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I. O. Dada, I. A. Igbe
Journal of Multidisciplinary Research in Healthcare, Volume 7, pp 33-48; doi:10.15415/jmrh.2020.71003

Overweight and obesity is a risk factor to chronic non-communicable diseases. This study assessed level of overweight/obesity and blood pressure among students of a higher institution in Southwest Nigeria. This cross-section study involved 300 students of a public higher institution in Ado-Ekiti, Southwest, Nigeria. A validated self-administered questionnaire was used to collect data on personal characteristics, feeding pattern and lifestyle of the students. Body Mass Index (BMI) was categorized into normal weight (BMI
Jib Acharya, Edwin Van Teijlingen, J Murphy Murphy, Basma Ellahi
Journal of Multidisciplinary Research in Healthcare, Volume 7, pp 1-12; doi:10.15415/jmrh.2020.71001

Background: This study explores food beliefs among poor mothers related to feeding their offspring. Mothers’ misconception of a healthy diet is one of the major causes of nutritional problems in preschool-aged children in Nepal and these beliefs and attitudes can result in the inappropriate feeding of young children. Objectives: The main objectives of this study were:• identify major barriers for recommending healthy food that are associated with existing cultures, religions and ethnic divisions;• assess the knowledge, attitudes, and beliefs about nutritious food amongst mothers;• assess health-seeking behaviour for children of low socio-economic status. Methods: Study used a qualitative focus group discussion. Fifty participants took part in seven focus groups to explore their food beliefs. The qualitative focus groups aimed to collect in-depth information around food beliefs and data were thematically analysed. Results: The study identified six key themes: (a) poverty; (b) knowledge; (c) policy; (d) beliefs about breastfeeding; (e) food beliefs: and (f) health-seeking behaviours/cultural influences. Many participants thought that illiterate and underserved populations are generally exposed due to financial scarcity, poor knowledge and strongly rooted in cultural practices, and beliefs. This study found ‘diversified views’ as a major barrier to food and health-seeking behaviours. Some groups recognised the negative effects of existing beliefs and taboos. However, the spiritual healers highlighted the importance of linking beliefs with cultural and religious norms and values. They showed the complex relationships between food and health-seeking behaviours and food recommendations with financial status and the perceived cultural practices of society. Conclusions: This study suggests that a public health approach is needed to address nutrition problems associated with behaviour and revealed major barriers which were associated with poverty, resources, and mothers’ education level.
Anurag Kanaujia
Journal of Multidisciplinary Research in Healthcare, Volume 7, pp 13-31; doi:10.15415/jmrh.2020.71002

Background: Early detection can decrease incidences of mortality related to cancer in India. Primary tests at detection centres (generally established in urban areas and mobile facilities), need to be followed by specialized cancer centric tests. This leaves a gap for discontinuation of diagnostic process. Other factors like the prevalence of Complimentary and Alternate medicine systems (CAM), availability of mainstream healthcare services, cultural and social beliefs need to be understood for new formats for diagnosis and treatment to be devised for minimizing delay in cancer diagnosis. Objective: This study was conducted in order:i. To understand role of various extrinsic factors in the development of cancer diagnostics and reason for adoption of CAM treatment strategies. And,ii. To develop a holistic understanding of these factors and their role in influencing delay in diagnosis of cancer in the Indian population. Methods: Through comprehensive analysis from a systems point of view, problems with systemic, economical, technological and socio-cultural factors emerged as reasons for slow development in the fight against cancer. Existing diagnostic and awareness dissemination networks are also analyzed for their strengths and weaknesses. Case studies on problems in early detection of cancer have pinned cognitive barriers like attitude, social practices and information to be the primary cause for low detection rates and high mortality. Interestingly, many studies point at “people’s attitude towards the disease” as a major bottleneck in adoption of mainstream medicine treatment. Results: This paper presents a review of multiple studies about factors influencing cancer diagnostics and treatment in India. Incorporating these factors, some postulates of a nascent model for development and recalibration of cancer diagnostic network are proposed. Cancer diagnostics involves tackling preconceived notions about cancer, challenging established sociocultural systems and reshaping social practices and people’s lifestyle. Public outreach programs (like camps, community events, ASHA workers and celebrity brand ambassadors) can be effective in changing attitudes in rural areas. Conclusions: CAM therapies are a group of traditional and modern medical practices that offer a pantheon of opportunities, however they can be dangerous to patients’ health if not used wisely. We support the suggestions made by other authors that an approach in integrative oncology may be effective for utilizing best of mainstream and complementary cancer treatment practices.
Raj Kumar
Journal of Multidisciplinary Research in Healthcare, Volume 7, pp 49-61; doi:10.15415/jmrh.2020.71004

Unusual appearances of COVID-19 (2019 novel corona virus) infected persons. The early epicenter of the pandemic, Wuhan, China has obtained medical and scientific information and knowledge in response to the infection of COVID-19. On thirteen case series and nine case-based reports, I want to put five significant facts of ophthalmic indicators of COVID-19 infected persons, hopefully, to deliver the fresh view as well as a wider perspective of COVID-19 infection.
Manjiri Ketkar Maslekar Manjiri Ketkar Maslekar
Journal of Multidisciplinary Research in Healthcare, Volume 6, pp 37-40; doi:10.15415/jmrh.2020.62005

Women’s mental health is a crucial and important aspect in her overall well-being but neglected as it is often asymptomatic. It is interesting to reflect on mental health for a woman who has multiple responsibilities - Her own, family, career, and responsibilities to the community and the impact it has on women career continuity and career progression. The ideal situation would be all for all groups to be partners and stakeholders in the same so that women can balance career along with other responsibilities. The article throws light on how postponing the career opportunities of women become a hurdle for her to restart her career and pacify her passion and how it affects the mental wellbeing.
Raj Kumar
Journal of Multidisciplinary Research in Healthcare, Volume 6, pp 11-23; doi:10.15415/jmrh.2020.62003

A novel β-coronavirus (2019 novel coronavirus) affected severe as well to uniform fetal pneumonia, travelled through a seafood bazaar of Wuhan town, Hubei region, China, also quickly extent toward excess boonies of China and more nations. The 2019-nCoV existed dissimilar after SARS-CoV, then cooperative the similar crowd receptor the social ACE2 (angiotensin-converting enzyme2). The regular crowd of 2019 novel coronavirus could conventional continue bat Rhinolophusaffin is a 2019 novel coronavirus presented 96.2% of entire-genome character toward BatCoV RaTG13. The person-to-person spread methods of 2019-nCoV involved tool, identical cough, sneeze droplet inhalation transmission, and obtain in-tuned with transmission, just like the interaction by way of oral, nasal, as well as eye mucous films. 2019-nCoV container too exist spread over the saliva, alsothus the fetal–oral ways similarly can remain a possible person-to-person spread mode. The observers now optometry run through representation just before the incredible danger of 2019-nCoV contagion because of the face-to-face announcement too thus the expose en route for tears, plasma, plus additional body liquids, besides therefore the diagnostic and treatment of apparatuses. Eye care professional perform inordinate heroes in stopping the spread of 2019-nCoV. At this time we indorse the contagion control actions all through optometry exercise just before block the person-to-person spread ways in eye care health center as well as hospitals.
Raj Kishor Kustwar, Suman Ray
Journal of Multidisciplinary Research in Healthcare, Volume 6, pp 25-36; doi:10.15415/jmrh.2020.62004

We have reached far ahead today when it comes to the telemedicine technology which was first installed in Boston in 1967 that made a regular interaction between physicians and patients at distant locations. Being a developing and lower-middle income country, currently India faces shortage of doctors, nurses & midwives, and healthcare infrastructure. Around 70% of Indian population lives in remote and rural villages lacking access to basic healthcare facilities. In such situations telemedicine plays a great role in providing quality and affordable healthcare to India’s poorest people, and is expected to bridge the rural-urban health divide. Whether telemedicine technology meets its objective to provide adequate healthcare services to the poor remote and rural population is matter of great concern. This article aims to provide an overview on this issue.
Swati Bidhuri, Mohd Mazhar Ali Khan, Tanveer Ahmad, Divya Rani Vaishnav, Faizan Sarwar
Journal of Multidisciplinary Research in Healthcare, Volume 6, pp 7-14; doi:10.15415/jmrh.2019.61002

National Capital Territory (NCT) of Delhi is experiencing rapid urbanization for the last few decades. The area is lagging behind in water and waste management infrastructure. This is due to the fact that Delhi is recording high growth rate of population mostly through in-migration over the year which is taxing much upon the existing water resources and the provisions made for water supply. Consequently demand is higher than supply of the safe drinking water. The consumption of unsafe drinking water is therefore increasing and is causing serious health problems among the fellow residents of NCT of Delhi. These health problems are basically related to the digestive as well as excretory systems of the human body. These disorders are promoting mortality particularly among those segments of population which do not have access to potable drinking water. This paper is therefore a modest attempt towards examining the population growth rate and the scenarios of demand and supply for potable water as well as the overall water related intestinal infections and related mortality at present and their future occurrence. This requires synergy between the different sectors of the state to overcome the problem. of intestinal infection diseases in the region.
Habtamu Molla
Journal of Multidisciplinary Research in Healthcare, Volume 6, pp 1-5; doi:10.15415/jmrh.2019.61001

Background: Tuberculosis is a global health problem and leading cause of mortality and morbidity in the world. Correct diagnosis of tuberculosis is the main challenge for control of tuberculosis. World health organization has prioritized improving diagnostic guidelines and tests for TB diagnosis. Priority has been given for development of new Tuberculosis diagnostic methods. But diagnosis of Tuberculosis highly affected by quality specimen collected which has been given less attention. The aim of this is to assess Yielding accuracy of morning and spot sputum samples for diagnosis Mycobacterium tuberculosis using Gene Xpert Mycobacterium Tuberculosis (MTB)/Rifampicin Resistance (RIF).Methodology: Cross sectional study was conducted and convenient sampling technique used to select participants. Checklists used to collect the data from April 1 to May 30, 2018 G.C. A total of two hundred twenty two (222) sputum samples from 111 suspected tuberculosis patients were analyzed using Gene Xpert MTB/RIF Assay. SPSS version 20 was used for statistical analysis. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research show an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant associationwith TB positivity.Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not association with TB positivity using Gene Xpert MTB/RIF Assay. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research shows an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant association with TB positivity. Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for the detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not associated with TB positivity using Gene Xpert MTB/RIF Assay.
Digvijay Singh, Chanchal Kaushik
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 57-63; doi:10.15415/jmrh.2019.52007

Objective: To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI)in emergency assessment of stroke in brain imaging from the review of literature. Method: Relevant databases (PubMed, google scholar etc.) were searched and literature were reviewed from 1995 to 2019. Literature from non-Scopus and unauthorized authorizations was excluded.Result: It was observed that for MRI DWI (Diffusion-weighted imaging) is preferred and in CT, axial sections are opted. In earlier studies, it was seen that neither CT nor MRI came out to besuperior. This may be due to the previous technology used. Some studies also, suggested that Diffusion-weighted imaging is highly accurate in diagnosis of stroke and also superior to CT. Another study suggested that SWI is a new approach in visualizing the hemorrhage in acute stroke. On one hand, evidence revealed that MRI is as good as CT. While on the other hand, literature concluded that CT angiography is good for intracranial and extracranial vasculature. Some studies suggested that CT is more reliable and is readily available for stroke. Conclusion: Present study concludes that both diagnostic imaging modalities i.e., CT and MRI have their advantages in diagnosis of ischemic and hemorrhagic stroke. Also chances of stroke increases with increase in age. Other factors influencing the stroke diagnosis and treatment are type of stroke, diagnostic imaging modality available, and cost-effectiveness of diagnostic exams performed.
Chanchal Kaushik, Inderjeet Singh Sandhu, Ak Srivastava
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 51-56; doi:10.15415/jmrh.2019.52006

Purpose: Exposures to medical ionizing radiations elevate the risk of stochastic effects such as cancer in exposed individuals. It is of utmost importance to monitor the radiation doses delivered to patients and their optimization to reduce the associated radiation risks without limiting the diagnostic information. Methods: Entrance surface air kerma (ESAK) in a total of 64 adult patients in diagnostic digital Xray examinations were calculated and effective doses were estimated as per International Atomic Energy Agency (IAEA). Results: Median ESAK (mGy) and associated effective doses obtained were skull PA (0.45mGy, 0.005mSv) and skull Lat (0.25mGy, 0.003mSv). Results were compared with UK diagnostic reference levels and studies in India.Conclusion: The comparison revealed that the calculated ESAK and effective dose values wereless than the published literature. ESAK values reported in this study could further contribute toestablishing LDRLs.
Sumit Kumar, Mandeep Kaur
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 1–9-1–9; doi:10.15415/jmrh.2018.51001

The aim of the study is to estimate the extent and determinants of healthcare expenditure of inpatients on childbirth in India. The study is based on sample of 14510 women who gave birth to a child (whether live or still-birth, vaginal or caesarean). To estimate the determinants two-part models has been utilised. The results indicate that women spent on average around INR 9103 per childbirth in hospitals. There are also wide variations in the spending pattern of women on childbirth. Household size, economic status, occupation, religion, and caste impact the expenditure on childbirth in hospitals. There are also wide variations in the spending of women belonging to different geo-graphical locations of India. Surgeries/caesarean or utilisation of facilities like special room and diagnostic tests etc. also significantly increase the expenditure. Women opting for public health facilities or having insurance spend less as compared to others. Government of India should increase investment in health to strengthen its current infrastructure. There is dire need to improve the quality of public health facilities, to reduce the regional imbalances in health facilities, to improve the coverage of health insurance in India for equitable and pro-people health facilities.
Raj Kumar, Deepak Gupta
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 33–37-33–37; doi:10.15415/jmrh.2018.51005

Purpose: To assess the contact lens compliance rate by using a self-administrated validated questionnaire, the level of awareness, compliance & detectable behavioral changes, patterns or trends in contact lens users. Methods: A questionnaire ,Cross sectional prospective study to understand the compliance in contact lens wearers, the questionnaires were distributed randomly among the users at various clinical & optical outlets. Based on various studies, and taking into account time constraints the sample size of 40 was taken. The mean age of 24 years was taken without any ocular pathology and systemic disease affecting the ocular health. Result: The majority of 87% of the subjects studied, preferred the monthly modality and 13 % preferred conventional yearly replacement lenses. Considering average duration of wear 64% of the subjects showed non- compliance and prolonged their wearing schedules beyond 8 hours. 38% of the contact lens users were not taking optimum care of the lens cases. A majority of 50% of the subjects rated better cosmetic appearance the most important factor, while 25% of them rated cosmetic & better vision equally important. 68% knew the availability of extended wear contact lenses that can be worn during sleep. Optical outlets are the places where the patient is more motivated for soft contact lens. Conclusion: Cost and convenience are two factors that must be considered when educating patients about proper lens care regimens. In addition, compliance is more likely if the patient is satisfied with the medical visit.
B. Bhardwaj, A. Mahajan, M. Singh, R. Roy, R. Sharma
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 25–32-25–32; doi:10.15415/jmrh.2018.51004

Rampant, irrational and unscientific use of antimicrobials by the healthcare practitioners is adding to the problem of antimicrobial resistance. Therefore, it is of utmost importance to evolve and implement new policies, recommence research actions and pursue steps to manage the crisis of antimicrobial resistance, which can be accomplished by a well-designed Antimicrobial Stewardship programme. A prospective observational study aiming to investigate the use of antimicrobials in Intensive Care Units by means of an AMS programme was carried out in a 400 bedded tertiary level hospital in New Delhi with 140 ICU beds. This evidence-based study looksinto the prescription and consumption of antimicrobials, specifically in the ICUs, and attempts to corelate it with the resistance pattern of antimicrobials being used. All the patients being treated with antimicrobials, admitted in the ICUs of the hospital were selected for this descriptive research. Information associated with antimicrobials including the susceptibility pattern of isolates and full dosage regime of each patient from the group was obtained by conducting daily audits for a period of five months. Among the usage of different antimicrobial categories (antibacterial, antifungal and antiviral), the resistance percentage correlation was predominantly focused on theantibacterial. However, the study suggests no conclusive direct or indirect correlation between the usage of an antibacterial (in terms of prescription and consumption) and its resistance, which itself could be a cause of concern for medical practitioners.
Pawan Kumar Sharma, Poonam Sandhir
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 17–24-17–24; doi:10.15415/jmrh.2018.51003

The present paper ascertains the functional efficacy of ASHAs and suggests measures for the optimization of their functioning in Punjab. For carrying out the study, different phases included random selection of three districts followed by two health blocks from each district and three sub centres from each block and subsequently one village from each sub centre. List of eligible women who had delivered a baby during the last three months prior to the survey was prepared and at last stage, five women from each village were selected at random. The findings revealed that the norms, including the age limit, educational qualification, residence and marital status set for the selection of ASHAs revealed clear adherence of the NHM guidelines. However two-thirds of the ASHAs were covering a population of more than 1,000 persons. About 90 percent of the ASHAs couldn’t specify their job responsibilities promptly on the activities related to spreading health awareness among adolescents, promoting hygiene practices, generating awareness on preventive measures on RTI/STI, HIV/AIDS, tobacco and alcoholism. About 94 percent of ASHA workers had received drug kit. However there were delays in the replenishment of drugs. As per NHM guidelines, no drug kit has AYUSH medications in it. Inter-sectoral collaboration among the ASHAs, ANMs, PRImembers and AWWs was more or less satisfactory even though ASHAs intervention in VHSNC meeting was not encouraging due to non-cooperation of other stakeholders. For strengthening of the ASHA programme, it is essential that the factors discouraging them are addressed properly.
Raj Kumar, Kavita Bhatnagar, Ashok Kumar Khurana, Naveen Meena, Himanshu Tripathi
Journal of Multidisciplinary Research in Healthcare, Volume 5, pp 11–15-11–15; doi:10.15415/jmrh.2018.51002

Several methods have been publicized to measure the fornix depth but the error in the measurement makes them inconvenient for the correct diagnosis of fornix depth in the eye. In view of the cruelty of disease the precise method is needed to correctly evaluate the fornix depth measurement. In this report, a novel approach is being addressed, to solve the depth measuring issue with the logical experimental design. The explanation with the proposed hypothesis is described here with the relevant scientific approach, the emphasis of certain advantages of the present invention over the conventional measurement approaches. In this case the diagnosis and the process of diagnosis should be accurate, but in the field of ophthalmology an accurate measurement of fornix depth without committing any error was a challenging task. So far in the development of the measurement of fornix depth is concern. Currently, we discussed a novel method for the measurements of fornix depth in ophthalmic eye, which will be beneficial to get the accurate value, however it was not possible in the previously reported methods. It will have many advantages over the existing methods.
, Sougrakpam Sushillo Singh, Priya Ravi
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 101-107; doi:10.15415/jmrh.2018.42009

Purpose: The operation theatre is the major cost and revenue centre in a hospital. The operation theatre’s optimum utilization will not only increase the revenue for the hospital but will also have a significant positive impact on customer satisfaction, for both internal and external customers. The present study aims in improving the existing process in an operation theatre suite of a tertiary care private hospital in Siliguri (West Bengal), which suffers from a process related problem, delay in scheduling operations (Sigma level 2.17), as found out in the Pilot Study. The study is carried out to improve the sigma level. Aligning with it, the operation theatre utilization is calculated with the objective of its bench marking, as per industry standards. Design/Methodology/Approach: The study is conducted within the framework of Defining, Measuring, Analysing, Improving, and Controlling (DMAIC) method of Six Sigma. To begin with, the Pilot Study is carried out to identify and define the problem. At the measuring and analysing stage, Pareto analysis technique is employed, aided by the Cause and Effect diagram. After the identification, causes are categorised as controllable and uncontrollable. This is followed by a brainstorming session, which is conducted in order to work out solutions relating to controllable causes. The Time Motion study data of 192 surgery cases is collected for the pre-implementation phase, while that of 236 surgery cases is collected for the post-implementation phase. An independent t test is carried out to find out the difference in the outcomes, both in the pre-implementation and the post-implementation phases, thereby reflecting the effectiveness of the solutions implemented. Findings: The baseline sigma level of 2.17 is improved to reach the 3.0 sigma level, concerning delay of scheduled operations. This is achieved by reducing the time lag that is experienced when shifting the patient from the Ward to the Operation Theatre, as also that relating to the cleaning and setting up of the Operation Theatre, between two surgeries. Practical implications: Reducing the set up and the cleaning time between two procedures helps in reducing the delay in scheduled operations, which can be achieved by the practice of shifting the patient one hour prior to the scheduled surgery. Similarly, when more surgeries need to be performed, their turnaround time can be reduced by deploying an adequate number of housekeeping staff. Thus, more number of surgeries can be done in a day and operation theatre utilization can be optimised.
R Kaur, M Khurana, R K Virk, A Sharma
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 77-81; doi:10.15415/jmrh.2018.42006

Biofilm refers to a group of microbes colonizing together and often adhered to a surface. The adherence is attributed to secretion of polymeric substances comprising of extracellular DNA, proteins, and polysaccharides thereby limiting the access and inhibitory activity of existing antimicrobial agents. Biofilm are a major cause of acute infections and pose immense clinical threat especially in conditions employing the use of invasive devices thus being a major source of mortality and morbidity. Hence there is a dire need to develop alternative treatment against biofilm-related infections. Advances in nanotechnology has opened new horizons. Nanoparticles derived from various metal present promising candidates to ameliorate biofilms owing to their antioxidant potential.
Santosh Kumar Sharma, Anil Kumar
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 83-93; doi:10.15415/jmrh.2018.42007

The ageing population, increasing pollution, and lethargic life style of human beings are some of the primary reasons for the growth of healthcare sector. Indian entrepreneurs have observed this growth opportunities and providing healthcare services in multiple ways. However, the literature emphasizes that without integrating information technology in existing healthcare facilities, quality service cannot be rendered to a large number of patients. With this backdrop, the present study is a novel endeavour to explore the role of information technology in Indian healthcare services. It aims to explain the relevance and dimensions of information technology in relation to healthcare services and examines the empirical relationship between identified dimensions and some demographical factors (age, educational qualification, income, and gender).The results of this study can be beneficial to healthcare professionals, service enablers, implementing agencies, and policy makers. Limitations, further research directions and conclusions have been discussed.
Pratyush Ranjan, Peeyush Ranjan
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 95-100; doi:10.15415/jmrh.2018.42008

Focus on service-profit chain by organizations in the service sector has been found to be of crucial importance. Companies in varied sectors like banking, airlines, restaurants and healthcare have become industry leaders by focusing on aspects of service-profit chain. This paper presents an analysis of service-profit chain in the healthcare sector. Taking two examples of hospitals from India and one from abroad this paper brings out the importance of focusing on the service-profit chain in this sector. An analysis of the practices in these hospitals, with a major focus on Aravind Eye Hospital, will give a perspective of how these hospitals have focused on the service-profit chain and made them efficient and effective and have enhanced their customers’ satisfaction. Service-profit chain analysis can help healthcare organizations to be customer focused. It can motivate organizations to develop attractive value propositions for customers. It can also provide a warning to organizations that are neglecting the interests of employees. Overall, the service-profit chain provides a useful framework for healthcare organizations in developing their strategy as well as implementing day-to-day operations.
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 109-113; doi:10.15415/jmrh.2018.42010

Technological innovations in healthcare are bringing a huge change in care and delivery system. Technology has improved accessibility as well as affordability in healthcare. But, does this technology provide the humane emotions that improve the patient experience. This article examines the technology role and humane concerns in healthcare and concludes that technology along with humane touch would help the healthcare industry to provide quality of care, on time.
Sunil Das
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 23-35; doi:10.15415/jmrh.2017.41003

This Paper aims at evaluation of Critical Success Factors (CSF) and its attributes in Indian healthcare. Various problems of health care industry through analysis of factors and its attributes using factor analysis, correlation and other framework parameters has been done. It was found that Human Resource Capability, Infrastructural Resources were the most significant CSFs apart from Operational process, Team management and culture. Surprisingly findings revealed that factors namely Top Management and Leadership were least significant. As there is no clear framework for excellence in healthcare, where stakeholders are an integral part of complete service, developed CSF and its connectivity to attributes may help to resolve the service level issues of Indian Hospital.
Gurpreet Kaur, Preety Narula, Harpreet Kaur
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 51-66; doi:10.15415/jmrh.2017.41005

Background of the study NST is a simple, non invasive test performed in pregnancy over 28 weeks of gestation. Pregnant women are generally positioned in the supine position because this position allow easy administration of the test. But supine position cause aortacaval compression which decrease blood supply to the fetus hence shows non reactive results. Hence position is one of the main factor which should be considered during non stress test. Methodology Aquasi experimental design was used. Total 60 antenatal women (30 experimental group I, 30 experimental group II) was selected by purposive sampling technique. Data collection method- Baseline maternal foetal bio-physiological parameters were assessed by performing NST for 10 minutes in baseline position(supine position) among experimental groups and then after a gap of 10 minutes semi-sitting and left lateral position was given to experimental group I and II respectively. Maternal and foetal bio-physiological parameters were assessed after 10 minutes of NST in both experimental groups I and II.Results Result of the present study revealed that baseline (supine) when compared with Semi-sitting position had significant effect on maternal foetal bio-physiological parameters at (p
R Kaur, M Khurana, M Bindal, A Sharma
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 37-49; doi:10.15415/jmrh.2017.41004

The present study is concerned with the development and characterization of bioadhesive carageenan gel encapsulating Amphotericin B and Lactobacillus acidophillus, prepared by graft co-polymeriztion against Candidal vaginitis. Intravaginal gel systems based on bioadhesive polymer (carrageenan) were characterized with respect to swelling index, bioadhesive strength, percent encapsulation and in vitro drug release antimicrobial studies. A marked increase in swelling index of gel encapsulating Lactobacillus was found to be 1.9±0.35. The percent encapsulation of drug was found to be 98.63%±.0.2% and that of Lactobacillus was 91.81 ±0.01. The viability was observed for interval of 6 hrs on trypton soya agar and showed that viability was highly conserved till 4 hrs. The antimicrobial study of gels encapsulating Amphotericin B and Lactobacillus showed that carageenan gel can inhibit Candida albicans upto a maximum extent. Bioadhesivity study also conducted for gels that showed a bioadhesivity of 84.66% ±.0.5% with drug, 88.66% ±.02% with Lactobacillus. In-vitro drug release showed a sustained type release of drug from the polymer i.e. there was initial burst of Amphotericin B up to 5 hours, after which there was a sustained release upto 10 days. Thus it has been concluded from the present study that bioadhesive gels encapsulating Amphotericin B can act as promising drug carriers along with Lactobacillus against candidal vaginitis.
Poonam Joshi, Meena Joshi, Aakansha Sharma, Anu Sachdeva, Rajesh Sagar, Ashok Kumar Deorari
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 1-9; doi:10.15415/jmrh.2017.41001

This quality improvement initiative was undertaken in a tertiary care neonatal intensive care unit (NICU) to improve communication between the HCP and parents related to the sick neonates admitted in NICU as measured by increase in parental satisfaction score from base line (34.5%) to 80% in 3 months time. A team was formulated to evaluate the reasons for low parental satisfaction resulting from communication between HCP and the parents of sick neonates and to further plan strategies for improving the same. Multiple PDSA cycles were implemented. The results of the all PDSA cycles were discussed amongst team members. Satisfaction of parents related to communication with HCP increased to more than 80% in 3 months time followed by increase up to 90% in sustenance phase. Multiple simple feasible interventions led to improvement in communication between the HCP and parents as evident by increase in satisfaction score (40.8 ± 4.3 vs. 40.8 ± 4.3 vs. 91.3 ± 4.8, p < 0.001). There was significant improvement in the satisfaction scores of the mothers on communication related to sick neonate in NICU at the end of intervention phase as well as in the sustenance phase. Multiple simple doable and feasible interventions had led to the improvement in communication between the HCP and parents hence improving the satisfaction of parents related to their communication with HCP.
Habtamu Molla Tesfaw, Kelemework Hussien
Journal of Multidisciplinary Research in Healthcare, Volume 4, pp 11-21; doi:10.15415/jmrh.2017.41002

Background Medical laboratory commodity management system especially storage system of laboratory supplies is a challenge for health professionals. Lacks of proper storage condition for laboratory commodities causes damaging commodities and stock out of essential supplies. The need of proper store management has gained a great attention for better laboratory service.Methods A Cross sectional study was conducted to assess storage conditions of commodities in eleven hospital medical stores in Addis Ababa from 1 January 2014 to 1 February 2014. A structured questionnaire was used to collect the data. Data was entered to EPI INFO version 3.1statistical software and analyzed with SPSS version 20 statistical analysis software. Graphs and tables were used to present the result. Results Data obtained from eleven governmental hospitals was analyzed. From these more than 45% of hospitals stores served for more than 12 years without amendments. Around 18% of hospital stores didn’t have adequate protection from sunlight whereas more than 90% didn’t have frozen storage of either -20oC or -70oC. But all of the stores had cold storage of 2-8oC. Only 36.36% of the hospital stores have separate flammable chemicals and 54.45% of hospital stores have separate hazardous chemicals. All store managers in this study are pharmacist and most of them are degree holders. Conclusion The storage conditions of majority of the hospitals have problems. Lack of adequate space and infrastructures to store medical laboratory commodities were challenges in half of the facilities. Adequate and regular training should be given to the responsible personnel for better storage of medical laboratory commodities.
Naveen Kumar, S.N.Panda, Preethi Pradhan
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 69-77; doi:10.15415/jmrh.2017.32007

Clinical scenario for critically ill patients involves large number of medical devices, such as, bed side monitors that provide vital information about the admitted patient. Critically ill patients need prompt and perfect decision, so that lifesaving drugs can be delivered at a proper time. Moreover suggestions/ recommendations of a super specialist doctor may also be required in hospitals. The main problem in hospitals is lack of specialist doctors, so, patients are not able to approach to them on time. Automatic drug delivery using microprocessor/ microcontroller has improved tremendously in recent years due to advancement in Information and Communication Technology (ICT). This paper is focused on various Drug Delivery System Interfaces used in emergency cases to reduce manual intervention. We are proposing a hybrid approach for drug dispensing, which can work as open or closed loop system. Another feature of this system is that it can be controlled from a remote location, so is to provide virtual presence of a doctor. The system will help the doctor monitor the patient as per the immediate requirement and deliver drug remotely to patient using smart phone.
R. Rajan, Paul Rajan Rajkumar
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 99-127; doi:10.15415/jmrh.2017.32010

The demand for Diagnostic Centers in India is propelled by changes in culture, increase in population, rise in infectious disease, increase in healthcare expenditure and rising adoption of preventive health check-ups. The Private diagnostic market in India has limited number of organized players and the overall market is driven by unorganized laboratories. The Diagnostic Imaging equipments such as X-ray, CT (Computed Tomography) Scanner and BMD (Bone Mineral Densitometer) need to be handled with utmost care as they have human made ionizing radiation exposure risks. India is one of the largest consumers of refurbished diagnostic imaging equipments and the beneficiaries include Diagnostic Centers, Corporate Hospitals and Chain of Diagnostic Laboratories. The Atomic Energy Regulatory Body (AERB) in India regulates the usage of diagnostic imaging equipments by evolving policies and procedures to be strictly followed by Diagnostic Centers for containing excessive radiation. The changes in procurement policy made by AERB in September 2015 have restricted importing of used diagnostic imaging equipments up to a maximum of 7 years. This regulatory change has triggered a research question, Diagnostic Laboratories - Are these Radiation Safe? This research was conducted with the objective of assessing whether diagnostic centers follow the best practices mandated by AERB. The researcher has conducted a very structured assessment on AERB compliance using 7 different parameters namely, Regulatory, Layout Engineering, Technician Competency, Human Safety, Operations Knowhow, Radiation Exposure Monitoring and Top Management Commitment. This study was conducted in 192 diagnostic centers across multiple cities in Tamil Nadu, with a structured questionnaire contained 34 questions. Based on the responses received on the actual practices followed by diagnostic centers to contain Radiation risk, Radiological Compliance Index (RCI) was estimated. The analysis has revealed that Top Management Commitment was very low with a RCI score of 2.02 (Moderate Presence of AERB recommended best practices) and Operations “Know-Know” was high with a score of 4.40 (High Presence of AERB recommended best practices). The comparative analysis of RCI between National Accreditation Board for testing and Laboratories (NABL) accredited (RCI Score 3.19) and Non NABL (RCI Score 3.18) diagnostic centers has indicated that the accreditation did not significantly influence the compliance. The Pearson correlation co-efficient has established moderately positive correlation with Revenue (+ 0.321) & Patient Queue size (+0.293) on RCI. This study has concluded with sufficient evidence and analysis that Private Diagnostic Centers need to focus on appointing Radiation Safety Officer, monitoring radiation exposure dosage, periodical equipment service, continuous training of their staff and periodical QA tests for equipment fitness in order to achieve significant regulatory compliance maturity levels. This research has further recommended similar research in private diagnostic laboratories in other states in India and comparative analysis of compliance to AERB guide lines between Government Hospitals and Private Diagnostic Centers.
Ravi Shankar Reddy
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 79-86; doi:10.15415/jmrh.2017.32008

Background: Patients withType II diabetes mellitus are showed to affect the sensory, reflex and motor systems in distal extremities. Studies have examined the mechanosensitivity and vibration threshold (VT) in type II diabetes mellitus patients in the lower limb and compared it with normal individuals. There is scanty literature available in comparison of the VTin the upper limb in type II diabetes mellitus patients with non-diabetic individuals. Methods: Thirty type II diabetic individuals (age - 55.60 ± 9.79 years)and 30 asymptomatic individuals (age - 53.43±9.96) without diabetes mellitus participated in the study. Tester at the baseline for both the groups using a bioesthesiometer measured VT. Bioesthesiometer is capable of deriving a vibration of 100 Hz. Following VTevaluation at the baseline, the tester performed the ULNT1 for all the subjects. During the sequence of the ULNT1, VTwas measured at initial onset of pain (termed as P1) and short of maximum pain (P2) as experienced by the patient. Results:There was a statistical significant difference inVTbetween diabetic and non-diabetic group subjects. VTwas raised in the diabetic group at all the three levelsof evaluation (baseline, P1 and P2) compared to the non-diabetic group with a p value < 0.001. Conclusion: VT of the upper limb is higher in individuals with type II diabetes mellitus as compared to non-diabetic individuals.
Mohd Taqi, Swati Bidhuri, Susmita Sarkar, Wani Suhail Ahmad, Padma Wangchok
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 125-149; doi:10.15415/jmrh.2017.32011

Health and well being of human resource plays an important role in the economic as well as social development of the country. To ensure better health of the people an adequate healthcare infrastructure is of primary importance. Inadequate infrastructure generally leads to poor quality of health services which is positively dangerous to health and welfare of the community at large. About 68% of India’s population still lives in rural areas, yet healthcare infrastructures in these areas are in pathetic condition. There are very few government health centers and even those are devoid of most of the medical facilities and personnel’s. Although the National Rural Health Mission (NRHM), launched in 2005 has made significant progress in the healthcare infrastructure (mainly in physical infrastructure) in rural areas and has impacted the lives of rural masses to some extent but it has simultaneously failed to bring desired results because of lack of implementation. So the accessibility and availability of health facilities as well as delivery of quality services in the rural areas deserve considerable attention from planners, researchers and healthcare workers. In this context, the present paper critically examines and evaluates the disparities in availability as well as accessibility of health infrastructure in rural areas of India.
O L Badaki, M F Adeola
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 151-159; doi:10.15415/jmrh.2017.32012

This study investigated peer pressure influence on premarital sexual behaviour of senior secondary school students in Kaduna State, Nigeria. The population for the study comprised students in public senior secondary schools in the twenty-three Local Government Areas of Kaduna State. Simple random sampling was used to select Kaduna North senatorial zones from the three existing zones in Kaduna State. Nine schools from thirty-two senior secondary schools were randomly selected. The population of senior secondary schools in Kaduna North zone was 5,730 in 2010/2011. 50% (2,865) of the population was used as sample size. A total number of 1,655 males and 1,210 female students were used. In each of the nine (9) schools, 319 copies of questionnaire were administered to the Students using simple random sampling technique. The data collected were statistically analyzed using descriptive statistics of mean, and standard deviation. The hypothesis was tested using one sample Z-test at 0.05 level of significance. It was found that, there is significant influence of peer pressure on premarital sexual behaviour among senior secondary school students in Kaduna State, Nigeria. It was recommended, that Kaduna State Ministry of Education to intensify awareness programme on premarital sexual behaviour through workshops or seminars for the students on how to deal with peer pressure, and other social pressures that may lead to sexual intercourse.
Meenakshi Sood, Preethi Pradhan
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 27-36; doi:10.15415/jmrh.2016.31004

Khalid A Alahmari
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 19-26; doi:10.15415/jmrh.2016.31003

Jaspreet Kaur Dullat, Ms Aanchal, AmritPal Kaur, Atinderpal Kaur, Bhupinder Kaur, Ms Chanderkanta
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 11-18; doi:10.15415/jmrh.2016.31002

Abdulmalik Sabitu, Magaji Yunusa Matazu, Ibrahim Sukola Tambaya
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 1-9; doi:10.15415/jmrh.2016.31001

Prema Chande, Tupti Khaladkar, Sweta Patel, Vinit Shah
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 37-42; doi:10.15415/jmrh.2016.31005

Ravirani Samuel, Manal M M Abdulrazzaq, Badr AbdullGaffar, Hassan Y Hotait, Mouza Al-Sharhan
Journal of Multidisciplinary Research in Healthcare, Volume 3, pp 43-55; doi:10.15415/jmrh.2016.31006

S. Paul Silvian, Priyanka G, Sayeda Begum, Gemini V Joy, S Senthil Kumar
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 149-156; doi:10.15415/jmrh.2016.22010

Rajaram Yadav, , Shrestha Saha
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 133-148; doi:10.15415/jmrh.2016.22009

Prema K Chande, Urmi Vora
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 113-123; doi:10.15415/jmrh.2016.22007

G N Sumathi
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 103-112; doi:10.15415/jmrh.2016.22006

Pratima Miglani
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 55-72; doi:10.15415/jmrh.2015.21004

Habtamu Molla Tesfaw, Aster Tsegaye, Fatuma Hassen
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 1-16; doi:10.15415/jmrh.2015.21001

Kalosona Paul, Shrestha Saha
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 31-54; doi:10.15415/jmrh.2015.21003

Yetayale Berhanu
Journal of Multidisciplinary Research in Healthcare, Volume 2, pp 73-90; doi:10.15415/jmrh.2015.21005

Manisha Kumari Patro
Journal of Multidisciplinary Research in Healthcare, Volume 1, pp 133-136; doi:10.15415/jmrh.2015.12009

Vandana Vp
Journal of Multidisciplinary Research in Healthcare, Volume 1, pp 137-142; doi:10.15415/jmrh.2015.12010

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