Prevalence of diabetic complications in rural goa, India

OBJECTIVE

To determine the prevalence of diabetes mellitus (DM) and its associated diabetic complications in rural Goa, India.

MATERIALS AND METHODS

A community-based study was carried out in a rural setting in Goa, India. About 1,266 participants were selected by systematic random sampling. The participants were interviewed using a semi-structured questionnaire and were subjected to anthropometric, clinical evaluation and biochemical investigations. American Diabetes Association criteria were used to determine the prevalence of diabetes and standard operational definitions were used to define the diabetic complications. Data was analyzed using SPSS version 14.0 while chi-square and chi-square for trend were the tests used.

RESULTS

Among the total 1,266 study participants about 130 (10.3%) were diabetics. The prevalence of the associated diabetic complications were as follows viz. neuropathy (60%), CHD (32.3%) and cataract (20%), retinopathy (15.4%), peripheral vascular disease (11.5%) and cerebrovascular accidents (CVAs) (6.9%). A significant rising trend in the prevalence of all diabetic complications was observed with advancing duration of diabetes.

CONCLUSION

The prevalence of DM and its associated complications was higher among the diabetic individuals in the rural setting of Goa, India. All the associated diabetic complications observed need to be addressed with appropriate prevention and control strategies.

Study of needle stick injuries among health care workers at a tertiary care hospital

A cross-sectional study was conducted among health care workers at a tertiary care hospital in Goa to study the problem of needle stick injuries. A structured questionnaire was used to interview the study participants at their work place. Participants were asked to recall needle stick injuries in the preceding 12 months. Factors such as work experience, type of procedure, action taken following injury etc were also studied. Statistical analysis was done with SPSS software. Around 34.8% (200/575) of the Health care workers had experienced a needle stick injury in the last one year. Needle stick injuries were equally distributed across different work experience periods. Hollow bore needles were responsible for 77.5% of needle stick injuries followed by suturing needles (19.2%). As far as use of personal protection was concerned only 58% of the health care workers were wearing gloves at the time of the injury. There is therefore an urgent need at the hospital level to have a uniform needle stick injuries policy covering safe work practices, safe disposal of sharps, procedures in event of needle stick injury, training including pre-employment training, monitoring and evaluation of needle stick injuries and procedures for reporting needle stick injuries.

Clinical budgeting and drug management on long-stay geriatric wards

Over-prescribing on long-stay wards for the elderly is a common problem. A scheme of senior doctor surveillance of prescribing on long-stay wards in a district general hospital is described, which involved stopping all drugs except those considered essential. A reduction of over 50% in the number of drugs taken per patient, and a saving of 34% in drug costs was achieved, without detriment to patients' well-being. Increased drug utilization on some wards is considered to occur because of the ward sister's demand for patients to be given drugs such as sedatives and tranquilizers. Regular re-education of nursing and junior medical staff to reduce over-prescribing is recommended.

Conceptual framework of a geographical information system for environment--public health surveillance in Goa

This paper proposes a conceptual framework for establishing a multidiscipline Geographical Information System for environment public health surveillance in the state of Goa. Sectors networking for the Geographical Information System encompass Directorate of Health Services including peripheral health setup, Public Works Department, State Pollution Control Board, Irrigation Department, Inspectorate of Factories and Boilers, Town and Control Planning Department, Meteorological Department etc. the applications of which would predict potential outbreaks / epidemics of water borne diseases, malaria, diseases linked to pollution and would support disease control activities. In addition to health applications, the data generated would be used by the respective sectors for their other planning and programming needs.

Prevalence of diabetes mellitus in a rural population of Goa, India

BACKGROUND

We aimed to estimate the prevalence of diabetes mellitus and study the associated factors in a rural population in Goa, India.

METHODS

A cross-sectional study was done in the rural area of Mandur, Goa. Participants>20 years of age were selected by systematic random sampling. They were interviewed with the help of a structured, pretested questionnaire. This was followed by clinical examination, anthropometry and relevant laboratory investigations. Diabetes mellitus was defined as per the American Diabetes Association (ADA) criteria. Statistical analysis was done using the SPSS software package (version 14.0).

RESULTS

The prevalence of diabetes mellitus in the study population was 10.3% (130/1266) with a prevalence of 8.4% among men and 12% among women. On bivariate analysis, the prevalence of diabetes mellitus was found to be significantly associated with age, occupation, family income, family history of diabetes, smoking, obesity, hypertension, and high serum cholesterol and triglycerides levels. Multiple logistic regression analysis identified age, family history, hypertension, smoking, total cholesterol and triglyceride as the Independently associated variables for diabetes mellitus.

CONCLUSION

Innovative community outreach programmes are required to create awareness, and for screening and treatment of diabetes mellitus to curb the growing epidemic of diabetes in the population.

Psychological distress among first-year medical students amidst COVID-19-related uncertainty at a medical college in Western India: A cross-sectional study

BACKGROUND

The sudden and rapid spread of the COVID-19 pandemic has created fear, worry and uncertainty in the student community. First-year medical students are likely to be doubly affected, for in addition to the stress of adapting to new learning processes, they are also now faced with uncertainties due to the COVID-19 pandemic. It was therefore decided to estimate psychological distress among the 1^st-year medical students among the COVID-19 pandemic-related uncertainty.

METHODS

A cross-sectional study was conducted on 1^st-year medical students studying at a Medical College in western India. Demographic and COVID-19 related data was collected from the students through Google Forms and psychological distress was measured by using the 20 point World Health Organization-Self Reporting Questionnaire (WHO-SRQ 20). The study was approved by the Institutional ethics committee. Informed consent was taken before administering the questionnaire to the study participants. Statistical analysis was conducted using the SPSS statistical software.

RESULTS

Prevalence of Psychological distress among the study participants by WHO-SRQ 20 Scale with cut off 7/8 as found to be 25.5%. Worried about themselves contracting COVID-19 Infection (odds ratio [OR]: 3.44; 95% confidence interval [CI]: 1.25-9.42), worried of the adverse financial effect on self and family due to COVID-19 pandemic (OR: 3.01; 95% CI: 1.29-7.04), worried that online mode of learning was putting them at disadvantage compared to traditional Teaching-Learning method (OR: 3.44; 95% CI: 1.25-9.42), and worried about adverse effects on social support due to COVID-19 pandemic (OR: 2.63; 95% CI: 1.27-5.43), were the factors significantly associated with psychological distress among the medical students.

DISCUSSION

There is an urgent need to develop a system to render counseling/professional help to all the students in need. This would ensure better mental health and would minimize any adverse academic outcomes among the students due to the COVID-19 Pandemic.

Bed utilization indices at a tertiary care hospital in Goa: an eight year trend analysis

A retrospective data analysis of records from medical records department of Goa Medical College Hospital was done to analyse the trends of various bed utilisation indices from 1999 - 2006. Average length of stay, bed occupancy rate, turnover interval and bed turnover ratio were the indices calculated. During the eight year period from 1999 to 2006, the average length of stay for the entire hospital registered a small decline from 6.23 to 5.51 days, the overall bed occupancy rate increased from 72.13% to 83.12% and the bed turnover interval declined from 2.41 days to 1.12 days. The Orthopaedics ward had the highest increase in bed occupancy and also fastest decline in turnover interval in 2006. Bed utilization indices are an objective measure of the efficiency of the hospital management system.

Sexual risk behaviors and HIV/AIDS awareness among males in a rural community in Goa

To study the heterosexual risk behaviors and to study the level of HIV/ AIDS awareness among males in a rural community in Goa. Survey was cross-sectional and community based. A sample of 300 males aged 15-49 years selected by stratified random sampling. An "UNAIDS protocol for measurement of HIV/STD prevention indicators" was used. SPSS software package was used for statistical analysis. One hundred and ninety eight (66%) males reported ever having sexual intercourse, of these 17% were single. Fifty three (17.7%) males reported intercourse with a non-regular partner in the past 12 months, of these 90.6% had intercourse with strangers, 92.5% had paid for sex and only 43.4% had used a condom for the last sexual encounter with a non-regular partner. Less educated males (<10th class), single and those employed have higher sexual indulgence with non-regular sexual partners. The level of knowledge about HIV/ AIDS was very high in all areas of causation and prevention. Although the awareness about sexual risk behavior was high, condom use was very low resulting in high risk behavior related to HIV/ AIDS and STDs among males. The study highlights the need for more effective behaviour change communication (BCC) strategies in the community as well as innovative methods like village level peer education.

Prevalence of human cysticercosis and taeniasis in rural Goa, India

A cross sectional study among 450 individuals selected by strafified random sampling was carried out in rural Goa to find out the prevalence of cysticercosis and taeniasis, as well as to study the role of various factors associated with this diseases. The study participants were administered a pre-tested structured questionnaire and subsequently blood and stool samples were examined. SPSS software was used to analyze the data statistically. The sero-prevalence of cysterosis was 22.4%, which increased with age. Prevalence of taeniasis was 9.7% by stool examination. Individuals with taeniasis were thrice more likely to have cysticercosis; however no association between sero-positivity for cysterosis and pork consumption as well as religion could be established. The study confirmed a high sero-prevalence of cysticercosis in Goa underscoring the need to general awareness about good cooking habits and sanitation.