scholarly journals Screening for autonomic neuropathy using validated non-invasive scale among diabetes patients treated in the selected primary health centres of Puducherry, India: an operational research

Author(s):  
Pruthu Thekkur ◽  
Vignesh Muruganandam ◽  
Narayan K. A. ◽  
Chithra Boovaragasamy

Background: Diabetes autonomic neuropathy (DAN) is a complication of diabetes which has direct implications on the mortality of diabetes patients. American Diabetes Association (ADA-2017) guidelines recommend early recognition and treatment of DAN. In this regard, we conducted a study among diabetic patients treated in the selected PHCs of Puducherry to determine the proportion with DAN and to assess the factors associated with DAN.Methods: A cross-sectional analytical study was conducted among diabetics and information on socio-demographic details, morbidity and behavioural risk factors were elicited using semi-structured interview schedule. The COMPASS-31 questionnaire was administered to assess the autonomic neuropathy symptoms. The data was captured using EpiCollect mobile app and analysed using Stata 12.0 software. The proportion of DAN was expressed as percentage with 95% confidence interval. The association between independent factors and DAN was assessed using multivariate generalized linear models. The prevalence ratio with 95% CI was used to express the strength of association.Results: Of the total 303 individuals with diabetes, 32 {10.6% (95% CI: 7.3%-14.6%)} were screened positive for autonomic neuropathy using COMPASS-31 scale. The number of individuals with diabetes who needed to be screened (NNS) for finding one with autonomic neuropathy was 10 (303/32).Conclusions: One in ten individuals with diabetes was screened positive for autonomic neuropathy. With good yield, there is need for including autonomic neuropathy screening as a component in the comprehensive care provided to diabetes patients in the primary health centres.

Author(s):  
Dora H. AlHarkan ◽  
Malak A. Almuzneef ◽  
Norah M Alhammad ◽  
Nora A. Alyousif ◽  
Lina A. Alyousif ◽  
...  

Background: The aim of the study is to estimate the level of knowledge about retinoblastoma (Rb) and its determinants among non-ophthalmic health professionals of Qassim region of Saudi Arabia.Methods: This cross-sectional survey was held in 2016 in primary health centres (PHC) and general hospitals in the study area. In addition to demography like age, gender, education, place of work, participants replied to five questions related to Rb with close-ended questions to respond. They were matched to the expert group's answers to estimate the level of knowledge.Results: One hundred and fifty-two non-ophthalmic doctors participated in the survey. The excellent grade of knowledge of Rb was in 66 [43.3% (95% confidence interval 35.5-51.3)] of participants. Very poor level of knowledge was noted in 13 [8.6% (95% CI 4.1-13.0)] participants. Male gender (P = 0.02) and physician category (P = 0.02) were significantly associated with the excellent grade of Rb related knowledge. The participant’s response by type of questions varied significantly (P<0.001).Conclusions: More than half of the non-ophthalmic health professionals had less than desired knowledge about Rb. Health education about Rb to health professionals could be gender sensitive and based on the type of profession. Increasing the awareness about retinoblastoma among non-ophthalmic health professional is important.


Author(s):  
Shrinivas K. Patil ◽  
Shivaswamy M. S.

Background: Primary health centre (PHC) is a basic health unit to provide an integrated curative and preventive health care to the rural population as close to the people as possible, with emphasis on preventive and promotive aspects of health care.Methods: A facility based cross-sectional study was conducted in Belagavi district of Karnataka in India. Twenty PHCs, two PHCs from each of the 10 talukas of Belagavi district were selected by simple random sampling. The study period was from 1st January 2014 to 31st December 2014. Data was collected using a predesigned and structured questionnaire for IPHS facility survey.Results: In this study, only 60% of primary health centres covered the population as per the IPHS norms. All the PHCs were providing the regular outpatient department (OPD) services, referral services, antenatal care, family planning and in-patient services. Bed occupancy rate was less than 40% in 55% of PHCs. Building area in 75% of PHCs were inadequate according to IPHS norms. Residential facility for staff was available only in half of the studied PHCs.Conclusions: IPHS guidelines were not fully being followed at PHC level in the district. Though the requirement of medical officers and pharmacists was fulfilled in almost all the PHCs, deficiency was seen in the appointing of Ayush doctors and staff nurses at PHCs. There is an urgent need of recruiting the deficient staff for efficient functioning of the PHCs.


Author(s):  
Radhika S. Suberi

Background: This study was conducted with the objective to assess the medical laboratories attached with primary health centres (PHCs) focusing on the current needs, gaps and to understand the utilization pattern of the laboratory services. There are hardly any relevant studies that are known to have investigated the functioning of laboratories attached with PHCs based on quality of service they are providing.Methods: This study was a cross sectional study based on observations and assessment made at 33 randomly selected medical laboratories attached with PHCs in Ahmedabad district, Gujarat. Checklist adapted from National Quality Assurance Standards (NQAS) and Indian Public Health Standards (IPHS) were used as a tool for data collection.Results: Though all the laboratories have been found to be functioning effectively based on the indicators in this study, some of the laboratories were not performing basic important tests like rapid plasma reagin (RPR) (18%) and hepatitis B surface antigen (HbSAg) (21%). None of the laboratories attached to the PHCs under study performed Widal test. There was very low utilization of urinary pregnancy test (UPT) (1.81%) in the first quarter of the year.Conclusions: Although most of the indicators reflect satisfactory performance of the laboratories, there exists certain gaps and needs that are essential in provision of quality laboratory services in the primary level of health care. The laboratory information management system (LIMS) was the major issue in the laboratories. 


Author(s):  
Vidya Gowda ◽  
Savitha Rani ◽  
Chandrakala . ◽  
Aishwarya . ◽  
Suhasini .

Background: The COVID-19 pandemic was caused by a novel corona virus first discovered in Wuhan, December 2019. The healthcare system in India was quickly overwhelmed as tens of thousands of people with flu-like symptoms swarmed the hospitals.Methods: The present community based cross-sectional study was conducted among the accredited social health activist (ASHA) workers working under the selected primary health centres from August 2020 to November 2020. Primary health centres were selected by using simple random sampling technique. Three primary health centres were selected from the southern region of Bengaluru. The data was collected, compiled and entered into a Microsoft excel worksheet and analyzed using statistical package for social sciences (SPSS) software v.22.0. Descriptive statistics and suitable tests of significance like Chi-square test were applied as required.Results: A total of 78 ASHA workers participated in the present study. Majority of them belonged to the age group of 33-44 years. The mean age of the participants was 34 (+1.390) years. The present study showed that, 56.5% of the study participants experienced depression, anxiety or stress during the time of COVID-19 pandemic. Around 65% of the ASHA and Anganwadi workers were aware of the personal prophylactic measures to be used to prevent COVID-19 disease according to the present study.Conclusions: A significant proportion (56.5%) of the ASHA workers experienced depression, anxiety and stress during this pandemic. Measures should be undertaken to address the same. 


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  

Abstract Background Nigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive, maternal, child, and adolescent health (RMCAH) services in primary health care facilities across the Nigerian States. Methods This was a cross-sectional study of 307 primary health centres (PHCs) in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and provision of RMCAH services before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using frequency and percentage, summary statistics, and Kruskal–Wallis test. Results Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients’ utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19. Conclusions The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.


2021 ◽  
Vol 8 (3) ◽  
pp. 426-432
Author(s):  
Srijana Gautam ◽  
Nisha Shrestha

Although in recent decades depression and diabetes patients are increasing the numbers and proportions worldwide. Eighty percent of individuals with Type 2 diabetes mellitus (T2DM) dwell in low- and middle-income countries. The real crisis of depression and diabetes, where it exists, is the personal crisis of day-by day. The objectives of this study is to determine the prevalence and associates factors of depression among diabetic patients in selected hospital in Nepal. A cross sectional study was conducted at tertiary center of Pokhara, Kaski .Study participants identified with type 2 diabetes mellitus (n=330) .Blood pressure, anthropometrics (height, weight and hip circumference) and glycated hemoglobin (HbA1c) were collected, a semi-structured interview was utilized to obtain information on socio-demographic and Beck Depression Inventory (BDI) was used as a tool to assess depressive symptoms among patients with type 2 diabetes mellitus .Logistic regression was used to investigate the associate factors of depression with diabetes patients. Majority (68.2%) of the respondents had no depression with diabetes, 16.7% of respondents having moderate, 12.4% having mild and few (2.7%) had severe depression with diabetes. Depression was significantly associated with Marital status (p=0.014), Educational status (0.016), Occupational status (p=0.003) and Drinking alcohol(p=0.020). The prevalence of depression with Diabetes in this study was 31.8%. Int. J. Soc. Sc. Manage. Vol. 8, Issue-3: 426-432


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