Research & reviews a journal of medicine (vol4, issue2) by STM Journals Publication

Research & Reviews : A Journal of Medicine (RRJoM)

May-August 2014

STM JOURNALS Scientific

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ISSN : 2348-7917

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STM JOURNALS

I take the privilege to present the hard copy compilation for the [Volume 4 Issue (2)] of Research & Reviews: A Journal of Medicine (RRJoM). The intension of RRJoM is to create an atmosphere that stimulates creativeness, research and growth in the area of Medicine. The development and growth of the mankind is the consequence of brilliant Research done by eminent Scientists and Engineers in every field. RRJoM provides an outlet for Research findings and reviews in areas of Medicine found to be relevant for National and International recent developments & research initiative. The aim and scope of the Journal is to provide an academic medium and an important reference for the advancement and dissemination of Research results that support high level learning, teaching and research in the domain of Medicine. Finally, I express my sincere gratitude and thanks to our Editorial/ Reviewer board and Authors for their continued support and invaluable contributions and suggestions in the form of authoring writeups/ reviewing and providing constructive comments for the advancement of the journals. With regards to their due continuous support and co-operation, we have been able to publish quality Research/Reviews' findings for our customers base. I hope you will enjoy reading this issue and we welcome your feedback on any aspect of the Journal.

Dr. Archana Mehrotra Director STM Journals

Research & Reviews: A Journal of Medicine

Contents

1. A Retrospective Study of Epidemiological Factors Associated with Measles in Children (0â&#x20AC;&#x201C;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

3. Emergency Contraception: Current Status in India Swayam Pragyan Parida, Vikas Bhatia

4. 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 16 5. Heart Rate and Serum Nitric Oxide Express Circahoralian Oscillation in Hypertensive Patients Marwan S. M. Al-Nimer, Ismail I. Hussein, Noori Y. Kattami

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

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

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 Bano1, KS Saluja2 1

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

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

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 Naithani2, Prof. Suresh Sharma3, Geetika Uppadhya4 1

M. Sc., Lecturer- Home science (Food & Nutrition), Swami Purnanand Degree College of Technical Education, Muni Ki Reti, Tehri Garhwal-249201, Uttarakhand, India 2 M.D., Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh-249203, Uttarakhand, India 3 M.Sc., Ph.D., Principal, Nursing College, All India Institute of Medical sciences, Rishikesh-249203, Uttarakhand, India 4 M.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 18â&#x20AC;&#x201C;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

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 75â&#x20AC;&#x201C;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

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, mental health outcomes

Type-2

diabetes

mellitus,

physical

and

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

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 Khilnani2, Laxmi Kant Goyal2*, Vishal Agrawal2 1

RUHS College of Medical Sciences, Jaipur, India 2 SMS 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

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.