A Record-based Analysis of Profile, Pattern and Outcomes of Geriatric Fractures in a Tertiary CareHospital, Chandigarh

Introduction: Older people with diseased conditions are more prone to fracture irrespective of gender. Osteoporosis is the most common cause of elderly fractures. Objectives: 1) To ascertain the profile and pattern of geriatric fracture cases reporting a tertiary care institution, 2) To ascertain the extent of mortality and complications in geriatric fracture cases, and 3) To ascertain the functional outcomes of geriatric fracture cases discharged from the tertiary care institute. Methodology: A list of geriatric fracture inpatients of an institution was made for 2014 - 2018. The data on the profile of patients, type of fracture, treatment received, the lag time between the reporting and the surgery, comorbidities, past medical history, cause/ place of fracture, length of stay, and status at the time of the phone-based interview were analysed through SPSS software. Results: The highest range of the age for fracture occurrence was 60-70 years. Female patients were more than the male ones. Femur fracture was the most common. The most common direct cause of the fracture was fall (indoor). Open reduction, internal fixation and arthroplasty were the commonest treatment performed. The lag time between the patient arrival to the health care and surgery was 0-5 days. The highest length of stay by the patients in the hospital was 0-10 days. Conclusion: The possible direct causes of the fracture reported in the study were falls, roadside accidents, trauma etc.

A Study on Traditional Beliefs and Practices during the Postpartum Period among Mothers at a District Hospital in Goa

Background: Several mothers do not adhere to the standard medical advice given by health professionals as observed during medical practice and tend to follow potential harmful practices during the postnatal period. Little evidence is available in the state of Goa on the various traditional practices observed by mothers post-delivery. Aim: To identify and explore various traditional beliefs and practices concerning newborn care and postpartum period among postnatal mothers at South Goa District Hospital. Materials and Method: This descriptive, cross-sectional study was conducted over a period of 3 months using convenient sampling among admitted postnatal mothers. Data were entered into an Excel spreadsheet and analysed using SPSS version 22. Results: Majority of the study participants breastfed their newborn babies within 24 hours of childbirth (97.50%). 96.25% of the mothers fed colostrum to their newborn babies. A significant proportion of mothers used new washed clothes for their babies (83.75%) and bathed them five days post-delivery (72.5%). No dressing was applied to baby’s umbilical stump (58.75%). Postpartum home confinement with newborn baby for 40 days was observed by 22.5% of the mothers. Mothers applied kajal to the baby’s face and eyes (50%), used bangles (35%) and anklets (16.25%) to protect baby from evil eye. Conclusion: The study highlighted the need for awareness of health professionals about the popular traditional practices observed among postnatal mothers in order to eliminate possible harmful practices and reinforce beneficial practices for a healthy postpartum period for the mother.

Maternal Deaths in India: A Review of Trends and Programmes

High-quality services during childbirth in a health care facility reduce maternal morbidity and mortality. High maternal mortality in India is a critical concern. In an attempt to decrease the maternal mortality rate (MMR), the Government of India has launched many programmes. This article discusses the trends in maternal mortality in India with the inter-state disparities. As per Sample Registration System (SRS), MMR in India was estimated to be 556 in 1990, but globally it was only 385 at that time. India has achieved about a 77% reduction in maternal mortality compared to the global average of 43% between 2005 and 2017, but a huge inter-state disparity in maternal death still exists. Approximately 65%-75% of the estimated maternal deaths in India occur in a few states, including the eight Empowered Action Group (EAG) states (Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh, and Uttarakhand), and Assam. For instance, the MMR reported for Assam (state which has the highest MMR) was 215 in 2017-18 which is five times higher than that of Kerala (43), which has the least MMR of all states. Most of the maternal deaths are due to direct causes and are largely preventable and treatable. There was a consistent reduction in MMR as a result of a number of interventions and programmes including Janani Suraksha Yojana (JSY) which helped in surging institutional deliveries.

Socio-Demographic Profile of Schedule Tribes of Five Integrated Tribal Development Agency Spots at Kurnool, Andhra Pradesh in India

Background: Tribal population is the second largest in India next to Africa, constituting 8.6% of total India population. Tribal population have unique physical, socio-economic and cultural environment but most deprived from health care facilities and vulnerable to malnutrition and diseases. Objective: To study the living condition of tribal people which includes socio-economic, demographic and health status profile along with providing health care facilities to tribes. Methods: Five Integrated Tribal Development Agency (ITDA) spots which belongs to Chenchu tribe of Kurnool district Andhra Pradesh were adopted. Data was collected through house-to-house survey and in Mobile medical camps in a pre-tested questionnaire provided by CCRUM. Results: A total of 3174 patients were screened among them 584 person of 130 families were selected for data collection. Majority (93.07%) were Hindu in the age group 21-30 years (31.6%), with male preponderance. Education status was fair (42.63%) population were illiterate. The basis amenities were good, (93.84%) use piped drinking water, all had open drainage system, (91.53%) use LPG, (89.23%) household surveys have pucca house, and (77.69%) use pit toilet. More than half of them (54.79%) were married, (70.16%) adopted permanent sterilization for family planning, 107 females registered when pregnant, majority delivered at hospital (53.44%), mostly (93.91%) visited family welfare center, 117(90%) household don’t have government health facility other than PHC or MCH. Conclusion: Low-income status, less literacy rate, and unhygienic sanitary conditions were common among Chenchu tribe of Andhra Pradesh. Majority of them (25.87%) suffered from Musculoskeletal diseases reported to OPD of mobile medical camps.

Rabies and International Travellers: A Missing Link

Introduction: Rabies is a viral disease endemic in more than 150 countries and territories with highest exposure in Asia and Africa. It is found in all continent except Antarctica. Countries which are not at risk for travel related diseases like rabies, traveller’s going there do not seek medical advice before travelling. In parts where rabies is still a problem, treatment may be in accessible. Methodology: It was OPD based cross sectional study in Adult Vaccination Centre at tertiary care institute. From July to September 2020, the data was collected. Pretested questionnaire was assessed by interview method. Results: We found that maximum travellers 69% were in the age group less than 30 years with mean age being 26. Only 10% of traveller had history of animal bite. Among them 52% had dog bite followed by 47% cat bite while 53% had bleeding. 52% had not used any pre hospital procedure after bite. 21% had applied turmeric, 15% applied slaked lime, while 10% had washed the wound with water and soap. 31% travellers travelled to South Africa. 97% travellers have the idea that dog bite can transmit the disease. Conclusion: Rabies pre-exposure vaccination should be offered to individuals traveling regularly to international destinations and who are at high risk of exposure to potentially rabid animal attacks.

Determinants of Breastfeeding Practices among Lactating Mothers in a Rural Block ofHaryana, India

Background: Human breast milk contributes to the physical growth of infants by meeting their nutritional needs and higher intelligence quotient by enhancing their brain development. Objective: To assess the prevalence of exclusive breastfeeding and to determine the contributing factors of exclusive breastfeeding practice in a rural area of Haryana. Methods: It was community-based cross-sectional study, conducted in a rural field practice area attached to the Department of Community Medicine of Pt BD Sharma, PGIMS, Rohtak. The study participants were infants aged 6-11 completed months and their mothers. Multistage sampling technique was used for enrolling 200 study subjects. SPSS was us for statistical analysis. Results: 119 (59.5%) infants were exclusively breastfed for 6 months. Homemakers were 1.37 times more likely to feed exclusively than working women. Women from joint families were 2.64 times more likely to feed exclusively than women from nuclear families. Exclusive breastfeeding had a statistically significant association with mode of delivery, breastfeeding counselling, motivation to feed till 2 years, receiving postnatal checkup, number of children, initiation of breastfeeding within 1 hour, and colostrum being given to infants. Infants given breastfeed within 1 hour had 1.12 times more chance of exclusive breastfeeding. Conclusion: Antenatal breastfeeding counselling and home-based postnatal visits by health workers increases the practice of colostrum administration, initiation of breastfeeding within 1 hour, and exclusive breastfeeding for 6 months. Capacity building in form of training and sensitisation of hospital staff, MPHW (F), and ASHA will help increaseexclusive breastfeeding among lactating mothers.

Anti-Ganglioside Antibody Negative Miller Fisher Syndrome with Atypical Features: A Case Report

Miller Fisher Syndrome (MFS), a variant of Guillain Barre Syndrome (GBS), is an immune-mediated neuropathy presenting with the classical clinical triad of ophthalmoplegia, ataxia, and areflexia. Although the clinical triad is the cardinal diagnostic clue, it can also present with a variety of other atypical neurological symptoms and signs beyond the classical triad. IgG anti-GQ1b antibodies are a powerful serological marker for the diagnosis of MFS, however, they can be absent in 10-15% cases of MFS. Here, we are describing a case of a 55-year old lady with an anti-ganglioside negative case of MFS with ptosis and bulbar palsy, who improved with IVIg.

A Study to Assess the Knowledge an Institutional Delivery among Primi Gravida Mother’s at Selected Hospital of Jabalpur City, Madhya Pradesh

Background: The institutional delivery is being widely promoted because of its ability to promote child survival and reduce risk of maternal mortality. A woman is likely to go through pregnancy complications at the time of labor. Institutional delivery gives a safe environment for the mother to avoid any risk of medical complications during labor. Aim: The present study was to evaluate the effect of planned teaching programme on the knowledge regarding premenopausal problem of women. Subject and Methods: Total sample size consumed of 100 women and convenience sampling was used area in Jabalpur Madhya Pradesh. Data was collected using a self-structured question are purposive sampling. Results: Regarding demographic variables majority highest number of respondents were in the age group of 24-29. Majority of the respondent (49%) had higher secondary education. 57% of them were house wives, 42% were belongs to 10,001-15,000 income group, 68% were in Hindu religion, 68% were in nuclear family, 56% were residing in urban area, 32% got information from magazines, newspapers, journals or books and 76% of them had not experienced in institutional delivery before. Conclusion: It was found that self-instructional module was very effective in improving the knowledge of mothers of adolescent girls on knowledge regarding institutional delivery.

COVID-19 and Tuberculosis Coinfection: A Report of Two Cases

COVID-19 and its sequelae are primarily known to affect the respiratory system. However, it can have varied manifestations affecting other systems as well. COVID-19 can lead to reactivation of tuberculosis which can have unusual extrapulmonary presentations as well. Coinfection of COVID-19 and tuberculosis is a risk factor for poor outcome. Here, we describe a series of two cases of COVID-19 with tuberculosis. In the first case, a patient who had apparently recovered from COVID-19 presented only a week later with polyserositis, and ultimately was diagnosed to be a case of disseminated tuberculosis. In the second case, the patient presented with COVID-19 and TB together. Clinicians must be aware and vigilant for this coinfection and complication in COVID-19 recovered patients even if they were of mild/ asymptomatic category.

Profile of Animal Bite Cases in a Tertiary Care Hospital in Mysuru

Animal bites cause a big burden worldwide in terms of morbidity and mortality. As per WHO, dog bites are the cause of major animal bite injuries followed by snake bites, cat bites, and monkey bites. Annually about 55,000–60,000 persons die of rabies, of which nearly one-third are from India alone. Rabies, though being a 100% fatal disease, is also a potentially preventable disease. Objective: To estimate the proportion of animal bites in patients attending anti-rabies clinic of a tertiary hospital, Mysuru. Material & Methods: A cross-sectional study was carried out during the period of June 2018 - May 2019. Secondary data was collected from the registers available at the anti-rabies clinic in KR Hospital, Mysuru, using a pretested proforma. This information was compiled in an excel sheet and analysed using simple measures like proportions, percentages, and graphs. Results: A total of 3861 animal bite cases were reported, out of which, 69.1% were males and 30.9% were females. Dog bites contributed the highest (92.1%) followed by cat bites (5.2%). As per the category of wounds, 59.6% were Category 2 and 36.2% were Category 3 wounds. Conclusion: Dog bite is the commonest animal bite which needs to be addressed as a priority with appropriate preventive strategies. There is a pressing need to create awareness among the general population about the need for timely health care seeking behaviour and to avail the benefit of free anti-rabies vaccination in the public health sector in order to prevent the risk of fatal events.