Medicine

Service Related Factors Associated with Antenatal GDM Screening among Mothers Delivered at Secondary Care Hospitals in Matara District

2023-04-26T11:07:45Z

Service Related Factors Associated with Antenatal GDM Screening among Mothers Delivered at Secondary Care Hospitals in Matara District Chandana, GJ; Wijesinghe, CJ Gestational Diabetes Mellitus (GDM), defined as ‘any degree of glucose intolerance with onset or first recognition during pregnancy’, accounts for certain adverse maternal and perinatal outcomes. Early detection and prompt glycaemic control can minimize such outcomes, thus universal screening for GDM is recommended. It has been incorporated to the maternal care programme since 2014 and carried out twice during antenatal period at field antenatal clinics. This study aimed to assess service related factors associated with effective implementation of antenatal GDM screening programme among mothers in Matara district. In a cross-sectional study, 423 postpartum mothers delivered at three secondary care hospitals in Matara district were recruited using a proportionate sampling technique. Data on access to antenatal GDM screening services and screening process were collected using an interviewer-administered questionnaire, and data on availability of screening facilities were collected using a data record sheet. Chi square test and Fisher’s exact test were used to test the association between variables. Response rate was 92.3%. Distance to the nearest lab with blood sugar testing was <30 minutes’ reach for 91.7% participants. Area Public Health Midwife was not available during the time of first and second GDM screening for 5.5% and 13.2% participants respectively and availability of logistics were 22.7% and 11.5%.Coverage and timeliness of first screening were found to be 91.4% and 72.4%, respectively and corresponding figures for second screening were94.5% and 59.5%. Proper documentation and appropriate referral were done in 76.8% and 47.7% respectively after first screening and in 65.4% and 21.2% after second screening. Screening coverage was negatively associated with a longer distance to nearest laboratory (p=0.002) and timeliness with nonavailability of logistics (p=0.002) in second screening, but not in first screening. Despite higher coverage, GDM screening programme needs improvement in timeliness, proper documentation and appropriate referrals. Availability of logistics at MOH level will improve performance of GDM screening and hence maternal care package.

Pesticide Use, Handling and Awareness among Rural Farmers in Sri Lanka: Implications on Emerging Chronic Kidney Disease of Uncertain Etiology (CKDu)

2023-04-26T11:01:42Z

Pesticide Use, Handling and Awareness among Rural Farmers in Sri Lanka: Implications on Emerging Chronic Kidney Disease of Uncertain Etiology (CKDu) Thakshila, WAKG; Ekanayake, EMDV; Abdul, KSM; Samanmali, MAGD; Jayasinghe, SS; Jayasumana, CS; Chandana, EPS; Siribaddana, SH; De Silva, PMCS Agrochemical exposure has been considered as the main risk factor of Chronic Interstitial Nephritis in Agricultural Communities (CINAC) in Sri Lanka. Poor awareness and agrochemical handling practices could lead to occupational exposure, and hence an observational study was conducted focusing on lifestyle, farming practices, agrochemical handling and awareness of health effects among farmers (n=3669) in CINAC emerging locations. Smoking (50%), alcohol consumption (50.8%) and chewing betel (45%) were very common among male farmers. A history of drinking water consumption from surface wells near agricultural activities was evident among farmers. More than 60% of the farmers were actively using herbicide formulations such as Glyphosates,Glufosinate, Paraquat,Diuron, Phenoxy and Sulfonylurea. Chlorpyrifos formulations were the most commonly used insecticides. Urea and Triple Super Phosphate fertilizers were mainly used throughout the cropping cycle. Agrochemical mixing using different pesticide formulations and fertilizers was common among farmers (56%) expecting higher yields. Manual application was preferred to mechanical resulting further imminent exposure. The majority of the farmers (> 68%) were over using agrochemicals by not adhering to the recommended doses. The use of protective cloths and equipment during mixing and applying was ignored; nevertheless 63% of the farmers were well aware of the potential health effects of agrochemicals and their practices. Farmers opted to store the agrochemicals outside their home; however, they dumped used containers within the farming locations. Our study confirms potential occupational exposure to agrochemicals and thus regulation and proper management of agrochemicals is essential for the wellbeing of the farmers.

Factors Affecting the Prevalence of Diabetes Mellitus

2023-04-26T11:06:37Z

Factors Affecting the Prevalence of Diabetes Mellitus Liyanage, LN Prevalence of diabetes mellitus has risen faster in low and middle income countries than in high income countries. An estimated 422 million people are suffering from diabetes worldwide. Many environmental factors contributed to development of diabetes. But the majority of the humankind is unaware of the factors of the prevalence for this. This study determines the various socioeconomic and demographic factors underlying the prevalence of diabetes mellitus. A cross sectional study was conducted among 100 participants chosen from a cluster sampling. The data about the socioeconomic status, occupation, body mass index, place of residence and food routine were collected and analysed. Out of 100 participants, 51% were suffering from diabetes mellitus and 61% of them were females. They were from various occupations, educational levels and socio-economic levels. Among them diabetics, 56.9% had family history of diabetes; and 47.10% were doing sedentary work. There was a significant association between diabetic and BMI x2 (3) = 31.041, p = .000. With a decreasing level of physical activity, people are more likely to be diagnosed with diabetes. Socioeconomic and demographic factors influence the commencement and evolution of diabetes mellitus. The majority of diabetic patients were doing sedentary work, had least knowledge of self-monitoring, and had a bad food routine. Therefore, measures must be taken to implement health policies to make the society aware about the diabetes mellitus.

Clinical Patterns of Acute Radiation Dermatitis among Patients Attending Dermatology Outpatient Department at District Government Hospital of Gulbarag – A Study

2023-04-26T11:50:11Z

Clinical Patterns of Acute Radiation Dermatitis among Patients Attending Dermatology Outpatient Department at District Government Hospital of Gulbarag – A Study Reshmi, Sharaneshwari N Radiation dermatitis (RD) is a commonly encountered adverse effect of definitive radiation therapy. The severity of RD is influenced by multiple patient and treatment-related factors. Radiation depletes the basal cell layer of skin and initiates a complex sequence of events leading to dose-dependent acute or late squeal. The management of RD requires a multidisciplinary approach. The aim is to highlight the pattern and the profile of patients with acute RD attending dermatology outpatient department. Hospitalbased cross-sectional study of 47 consecutive adult patients with acute RD attending skin outpatient department over a period of 12 months. A total of 47 patients of RD attended the skin clinic, of which were 16 males and 31 females. The RD was reported within the first 2 weeks of initiation of therapy in most of the patients. Grade 1 RD was the least common presentation. This study highlights the importance of grading the RD, for the appropriate management of the patients suffering from the same and is also a step toward the prevention of the RD.