My broodings

It has been long since I put up any thing.
Well, It was a long break and jouney to the holy land. I felt refreshed and good.
I was happy I got the ooportunity to do a session on Epidemiology for clinicians at the OAsis hospital Alain. The feedbacks from the participants was good.
It was good to hear that our students enjoyed their participation at Student's conference and that their presentations were appreciated. One of them got a prize too!
Now I need to get back to my present batch of students to come up with good project reports.
I trust they will make good ones.

Some more studies are being published today. There are reports on Obstetric complications and immunisation coverage of children.
1. Title Of The Study:
The Prevalence of Diseases Complicating Pregnancy.

Name Of Authors: Priya Jose
Kiran Gopal
Jinu.T.Eldho


Institution: M.O.S.C. MEDICAL COLLEGE,KOLENCHERY
Background: Obsterics is largely preventable medicine.The aim is to Provide good health and a healthy baby.Diseases Complicating Pregnancy like Anaemia, Hypertension,Diabetes Mellitus have become one of the major causes of maternal mortality. So the early diagnosis decreases the risk and prevents much of the maternal and fetal sickness and death.
Objectives: To study the Prevalence of Diseases Complicating Pregnancy among all Pregnant ladies of Age groupn15-35 years who are coming for Antenatal check up in Department of Obstetrics and Gynecology of MOSC Medical College Hospital, Kolenchery during the time period of September 17- October 17 2007 by conducting a Cross sectional Study
Materials and Methods: Study Design: Cross Sectional study

Sample Size: All Pregnant ladies who are coming for
Antenatal check up in Dept of OBG of
MOSC MCH,Kolenchery during the
timeperiod of September 17 – October 17
2007.

Data Collection: Personal Interview Method with a Semi.
structured pre tested pre-reviewed
Questionnaire

Results: The most common diseases complicating pregnancy is anaemia(34%). It occurs mainly in the age group of 15 – 25 years and in those who belonging to Low Socio economic Status.It is mainly in First trimester and its occurrence is more in Primi.next comes Diabetes Mellitus, Urinary Tract Infection,Hypertension respectively.

Conclusion: With the advancement of medical facilities and Health education, Diseases complicating pregnancy has come down to a great extend, thus reducing the maternal morbidity and mortality of both mother and infant. Regular Antenatal Check up ensures more chance of diagnosing those diseases, thus we foresee the complications and reduces the maternal mortality.

2. The Study:

The immunization status of children Under five years Age.
Name Of Authors: Nikhilesh Menon.R
Jaya.G.
Institution: M.O.S.C. MEDICAL COLLEGE,KOLENCHERY

Background: Vaccines — which protect against disease by inducing immunity — are widely and routinely administered around the world.Immunization is a proven tool for controlling and even eradicating disease.The various diseases like :Polio,diphtheria,measles,tetanus,Rubella, Pertussis,Mumps,Meningoacoccal meningitis H.influenza,Meningitis,Chicken Pox,S.pneumoniae pneumonia,Hepatitis B. can be easily prevented by immunizing at the correct age. The National scenario of the Immunisation status is far from satisfactory..
Objectives: To study the immunization status of children below five years, find out the potential socio-cultural,economic and religious influences on vaccine uptake in the project field area and to study the awareness regarding the Universal Immunisation Schedule.

Materials and Methods: Study Design: Cross Sectional study

Sample Size: 100

Data Collection: Interview Method with a Semi structured pretested peer-reviewed Questionnaire.

Results: Immunistion Status was 93%. These 93% were also aware about the Universal Immunisation Schedule. Among the unimmunised 28% had socio-religious Inhibitions against vaccination.

Conclusion: The Immunisation Status in The field Area of M.O.S.C. Medical College (Puthrukka Panchayath Wards ix and x) is 93% (For The Vaccines Included in the National Immunisation Schedule) which is Satisfactory.

Today I received two more abstracts. One is on varicose vein and its risk factors. The other is on immunisation coverage. I am psoting them both

1.
Title Of The Study:
Prevelance of Varicosity among people Whose Work Demands Standing For Long Hours.
Name Of Authors:
Divya Aleena Jacob
Meera Shruthy
Vinitha T.V.
Institution: M.O.S.C. MEDICAL COLLEGE, KOLENCHERY

Background: Varicose vein is one of the most important venous disorder affecting the lower limb.It commonly Occurs in those whose work demands standing for Long hours.Other causes are Heredity,Hypertension,O.B.G. conditions,Deep vein Thrombosis.Varicosity Can lead to Complications like Haemorrhage,Phlebitis,ulceration and skin changes.Prevalence of varicosity in developing countries have been found to be 20% in text books.We Designed this project to find out the prevalence of Varicose vein and risk factors and complications.
Objectives: To Study The prevalence of varicose Veins , Risk factors and the complications of varicose veins among School Teachers
Materials and Methods:
Study Design: Cross Sectional study
Sample Size: 100
Data Collection: Interview Method with a Semi structured pretested peer-reviewed Questionnaire and Clinical Examination.
Data Analysis:- Descriptive statistical methods were used first. We found out the prevalences. Interval estimations like 95% Confidence Intervals were calculated.
Since we found two different groups in our sample we did a case control analysis and calculated Odds Ratio for strength of association of standing for long duration as a risk factor for varicose vein.
Results:-
Prevalence of varicose veins 19% (95% CI- 11.2- 26.8)
Among those affected 89.5% had a history of standing for long duration.
Odds Ratio 12.363
26.3% had complications from this disease.

Conclusion: Prevalence of varicose veins among school teachers was 19%.Standing for Long hours was a major risk factor as compared to other known risk factors. Skin pigmentation was found to be the most frequent complication.
Health Education and cutting down of working hours maybe recommended to bring down the prevalence of Varicose veins.
Note: Meera Shruthy (Presenting Author)

2.

Today I received some abstracts from my students. I am psoting them here. There are studies on Tuberculosis patient defaulting, Breast feeding practices, prevalence of hypertension
1.

Magnitude, Profile & Pattern of Category II patients & Risk Factors associated with Non-Adherence to DOT in RNTCP centres, Eranakulam district

Name of Authors: Johns Shaji Mathew
Salman Mohamed Kutty, C

Institution: MOSC Medical College Hospital, Kolenchery

Background: Tuberculosis (Tb) continues to remain one of the most pressing health problems in India. Revised National Tuberculosis Control Programme (RNTCP), which adopted WHO’s Directly Observed Treatment (DOT) regime was introduced in 1997 for combating Tb after the failure of National Tuberculosis Programme (NTP,1962). Not much published data is available on retreatment patients under RNTCP, causes for their being retreated and their treatment outcome. In this project we would like to shed some light on these issues.

Objectives: To assess magnitude, pattern and profile & risk factors associated with Non-Adherence to DOT among Category II patients re-registered at randomly selected RNTCP centres, Eranakulam District.

Materials & Methods :
A cross sectional study was done among subjects (retreatment patients) from 6 RNTCP centres in Eranakulam District during the last quarter of 2007. Subjects were interviewed with the help of a structured questionnaire on past history of Tb and other socioeconomic parameters.

Results: These results are simple proportions.
Magnitude of CAT II patients-21.38%.
Patients were found to be belonging to higher age group (>50)
with 100% Male predominance. Large proportion of the subjects were found to be using Alcohol and Tobacco.
Defaulters-50%, Relapse-21.42%, Failure-28.57%
Most important risk factors for Non-Adherence to DOT (Defaulters) were- Male Gender (100%), Alcohol(71.42% ) & Smoking(57.14%).

Conclusion:
We found that males, alcoholics & smoking were predictive factors of default with DOT. Devoting attention to those with predictive risk behaviors from the initiation of the treatment with close supervision and counseling would minimize incidence of defaulters and hence speedy achievement RNTCP goals.

2.

Title Of The Study:
Awareness and Practice of Breast Feeding among Nursing Mothers in M.O.S.C Medical College Hospital, Kolenchery, Ernakulam District.

Name of Authors: David Vincent,
Lakshmi Priya Menon.

Institution: MOSC Medical College, Kolenchery.

Background: Baby friendly hospital initiative was introduced for betterment of both mother and child. Though Kerala has been declared as a baby friendly state, it was of concern whether the principles of baby friendly hospital initiative were being practiced satisfactorily. Stressing on the various aspects of breast feeding, this project tries to assess the present awareness and practice of breastfeeding among nursing mothers in MOSC Medical College Hospital, Kolenchery.
Objectives: Assess awareness and practice of breast feeding among study subjects.

Materials & Methods :
A cross sectional study was conducted at postnatal & pediatric wards of MOSC Medical College, Kolenchery from October to November 2007. A total of 300 nursing mothers of children between the age group of 0-6 months were consecutively identified .The subjects were interviewed and data was collected using structured, pretested peer reviewed questionnaire.

Results:
43 % were aware that 4-6 months is period of exclusive breast feeding . 54.82% were aware that breast feeding should be continued for upto 2 years. 89.63% claim awareness about ideal breast feeding practices. 78 % normal deliveries initiated breast feeding within ½ hour. 51.23% caesarean sections initiated breast feeding within 4 hours. 90% gave colostrum. 80% practiced demand feeding. 100% employed correct positioning while feeding. 98.5% practiced burping after breast feeding.

Conclusion:
Majority of people have good awareness about healthy breast feeding practice. Area which requires improvement are duration of exclusive breast feeding and required period of breast feeding for children.

3.

Prevalence of hypertension among rural population above the age of 30 years.

Name of Authors: Vivek Krishnan.
Indu R.

Institution: MOSC Medical College, Kolenchery.

Background: Hypertension is an emerging epidemic with high mortality .It has several modifiable risk factors including obesity, dietary factors, alcoholism, smoking, sedentary lifestyle. Community surveys have documented 10 times increase in the prevalence of hypertension in rural population. We designed this project to find out the prevalence of hypertension and also the socio demographic factors & behavioral aspects of community people and relate it with risk for hypertension.

Objectives:
1. To find out the prevalence of hypertension among rural population above the age of 30 years.
2. To find out the risk factors.
3. To find out the socio-demographic factors associated with hypertension.

Materials & Methods :
A cross sectional study was done at Aikkarnad panchayat, Vadavukode block during October –November 2007. The total number of study subjects were 180. Among which 74, who were hypertensive were interviewed for prevalence of risk factors using a structured, pre-tested and peer reviewed questionnaire.

Results:
Prevalence of hypertension 41.1%. It was found that increase in number of
hypertensives with increasing age, 2.7% in age group 30-39, 6.7% in 40-49, 33.7% in 50-59, 25% in 60-69, 37.8% in 70- 79 & 9.4% in above 80 age groups .
Major risk factors were male preponderance (55.4%), lack of exercise (83.7%), smoking (37.8%), consumption of alcohol (27 %.), lack of salt restriction(62 %).

Conclusion:
A high prevalence of hypertensives are encountered(41.1%). Smoking, alcoholism, lack or only mild exercises, no salt restriction were highly prevalent among these hypertensives & should be controlled at the initial phase of treatment to reduce mortality & morbidity caused by hypertension.

There wasn't much happening these days. Some of my students are getting ready to present their papers in a medical student' s conference. I expect to get the abstracts they prepare and post here. Some of their papers are very interseting. It is indeed a great skill to summarise a whole project into a few hundred words.

Research about social network sites

Very interestingly as soon as I started this blog I had a student coming to me to help him with research on social netwroking sites. He seemed to be concerned that blogging and usage of these sites are causing more harm to youngsters than benefit. Well, it was a new thought to me. We have drawn up a project and I am awaiting his findings. He is a social science student. If any of you who read this has a comment please post them.

Hello

Hello Everyone,

I am Dr. Marina Rajan Joseph, Associate professor of Community Medicine and Epidemiologist at the MOSC Medical College, Kolenchery, India. I have been in the field of Epidemiology and Teaching for the past 13 years. I am closely associated with the Tuberculosis Control Program (RNTCP) in India.

My work with the community has multiple dimensions like general health promotion and awareness, medical insurance, micro-credit for community development, counseling, transactional analasis etc.

Epidemiology being the logical basis for all medical practice, has always fascinated me. I believe every undergraduate student should be thorough with the basics of theory and practice of epidemiology during the course of undergraduate medical studies.

To realise my passion, I have written a book titled "Epidemiology for undergraduates" published by JP Medical Publishers, New Delhi, India.

This blog titled "epidemiologyforeveryone" or EFE is intended to consolidate and make available for everyone, the epidemiologic studies and findings of my undergraduate students at the MOSC Medical College, Kolenchery.

I hope this will inspire an interest in epidemiology and statistical methods for scientific research among the medical undergraduate student community in Kerala, and be the platform for greater things in the future.

Wishing sincerely for your cooperation and support through your comments and feedbacks,

Marina
marina.rajan@gmail.com