Study of electrolyte disturbance in chronic liver disease patients attending a hospital in Kumaon region.

Introduction: Pathophysiological changes secondary to cirrhosis predispose patients of chronic liver disease to develop various electrolyte disturbances which have a significant impact on morbidity, mortality, and prognosis of these patients. This study aims to estimate the level of electrolyte disturbance and its association with the severity, complication, and outcome in chronic liver disease patients attending a hospital in the Kumaon region of Uttarakhand. Methods: Our study was a hospital-based cross-sectional study conducted on 100 chronic liver disease patients at the OPD/IPD Department of Medicine, Dr. Sushila Tiwari Hospital, Haldwani, Uttarakhand, from January 2020 to September 2021. Results: Hyponatremia was observed in 49% of the patients, hypokalemia in 30%, and hypocalcemia in 16% of the patients. The electrolyte levels were similar irrespective of the disease severity and presence of complications. The sodium and potassium levels had a significant association with the outcomes. Conclusion: Hyponatremia was the commonest electrolyte disturbance seen in the study patients. No significant association was observed between the electrolyte and severity of the disease and complications.

Is the rule of halves in hypertension valid uniformly across India? A cross-sectional analysis of national family health survey-4 data.

Background: Hypertension is widely prevalent across India. The rule of halves is commonly used to describe the attrition and gaps in the care cascade of hypertension management across detection, availing treatment, and having controlled blood pressure (BP) on treatment. Objectives: Using nationally representative data, we aimed to assess the rule of halves in hypertension management in different states of India and across sociodemographic, health system, and personal factors. Methods: A descriptive analysis of secondary data from the National Family Health Survey-4 was conducted. We included 770,662 individuals (112,122 men and 658,540 nonpregnant women) of 15-49 years of age. The proportion of individuals not aware of hypertension status among those with high BP, known hypertensives not availing of treatment, and uncontrolled BP among those on treatment were expressed as percentage with a 95% confidence interval (CI). Results: Of those with high BP, 48.5% (95% CI: 47.8%-49.3%) were not aware of their hypertensive status. Among known hypertensives, 72% (95% CI: 71.2%-72.8%) had not availed treatment for hypertension. Among those on treatment, 39.8% (95% CI: 38.7%-40.9%) had uncontrolled hypertension. Conclusion: The rule of halves of India shows that the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke has made relatively good progress with the detection of hypertension and achieving BP control among those on treatment. However, with three-fourth of known hypertensives not availing treatment, more dividends from the detection of hypertension efforts could be realized. The program needs to especially focus on ensuring the treatment for those detected with hypertension.

Study of clinico- epidemiological profile of COVID-19 positive pregnant females in a tertiary care hospital of Kumaon region.

Introduction: Pregnant females are considered as a high-risk group for the prevention and control of various communicable diseases. Therefore, this research was undertaken to study the clinic-epidemiological profile and biochemical parameters of COVID-19-positive pregnant females in a tertiary care hospital. Methods: This hospital-based retrospective study was done on COVID-19-positive pregnant females admitted during April 2020-March 2021. A total of 139 patients were included in the study. Clinical, epidemiological, hematological, and biochemical profiles were described using frequency, percentages, mean, standard deviation using Microsoft Excel software. Results: The mean age of study participants was 25.36 ± 3.79 years, mean duration of pregnancy was 37.53 ± 3.31 weeks. The majority of the patients were asymptomatic (89.2%). Abdominal pain was the most common symptom (66.7%) among symptomatic. All patients were managed conservatively. Conclusion: The study showed the mild nature of COVID-19 among pregnant females as the majority of them pregnant were asymptomatic and few presented with mild symptoms.

Liver abscess in children - Clinical profile and outcome in a resource-limited setting.

Background: Liver abscess continues to be a major cause of morbidity in developing countries. There is no gold standard for management; it has to be tailor made for each child depending on availability of resources. We aimed to study clinical features, laboratory parameters, treatment, and outcome of children with liver abscess in resource-limited settings. Materials and Methods: This is a retrospective observational cohort study of children less than 16 years admitted in pediatric ward with diagnosis of liver abscess during 4 years duration (2016-2019). Demographic data, clinical features, laboratory, ultrasonographic (USG) and microbiological findings, management, and outcome were documented. For descriptive analysis, mean ± standard deviation/median with interquartile range, percentages were used and for testing association, Chi-square test and independent t-test were used. P value <0.05 was considered significant. Results: The mean age of children was 8.4 ± 4.4 years (19- 7 male and 11 female). Fever with chills was the most common symptom (19, 100%), followed by right upper quadrant pain (18, 89.5%), vomiting (7, 36.8%), and pleural effusion (6, 31.6%). Of the 19 children, 26.3% (5) were moderately undernourished and 63.2% (12) severely undernourished. Among the laboratory parameters, leukocytosis (16, 84.2%), anemia (19, 100%), and raised C Reactive protein (CRP) (19, 100%) were seen. Liver abscess on USG was solitary in 14 (73.7%), multiple in five (26.3%), in the right lobe in 14 (73.7%), and left in five (26.3%) with average volume of 104.5 ± 79.2 cc. Blood culture was positive in 22.2% (4/19) with growth of Staphylococcus in 10.4% (2), Pseudomonas in 5.2% (1), and Escherichia coli in 5.2% (1). Pus culture was positive in one (1/8, 12.5%) showing Pseudomonas. Half (9/19) of children were managed on only antibiotics and the other half (10/19) were managed by USG-guided aspiration on two to three occasions along with antibiotics successfully with no mortality. Conclusion: High index of suspicion in children with fever, right upper abdomen pain, positive CRP, and anemia should prompt an urgent USG. Liver abscess can be successfully managed by intravenous antibiotics and USG-guided aspiration in larger abscess, with no mortality. However, in case of signs of impending perforation, surgical management should be considered.

Dietary Diversity and Stunting among Infants and Young Children: A Cross-sectional Study in Aligarh.

CONTEXT: Child undernutrition is a public health problem in a developing country like India. Dietary diversity is an important immediate determinant of undernutrition. AIMS: The aim of this study is to find the prevalence of stunting among infants and young children aged 6-23 months and its association with dietary diversity. SETTINGS AND DESIGN: This study was community-based cross-sectional study. It was carried out in the registered families of the Urban Health Training Centre and Rural Health Training Centre, Department of Community Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh. METHODS: A total of 326 children aged 6-23 months were included in the study. Study tools were predesigned and pretested questionnaire, modified infant and young child feeding practices questionnaire, and infantometer. Systematic random sampling with probability proportionate to size technique was utilized to drawn necessary sample size. STATISTICAL ANALYSIS: Wald's statistics, Z-scores, and bivariate and multivariate logistic regression (LR) (stepwise backward LR) were used. RESULTS: The prevalence of stunting in study population was 45.7% (95% CI - 40.1%, 51.1%); moderate stunting was 33.7% (95% CI - 28.8%, 39%); and severe stunting was 12% (95% CI - 8.8%, 16%). The prevalence of stunting was significantly associated with dietary diversity (OR - 0.17, 95% CI - 0.10-0.29). CONCLUSIONS: The study concludes that dietary diversity is a significant predictor of stunting. Therefore, interventions aimed at improving dietary diversity should be taken to reduce the burden of stunting among infants and young children.

Locomotor problems among rural elderly population in a District of Aligarh, North India.

INTRODUCTION: Locomotor functions decline with the age along with other physiological changes. This results in deterioration of the quality of life with decreased social and economic role in the society, as well as increased dependency, for the health care and other basic services. The demographic transition resulting in increased proportion of elderly may pose a burden to the health system. OBJECTIVES: To find the prevalence of locomotor problems among the elderly population, and related sociodemographic factors. MATERIALS AND METHODS: The study was a community-based cross-sectional study done at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India. A sample of 225 was drawn from 1018 elderly population aged 60 years and above using systematic random sampling with probability proportionate to size. Sociodemographic characteristics were obtained using pretested and predesigned questionnaire. Locomotor problems were assessed using the criteria used by National Sample Survey Organization. Data were analyzed using SPSS version 20. Chi-square test was used to test relationship of locomotor problems with sociodemographic factors. P <0.05 was considered statistically significant. RESULTS: The prevalence of locomotor problems among the elderly population was 25.8%. Locomotor problems were significantly associated with age, gender, and working status whereas no significant association with literacy status and marital status was observed. CONCLUSION: The study concluded that approximately one-fourth of the elderly population suffered from locomotor problems. The sociodemographic factors related to locomotor problems needs to be addressed properly to help them lead an independent and economically productive life.

Complementary feeding practices among children aged 6-23 months in Aligarh, Uttar Pradesh.

CONTEXT: Complementary feeding practices play an important role in the growth and development of the children. AIMS: The aim of this study is to determine the prevalence of complementary feeding practices among children aged 6-23 months and its association with various sociodemographic factors. SETTINGS AND DESIGN: The study was a community-based, cross-sectional study conducted at field practice area of Urban Health Training Centre and Rural Health Training Centre, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. MATERIALS AND METHODS: Mothers of children aged 6-23 months of age interviewed using the infant and young child feeding questionnaire for complimentary feeding indicators, namely, minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). The sample size drawn was 326 using systematic random sampling with probability proportionate to size. STATISTICAL ANALYSIS USED: Wald's statistics, bivariate and multivariate logistic regression. RESULTS: MDD was adequate in 42.6% children, MMF in 50.9% children, and MAD in 35.6% children. MDD was significantly associated with area of residence, birth order of child, and Standard of living index (SLI); MMF was significantly associated with area of residence, sex of child, and literacy status of mother; MAD was significantly associated with area of residence, sex of child, birth order of child, and SLI. CONCLUSION: The study revealed that approximately 50% of mothers practiced inadequate complementary feeding. The feeding practices were found to be significantly associated with various sociodemographic factors highlighting the importance of addressing these factors if we aim an improvement in feeding practices.

EXISTENCE OF RULE OF HALVES IN HYPERTENSION: AN EXPLORATORY ANALYSIS IN AN INDIAN VILLAGE.

INTRODUCTION: India is a country in transition, the population is graying and the non communicable diseases are rising. In the rural areas of India, the detection of hypertension is poor because of limited healthcare facilities and poor awareness among the people. In one such village, Mirzapur, adopted by the Aligarh Muslim University, there is a planned project to control hypertension in the villages through some innovative approaches. This study was the assessment phase of this project for mass management of hypertension to steer and guide the next phase of the project. AIM: The main objectives of this study were: to determine the prevalence of hypertension in residents ≥ 40 years in Mirzapur village, Aligarh, and, to assess the presence of rule of halves in hypertension. RESULTS AND DISCUSSION: The present study in residents more than 40 years of age in the Mirzapur village in Aligarh found that the prevalence of hypertension in the study population was 41.9%, with a higher prevalence in older age groups. The mean blood pressure of the study population was found to be 100.03±13.17 mm Hg. The high prevalence reported in the present study reflects and reaffirms the increasing trend of hypertension in not only the urban, but also rural India, at least in the older age group. The problem of hypertension, due to its silent and asymptomatic nature, frequently depicts a rule of halves in places with weaker health system and an equally weaker health awareness and information among populations and the same is true for this village. CONCLUSION: There is an urgent need to conduct similar researches in other adopted villages of the country for the sake of inclusive development to find the exact burden of this silent and asymptomatic killer. More importantly, there is a need to find innovative solutions to combat the problem of hypertension detection and management.