Amarjeet Singh - Academia.edu (original) (raw)
Papers by Amarjeet Singh
International Journal Of Community Medicine And Public Health, 2021
Background: Depression (D), anxiety (A) and stress (S) are common issues among students nowadays.... more Background: Depression (D), anxiety (A) and stress (S) are common issues among students nowadays. The occurrence of D, A, and S was primarily considered to be associated with the students’ academics, especially in twelfth standard because these groups are highly vulnerable to immense pressure, rising competition for undergraduate courses and constant changes in the education system. The objective of this study was to find the comparative magnitude of occurrence and severity of D, A, and S in the science and non-science stream among twelfth standard students. Methods: This cross-sectional study was carried out across 460 students of twelfth standard from all streams. A socio-demographic questionnaire along with DASS-42 was distributed. The scores were calculated and percentage, mean scores, standard deviation, p values, odds ratio were obtained.Results: A statistically significant difference was seen in the mean scores of depression and anxiety among science and non-science students...
Advances in preventive medicine, 2016
Background. The available health information on websites should be reliable and accurate in order... more Background. The available health information on websites should be reliable and accurate in order to make informed decisions by community. This study was done to assess the quality and readability of health information websites on World Wide Web in India. Methods. This cross-sectional study was carried out in June 2014. The key words "Health" and "Information" were used on search engines "Google" and "Yahoo." Out of 50 websites (25 from each search engines), after exclusion, 32 websites were evaluated. LIDA tool was used to assess the quality whereas the readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and SMOG. Results. Forty percent of websites (n = 13) were sponsored by government. Health On the Net Code of Conduct (HONcode) certification was present on 50% (n = 16) of websites. The mean LIDA score (74.31) was average. Only 3 websites scored high on LIDA score. Only five had readability sco...
Indian pediatrics, 1996
To estimate the incidence of minor injuries and to study the wound care practices of school child... more To estimate the incidence of minor injuries and to study the wound care practices of school children. A fortnightly follow up of urban (n = 112) and rural (n = 110) high school children was done in Chandigarh and rural Haryana between 1990-1992. Initial point prevalence survey was followed by fortnightly follow up survey involving interview for assessing incidence and wound care practices among students. Government high schools of Chandigarh and rural Ambala in between 1990 to 1992. Ninth class school children from urban (n = 112) and rural (n = 110) areas. Average episodes of minor injuries per year were 2.9 in rural and 2.1 in urban area, point prevalence was higher in urban area. First-aid training of teachers or the students was lacking in both the areas. Many of the injuries (41-46%) occurred during the school time. Fingers/hand or feet were affected most. Main sources of injuries were farm implements, thorn, blade and stick in rural area and finger nails, kitchen appliances an...
Background : Milk is globally described as complete diet. Milk is most commonly diluted with wate... more Background : Milk is globally described as complete diet. Milk is most commonly diluted with water-this not only reduces its nutritional value, but contaminated water can also cause additional health problems. Objectives : To ascertain the composition and level of adulteration in the collected raw milk samples Methodolog: A total of 90 milk samples were collected from milk vendors in Tricity (Chandigarh, Panchkula and Mohali) and were analyzed for total solids contents (milk fat %, milk solids not fat %) using standardized methods. Results : Average fat content was 4.6±1.37%, SNF was 7.87±1.33%and TS was 12.4±1.93 %. Only 21 samples (23.33%) met standards prescribed by Food Safety and Standards Authority of India, (FSSA) 2006. No other adulterants such as starch, urea, sodium hydroxide etc. were found in any of the collected milk samples. Conclusion: Quality of 77% of the collected milk samples from Tricity (Chandigarh, Panchkula, Mohali) was below the standards. Therefore, regular check up of milk should be carried out at various critical control points.
Indian Journal of Medical Informatics, Sep 3, 2012
Indian Journal of Palliative Care, 2015
Journal of the Indian Medical Association, 2012
To estimate the prevalence of primary dysmenorrhoea among the school girls, to determine its impa... more To estimate the prevalence of primary dysmenorrhoea among the school girls, to determine its impact on their routine life and to ascertain the practices adopted by them for management of primary dysmenorrhoea, a cross-sectional study was conducted in two schools of Chandigarh, India. Two hundred twenty-four school girls in the standard VIII to X of the selected schools, who had attained menarche, were included in the study. A modified menstrual distress questionnaire was used to score the severity of dysmenorrhoea and its impact on their life. Visual analogue scale for pain was used to measure pain during menstruation. Analysis was done by percentage, mean and standard deviation. Prevalence of dysmenorrhoea was 59.82%. Sickness absenteeism due to dysmenorrhoea was reported in 25.8% girls. According to visual analogue scale for pain scoring, 52.3% had moderate pain and 25% cases had severe pain. Menstrual distress questionnaire scores showed mood swings, irritability, difficulty in c...
The single modified Kratzer equation relating EC to flow at Vernalis has been replaced by salt ba... more The single modified Kratzer equation relating EC to flow at Vernalis has been replaced by salt balance calculations at different points from Lander Avenue to Vernalis. Significant improvement has been reached through the disaggregation of the flow model representation of the western side of the river basin. However, for the current model, the EC-flow scatter plots (rating curves) for Vernalis overestimate EC for the months of February and March.
Indian journal of palliative care
Nonpharmacological interventions (NPIs) have been advocated for knee osteoarthritis (KOA). There ... more Nonpharmacological interventions (NPIs) have been advocated for knee osteoarthritis (KOA). There are many gaps in the evidence to their efficacy in India. The study aims to compare the impact of two packages of NPIs on various outcome variables of KOA patients. This was a randomized controlled trial in a tertiary care hospital. A study population ( = 123) of KOA patients aged 40-65 years. Stratified block randomization was done for mild or moderate KOA into two groups. Group "A" patients received a package of NPIs including a set of supervised exercise sessions, kinesthesia, balance, and agility (KBA), meditation, weight reduction advice, and weekly telephonic reminders. Group "B" patients received the same package except for KBA & meditation. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) and performance-based measures were measured. -test and repeat measures ANOVA were undertaken. A significant intragroup reduc...
BMJ case reports, Jan 23, 2017
In North India, preference for sons has been blamed for repeated incidents of female feticide, de... more In North India, preference for sons has been blamed for repeated incidents of female feticide, despite the legislation in the form of the Pre-Conception and Pre-Natal Diagnostic Techniques Act, 2002. We describe how a team of local private doctors offer package deals to pregnant women and their families in rural areas. The fetal sex is determined at night using a portable ultrasonography machine.If the fetus is a girl, an immediate induced abortion is offered in the clients' home. If complications arise, women are advised to attend hospital. Such a patient visited us with a history of bleeding per vagina following incomplete induced abortion. This case study highlights the fact that female feticide continues to occur in India.
BMJ case reports, Jan 17, 2018
In this case study, we describe our experiences with a rural poor family from north India that in... more In this case study, we describe our experiences with a rural poor family from north India that initially contacted faith healers for treatment of their child who was having symptoms suggestive of epilepsy, but the seizures continued even after this. The family migrated to a city, where they started allopathic treatment, but eventually they had to discontinue it as there was no apparent relief. Again, they went back to their native village and restarted the treatment from the faith healer.This case study highlights the fact that in spite of the significant development of medical science, many questions pertaining to epilepsy treatment are still unanswered. Such dissatisfaction with the allopathic treatment of epilepsy is very common. Complexity of the disease and high cost of modern medication, side effects of drugs, efficient but heavy treatment protocols and unpredictable outcome are responsible for continued practice of people consulting faith healers for treatment of epilepsy. Ho...
BMJ case reports, Jan 13, 2017
In this case study, we describe our experiences with a woman employed as a housemaid who sought u... more In this case study, we describe our experiences with a woman employed as a housemaid who sought unsafe abortion services from a private doctor. This was her sixth pregnancy, after previously giving birth to one son and two daughters and undergoing two induced abortions. Her husband remained opposed to the use of contraception. Initially, she had sought medical termination of pregnancy through a government hospital but was denied because of procedural delays, specifically the non-availability of an ultrasonography report consequent to a lack of proof of identity (ie, the AADHAAR card, a unique identification card for recording biometric and demographic data in India). She finally sought the services of an unqualified private physician and received oral abortifacient agents. Consequently, she was required to seek treatment for bleeding per vaginum from the dispensary staff at a government hospital. We note that many such incidents occur in our daily practice but remain unnoticed and u...
Indian journal of palliative care
More than 80% of bedridden patients develop bedsores in home care settings. Training of informal ... more More than 80% of bedridden patients develop bedsores in home care settings. Training of informal caregivers can significantly affect the quality of care to these patients. The objective of this study is to compare the effectiveness of two caregiver training strategies on prevention of bedsores among bedridden patients. The study was carried out in Chandigarh. The study center was at PGIMER, Chandigarh. Seventy-eight bedridden patients being taken care in their homes were identified. These were randomly allocated into two groups. Group A received Prevention Package I, i.e., self-instruction Manual (SIM), training, and counseling. Group B received Prevention Package 2, i.e., only SIM. All these patients were followed up periodically for 1 year. During each follow-up, patients were observed for bedsore development. Braden scale was used to assess the risk factors of bedsores. Katz scale was used to evaluate the level of functional dependence of patients. Descriptive statistics was used...
AIMS Public Health
Childhood blindness due to corneal ulceration was prevalent among poor Indian children. To tackle... more Childhood blindness due to corneal ulceration was prevalent among poor Indian children. To tackle this situation, the National Institute of Nutrition (NIN), Hyderabad, India, Vitamin-A (Vit-A) prophylaxis programme was launched nationally in 1970 after field testing. Research of Indian Council for Medical Research (ICMR) documented that prevalence of Vit-A deficiency signs such as Bitot's spot decreased among children, over a period of time. However, this decrease cannot be ascertained is due to mass Vit-A prophylaxis programme. This is because coverage was low and patchy. Improved nutrition status, wider vaccination coverage, increased rate in breast feeding and improvement of healthcare services played a crucial role. Rather many studies revealed that (mass prophylaxis to the child who is having adequate Vit-A level) it may be harmful to certain group of children as a result of acute toxic symptoms. High dose of Vit-A is capable of loss of bone density-hence retarded growth may be observed in susceptible individuals. To tackle this issue food based approach should be promoted (which includes breast feeding) along with timely measles vaccination. The children who have signs of Vit-A deficiency (e.g. night blindness, xeropthalmia, Bitot's spot) or post measles children should receive Vit-A in age specific daily doses for two weeks along with Vit-A rich food, like green leafy vegetables, red palm oil, liver etc. Public spirited citizens, together with scientific community in India, should discourage this "one size fit to all" approach. It will not only avoid the ill effects of high dose of Vit-A but also it will help us optimal utilization of health resources in a resource poor country like India.
Clinical Nutrition ESPEN
Childhood blindness due to corneal ulceration has historically been prevalent among poor Indian c... more Childhood blindness due to corneal ulceration has historically been prevalent among poor Indian children. To tackle this situation the National Institute of Nutrition (NIN), Hyderabad, India, launched (after field-testing) massive dose based national vitamin A (Vit-A) prophylaxis program. Over a period of time reduction in childhood mortality was also hailed as a beneficial effect of the program. Data from the Indian Council for Medical Research (ICMR) indicate that in most Indian states there has been a gradual reduction in the prevalence of Bitot's spots. However, it was not attributed to the prophylaxis program because of its low and patchy coverage. It was, rather, attributed to the control of malnutrition, along with measles vaccination and improvement in healthcare access. Various studies have concluded that massive dose vitamin A prophylaxis does not reduce childhood mortality; this may have been due to the Hawthorne effect; whereby beneficial effects arose from frequent contact of health workers with community members. Paradoxically, harmful effects of massive doses of Vit-A are documented, e.g. acute toxicity in certain groups of children, ranging from increased intracranial pressure, mental retardation (postnatal period), and even death. Vit-A also intensifies bone demineralization, and increased levels can lead to calcium deficiency and, hence, growth retardation in vulnerable children. According to the present authors, for children who have Bitot's spots or who have just recovered from an attack of measles, the best approach is to give Vit-A in therapeutic doses along with adequate daily intake of vegetables and fruits. Public-spirited citizens, along with the scientific community, must ensure the scrapping of the universal massive dose Vit-A prophylaxis approach, to avoid Vit-A toxicity and reduce economic burden to the health system.
Science and engineering ethics, Jan 23, 2017
The issue of 'mandatory publications' has generated serious flak about its usefulness amo... more The issue of 'mandatory publications' has generated serious flak about its usefulness among the various stakeholders. A lot of debate centers around the question of 'lack of will' or 'lack of skill' as a reason for the diminishing research interests among the medical faculty in India. In our view, it is the lack of will to publish good quality research which is to be blamed rather than the lack of skill to do good quality research.
BMJ case reports, Jan 21, 2017
India accounts for one-fourth of the global tuberculosis (TB) burden. The National TB Program was... more India accounts for one-fourth of the global tuberculosis (TB) burden. The National TB Program was started in 1962. Over a period of time, some lacunae such as poor case detection rate and incomplete treatment were observed. Later, the government formulated the Revised National Tuberculosis Control Program (RNTCP), which achieved a case detection rate of 70% and a cure rate of 85%. Still, the problem of relapse and defaulter cases persists. In 2014, 6% defaulter cases were reported from India. RNTCP has also focused on microlevel aspects, that is, newer diagnostics such as GenXpert, line probe assay and medicines such as bedaquiline for drug-resistant TB. Action on the macrolevel aspects, for example, social determinants, is ignored. This is natural because these are out of the purview of the health sector. This case study reflects how a resident doctor in a rural clinic of North India tried to resolve the macrolevel and microlevel issues pertaining to defaulter TB cases.
Medical journal, Armed Forces India, 2017
Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safet... more Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safety and Standards Act (FSSA), 2006, indicates the concern of our Govt. for food safety. Research on effectiveness of food safety interventions in our country is remarkably scarce. Hence, the present study was conducted in a tertiary care hospital of north India to create evidence-based results for food safety interventions. The study was before and after intervention trial which was registered with CTRI. Data collection was paperless using a software. All food handlers (n = 280) working inside the hospital were recruited. Intervention package comprised Self-Instructional Manual in Hindi for food handlers, short film for sensitization of food handlers on food safety titled 'Gravy Extra', and a documentary titled 'Food Safety from farm to Fork'. Chi square test, paired t test, and Wilcoxon sign rank test were used. The mean age of food handlers was 35 ± 2 years. Majority (61....
Medical journal, Armed Forces India, 2016
Various studies in India have reported the prevalence of anaemia to be more than 50% among women ... more Various studies in India have reported the prevalence of anaemia to be more than 50% among women of the reproductive age group. A community-based study was done to find out the prevalence of anaemia in non-pregnant, non-lactating wives of serving soldiers in a military station. It was a cross-sectional study. The sample size was 600. Venous blood was collected for haemoglobin and ferritin levels. Analysis was done by SPSS 20. The mean age at marriage was 19.8 years (SD + 2.76). The average age at first childbirth was 20.88 years. Major symptoms reported were weakness (24.34%), giddiness (23.47%), fatigue (20.17%) and heavy bleeding (3.13%). Prevalence of anaemia in our study was 13.9%, which is much below the national prevalence. Prevalence of iron-deficient status was reported in 153 (26%) individuals. Out of these, 81 subjects were non-anaemic (Hb > 12d/dL) but were iron deficient (ferritin <15 μg/L). Sixty out of these 81 subjects reported presence of fatigue and 36 had wea...
Environmental health insights, 2016
Farmers in developing countries are exposed to pesticide hazards due to unsafe handling. This stu... more Farmers in developing countries are exposed to pesticide hazards due to unsafe handling. This study was conducted to identify the prevailing practices of pesticide use and factors affecting the handling of pesticides among the farmers of Chitwan, Nepal. A cross-sectional study was conducted among 125 farmers. None of the farmers completely followed all the protective measures. About 59% disposed the empty pesticide containers to a nearby water source and 62% preferred house ceilings as a storage place. Males (aOR = 3.99, CI = 1.63-9.78) and older farmers (aOR = 6.18, CI = 2.59-14.72) were more likely to smoke or chew tobacco during the process of spray. Males (aOR = 2.42, CI = 1.03-5.67), literate farmers (aOR = 3.56, CI = 1.51-8.33), and farmers aware of color coding (aOR = 2.67, CI = 1.13-5.67) were more likely to read the labels on pesticide bottles. In spite of an extensive use of pesticides, the farmers were not following proper and safe handling practices, exposing them and th...
International Journal Of Community Medicine And Public Health, 2021
Background: Depression (D), anxiety (A) and stress (S) are common issues among students nowadays.... more Background: Depression (D), anxiety (A) and stress (S) are common issues among students nowadays. The occurrence of D, A, and S was primarily considered to be associated with the students’ academics, especially in twelfth standard because these groups are highly vulnerable to immense pressure, rising competition for undergraduate courses and constant changes in the education system. The objective of this study was to find the comparative magnitude of occurrence and severity of D, A, and S in the science and non-science stream among twelfth standard students. Methods: This cross-sectional study was carried out across 460 students of twelfth standard from all streams. A socio-demographic questionnaire along with DASS-42 was distributed. The scores were calculated and percentage, mean scores, standard deviation, p values, odds ratio were obtained.Results: A statistically significant difference was seen in the mean scores of depression and anxiety among science and non-science students...
Advances in preventive medicine, 2016
Background. The available health information on websites should be reliable and accurate in order... more Background. The available health information on websites should be reliable and accurate in order to make informed decisions by community. This study was done to assess the quality and readability of health information websites on World Wide Web in India. Methods. This cross-sectional study was carried out in June 2014. The key words "Health" and "Information" were used on search engines "Google" and "Yahoo." Out of 50 websites (25 from each search engines), after exclusion, 32 websites were evaluated. LIDA tool was used to assess the quality whereas the readability was assessed using Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), and SMOG. Results. Forty percent of websites (n = 13) were sponsored by government. Health On the Net Code of Conduct (HONcode) certification was present on 50% (n = 16) of websites. The mean LIDA score (74.31) was average. Only 3 websites scored high on LIDA score. Only five had readability sco...
Indian pediatrics, 1996
To estimate the incidence of minor injuries and to study the wound care practices of school child... more To estimate the incidence of minor injuries and to study the wound care practices of school children. A fortnightly follow up of urban (n = 112) and rural (n = 110) high school children was done in Chandigarh and rural Haryana between 1990-1992. Initial point prevalence survey was followed by fortnightly follow up survey involving interview for assessing incidence and wound care practices among students. Government high schools of Chandigarh and rural Ambala in between 1990 to 1992. Ninth class school children from urban (n = 112) and rural (n = 110) areas. Average episodes of minor injuries per year were 2.9 in rural and 2.1 in urban area, point prevalence was higher in urban area. First-aid training of teachers or the students was lacking in both the areas. Many of the injuries (41-46%) occurred during the school time. Fingers/hand or feet were affected most. Main sources of injuries were farm implements, thorn, blade and stick in rural area and finger nails, kitchen appliances an...
Background : Milk is globally described as complete diet. Milk is most commonly diluted with wate... more Background : Milk is globally described as complete diet. Milk is most commonly diluted with water-this not only reduces its nutritional value, but contaminated water can also cause additional health problems. Objectives : To ascertain the composition and level of adulteration in the collected raw milk samples Methodolog: A total of 90 milk samples were collected from milk vendors in Tricity (Chandigarh, Panchkula and Mohali) and were analyzed for total solids contents (milk fat %, milk solids not fat %) using standardized methods. Results : Average fat content was 4.6±1.37%, SNF was 7.87±1.33%and TS was 12.4±1.93 %. Only 21 samples (23.33%) met standards prescribed by Food Safety and Standards Authority of India, (FSSA) 2006. No other adulterants such as starch, urea, sodium hydroxide etc. were found in any of the collected milk samples. Conclusion: Quality of 77% of the collected milk samples from Tricity (Chandigarh, Panchkula, Mohali) was below the standards. Therefore, regular check up of milk should be carried out at various critical control points.
Indian Journal of Medical Informatics, Sep 3, 2012
Indian Journal of Palliative Care, 2015
Journal of the Indian Medical Association, 2012
To estimate the prevalence of primary dysmenorrhoea among the school girls, to determine its impa... more To estimate the prevalence of primary dysmenorrhoea among the school girls, to determine its impact on their routine life and to ascertain the practices adopted by them for management of primary dysmenorrhoea, a cross-sectional study was conducted in two schools of Chandigarh, India. Two hundred twenty-four school girls in the standard VIII to X of the selected schools, who had attained menarche, were included in the study. A modified menstrual distress questionnaire was used to score the severity of dysmenorrhoea and its impact on their life. Visual analogue scale for pain was used to measure pain during menstruation. Analysis was done by percentage, mean and standard deviation. Prevalence of dysmenorrhoea was 59.82%. Sickness absenteeism due to dysmenorrhoea was reported in 25.8% girls. According to visual analogue scale for pain scoring, 52.3% had moderate pain and 25% cases had severe pain. Menstrual distress questionnaire scores showed mood swings, irritability, difficulty in c...
The single modified Kratzer equation relating EC to flow at Vernalis has been replaced by salt ba... more The single modified Kratzer equation relating EC to flow at Vernalis has been replaced by salt balance calculations at different points from Lander Avenue to Vernalis. Significant improvement has been reached through the disaggregation of the flow model representation of the western side of the river basin. However, for the current model, the EC-flow scatter plots (rating curves) for Vernalis overestimate EC for the months of February and March.
Indian journal of palliative care
Nonpharmacological interventions (NPIs) have been advocated for knee osteoarthritis (KOA). There ... more Nonpharmacological interventions (NPIs) have been advocated for knee osteoarthritis (KOA). There are many gaps in the evidence to their efficacy in India. The study aims to compare the impact of two packages of NPIs on various outcome variables of KOA patients. This was a randomized controlled trial in a tertiary care hospital. A study population ( = 123) of KOA patients aged 40-65 years. Stratified block randomization was done for mild or moderate KOA into two groups. Group "A" patients received a package of NPIs including a set of supervised exercise sessions, kinesthesia, balance, and agility (KBA), meditation, weight reduction advice, and weekly telephonic reminders. Group "B" patients received the same package except for KBA & meditation. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) and performance-based measures were measured. -test and repeat measures ANOVA were undertaken. A significant intragroup reduc...
BMJ case reports, Jan 23, 2017
In North India, preference for sons has been blamed for repeated incidents of female feticide, de... more In North India, preference for sons has been blamed for repeated incidents of female feticide, despite the legislation in the form of the Pre-Conception and Pre-Natal Diagnostic Techniques Act, 2002. We describe how a team of local private doctors offer package deals to pregnant women and their families in rural areas. The fetal sex is determined at night using a portable ultrasonography machine.If the fetus is a girl, an immediate induced abortion is offered in the clients' home. If complications arise, women are advised to attend hospital. Such a patient visited us with a history of bleeding per vagina following incomplete induced abortion. This case study highlights the fact that female feticide continues to occur in India.
BMJ case reports, Jan 17, 2018
In this case study, we describe our experiences with a rural poor family from north India that in... more In this case study, we describe our experiences with a rural poor family from north India that initially contacted faith healers for treatment of their child who was having symptoms suggestive of epilepsy, but the seizures continued even after this. The family migrated to a city, where they started allopathic treatment, but eventually they had to discontinue it as there was no apparent relief. Again, they went back to their native village and restarted the treatment from the faith healer.This case study highlights the fact that in spite of the significant development of medical science, many questions pertaining to epilepsy treatment are still unanswered. Such dissatisfaction with the allopathic treatment of epilepsy is very common. Complexity of the disease and high cost of modern medication, side effects of drugs, efficient but heavy treatment protocols and unpredictable outcome are responsible for continued practice of people consulting faith healers for treatment of epilepsy. Ho...
BMJ case reports, Jan 13, 2017
In this case study, we describe our experiences with a woman employed as a housemaid who sought u... more In this case study, we describe our experiences with a woman employed as a housemaid who sought unsafe abortion services from a private doctor. This was her sixth pregnancy, after previously giving birth to one son and two daughters and undergoing two induced abortions. Her husband remained opposed to the use of contraception. Initially, she had sought medical termination of pregnancy through a government hospital but was denied because of procedural delays, specifically the non-availability of an ultrasonography report consequent to a lack of proof of identity (ie, the AADHAAR card, a unique identification card for recording biometric and demographic data in India). She finally sought the services of an unqualified private physician and received oral abortifacient agents. Consequently, she was required to seek treatment for bleeding per vaginum from the dispensary staff at a government hospital. We note that many such incidents occur in our daily practice but remain unnoticed and u...
Indian journal of palliative care
More than 80% of bedridden patients develop bedsores in home care settings. Training of informal ... more More than 80% of bedridden patients develop bedsores in home care settings. Training of informal caregivers can significantly affect the quality of care to these patients. The objective of this study is to compare the effectiveness of two caregiver training strategies on prevention of bedsores among bedridden patients. The study was carried out in Chandigarh. The study center was at PGIMER, Chandigarh. Seventy-eight bedridden patients being taken care in their homes were identified. These were randomly allocated into two groups. Group A received Prevention Package I, i.e., self-instruction Manual (SIM), training, and counseling. Group B received Prevention Package 2, i.e., only SIM. All these patients were followed up periodically for 1 year. During each follow-up, patients were observed for bedsore development. Braden scale was used to assess the risk factors of bedsores. Katz scale was used to evaluate the level of functional dependence of patients. Descriptive statistics was used...
AIMS Public Health
Childhood blindness due to corneal ulceration was prevalent among poor Indian children. To tackle... more Childhood blindness due to corneal ulceration was prevalent among poor Indian children. To tackle this situation, the National Institute of Nutrition (NIN), Hyderabad, India, Vitamin-A (Vit-A) prophylaxis programme was launched nationally in 1970 after field testing. Research of Indian Council for Medical Research (ICMR) documented that prevalence of Vit-A deficiency signs such as Bitot's spot decreased among children, over a period of time. However, this decrease cannot be ascertained is due to mass Vit-A prophylaxis programme. This is because coverage was low and patchy. Improved nutrition status, wider vaccination coverage, increased rate in breast feeding and improvement of healthcare services played a crucial role. Rather many studies revealed that (mass prophylaxis to the child who is having adequate Vit-A level) it may be harmful to certain group of children as a result of acute toxic symptoms. High dose of Vit-A is capable of loss of bone density-hence retarded growth may be observed in susceptible individuals. To tackle this issue food based approach should be promoted (which includes breast feeding) along with timely measles vaccination. The children who have signs of Vit-A deficiency (e.g. night blindness, xeropthalmia, Bitot's spot) or post measles children should receive Vit-A in age specific daily doses for two weeks along with Vit-A rich food, like green leafy vegetables, red palm oil, liver etc. Public spirited citizens, together with scientific community in India, should discourage this "one size fit to all" approach. It will not only avoid the ill effects of high dose of Vit-A but also it will help us optimal utilization of health resources in a resource poor country like India.
Clinical Nutrition ESPEN
Childhood blindness due to corneal ulceration has historically been prevalent among poor Indian c... more Childhood blindness due to corneal ulceration has historically been prevalent among poor Indian children. To tackle this situation the National Institute of Nutrition (NIN), Hyderabad, India, launched (after field-testing) massive dose based national vitamin A (Vit-A) prophylaxis program. Over a period of time reduction in childhood mortality was also hailed as a beneficial effect of the program. Data from the Indian Council for Medical Research (ICMR) indicate that in most Indian states there has been a gradual reduction in the prevalence of Bitot's spots. However, it was not attributed to the prophylaxis program because of its low and patchy coverage. It was, rather, attributed to the control of malnutrition, along with measles vaccination and improvement in healthcare access. Various studies have concluded that massive dose vitamin A prophylaxis does not reduce childhood mortality; this may have been due to the Hawthorne effect; whereby beneficial effects arose from frequent contact of health workers with community members. Paradoxically, harmful effects of massive doses of Vit-A are documented, e.g. acute toxicity in certain groups of children, ranging from increased intracranial pressure, mental retardation (postnatal period), and even death. Vit-A also intensifies bone demineralization, and increased levels can lead to calcium deficiency and, hence, growth retardation in vulnerable children. According to the present authors, for children who have Bitot's spots or who have just recovered from an attack of measles, the best approach is to give Vit-A in therapeutic doses along with adequate daily intake of vegetables and fruits. Public-spirited citizens, along with the scientific community, must ensure the scrapping of the universal massive dose Vit-A prophylaxis approach, to avoid Vit-A toxicity and reduce economic burden to the health system.
Science and engineering ethics, Jan 23, 2017
The issue of 'mandatory publications' has generated serious flak about its usefulness amo... more The issue of 'mandatory publications' has generated serious flak about its usefulness among the various stakeholders. A lot of debate centers around the question of 'lack of will' or 'lack of skill' as a reason for the diminishing research interests among the medical faculty in India. In our view, it is the lack of will to publish good quality research which is to be blamed rather than the lack of skill to do good quality research.
BMJ case reports, Jan 21, 2017
India accounts for one-fourth of the global tuberculosis (TB) burden. The National TB Program was... more India accounts for one-fourth of the global tuberculosis (TB) burden. The National TB Program was started in 1962. Over a period of time, some lacunae such as poor case detection rate and incomplete treatment were observed. Later, the government formulated the Revised National Tuberculosis Control Program (RNTCP), which achieved a case detection rate of 70% and a cure rate of 85%. Still, the problem of relapse and defaulter cases persists. In 2014, 6% defaulter cases were reported from India. RNTCP has also focused on microlevel aspects, that is, newer diagnostics such as GenXpert, line probe assay and medicines such as bedaquiline for drug-resistant TB. Action on the macrolevel aspects, for example, social determinants, is ignored. This is natural because these are out of the purview of the health sector. This case study reflects how a resident doctor in a rural clinic of North India tried to resolve the macrolevel and microlevel issues pertaining to defaulter TB cases.
Medical journal, Armed Forces India, 2017
Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safet... more Food-borne illnesses have been a recognized hazard for decades. Recent promulgation of Food Safety and Standards Act (FSSA), 2006, indicates the concern of our Govt. for food safety. Research on effectiveness of food safety interventions in our country is remarkably scarce. Hence, the present study was conducted in a tertiary care hospital of north India to create evidence-based results for food safety interventions. The study was before and after intervention trial which was registered with CTRI. Data collection was paperless using a software. All food handlers (n = 280) working inside the hospital were recruited. Intervention package comprised Self-Instructional Manual in Hindi for food handlers, short film for sensitization of food handlers on food safety titled 'Gravy Extra', and a documentary titled 'Food Safety from farm to Fork'. Chi square test, paired t test, and Wilcoxon sign rank test were used. The mean age of food handlers was 35 ± 2 years. Majority (61....
Medical journal, Armed Forces India, 2016
Various studies in India have reported the prevalence of anaemia to be more than 50% among women ... more Various studies in India have reported the prevalence of anaemia to be more than 50% among women of the reproductive age group. A community-based study was done to find out the prevalence of anaemia in non-pregnant, non-lactating wives of serving soldiers in a military station. It was a cross-sectional study. The sample size was 600. Venous blood was collected for haemoglobin and ferritin levels. Analysis was done by SPSS 20. The mean age at marriage was 19.8 years (SD + 2.76). The average age at first childbirth was 20.88 years. Major symptoms reported were weakness (24.34%), giddiness (23.47%), fatigue (20.17%) and heavy bleeding (3.13%). Prevalence of anaemia in our study was 13.9%, which is much below the national prevalence. Prevalence of iron-deficient status was reported in 153 (26%) individuals. Out of these, 81 subjects were non-anaemic (Hb > 12d/dL) but were iron deficient (ferritin <15 μg/L). Sixty out of these 81 subjects reported presence of fatigue and 36 had wea...
Environmental health insights, 2016
Farmers in developing countries are exposed to pesticide hazards due to unsafe handling. This stu... more Farmers in developing countries are exposed to pesticide hazards due to unsafe handling. This study was conducted to identify the prevailing practices of pesticide use and factors affecting the handling of pesticides among the farmers of Chitwan, Nepal. A cross-sectional study was conducted among 125 farmers. None of the farmers completely followed all the protective measures. About 59% disposed the empty pesticide containers to a nearby water source and 62% preferred house ceilings as a storage place. Males (aOR = 3.99, CI = 1.63-9.78) and older farmers (aOR = 6.18, CI = 2.59-14.72) were more likely to smoke or chew tobacco during the process of spray. Males (aOR = 2.42, CI = 1.03-5.67), literate farmers (aOR = 3.56, CI = 1.51-8.33), and farmers aware of color coding (aOR = 2.67, CI = 1.13-5.67) were more likely to read the labels on pesticide bottles. In spite of an extensive use of pesticides, the farmers were not following proper and safe handling practices, exposing them and th...