. Results: The perinatal mortality rate was 17.07 per 1,000 births; stillbirth rate was 2.39 per 1,000 births; and early neonatal death rate was 15.16 per 1,000 live births. Clinically relevant factors independently associated with perinatal death included: low birth weight, breech presentation, birth asphyxia, sepsis, respiratory distress syndrome, congenital malformations and meconium aspiration syndrome. Over one-half of early neonatal deaths occurred during the first two post natal days, and the most common causes were low birth weight/prematurity (28.80%), asphyxia (13.04%), and congenital malformations (9.23%). Conclusion : Most neonatal deaths occur soon after birth, and nearly three-quarters are caused by low birth weight/prematurity or asphyxia. Neonatal mortality might be reduced by targeting interventions to improve neonatal resuscitation and care of larger preterm infants. Specifically, deaths due to breech presentation, a common risk factor, will be reduced by making available emergency obstetric care.

Carotid intima-media thickness and apolipoproteins in patients of ischemic stroke in a rural hospital sett ing in central India: A cross-sectional study

Context:Carotid intima-media thickness (CIMT) and apolipoproteins have been found as a risk factor for ischemic strokeObjective:The objective was to study the carotid intima-media thickness, apolipoproteins, and their relation in patients of ischemic stroke in central rural India.Settings and Design:A cross-sectional study was performed in a rural hospital in central India.Materials and Methods:In all patients of ischemic stroke proven by computerized tomography (CT), CIMT, apolipoprotein A-I (ApoA-I), and apolipoprotein B(ApoB) were measured.Statistical Analysis Used:We used Student's t-test to compare means, a chi-square test to compare proportions, and a Mann-Whitney test to compare medians. A P value <0.05 was considered significant.Results:The mean age of our study population (N=106) was 61 years. The mean CIMT was 0.83 mm ranging from a minimum of 0.45 mm to a maximum of 1.096 mm. Mean CIMT was significantly higher than expected 0.67 values, which was calculated according to the age of the study population. The association of decreased ApoA-I < 100 mg/dl and increased ApoB > 90 mg/dl with CIMT > 0.7 mm was statistically significant with P<0.001.Conclusions:The CIMT in computerized tomography-proven ischemic stroke was significantly higher than expected for the age of the study population. The relation of decreased ApoA-I and increased ApoB with CIMT > 0.7 mm was also statistically significant.