A study to assess knowledge of primary health workers on malaria epidemiology, diagnosis, and treatment in Patiala district, India

Background: India accounts for (4%) of all malaria cases worldwide. The World malaria report 2017 showed that, by 2016, global progress against malaria had stalled and was off track to meet the Global Technical Strategy milestones for 2020. Aims and Objectives: The aim of the study is to assess knowledge of rural medical officers (RMO) and health workers on malaria epidemiology, diagnosis, and treatment as per National Vector Borne Disease Control Program of India guidelines. Materials and methods: A descriptive, observational, and cross-sectional study was done among government health personnel’s using a semi-structured questionnaire. Results: In the present study, 258 health personnel’s participated comprising multipurpose health workers female (MPHW-F), multipurpose health worker male (MPHW-M), and RMO. The standardized score on knowledge of vector biology and epidemiology was 72% and 54% for RMO and (MPHW-M), respectively. On malaria diagnosis, MPHW-M has got median score (53%) as compared to RMO (46%). On national malaria drug policy, there is a marginal difference between median score of RMO (42%) and MPHW-M (40%). Overall, there is incomplete and poor knowledge of treatment of malaria among all health personnel’s with lack of concept about presumptive treatment. Training showed some positive impact on the knowledge of MPHW-F but no impact on MPHW-M. Graduates and experienced workers have got better knowledge than undergraduates and MPHW-M have more knowledge than MPHW-F. There is poor knowledge of reporting formats, and usage of rapid diagnostic kits among all the health personnels. There was no significant impact of education qualification, in service training and work experience on the knowledge of Male health workers. Conclusion: Training needs to be suitably tailored as there is a lot of scope of improvement in the knowledge regarding malaria diagnosis and treatment among health workers.

A study to Assess Anxiety, Stress and Depression among MBBS interns working in Covid care Isolation facility of a tertiary level Hospital: An Observational study

Introduction: The Emergence of new Delta strain of Corona virus has created havoc with all health care systems across the globe, there has been tremendous pressure due to shortage of health care workers forcing government to involve MBBS interns to overcome the shortage of health staff in Covid care. Aims & Objectives: To assess magnitude of anxiety, stress and depression among MBBS interns working in Covid Isolation facility of Government Medical College, Patiala. Material and methods: The Google form was created and the link to the online questionnaire was circulated through whatsapp group to the MBBS Interns working in Covid isolation facility during June to July 2021. The form included two instruments the Perceived Stress Scale-4 (PSS-4) and the Patient Health Questionnaire for Depression and Anxiety-4 (PHQ-4). Results: A total of 144 interns participated in the survey .Patient Health Questionnaires and Perceived Stress Scale-4 (PSS-4 ) scores of interns were 56% and 49% respectively. Anxiety and depression symptoms requiring further evaluation were seen in 19% of the Interns. Univariate analysis of PHQ-4 and PSS-4 shows statistically significant association with past history of psychiatric ailment .Conclusion: Careful monitoring of psychological and mental wellbeing of interns during the pandemic will go a long way in mitigating the worsening psychological wellbeing of budding doctors and interns.

The Magnitude of Psychological Distress Among Interns During COVID-19 Pandemic: A Multicentric Cross-Sectional Study

Background: COVID-19 has raised serious concerns about the wellbeing of frontline health care work-ers. Healthcare staff are at increased risk of psychological health problems when dealing with challenges of the COVID-19 pandemic. Among the healthcare professionals, the most commonly affected are those working on the frontline, who are the first to come in contact with the patients. Objectives: To determine the levels of depression, anxiety and stress among interns during COVID-19 pandemic, and, to assess the factors affecting mental health of the interns during COVID-19 pandemic. Methodology: This was a web-based multicentric cross-sectional study conducted among interns of var-ious tertiary care teaching hospitals providing COVID care services, during July � August 2021. Data was collected using a self-administered online questionnaire based on the standard DASS-21 scale that as-sessed the various domains of psychological distress. Result: Among the study subjects 46% suffered with all three psychological domains like depression, anxiety and stress, 15% had only anxiety, around 10% had anxiety and depression during the COVID-19 pandemic while 22.5% had no psychological problems. Conclusions: Significant proportions of interns were suffering from depression, anxiety and stress. Fear of COVID-19, long working hours, usage of PPE, COVID vaccination status, and COVID-19 infection status were identified as potential predictors of psychological distress.

Asynchronous e-learning in microbiology for undergraduate medical students

Background: The most common teaching method in medical institutes in India and throughout the globe is standard lesson-based teaching. E-learning is the use of internet technology to facilitate conscious learning and increase knowledge and competences, notably during the COVID-19 epidemic. Aim and Objectives: The aim of study was to develop a module for an interactive disease-based e-learning teaching session to impart knowledge to undergraduate medical students regarding the microbiological diagnostic techniques for enteric fever/the given organism with objectives of the study was (i) to investigate how Phase II MBBS students feel about e-learning; (ii) to evaluate the impact of this intervention on students; and (iii) to encourage application of this imparted knowledge and skill for rapid, precise, and early diagnosis of the disease. Material and Methods: The research was conducted at the department of microbiology. This was done for the session 2020–2021 of Phase II undergraduate students. All the second professional MBBS were enrolled in the study n = 229 and were better informed about the definition of e-learning. The course material was provided in the form of PowerPoint presentations, questionnaires, and text questions using Google Docs. Students provided feedback in the form of a semi-structured pre-validated set of questions at the conclusion of the week, and the collected data were quantitatively analyzed. There were both closed-ended and open-ended questions in the survey. Results: The results of the feedback questionnaire revealed that the program was of benefit to the students. Nearly 77% of students felt the new teaching and learning method enhanced their grasp of the courses and that the issues presented were important to them. Conclusion: The students responded in a positive way to the new teaching and learning method. It was informative, applicable, and effective to the students. It also increased the level of communication and feedback between teacher and students. To conclude, in the medical program, e-resources may be used to enhance conventional lesson-based instruction.

Knowledge of rural women regarding activities of accredited social health activist in three different villages of District Amritsar: A cross-sectional study

Background: Accredited Social Health Activist (ASHA) is the grass root level worker and hence plays a prime role in making primary healthcare accessible to rural areas. She creates awareness on health and persuading the community toward local health planning and hence plays major role in increasing utilization of health services. The knowledge of the people about the availability of ASHA in their area and about the activities performed by her also play important role in utilization of services given by ASHA. Hence, keeping this in view the present study was conducted. Aim and Objectives: (1) The aim of the study was to assess the knowledge of the rural women about the availability of ASHA in their area and (2) to assess the knowledge of the rural women about the activities performed by ASHA. Materials and Methods: The study was conducted in rural field practice area of Government Medical College, Amritsar, Punjab. The study was a cross-sectional type and the adult decision maker female of the family was interviewed using a pre-designed and semi-structured pro forma after approval from Institutional Ethics committee. A total of 1521 females were interviewed. Results: The present study revealed that majority (52.3%) of the respondents were in the age group of 24–45 years, 41.7% illiterate and 54.6% in the upper lower class. It was found that 45.8% respondents were visited by ASHA and out of these, majority of the respondents (78.2%) were visited for Maternal and child health services followed by health awareness (20.7%) and minor illnesses (9.9%). Conclusion: The visits by ASHA were irregular and majority of the respondents were visited by ASHA for maternal and child health services in all the three villages and hence knowledge regarding these activities was seen to be more among the respondents. However, overall less knowledge was seen among the villagers about other activities being performed by ASHA worker.

Estimation of age from epiphyseal fusion in iliac crest.

Scientific estimation of age of an individual whether living, recently dead person, disintegrated and decomposed dead bodies, skeletal remains or incomplete skeleton or fragmentary remains is a vexing problem for medical jurist, in both civil and criminal cases and is an important part of examination in medico-legal practices. A large number of researchers have studied this process, hoping to understand its origin, evolution and consequences as well as to try to combat it. In the present study 100 individuals are studied between the age group of 16 to 25 years in male and female separately i.e. 50 males and 50 females, whose X- ray examination is done at Rajindra Hospital; Patiala, Punjab. The study is undertaken to know the time of fusion of epiphyses of iliac crest. In this study, every individual’s X-ray pelvis AP view is taken to know fusion of iliac crest epiphyses. SAA

Age estimation from medial end of clavicle by x- ray examination.

Fixing up of the individuality of a person, no matter if it is new born baby in the hospital or in criminal cases and in civil cases like marriage, inheritance of property, passport, insurance claims, disputed sex and missing persons etc. has got its own importance. In the present study 100 individuals are studied between the age group of 16 to 25 years in male and female (separately), whose X- ray examination is done at Rajindra Hospital ; Patiala, Punjab. Male and female individuals were studied with age interval of two years and ten cases from each age interval were taken. The study is undertaken to know the fusion of medial end of clavicle to know the fusion of epiphysis. In this study, every individual’s X-ray chest AP view is taken to know fusion of epiphysis at medial end of clavicle.

Athersclerosis in coronaries in Malwa Region of Punjab.

The study involves the gross and microscopic examination of coronary arteries of 200 cases of all age groups brought to mortuary of Rajindra Hospital Patiala for post mortem from Malwa Region of Punjab. The study was carried out to find out prevalence, pattern, frequency and severity of atherosclerotic changes in coronary arteries. The study was conducted in the department of Forensic Medicine and Department of Pathology Government Medical College Patiala.

Changes in the levels of vitreous potassium with increasing time since death.

This study was done to know the changes in the levels of potassium in the vitreous humour of eye with increasing time since death by flame photometry method. 200 cases brought to the mortuary of Govt. Medical College, Patiala, formed the material of this study. The cases were divided in 2 groups, burn cases (24) and non-burn cases (176). The data thus collected was analyzed statistically. It was found that the vitreous humour potassium concentration was increasing in a linear fashion with increasing time since death and this increase in the level was independent of the factors like age, sex, environmental temperature and humidity.

Pathological findings in liver autopsy.

Liver is the site of many diseases, many of which become symptomatic while some are diagnosed only on autopsy. Involvement of liver is secondary to cardiac, metabolic and social problems like alcoholism. In this autopsy study of one hundred cases of liver specimens, fatty change, venous congestion, cirrhosis of liver, malignancy, hepatitis and chronic abscess are reported; fatty change being the predominant finding.

Age estimation in old individuals by CT scan of skull.

Determination of age goes on becoming difficult as the age advances particularly after the age of 40 years with conventional methods. To overcome this problem the present study was carried out. In the present study 100 cases with age range of 40 to 70 years were taken. The study was carried out to estimate timings of suture closure with the help of axial sections at different levels of sutures of skull on CT scan. The closures of lambdoid, parieto-mastoid, coronal and squamous sutures were studied and grading was done depending upon closure of sutures. Each suture was found to close at particular age group. Each individual was exposed to CT scan and 3 axial sections (cuts) were taken for each individual. Each suture was found to close at particular age group.

Involvement of genitofemoral nerve with genital lesions in lepromatous leprosy.

The case of a male patient diagnosed to have lepromatous leprosy with type 2 reaction on multibacillary multidrug therapy, with unusual, widespread involvement of genitalia in the form of plaque and nodules of leprosy over scrotum and perimeatal region of glans, necrotic lesions of erythema nodosum leprosum over scrotum, neuritis of genital branch of genitofemoral nerve bilaterally, and azoospermia, is reported.