STM JOURNALSScientific Technical Medical

Research & Reviews : A Journal of Medicine

(RRJoM)

May-August 2014

ISSN : 2348-7917

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STM JOURNALS

1. A Retrospective Study of Epidemiological Factors Associated with Measles in Children (0–5 Years) in Four Villages of Barabanki District in Rural Uttar Pradesh

Nadeem Ahmad, Rubeena Bano, KS Saluja 1

2. A Pilot Loco-Regional Study over Relation of Serum Levels of Iron and Zinc in Pregnant Females of Uttarakhand, India Jyoti Bharadwaj, Manisha Naithani, Prof. Suresh Sharma, Geetika Uppadhya 4

3. Emergency Contraception: Current Status in IndiaSwayam Pragyan Parida, Vikas Bhatia 12

4. Effect of Patient Counseling in Improving Physical and Mental Health of Type-2 Diabetes Mellitus PatientsAmareswara Reddy Gangula, Gowthami Reddy V, Divyaja M, Kanala Siva Kumar Reddy, Samjeeva Kumar E 16

5. Heart Rate and Serum Nitric Oxide Express Circahoralian Oscillation in Hypertensive PatientsMarwan S. M. Al-Nimer, Ismail I. Hussein, Noori Y. Kattami 20

6. Microalbuminuria and Other Risk Factors in Diabetic RetinopathyKhushbu Jindal, Kamlesh Khilnani, Laxmi Kant Goyal, Vishal Agrawal 26

7. Validation of Indian Diabetes Risk Score (IDRS) in a Subset of North Indian Population through Amer Diabetes Study (ADS)Sanjeev Thakral, SS Haldiya, Harsh Kumar Garg 33

ContentsResearch & Reviews: A Journal of Medicine

RRJoM (2014)© STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

A Retrospective Study of Epidemiological Factors

Associated with Measles in Children (0–5 Years) in Four

Villages of Barabanki District in Rural Uttar Pradesh

Nadeem Ahmad1*, Rubeena Bano

1, KS Saluja

2

1Integral Institute of Medical Sciences & Research, Lucknow, India

2Hind Institute of Medical Sciences & Research, Barabanki, Lucknow, India

Abstract Measles is a leading cause of death among young children even though a safe and cost-

effective vaccine is available to prevent the disease. The objective of the present study

was to study the epidemiology of measles in children (0–5 years) in the four villages of Barabanki district in rural Uttar Pradesh and also to study various factors responsible

for measles in rural Uttar Pradesh. It is a retrospective cross-sectional epidemiological study conducted in the four villages in Barabanki. A total of 2220 children (1225 male

and 995 female) were selected. All the houses having children 0–5 years were taken up

for the study. The mothers were interviewed with a pretested, structured questionnaire and data was analyzed by SPSS Software, version 16.0. In the present study, 25.27%

children were normal, 53.92% children were malnourished (Grade I), 15.63% were

having Grade II and 5.18% Grade III malnutrition as per Gomez classification. Measles vaccine was not given in 77.61% children and in only 22.39% it was given. Most of the

measles cases (32.94%) occurred during the winter season between December to February, showing the normal seasonal trend of measles.

Keywords: Measles, malnutrition, rural area

RRJoM (2014) © STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

A Pilot Loco-Regional Study over Relation of Serum

Levels of Iron and Zinc in Pregnant Females of

Uttarakhand, India

Jyoti Bharadwaj1*, Manisha Naithani

2, Prof. Suresh Sharma

3, Geetika Uppadhya

4

1M. Sc., Lecturer- Home science (Food & Nutrition), Swami Purnanand Degree College of Technical

Education, Muni Ki Reti, Tehri Garhwal-249201, Uttarakhand, India 2M.D., Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences,

Rishikesh-249203, Uttarakhand, India 3M.Sc., Ph.D., Principal, Nursing College, All India Institute of Medical sciences,

Rishikesh-249203, Uttarakhand, India 4M.S., Consultant-Gynecology & Obstetrics Department, Nirmal Ashram Hospital,

Rishikesh-249201, Uttarakhand, India

Abstract Zinc has been established to be essential for humans and act as an electron acceptor contributing to catalytic activity in many important enzymes. Zinc also plays a very

important role in pregnancy. There is very few data in India on serum levels of

micronutrients in pregnant women specially Zinc and its relation with serum Iron (Fe) levels. We decided to carry out this pilot study in order to provide the baseline data that

may have public health implications and further guide us. This study was conducted in

the hill region of Uttarakhand, India enrolling sixty (60) pregnant women, in the age group of 18–35 years with (20) twenty control cases to compare with standard serum

levels. Blood Hemoglobin with serum iron and zinc levels was estimated. In the present study 48.3% of the pregnant women had hypozincemia and prevalence was higher in

anaemic pregnant women (53.57%). Serum zinc levels are significantly lower in iron

deficient anaemic pregnancy (IDAP), when compared to non-iron deficient anaemic pregnancy (NIDP) and in control cases. The fall in zinc level may be due to physiological

response of the maternal blood volume expansion though the role of iron supplementation cannot be ignored as iron and zinc have been shown to competitively

inhibit each other's absorption. Biochemical analysis during pregnancy can help us to

diagnose the specific nutrient deficiency and provide ideal therapeutic measures.

Keywords: Zinc, Iron, Anaemia, Hypozincemia, Maternal health

RRJoM (2014)© STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

Emergency Contraception: Current Status in India

Swayam Pragyan Parida*, Vikas Bhatia All India Institute of Medical Sciences, Bhubaneswar-751019, India

Abstract Worldwide, the incidence of unsafe abortion has increased in spite of gradual increase in

use of contraceptives. About one-third of pregnancies are unplanned and 20% pregnancies end in abortion. Lack of knowledge on emergency contraceptives is one of

the reasons behind unplanned pregnancies in many developing countries. As per NFHS-3, the overall knowledge about EC is meagre 12% among currently married

women with several states having lower than 5%. Levonorgestrel (LNG) has been

approved for use in India since 2001. The major initiative taken by the Government of India is by including ASHA in family welfare program where they act as depot holders

and provide information and ECs to the women in rural areas where the knowledge and

use is minimum but the requirement is maximum. LNG is a very safe and effective contraceptive pill, the efficacy ranging between 75–99%. Focus on improving awareness

and availability of EC will definitely decrease unplanned pregnancies, unsafe abortions and maternal mortality.

Keywords: Emergency contraception, knowledge, emergency contraceptive pill,

Levonorgestrel

RRJoM (2014)© STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

Effect of Patient Counseling in Improving Physical and

Mental Health of Type-2 Diabetes Mellitus Patients

Amareswara Reddy Gangula*, Gowthami Reddy V, Divyaja M,

Kanala Siva Kumar Reddy, Samjeeva Kumar E Department of Pharm D, P Rami Reddy Memorial College of Pharmacy, Kadapa,

Andhra Pradesh, India

Abstract Diabetes mellitus is a heterogeneous metabolic disorder characterized by chronic hyperglycemia with insulin hypo-secretion or insulin insensitivity. Despite the availability

of treatment, diabetes has remained a major cause of death. The main goal of any

medical care is the improvement of the patients’ overall quality of life. The aim of this

paper was to assess the impact of pharmacist provided patient counseling on physical

and mental health outcomes in type-2 diabetes mellitus. The prospective observational

study was carried out at Rajiv Gandhi Institute of Medical sciences (RIMS), Kadapa. This study was conducted over a 2-month period from February 2014 to March 2014.

The study population was both men and women if they had uncontrolled type-2 diabetes mellitus, FBS level > 129 mg/dL and RBS > 200 mg/dL, age group (> 30 years). The

patients meeting the inclusion criteria were asked to fill the SF-12 questionnaire and the

baseline data was obtained. Each patient was counseled regarding their disease, medications and lifestyle modifications and advised to revisit after one month. Upon their

revisit same questionnaire was again asked to be filled by them and the data obtained

were compared with baseline data collected previously. Out of 200 patients, majority of patients 168 (84%) answered only physical components, followed by 152 (76%)

answered both physical and mental components, finally 56 (28%) patients answered only mental components. Upon assessing the physical and mental health functioning of the

patients, there was an improvement in both the components after providing education by

counseling process regarding disease, medication and lifestyle changes. The present

study also concluded that chronic diseases like diabetes affect the quality of life of

patients. As the main goal of any medical care is the improvement of the patients’ overall quality of life, the clinical pharmacist imparted patient education through counseling has

a major role in improving the physical as well as mental health outcomes.

Keywords: Patient counseling, Type-2 diabetes mellitus, physical and

mental health outcomes

RRJoM (2014)© STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

Heart Rate and Serum Nitric Oxide Express

Circahoralian Oscillation in Hypertensive Patients

Marwan S. M. Al-Nimer*, Ismail I. Hussein, Noori Y. Kattami College of Medicine, Al-Mustansiriya University, Baghdad, Iraq

Abstract Cardiovascular cells possess circadian oscillators and certain cardiovascular diseases

are attributed to disruption in cardiac circadian rhythm. This study is aimed to find the

association between the serum level of nitrogen species and the electrocardiograph records taking in consideration the circahoralian oscillation in hypertensive patients. A

total number of fifty hypertensive patients and twenty healthy subjects were admitted in

this study. The anthropometric measurements and lipid profile were determined. Serum nitric oxide and peroxynitrite were measured at the same time of electrocardiograph

(ECG) records twice over a period of 60 min. The mean values of baseline record of electrocardiograph parameters non-significantly differed from corresponding values of

healthy subjects. Hypertensive patients showed significant (p < 0.05) decrease in sinus

heart rate in second record (74.202 ± 20.768 beat/min) compared with the first record (80.494 ± 12.266 beat/min). In hypertensive patients, the mean serum nitric oxide levels

decreased to 60% of the mean value of healthy subjects while peroxynitrite increased by four fold of healthy subjects. The significant oscillation in heart rate over 60 min, at rest,

is associated with significant changes in nitrogen species levels. It concludes that

circahoralian (ultradian) rhythm existed in hypertensive patients in term of simultaneous oscillation in heart rate and nitrogen species.

Keywords: Hypertension, heart rate, nitrogen species, circahoralian oscillation

RRJoM (2014)© STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

Microalbuminuria and Other Risk Factors

in Diabetic Retinopathy

Khushbu Jindal1, Kamlesh Khilnani

2, Laxmi Kant Goyal

2*, Vishal Agrawal2

1RUHS College of Medical Sciences, Jaipur, India

2SMS Medical College, Jaipur, India

Abstract The objective of this paper was to study positivity of microalbuminuria and other risk factors in DM type II and their relation to DR. An analytic study was done among 300

selected cases of Type 2 DM in one year. The grading of the severity of DR was done

using ETDRS protocol. Tests for hemoglobin, fasting blood sugars, micro-albuminuria, glycated hemoglobin (HbA1c) and lipid profile were done. 137 (45.67%) cases of DM

found to have DR [22(7.33%) mild NPDR, 43 (14.33%) moderate NPDR, 30(10%)

severe NPDR and 42 (14%) PDR]. 61(20.33%) cases of DR have microalbuminuria [50% (21/42) cases of PDR, 66.67% (20/30 cases) in severe NPDR cases, 34.89% (15/43

cases) in moderate NPDR and 13.64% (3/22 cases) in mild NPDR cases]. Duration of DM, hypertriglyceridemia, cholesterol had positive relation with DR. Levels of HDL,

LDL and hemoglobin had no relation with DR although the occurrence of low HDL, high

LDL, hypertension and anemia had relation with DR. Occurrence and progression of DR is associated with uncontrolled DM, long duration of DM, dyslipidemia, anemia and

hypertension. Microalbuminuria is a contributing factor in the degree of retinopathy.

Keywords: Diabetic retinopathy, diabetes mellitus, microalbuminuria, risk factors

RRJoM (2014) © STM Journals 2014. All Rights Reserved

Research & Reviews: Journal of Medicine ISSN: 2249-8648 (online), ISSN: 2348-7917 (print)

Volume 4, Issue 2

www.stmjournals.com

Validation of Indian Diabetes Risk Score (IDRS)

in a Subset of North Indian Population through

Amer Diabetes Study (ADS)

Sanjeev Thakral*, SS Haldiya, Harsh Kumar Garg Department of Medicine, National Institute of Medical Sciences Hospital, Jaipur, India

Abstract The study was conducted at Amer locality in Jaipur on adults aged 20 years or more to

validate the Indian Diabetes Risk Score (IDRS). The study group comprised 551

participants (68.9% response rate). The OGTT was performed using 75 g of glucose. The

IDRS was calculated using age, family history of diabetes, physical activity and waist measurement. ROC curves were constructed to identify the optimum value (> 60%) of

IDRS for determining diabetes as diagnosed using WHO consulting group criteria. It was

found that 71 of the study individuals were known diabetic subjects, while 45 subjects were diagnosed to have newly diagnosed diabetes. An IDRS score of > 60 had the best

sensitivity (62.2%) and specificity of (73.7%) for detecting diabetes in this community.

This study confirms and validates the IDRS as being a valid, simple and reliable screening tool to identify undiagnosed diabetes in the community. The IDRS score > 60

had the highest sensitivity and specificity to identify undiagnosed diabetes.

Keywords: Diabetes, risk, IDRS, ADS.