Abstracts of Selected Papers
Road safety awareness and driving practices: Perception of students at an urban Indian university
Rajiv Yeravdekar1, Abhay Saraf2, Yatin Pimple3, Abhijeet Safai3, Samir Barve3, Sharvari Shukla4
1Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, Pune, India, 2IQVIA, New Delhi, India, 3Symbiosis Community Outreach Programme and Extension, Symbiosis International (Deemed) University, Pune, India, 4Symbiosis Statistical Institute, Symbiosis International (Deemed) University, Pune, India
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Introduction: Road traffic injuries are the eighth leading cause of death globally. The General Assembly of the United Nations (UN) has declared 2011-2020 as ‘Decade of Action for Road Safety’ with a goal of reducing fatalities at global levels. Globally, a rise in the motor vehicle population paripassu with an expansion of road network has brought with it the challenge of addressing adverse factors such as road accidents, related injuries and fatalities. Unfortunately, road fatalities occur amongst the most productive age of 15 to 44 years; with India contributing to 73% of fatalities in the South East Asian region. This study was therefore carried out with the objective of assessing awareness of road safety and driving practices (both safe & unsafe) amongst students and accordingly recommend appropriate measures to bridge the gap in relation to road safety knowledge and promote safe driving practices.
Result: Of the 384 students enrolled, 54 percent and 46 percent were boys and girls respectively, with an age range from 18 to 31 years (Mean 20.1 years and SD±2.3). The traffic sign least known to the students was ‘Give way’ (24%) while ‘No horn’ traffic sign was known to all students. Exceeding lawful speed limit (25%) was the most commonly followed unsafe driving practice while drunken driving (3.1%) was the least followed unsafe driving practice. Thirty-six and twenty-three percent students reported not using helmet while driving two wheeler and seatbelt while driving four wheeler vehicles respectively.
Conclusion: The overall awareness of road safety and driving practices was high among students. It was higher among boys as compared to girls. The observations of the study emphasize the need to create awareness related to few unknown traffic signs like yellow signal, give way and no parking; monetary penalties and safe driving practices like use of helmet and seatbelts. Use of mass media, signboards and posters could be strengthened to increase road safety awareness.
Keywords: Driving practices, Helmet use, Road Traffic Accidents, Road safety awareness, Seatbelt use, University students.
Comparative study of EMS access number in the Developed and developing countries and feasibility to have a common emergency access number for India
Parag Rishipathak1, Rajiv Yeravdekar2, Prasad Rajhans3
1Deputy Director, 2Director, 3Consultant in EMS, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, Pune, India
Introduction: The Emergency Access Numbers that are operational in various nationally and learn from the other Emergency Access Numbers operational in other countries. To study EMS access number in the developed and developing countries. To study feasibility of having common Emergency access number for India.
Materials and Methods: The present study focuses on Emergency Access Number in select countries of the world based on questionnaire circulated and responses obtained. This study is based on the responses obtained from EMS stakeholders working in EMS field in India and various parts of the World.
Result: Developing countries except Bangladesh and Nepal from the study have proper emergency systems in place with universal emergency telephone number to contact in case of emergency, whereas there is no single system or number, which could play a major role in managing emergency medical services across India.
Conclusion: In spite of the development in the healthcare sector over the past decade India is yet to create a single comprehensive EMS that can be accessed throughout the country. Only fourteen states have managed to launch state wide EMS, as on today. One-Naught-Eight (108) is a free telephone number for emergency services to call in these states. In other states of the country emergency services can be called by dialing Police -100, Fire – 101, Ambulance – 102. In addition, hospitals in the country provide different telephone numbers for ambulance services. A person in distress cannot be expected to remember such specific phone numbers during an emergency. Thus access to emergencies becomes difficult. The lack of a common emergency number across the country is a major hurdle in creating a reliable emergency service. Thus to provide good Emergency Medical Services & prevent needless death or disability & help victims in case of an emergency, India should have common Emergency Access Number Across the country.
Keywords: Emergency Access Number, Emergency Medical Services.
Health Technology Assessment: Opening pathway for implementing Robotic surgery in a University Teaching hospital
Dinesh T.A., Prem V. Nair, Thiba Salam, Vidya Jha
Amrita Institute of Medical Sciences and Research Centre, Kochi, India
Introduction: Health Technology Assessment (HTA) is a systematic multidisciplinary activity which assesses application of health technology. It evaluates the safety, clinical efficacy and effectiveness, its cost and cost effectiveness. Surgical robots provide an improved 3D view of surgical area and a better manipulation of surgical arms as compared to conventional laparoscopic surgery. Objective of the study is to perform Cost benefit analysis of robotic surgery (RS).
Originality: Original research work
Materials and methods: A retrospective cross sectional study was done for a period of 2 months. 50 robotic and 40 open surgical cases were selected. Direct & indirect costs of care were estimated along with assessment of operational costs for RS. Statistical analysis was performed. Correlation of length of stay (LOS) was done with direct and indirect costs incurred.
Results: Robotic surgery is a high end CapEx model but financially viable. A positive NPV was seen with ROI in the 5th year. Operational cost and material cost were found to be statistically higher for RS. Pharmacy cost and nursing cost showed a high degree of correlation with LOS in gynaecological oncology department. Reduced LOS, less pain and faster recovery are the major positive impact that harbinger the socioeconomic benefit. Surgeons too have greater visualization and dexterity. RS provides better patient care by shortening recovery period and post-operative care.
Conclusion: HTA is ‘a bridge’ between evidence and policy-making. It guides decision-makers about appropriate use of technology and efficient allocation of resources. RS is an advanced approach which significantly improves patient care and provides more flexibility and precision to surgeons.
Keywords: Decision-making, HTA, Robot.
Awareness about Laws amongst Patients visiting Epilepsy Clinic of a Tertiary Neurosciences Hospital: An Observational Study
Indranil Ghosh1, Ashish Dutta2, Bibhukalyani Das1
1Department of Neuroanaesthesiology, 2Department of Neurology, Institute of Neurosciences, Kolkata, India
Introduction: According to World Health Organization (WHO), "Epilepsy is one of the oldest conditions known to mankind”. The present study has been carried out to assess the awareness about law amongst individuals having epilepsy.
Originality: This is an overview of the conflict that exists between the legal system and persons with epilepsy in India.
Methods: This study has been conducted through questionnaire method distributed amongst people visiting the epilepsy clinic of a tertiary neurosciences hospital.
Results and Discussion: None of the respondents were aware about laws for epileptic patients. Few had driving license although they had concealed their condition during the training. Some of them were married; however, divorce rates were high amongst females. Nobody had faced legal hassles but was of the opinion that the state needs to do a lot for them. There are still many goals to meet, which require the united efforts from the parents, persons with epilepsy, the Indian Epilepsy Association and the legal fraternity.
Conclusion: According to Indian Law epilepsy is a state of temporary insanity. Repeated petition to the government by the Indian epilepsy association have not borne fruitful results.
Keywords: Epilepsy, Law
Optimizing Maternal and Child Healthcare in India Through the Integrated Use of Artificial Intelligence Big Data and Telemedicine: A Literature Review
Vedang Tyagi1, Skannd Tyagi2, Mahak Agarwal3
1Medical Intern, Shri Ram Murti Smarak Institute of Medical College, Bareilly, 2Director, E Info Solutions, 3Junior resident, Shri Ram Murti Smarak Institute of Medical College, Bareilly, Uttar Pradesh, India
Introduction: The Maternal Mortality Rate (MMR) and the Infant Mortality Rate (IMR) of India are an alarming 174/1,00,000 live births and 34/1000 live births. This is a result of poor quality and inaccessible healthcare. This literature attempts to review the published works offering a solution to the aforementioned issue with reference to Artificial intelligence, telemedicine, big data and their integration.
Objectives: To review the published literature regarding use of artificial intelligence, big data and telemedicine in healthcare to offer a solution to reduce the MMR and IMR. One of the greatest problems in India are the MMR and IMR. The use of technology for optimizing maternal and infant health-care has not been studied in India.
Methods: Literature search using keywords Artificial intelligence, e-health and big data analysis was performed.
Result and Discussion: It was seen that such integration is being utilized to improve healthcare in various countries across the world. In India however, such application has not been envisaged. Healthcare will be accessible in the remotest corners.
Conclusion: The use of such integration has been beneficial in optimizing healthcare, albeit requires further clinical evaluation.
Keywords: Artificial Intelligence, Analytics, Big data, Digital healthcare, EMR, Technology, Telemedicine.
Evaluation of a Novel Dynamic Bed Bioreactor for Cultivation of Mammalian Cells
Ravindra Ganpat Muley1,2, Rajeev Mhalsakant Dhere2
1Ph.D. scholar, Department of Health & Biomedical Sciences, Symbiosis International (Deemed) University, 2 Serum Institute of India Private Limited, 212/2, Hadapsar, Pune, India
Introduction: Bioreactors offer benefits for high density growth of anchorage dependent cells because of efficient mixing and controlled growth conditions. Continuous improvements in bioreactor design and its operation are needed to enhance the productivities of vaccines and biologicals.
Objective: Performance of a novel dynamic bed bioreactor operated in perfusion mode was evaluated for high density growth of mammalian cells. Dynamic bed bioreactor operated in glucose based perfusion mode was evaluated for high density cell growth under the given operating conditions.
Methods: MRC-5 cells and Vero cells were cultivated by glucose fed perfusion method in 0.5 L CellBRx bioreactor with periodic sampling for glucose and cell growth analysis. Minimum Essential Medium with Hanks’ salt and 10% fetal bovine serum was used as nutrient medium.
Results and Discussion: Higher cell densities were observed for Vero cells compared to the MRC-5 cells consistent with glucose uptake rate profiles. Oxygen transfer rate capacity of the bioreactor was observed to be more than the peak oxygen uptake rates of the growing cells under given conditions. Sustainable high densities of cell substrates achieved in this system can be explored further for the production of next generation viral vaccines.
Conclusion: Adequate quantities of vaccines and biologicals are needed in the developing world at affordable prices. This goal can be achieved by enhancing productivities. Improvements in bioreactor designs and operating strategies are some of the approaches towards the goal.
Keywords: Dynamic bed bioreactor, Glucose uptake rate, Oxygen transfer rate.
Influence of Mobile Communication on Utilization and Outcome of Maternal Health Services in Rural Area
Vidyadhar Bangal1, K V Somasundaram2, Sunil Thitame3
1Professor and Head, Department of Obstetrics and Gynaecology, Rural Medical College,2 Director, Centre for Social Medicine, Pravara Institute of Medical Sciences, Assistant 3Professor ,Co-ordinator - MPH programme , Centre for Social Medicine, Pravara Institute of Medical Sciences Loni, Tal-Rahata, Distt-Ahmednagar, Maharashtra, India
Introduction: The rapidly expanding mobile network coverage and mobile phone usage has revolutionized new ways of delivering health services. Objective is to assess the influence of mobile communication between health facility and pregnant women on utilization and outcome of maternal health services. The scientific application of mobile phone technology for improving maternal health outcome in rural area is a novel idea and underexplored area.
Methods: The prospective randomized control study involving four hundred pregnant women was undertaken. Women from control group received routine antenatal care and advice. Intervention group received mobile phone calls in addition, as reminders about next visit and SMS on maternal health.
Result and Discussion: Women from intervention group had 23% more number of antenatal visits,15% more institutional deliveries, lower perinatal mortality (2.94% versus 3.82%) as compared to the control group. The complications during pregnancy and labour were less in (14.00% and 21.00%) in intervention group. Significantly large number of women from intervention group (85.00% versus 21.00%).) turned up for postnatal follow up, as compared to control group. Outcome of the present study will be useful in improvement in maternal health and pregnancy outcome by optimum utilization of services in rural area.
Conclusion: m-Health tools present an opportunity to influence behaviour change and ensure that women access prevention services, including antenatal, natal and postnatal care. Use of Mobile technology in health has a great potential and promise for improving the health of the rural community.
Keywords: Antenatal care, M health, Pregnancy outcome.
Exposure to Laundry Processes and Its Effect on Lung Function among Laundry Workers: A Case-Control Study
Moumita Chakraborty1, Sharvari Shukla2, Mahesh Pund1, Sammita Jadhav3, Nitin Abhyankar4
1 Student-M. Sc Medical Technology, 2Professor, 33Deputy Director; Academics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, 4Chest Physician, Poona Hospital and Research Centre, Pune, India
Introduction: Occupational lung diseases results from a prolonged exposure to irritants at the workplace. Laundry-workers get exposed to noxious particles during various laundry processes such as washing, dry-cleaning, pressing clothes etc. Assessing their lung functions will help us in developing standard threshold of exposure levels to avoid development of chronic lung diseases.
Objective: To study the impact of long term exposure to noxious particles such as (detergents, starch, volatile organic compounds) on the lung functions of laundry-workers. It is first study on laundry-workers from Pune.
Methods: The study conducted in two clusters of laundry colonies of Pune city. We enrolled 98 male participants. Of them, 50 apparently healthy male launderers (exposed) and 48 age-matched participants (unexposed), residing at the same location. We collected socio-demographic information along with assessment of their respiratory symptoms and lung function by using spirometry test.
Results: On average participants were 46 years old (range 25-70) with BMI 25.6(±12.4) kg/m2. Two groups were comparable (p<0.05 for age, BMI). The average occupation duration of laundry workers was 10.1(±6.9) years with work hours 9.0(±2.02)/day. About 32% laundry-workers and 19% non-laundry-workers were smokers. High proportion of laundry-workers 33(66%) had more respiratory symptoms(p=0.016), highly disturbed-sleep due to respiratory symptoms (p=0.021) compared to non-laundry workers. High proportion of laundry-workers 30(60%) showed abnormality (restriction/obstruction/small-airway disease) whereas only 19(39%) non-laundry workers showed abnormal spirometry test (p=0.043).
Application: The study will benefit in improving the lung function among laundry-workers.
Conclusion: Exposure to noxious particles related to laundry work significantly reduces the lung function and produces more respiratory symptoms among the launderers as compared to the non-laundry workers.
Keywords: Laundry-workers, Respiratory symptoms, Spirometry.
Community Based Micro Health Insurance Schemes to provide quality health care with equity in rural India
Surekha Tayade1, Jaya Kore2, Noopur Singh3
1Professor, 2Senior Resident, 3Junior Resident, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
Introduction: Over 40 % of hospitalized Indians borrow heavily or sell assets to cover expenses of health care. Kasturba Hospital offers high quality, low cost healthcare through unique insurance schemes to minimize ‘out of pocket’ expenditure and provide accessible, affordable health care. Objective of the study is to evaluate the health insurance schemes run by Kasturba Hospital in rural India
Novelty: These schemes are unique and have won global acclaim. A villager can insure himself and his family by paying Rs 400 a year with a 50 % subsidy on hospital services. Jowar Health Insurance Scheme has a common fund created by the villagers by collecting Jowar during the annual harvest time for heavily subsidized health care.
Methods: Hospital information system was used to evaluate health insurance schemes of the hospital and number of beneficiaries from January to December 2017 with social determinants were analyzed
Result: Hospital runs 5 schemes - Hospital Insurance card, Kisan Card and Jowar card for 50 % benefit, Yellow card for 100 % subsidy and Mahatma Jyotiba Phule Jan AarogyaYojna (MJPJAY). In 2017, 42953 families (192841 members) from 40 villages obtained the benefit of hospital insurance, 1554 of Yellow card, 2334 of Kisan cards, 6888 of Jowar cards and 4061 of MJPJAY. Rural families from adopted villages of institute were main beneficiaries. SES did not appear to inhibit uptake. Families from below poverty line benefitted from MJPJAY
Conclusion: Community Based Micro Health insurance schemes involving participatory approach are considered viable options and prioritized by villagers to meet their health needs &are able to provide health care with equity. Families with greater financial liabilities find them attractive. This is easily applicable in various health care setups with large healthcare benefit, especially to rural population as participatory approach is promoted
Keywords: Community Based Health Insurance Schemes, Micro health insurance, Rural Health
Market mapping of the surgical solutions used in the hospitals of Bihar and Jharkhand
Meenal Kulkarni11, Priyanka Patelia2
1Asisstant Professor, 2Student, Symbiosis Institute of Health Sciences, Symbiosis Institute of Health Sciences, Pune, India
Introduction: The present study is market mapping conducted in states of Bihar & Jharkhand to identify trends and corresponding variables between hospitals (consumers) and surgical solutions that included Gowns, drapes, examination gloves, sterilized drapes, to provide base for better product development. The study focuses at identifying brands available, satisfaction level on purchase parameters: -type of material, quality based on barrier protection, flame resistance, microbial resistivity, product availability, training regarding usability etc.
Objective: Market mapping activity in this part of India is conducted in depth.
Methods: Fifty hospitals were selected on random basis. Data was collected with help of a questionnaire based on parameters mentioned under objectives, responses from the quality control officers, technicians of intensive care units and doctors were obtained. Data analysis was performed using SPSS (Statistical Package for Social Sciences).
Results: Surveyed hospitals were mostly purchasing their products through local wholesale markets without much of brand concern. 95% of the hospitals were using the products made up of linen due to low cost of material and reusability. Only 10.33% hospitals are given training regarding the method of handling and usage of the products. No cases of hospital-associated infection were reported by the hospitals surveyed with use of current surgical products. The results can help manufacturers to provide surgical solutions that are innovative and technologically sound. It will help in creating awareness amongst healthcare providers about the usage of such products.
Keywords: Market mapping, Quality, Surgical solutions.
Willingness to pay for the pentavalent Hib vaccine among parents of children under five years of age in a rural population in India
Shomik Ray1, Luke Vale2, Laura Ternent3
1Associate Professor, Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, India, 2.3Institute of Health and Society, Newcastle University, United Kingdom
Introduction: The study aimed to assess the willingness to pay (WTP) for the pentavalent HiB vaccine among parents of children less than 5 years of age in rural Purulia, West Bengal using a contingent valuation (CV) method.
Objectives: Apart from assessing the WTP for the vaccine, the study also assessed the validity of the selected CV method and identified the determinants of WTP.
Originality: The study is the largest CV study on vaccination programmes in India and also the first CV study on the HiB vaccine in India. The study establishes the validity of CV methods for evaluating health programmes.
Methods: Shuffled payment cards followed by open ended question were used to assess WTP in a cross section of 873 households across 4 blocks of Purulia. 3 different CV methods were tested.
Results and Discussion: The WTP for the HiB vaccine was calculated at Rs.348 (95% CI: 28, 416). 88% parents were willing to buy the vaccine for the child. WTP went up with household income, education level of the parent, health and hygiene habits, positive health seeking behaviour and went down with the number children of the respondent. There was no evidence of a gender bias.
Application: Contingent valuation promises to be a useful method for evaluating health programmes apart from providing a transparent method to assign monetary values to health benefits.
Conclusion: The study indicates a high demand for the pentavalent HiB vaccine in the study population and provides inputs for a cost-benefit analysis.
Electronic Medical Record in rural areas of Andhra Pradesh and Telangana: Challenges and possibilities
Kasturi Shukla1, Aditi Kane2
1Assistant Professor, 2Student, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, Pune, Maharashtra, India
Introduction: The quality of healthcare depends on many factors, including timely availability of a patient's medical information. There is a wide gap in healthcare services provided to rural and urban areas of India.
Objective: To study the use of EMR in chronic disease management and to study the challenges while implementing EMR in rural areas of Andhra Pradesh.
Methods: In this project, the study design used was Descriptive research and was conducted in the states of Andhra Pradesh and Telangana. Under hospital they have formed a foundation, under which they had different community centres in different villages where the EMR software was implemented. Study was conducted among the patients visiting to the community centres.
Results and Discussion: Out of 1305 patients 576 were diabetic which is 44% and 688 were having hypertension which is 52% of total number of patients. Initial adoption of an EMR system requires allocation of time for learning and training. Primary care (Community centres) practices need to budget for the one-time costs associated with implementation.
Application: EMR have been promoted as a potential tool for narrowing the quality gap. The benefits of electronic medical records include increased use of appropriate preventive services, improved chronic disease management, and reduction in medical errors.
Conclusion: Clinical documentation and health information portability are the biggest challenges in urban and rural areas of India. This project focuses on how EMR system could help in prompt availability of medical information at the point of care.
Keywords: Challenges, Diabetes Management, Electronic Medical Record.
Management of Medical Records in a Multispecialty Tertiary Care Hospital at Surendranagar, Gujarat - A Cross-Sectional Study
Associate Medical Data Review Manager, IQVIA, Mumbai, India
Introduction: Health facilities deal with life and health of patients. Quality of medical care relies not only on its staff, high-quality equipment and facilities but also on good record keeping. Proper filing of medical record ensures easy retrieval of health information and prevents delay in healthcare delivery. Objective of the study is to investigate the record management practices in a multi-specialty tertiary care hospital of Surendranagar district, Gujarat.
Methodology: A survey design was used while a total of 130 hospital staff was sampled using non-probability technique. Questionnaire was used as a tool for data collection. Data collected was analysed using frequency counts and simple percentages.
Result and discussion: 77.97% of response on type of record created was patient records. Among the staff involved in record management, 31.11% had a working experience between 6-9years. The records were both in paper and electronic format as mentioned by 72.22% respondents. 73% mentioned records were archived in numeric, 14% in alpha-numeric and 13% in both formats. Records were disposed by manual techniques.
Conclusion: Most commonly nursing staff was involved in record creation. Records were created in paper format and filed both in numeric and alpha-numeric sequence. Confidentiality and security of records are the major mechanism employed at the hospital. The most common problem faced in record management in this study was damage of records including tearing and weather effects on paper records.
Keywords: Health facility, Record keeping, Record management.
An Examination of Perceived Ergonomic Workstation Design as a Determinant of Software Project Planning and Execution of a Programmer in India
Chetan Panse, Ravi Kumar
Associate Professor, SIBM Pune, Symbiosis International (Deemed) University, Pune, India
Introduction: The research theme relates to perceived software project planning and execution of computer programmer and presents a systematic analysis of technical & non-technical factors that influence programmers’ ability to plan & manage a software project. This study has been conducted on Indian software industries to understand which are the significant factors that affect Software Project Planning and Execution. The factors considered were: Ergonomic Workstation design, Work Organization, Work-related health issues, Office environment and HR Practices, Quality management system, Domain Knowledge, Technology and Software project planning and execution.
Originality: Software programming & its quality is an intelligent work which is built entirely on human capital & not many attempted to understand how it is done & what are the factors that affect it.
Methods: The data was collected using random sampling from programmers by way of a structured questionnaire. The analysis was done using Structural Equation Modelling (SEM) using AMOS 20. The total sample size was 199.
Results: The overall model fit looks adequate with the CMIN/DF is 1.821 while all other parameters such as GFI, AGFI, CFI & RMSEA are within the recommended value. Ergonomic workstation design leads to less occupational hazards.
Conclusion: The major finding of the study was that two factors, i.e. Ergonomic Workstation and Domain Knowledge have a significant impact on software project planning & execution.
Keywords: Domain knowledge, Ergonomic workstation, Software project planning.
Association of Body Composition, Nutritional Status and Menstruation among Early Adolescent Girls
Harshada Thakur1, Devaki Gokhale2, Sneha Kasale3, Suhas Otiv4
1Research Scholar, 2Assistant Professor, 3Student, Symbiosis School of Biological Sciences, Symbiosis International (Deemed) University, Pune, 4Consultant, Department of Obstetrics and Gynaecology, KEM Hospital and Research Centre, Pune
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Introduction: Adolescence is a critical transition age where tremendous growth pace occurs, where girls undergo physical, mental and hormonal changes. Menarche is attained by adolescents between the age group of 12-15 years. Menstrual irregularity and dysmenorrhoea are prevalent among Indian adolescent girls. The factors contributing to the disorders are nutritional status, physical activity level, body composition, hormonal imbalance and combination of many factors. Objective of the study is to explore the correlation between age at menarche and menstrual disorders in school going girls in the light of their nutritional status and body composition.
Methods: A total of N=150 girls from CES’s Abhiman English Medium school participated in the study. Data of menstruation, nutrition and physical activity collected using structured questionnaires through interview method. Anthropometric measurements included height, weight, wait and hip circumference. Body composition assessed using TANITA body composition analyser.
Result and discussion: 7About 109(72.7%) girls had attained menarche whereas 41(27.3%) were yet to attain menarche. The girls who had attained menarche maximum number 80(53.4%) of girls were in age group below 12 years. The most common disorder reported was Dysmenorrhea 81(54%). The intake of energy and protein was deficit among most of the girls. Girls skipped one of the meals mainly breakfast. Means of body fat %, lean body mass, visceral fat was significantly higher among the girls who had already attained menarche. The mean weight, waist circumference, hip circumference was significantly higher in the girls who had occurrence of dysmenorrhoea. The time spent on sedentary and other activities were higher among the girls who had dysmenorrhoea.
Conclusion: It was observed that the body composition, nutritional status and physical activity were different across menstrual status and menstrual disorders. Dysmenorrhea was one of the most common menstrual disorders reported.
Keywords: Body Composition, Menstruation, Nutritional Status, Physical Activity.
Caesarean Births in Tamil Nadu: Levels, Change, Residential Differences and Differentials
Vaijayanti Patwardhan1, Vaithilingam Manjamuthu Viruthambal2
1Consultant Gynecologist, Project Coordinator, KEM Hospital Research Centre, Pune, India 2Research Officer, International Institute for Population Sciences, Mumbai, India
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Introduction: Caesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby. C-sections are performed whenever abnormal conditions complicate labor and vaginal delivery, threatening the life or health of the mother or the baby. Objective of the study is to analyse the caesarean births in rural and urban areas with private and public health facilities in Tamil Nadu.
Originality: To understand the levels, change, residential differences and differentials of C-section births.
Methods: Data are used from National Family Health Survey-4 (2015-16). The bivariate analysis is carried out.
Results and Discussion: Telangana with 19 states in India and Kanyakumari with 21 districts in Tamil Nadu are at the top with more than national and state averages respectively in the percentage of births delivered by C- section. Jammu & Kashmir, Manipur and West Bengal and the districts Karur, Ramanathapuram, and Tirunelveli are above the national and state averages respectively in the percentage of births delivered by caesarean section in total, rural and urban areas, and in urban-rural difference and percent change. The C-section births are more among women with first order births and with higher family income. Knowledge about the prevalence, change residential differences and differentials of C-section births will help the relevant professionals/authorities to recommend and conduct such births only in necessary circumstances and have monitoring over the areas with more such births.
Conclusion: Caesarean births are more in urban areas and a private health facility.
Keywords: Caesarean, C-section, Health facility.
Improving Compliance Rate of Critical Value Reporting in a Tertiary Care Hospital in Mumbai
Ruchira Dongre1, Neha Ahire2
1Student, 2Assistant Professor, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, Pune, India
Introduction: Critical values of laboratory test results are those results that require urgent medical action and should be communicated to the clinician urgently. Accurate, prompt communication of results to the clinician by the laboratory is of extreme importance. Critical result reporting is a requirement for accreditation bodies worldwide. Repeating of the critical result has been used as a means to improve the accuracy of notification. The Joint Commission (JCI), an independent and not-for-profit organization endeavored to improve patient safety and quality of health care, defines a critical test result as “a test that requires immediate communication of result irrespective of whether it is normal, significantly abnormal or critical.” Reporting of laboratory critical values has become an issue of international interest because of significant regulatory, medico legal and clinical concerns.
Methods: A study to improve the compliance rate of critical value in a tertiary care hospital in Mumbai was carried out for a duration of 3 months. The scope of the study included all the results termed as critical based on pre-defined standards. The study procedure undertaken was observation, Intervention and post observation. Data was analyzed by calculating the percentage compliance of critical value reporting introducing an intervention and post observation after the intervention.
Result: Interventions in the form of training and documentation were introduced which were found to be highly successful as it increased the overall critical value reporting compliance from 78 to 98 %, thus improving the safety of patients and quality of care given to them.
Keywords: Critical value reporting, communication, patient safety, compliance, laboratory tests.
Utilization Pattern of Blood and Blood Components in a Blood Bank of a Tertiary Care Hospital in Mumbai
Nupur Desai1, Kasturi Shukla2, Neha Ahire2
1Student, 2Assistant Professor, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, Pune, India
Introduction: The need for blood transfusion is escalating day by day. Transfusions are used for various medical conditions to replace lost components of the blood. One may need a blood transfusion due to several reasons including blood lost during major surgery, childbirth, a severe accident and in severe cases of anemia. Since there is no substitute for blood and its products blood should be utilized thoughtfully and optimum utilization should be ensured.
Methods: A retrospective study was carried out in a tertiary care hospital for a period of one month to study the utilization of the blood. The parameters studied included detailed study of the components of blood utilized and not utilized. Non - utilized components of blood were returned back to the blood bank the records of which was obtained from blood bank records. Classification of blood components utilized was done age-wise, gender -wise and department-wise. Also, percentage of discard of blood components from blood bank as well from the components being returned was noted.
Results: The total units of blood collected in the month of February & March were 853 and 791 units respectively. The components maximally utilized were leucocytes reduced red cell component. The component, which showed maximum wastage, was Random donor platelet. It was observed that maximum blood was utilized within the age group 41-64. In addition, male patients required more of blood units than females. The departments, which issued the maximum blood components, was cardiovascular surgery. The reason for maximum wastage was found to be “Expired Sample”. The maximum return seen was of red blood cells. The average time taken for return was 113 minutes.
Conclusion: This study implies the need for efficient blood banking so that blood components can be utilized resourcefully and minimal wastage can be ensured.
Keywords: Blood bank, Returns, Utilization, Wastage.
Comparative Study of Ambulance Services in the Developed and Developing Countries and Feasibility to Have Standardized Ambulance Services for India
Parag Rishipathak1, Rajiv Yeravdekar2, Prasad Rajhans3
1Deputy Director, 2Director, 3Consultant in EMS, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed) University, Pune, India
Introduction: Emergency Medical Service (EMS) is provided by a variety of individuals, using a variety of methods. The levels of service available will fall into one of three categories: Basic Life Support (BLS), Advanced Life Support (ALS) and Intermediate Life Support (ILS). The objective of the study was to compare the ambulance services in the developed and developing countries and to study the feasibility of having standardized ambulance services for India.
Methods: The present study focuses on Ambulance services in select countries of the world based on questionnaire circulated and responses obtained. This study is based on the responses obtained from EMS stakeholders working in EMS field in India and various parts of the World. Their responses were corroborated for authenticity through additional sources e.g. website, official publications of their Institutions and in some cases through personal interaction with the authorities.
Results: There is no standardization of ambulance design across various procurements in the country and the industry is forced to re-integrate their vehicles every now and then. Most of the ambulance specifications are written by medical specialists who are unable to translate the user requirements in automobile terminology there by resulting in a huge gap between the user expectations and industry deliverability. Developed and developing countries have both Basic Life Support (BLS) & Advanced Life Support (ALS) type of Ambulances.
Conclusion: The real concept of an ambulance is missing in India. EMS is responsible for delivery of Emergency care in pre-hospital or out of hospital environment and to develop relatively good EMS model. India should have both BLS as well as ALS type of ambulance services which should include Ambulance Vehicles, Ambulance drivers and Emergency Medical Technicians (EMT’s). There is also need to issue necessary instructions to the buyer of the incompletely built vehicle about the constructional and functional aspects of the ambulance.
Keywords: Advanced Life Support (ALS), Ambulance, Basic Life Support (BLS), Emergency medical service, Intermediate Life Support (ILS).