Thursday, 1 September 2016

Medical Journal: IMJ Health: Volume-2, Issue-8, August 2016

Medical Journal: Volume-2, Issue-8, August 2016

Critical Review of Different Sociological Perspectives toward Conceptualization of Management of Health Services

Abstract—Theories of sociology of health and illness defy the biomedical model of disease as many of them are ‘concerned with the social origins and influence on disease’ rather than pathological reasons only. There are five sociological perspectives of health and illness: Social Constructionism, Marxism, Feminism, Foucaulian analysis, and Functionalism. These different sociological perspectives were critically analyzed through this article as for better understanding of conceptualize management of health services Social Constructionism is a sociological perspective focus on the sociology of knowledge and reality. Marxism focuses on equity between social classes and emphasizes inequality in capitalist society. According to Marxism inequality of distribution healthcare services in capitalist society arise from the marginalization of some categories of the population who do not contribute to economic system. Feminist theory is to understand and explore the multiple and various reasons for inequalities between the genders. In the healthcare sector, feminists believe that healthcare organizations are hierarchical systems, where doctors (usually men) are at the top level while nurses (usually women) have a lower level of importance. Main areas that Foucault theory emphasizes are power, knowledge and discourse. Foucault believes that there is a relationship between power and knowledge. This relationship appears clearly in the health field, as medical professionals comprise a group of people who have special knowledge (medical knowledge) and they gain the power from this knowledge. Finally, functionalism is a sociological perspective that describes society as a system made up of ‘interconnected and interrelated parts’ and it highlights the relationships between different parts of society In conclusion, the five sociological perspectives provide holistic picture about conceptualization of healthcare systems.

KeywordsSocial Constructionism, Marxism, Feminism, Foucaulian analysis, Functionalism

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Perforated Jejunal Gastrointestinal Stromal Tumor(GIST) Presenting as Acute Abdomen: A Rare Presentation

Abstract— Gastrointestinal stromal tumors (GIST) are rare neoplasms of the gastrointestinal system. A case of 40 year old man having tense tender abdomen with obliterated liver dullness and shifting dullness was presented in emergency, it was further investigated on X rays, where pneumoperitoneum was found. This case was then decided to go for Laparatomy after routine investigations to further explore. On exploratory laparatomy, diffuse peritonitis with brown coloured fluid was observed. A 10 x 5 x 7 cm mass was found having an opening communicating with the gut lumen was present around 10 cm from the ligament of treitz. However, no adjacent structures, liver or parietal peritoneum seemed to be involved. Gross examination of the specimen revealed an outward bulging mass, which was centrally necrotic and contained hemorrhagic-necrotic material. On histo-pathological examination, features suggestive of gastrointestinal stromal tumor (GIST) with mixed spindle and epitheoid pattern was seen. Mitoses were slightly increased (<5/10' HPFs) leading to the conclusion of LOW GRADE GIST with tumor free margins of gut (R0 resection). So it was a case of Gastrointestinal stromal tumors (GIST), which is a rare medical presentation. So it was decided to report this case as a rare case presentation.

Keywords: Gastrointestinal Stromal Tumors (GIST), Neoplasms, Gastrointestinal system

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Microbiological Study of Pharyngitis at a Teaching Hospital, Chinakakani, (Andhra Pradesh) India

Abstract—The aim of the study was to observe the prevalence of various microorganisms from throat swab specimens in patients attending a tertiary care hospital at Chinakakani, Guntur. Throat swab specimens were collected aseptically from 100 patients and cultured on appropriate bacteriological media. Isolates were identified by biochemical tests & antimicrobial susceptibility performed by standard methods. Out of 100 Samples, culture was positive in 25 samples. So Bacterial infection was found in 25% of Pharyngitis. Streptococcus pyogenes was the commonest isolate, followed by Staphylococcus aureus and Candida albicans. Majority of bacteria were Streptococcus pyogenes, Staphylococcus aureus and Candida albicans. In 60% it was mixed infection. The susceptibility patterns varied depending on the drugs, but most of the organisms were susceptible to penicillin, erythromycin and vancomycin. Improved personal hygiene and health education of the masses on how to care for ear, nose and throat will greatly reduce these microbial infections. This study will be useful for control strategies and for predicting pathogen prevalence in throat swabs.

Keywords Pharyngitis, Streptococcus Pyogenes, Throat Swab

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Factors associated with Dementia with special reference to Serum Homocysteine Level: A Case-Control Study

Abstract—Prevalence of degenerative dementias and dementias associated with cerebrovascular disease is increasing with the time. Dementia is one of the most significant public health problems. Demographic data, medical history, general biochemical data and serum total homocysteine (tHcy) levels was used in this study to examine the differences between dementia and normal control groups. A cross-sectional study was conducted on 236 individuals who were above the age of 65 years. These participants went through the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), demographic characteristics, biochemical data and tHcy level. Each of the above mentioned factors was assessed. There were significant differences in the history of hypertension, diabetes mellitus, marital status, alcohol consumption (AC), BMI value, and triglyceride (TG) and serum tHcy levels. The logistic regression analysis showed significant differences in marital status, AC and tHcy. So it can be concluded that elevated serum tHcy, no AC and no partner are associated with the risk of dementia in elders of Southern Taiwan. It needs further researches to identify and reduce the risk of dementia.

Keywords: Dementia; Homocysteine; partner; alcohol consumption.

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Morphometric study of Sacral Hiatus for Caudal Epidural Block

Abstract— Study of variation of sacral hiatus in dry bone is important as it determines access of sacral hiatus for caudal epidural anaesthesia and analgesia. So this descriptive observational study was conducted on 80 adult sacrum bones were studied at department of Anatomy, SMS Medical College, Jaipur with the aim to examine Morphometry of Sacral hiatus including shape, length, A-P diameter at apex and transverse width at base. Most commonly found shape of sacral hiatus in this study was inverted U/V shape. Length of sacral hiatus ranged 6 to 43 mm with more than half cases having length between 10-20 mm. Most sacrum (81.25%) had anterio-posterior diameter of 4 to 8 mm. Half of the sacrum had transverse width at sacral cornua between 9-13 mm. It can be concluded that anatomical variations in sacral hiatus are cause of caudal epidural anaesthesia failure and procedure related complications. Understanding these variations may improve success of caudal epidural anaesthesia and decrease incidence of complications. So this study will be useful to increase success rate of epidural anaesthesia.

Keywords Sacrum, Sacral hiatus.

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Medical Journal: IMJ Health: Volume-2, Issue-7, July 2016

Medical Journal July 2016 Issue

Glycolic Acid Peels Versus Salicylic Acid Peels in Atrophic Acne Scars : A Randomized Comparative Study

AbstractScarring is a well recognized sequel of acne. Because of the prevalence of acne scarring and strong negative emotions it engendering affected patients, several approaches have been developed for its treatment with varying success rates. Glycolic acid 50% peels and Salicylic acid 30% Peels are classified as superficial peel and are consider safe in Indian patients. While chemical peels are widely being used in India for various indications. There is a paucity of published studies on the efficacy of chemical peel specifically for acne scars in Indian patients.

Purpose of this study was to evaluate and compare the effectively of these two agents in the treatment of acne scars. Eighty cooperative patients[≥18 years age]with predominantly moderately atrophic acne scarring were randomly divided into 2groups of 40each.Patients of group A received Glycolic acid peels and patients in group B, Salicylic acid was used at 3weeks interval for four sessions. Objective evaluations of treatment response. Subjective assessments of treatment response were also done separately by the researcher, an independent observer and the patients separately.

Both of agents led to significant reduction in the total acne scar score[p< 0.05]but no significant difference was noted between the two peels. Side effects were lesser with Salicylic acid peel.

Hence conclusion was drawn that both 50% Glycolic acid and 30% Salicylic acid peels are safe in Indian skin and equally effective in the treatment of mild to moderate acne scarring.

Keywords Acne Scare, Acne Peels, Glycolic acid peel, Salicylic acid peel

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Effect of Root Heal Therapy (RHT) on Asthma: A Quincy Experiment

Abstract—Asthma is a chronic inflammatory disease of the airways that affects people of all ages. It may manifest as severe attacks, which can require urgent health care. It causes limitations in daily activities, loss of school and work days, lung function impairment, reduced quality of life, and an adverse socioeconomic burden. There is no cure of asthma, once it is diagnosed it can be managed by a good treatment plan, so that patient can live a better quality of life with the disease. This present study was planned to compare the effect of traditional treatment alone and in combination with Root Heal Therapy on asthma cases. A Quincy experiment was conducted on 60 patients of Asthma, who were taking treatment from a physician working in Jaipuriya Hospital, Jaipur. Out of these 60 asthama patients who were receiving traditional treatment, 30 patients were given this RHT along with traditional treatment. Baseline status of asthma and Asthma Quality of life Questionnaire (AQLQ) was assessed. These cases were followed for 18 months, again they were assessed as per AQLQ. Changes in status of asthma in both the group over this period were compared with Chi-square test and Unpaired 't' test. It was found that significantly more cases were benefited with this RHT in the form of number of spells of asthma, duration of illness due to asthma, mean days of activity loss and proportion of cases needed hospitalization during last one year. Pulmonary Function test were also better in experimental group than control group. Although mean number of eosinofills decrease was also found higher in experimental group but it was not found significant. It is concluded that Quality of life of these asthma cases were significantly improved on physical, emotional, social and occupational domains of life in cases with RHT than the cases only on traditional treatment.

Keywords Asthma, Root Heal Therapy (RHT), Pulmonary function tests, Asthma Quality of life Questionnaire (AQLQ).

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Association of Tuberculosis and Biochemical Nutritional Status A Case-Control Study

AbstractPulmonary tuberculosis is a very infectious disease and is a public health problem specially in developing country like India. Association between tuberculosis and nutritional status is assumed by various authors at time to time. So this present study was aimed to where there is any association between tuberculosis and nutritional status of individual. For study purpose 40 newly diagnosed tuberculosis taken in one group (Group A), 30 cases of relapse cases of tuberculosis in group 'B' and 30 matched healthy controls in group 'C'. Protein and micronutrient levels of each of the subject were assessed and compared group wisely. Significance of difference was inferred by Unparied 't' Test. It was found in this study that Protein, Albumin, Alkaline Phosphatase and Vitamine D were significantly lowered in Tubercular cases than controls. So it can be concluded that tuberculosis is more common in nutritionally deficit individuals.

Keywords: Tuberculosis, Nutritional Status, Protein Level, Macronutrient Level.

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Socio demographic profile of Diabetic cases attended at Diabetic clinic of a tertiary hospital of western Rajasthan India

AbstractDiabetes Mellitus is a lifestyle disease it is increasing with increase of urbanization. It is a side effect of development. Nowadays with the development of community it is also on increase trend. So this study was conducted on 250 patients of diabetes attended at Diabetic Clinic of SMS Hospital Jaipur, with the aim to find out socio-demographic profile of these diabetes cases. General information about the these case was gathered in a pre-designed semi-structured performa. It was found in this study that majority of cases were in age group of 31 to 45 years with slight male dominance. Education wise majority were Graduate followed by secondary educated and others. Likewise occupation wise majority were either unemployed of professional. Majority of cases were from Socio economic Class II and III. So it can be concluded that diabetes is a disease of middle age slight male dominance and of educated middle class individuals. Further studies are required to establish this fact.

Keywords Diabetes Mellitus, Socio-demographic profile

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Acute Illness episodes and Limitation of Daily Activity of Life in Geriatric population in Jaipur: A Period Prevalence Study

Abstract Elderly population is increasing due to demographic shift in favor of geriatric population. This age group is susceptible for many acute and chronic health problems which may lead to limitation daily activities of life. Study of acute and chronic health problems with limitation daily activities of life of this population is required to frame comprehensive policies to make ageing a comfortable experience. So this cross-sectional period prevalence study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to study episodes of acute health problems within last one month and limitation daily activities of life within last years of this population of elderly population. Study population consist of 1620 elderly with M:F ratio 0.95. Mean age of elderly was 66.08 years with slight female predominance i.e. 1048 females for 1000 males in Jaipur city. It can be concluded from 41.6% of elderly were having difficulty in performing activity of daily living and this difficulty was found more in females that males and in older ages. It was also revealed that 44.37 of elderly had one or more episodes of acute illness in last one month. These number of episodes of acute illness in last one month was found more in males and in older age groups.

Key words- Elderly, Geriatric, Acute Illness, Daily activities of Life.

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