OUTCOME OF EYES TREATED FOR RETINOPATHY OF PREMATURITY IN POSTERIOR ZONE I: An Eastern India Study.

PURPOSE: To analyze the outcomes of eyes treated for retinopathy of prematurity in posterior Zone I. METHODS: In a part retrospective (9 years) and part prospective (1 year) interventional study, we analyzed eyes treated for retinopathy of prematurity in posterior Zone I with a minimum follow-up for 6 months. RESULTS: This study included 109 eyes of 56 infants; mean gestational age and birth weights were 29.3 (±2.1) weeks and 1112.5 (±381.9) g, respectively. The treatment included intravitreal anti-vascular endothelial growth factor as the initial treatment modality in 101 eyes (92.6%), either alone (27 eyes) or combined with laser or vitreous surgery (73 eyes). Laser was the initial treatment modality in eight eyes, either alone (n = 3) or in combination with surgery (n = 5). With anti-vascular endothelial growth factor alone, 30.68% (n = 27) eyes responded favorably, and the remaining 69.32% (n = 59) eyes needed retreatment (laser in the majority). At the final follow-up, 89.9% (out of 109) of eyes did well anatomically. Good outcome was significantly linked to no detachment at presentation ( P < 0.0001) and the presence of well-defined central vascular trunks ( P = 0.001). CONCLUSION: Treating the eyes before retinal detachment with bevacizumab followed by laser (and surgery, if needed) results in a favorable outcome in babies with posterior Zone I retinopathy of prematurity.

Prevalence, associated risk factors of depression and mental health needs among geriatric population of an urban slum, Cuttack, Odisha.

OBJECTIVES: To find the prevalence of depression among elderly population of urban slum of Cuttack and to study its association with sociodemographic factors, comorbidities, and various life events and also to explore the mental health needs of the study subjects as perceived by them. METHODS: It was a cross-sectional study carried out in the urban slum, Jobra of Cuttack city in Odisha. Simple random sampling was done using random number table to select the study subjects. Predesigned pretested questionnaire including Geriatric Depression Scale, Lawton's Instrumental Activities of Daily Living, and Katz Index of Independence in Activities of Daily living and questions on important life events including their perceptions regarding existing mental health services were used for data collection. Data were analyzed using SPSS, and binary logistic analysis was done to find the independent determinants of severe depression among elderly. RESULTS: Out of 354 study subjects, 249 (70.3%) were males. Depression in severe and mild form was present among 44.9% and 36.2%, respectively. Independent risk factors of severe depression by multiple logistic regression analysis were low socioeconomic class, female gender, diabetes mellitus, hypertension, death in family members, conflicts in family, and chronic illness in family members. CONCLUSION: The prevalence of depression among the elderly in the urban slum was close to 80% with 45% being at risk of severe depression. Females from low socioeconomic class with comorbidities and having life stressors need to be screened regularly in the community level, and facility for counseling should be provided to them.

Prevalence and risk factors of people at-risk of obstructive sleep apnea in a rural community of Odisha, India: a community based cross-sectional study.

BACKGROUND: Obstructive sleep apnea (OSA) is a progressive sleep disordered breathing condition characterized by repeated episodes of upper airway collapse during sleep. Despite being the most common sleep apnea, it often remains undiagnosed and untreated, especially in rural communities. There is a paucity of literature estimating the prevalence of the disease and associated risk factors from the rural population of Odisha. METHODS: It is a cross-sectional study that was conducted in a rural community of Odisha, India to find out the prevalence of people living with the risk of OSA. Multi-staged sampling was done. Participants were evaluated using the Berlin questionnaire (BQ) after obtaining informed consent. Data were analyzed using SPSS with the significance level set at 95%. Univariate and multivariate analysis was done to evaluate the risk factors associated with the condition. RESULTS: Out of 200 community dwellers surveyed using the BQ, 25% had a high likelihood of OSA. Among these high risk subjects, snoring was reported by 70%, excessive daytime sleepiness by 50%. Out of those who were at risk of OSA, 28% were smokers and 48% reported alcohol use. The associated risk factors were age >35 years (OR = 4.5, 95% CI = 1.4-13.8, p < 0.05), BMI ≥ 25 kg/m2 (aOR = 3.5, 95% CI = 1.2- 10.5, p < 0.05), alcoholism (aOR = 4.5, 95% CI = 1.8-11.1, p = 0.001), and hypertension (aOR = 11.5, 95% CI = 4.7-28, p < 0.001). The prevalence was not affected by the type of diet (vegetarian vs non-vegetarian), use of tobacco or tea consumption. CONCLUSION: OSA is highly prevalent in the rural community of Odisha. Independent risk factors associated with such subjects were obesity, regular alcohol consumption, and hypertension. Further prevalence studies are recommended.

Nomophobia: mobile phone dependence among students of a medical college in Central Odisha, India

Background: Nomophobia, stands for “no mobile phone phobia". The tremendous increase in mobile phone usage among youngsters has led to negative impact on their mental health status. Current study aims at finding out the prevalence of nomophobia (mild, moderate, and severe), various health related conditions and independent risk factors of severe nomophobia among medical students of a tertiary care college and Hospital of Central Odisha.Methods: A cross sectional study carried out among 450 students of a medical college of Central Odisha. Simple random sampling was done. Predesigned pretested questionnaire including Nomophobia questionnaire (NMP-Q) was used for data collection. Data was analyzed using SPSS and logistic regression was used to evaluate the independent risk factors of severe nomophobia.Results: Out of 450 students, 246 (54.6%) were boys and rest were girls. Nomohobia was universally present and students suffering from mild, moderate and severe form of nomophobia comprised of 33 (7.3%), 327 (72.7%) and 90 (20%) respectively. Independent risk factors of severe nomophobia were fourth year of study and above (aOR=2.69), use of costly handsets (aOR=4.56), monthly bill of more than rupees 500 for cell phone use (aOR=6.09) and anxiousness of staying updated with news all the time (aOR=4.86).Conclusions: Nomophobia is a highly prevalent condition among the medical students found across age groups, gender and socio-economic status which depends on phone usage. It is recommended that screening and proper counselling should be available in order to decrease the burden and create awareness about nomophobia among the medical students.

Changing physician behavior: interventions to improve prescription writing practices in a secondary level hospital in Delhi.

Background: According to a report by World Health Organization (WHO) in 2003, approximately 50% of all patients fail to take their medicine correctly. This is due to errors in prescription, underuse or misuse of medicines and ignorance of prescribers, dispensers, and patients. Methods: It is a hospital-based interventional-study carried out in a secondary level multispecialty hospital of Delhi. Investigators collected 536 prescriptions from the outpatient department of various departments and studied according to WHO core prescribing indicators for assessing drug prescription writing pattern. Interventions to improve the prescribing pattern included one continued medical education session and one workshop on prescription writing (providing essential drug list [EDL] etc.,), sharing the baseline data with the physicians and administrative approach. Evaluation of the prescribing pattern after 6 weeks of the intervention was done to find out the impact. Results: On an average 3.43 drug per encounter before intervention increased to 3.46 drugs per encounter. Inclusion of generic drugs and from EDL increased significantly from 54.8% to 73.4% and 76.9% to 88.4% respectively.. Prescribing antibiotics and injectables showed no significant reduction from baseline. The completeness of the prescriptions with respect to the various components improved significantly. Conclusion: Combining different intervention seems a noble approach to improve the prescription writing practices with respect to completeness and inclusion of generic drugs, drugs from EDL.