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Results in Journal International Journal of Medical Sciences and Nursing Research: 19

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Sudharsan Vasudevan, Samiksha Singh, Nisha Newar, Amaljith AB
International Journal of Medical Sciences and Nursing Research, Volume 2, pp 5-9; https://doi.org/10.55349/ijmsnr.20222159

Abstract:
Background: Covid-19 an illness caused by SARS- COV-2 virus, it has killed millions of people all over the world and has wreaked havoc in India too. Even today there is no confirmed drug that can successfully tackle the illness. According to WHO, efficient vaccines and equitable access to them is vital to curbing the Covid-19 pandemic. Materials and Methods: With the help of a semi-structured question guide, six focus group discussions were conducted in several villages in East Khasi hills Meghalaya, each focus group had 6-12 participants, thematic analysis was used to analyze the data. Results: Most of the villagers are affected by covid-19 and the lockdown measures to curb it, but their perceptions on vaccinations were negative. Certain thematic areas that seemed to repeat were, religious beliefs, lack of awareness, individual freedom to choose, not feeling like they require it as they are just agricultural laborers, fear of side effects, and the prevalence of negative propaganda on social media. Most believe if it’s mandatory to take the vaccine everyone would take it. Few village heads suggested better awareness might be able to convince a few. Conclusion: The majority said they were not ready to get vaccinated, and cited religion and individual freedom to choose as the reasons for their reluctance. Health awareness programs and more pro vaccine governmental policies may help improve coverage. Keywords: covid-19, covid vaccination, tribal health, vaccine hesitancy, Meghalaya
International Journal of Medical Sciences and Nursing Research, Volume 2, pp 17-19; https://doi.org/10.55349/ijmsnr.2022211719

Abstract:
Research is the main key method of the advancement of medical field. It is a continuous process and it gives the new and best method/way of new treatment/way of medication in the medical field. It is an important and essential education method in the medical education curriculum in India. Not only in India, doing research and submission it in a proper way or method is a mandatory procedure in the medical education process in worldwide medical education. Anybody wants to prove their finding in medical or any other field then; they will do some research with proper permission and procedure and submit their finding using by biostatistical tools and applications and to prove scientifically in a proper way. Research is very much useful to find the consequences, and other information about Covid-19 pandemic to doctors/scientist/health care providers’/policy makers/State and Central Governments to take necessary precautionary measures. Biostatistics means the application of statistical tools to scientific research in health care related areas like medicine, biology, and public health. From research only, one can prove or develop a new method or tools or procedure to a new area/field by using biostatistical tools or methods. Research and applications of biostatistical tools are interrelated with each other. Without using of biostatistical tools, no one has to prove their findings are scientifically. So, it is the back bone of any kind research/study. These two things are very important in our Indian medical education/curriculum and other foreign countries also. So, in this short communication, I have to discuss about the needs and importance of research and biostatistics concepts and its applications in the under graduate and post graduate medical education. Keywords: medical education, medical curriculum, under and post graduate students, research, biostatistical tools, India
, Amitha Prasad
International Journal of Medical Sciences and Nursing Research, Volume 2, pp 10-16; https://doi.org/10.55349/ijmsnr.2022211016

Abstract:
Background: This study aimed to determine the prevalence of Diabetic Retinopathy and to find the associated risk factors of DR among known Type II DM patients. Materials and Methods: A hospital-based cross-sectional and single center study was conducted among Type II DM patients with and without DR in the department of Endocrinology with a sample size of 150 with DM patients in 2018. Data were expressed as mean, standard deviation, proportions, Chi-Square, t-test test and Binary Logistic Regression analysis. Results: Diabetic patients 150 were identified as Type II DM as per inclusion criteria with aged 30 years and above. Among 150 Diabetic patients, 39 (26%) patients had Diabetic Retinopathy and 111 (74%) patients were not having Diabetic Retinopathy. The association between groups (with and no DR) and duration of DM were very highly significant with p-value < 0.01. DR prevalence was higher in female when compared with male population. Conclusion: From our study, we have concluded that the prevalence of DR was very high. DR was strongly associated with HbA1C, FBS, duration of DM, medication, duration of hypertension and smoking. Hence, there is a need for regular screening check-up with ophthalmologist to prevent diabetic retinopathy or to prolong or to escape from the vision loss. Keywords: type II diabetic mellitus, diabetic retinopathy, prevalence, risk factors
Balasubramaniam Ramakrishnan, Senthamarai Kannan Kaliyaperumal, Mahalakshmi Rajendran
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 23-28; https://doi.org/10.55349/ijmsnr.2021122328

Abstract:
Background: The developed Semi-Markov model with Kumaraswamy Exponentiated Inverse Rayleigh distribution examined patients with hypertension, heart diseases, smoking habits and Stroke, is measured from one state to another. Materials and Methods: Patients with Non-Communicable disease described through Kumaraswamy Exponentiated Inverse Rayleigh distribution. Results: The estimated parameters of Semi-Markov model with this distribution predicted by the maximum likelihood estimation for each successive state observed significant abnormality. The data noted predicts established model is a good fit for many attributes that prevailed in studied data. The developed Semi-Markov model is a best fit for non-Communicable disease in the long run of patient’s data. Through different Exponential family distribution, one can look at for further perfect fit of patient data, which is to be estimated. Conclusion: This model can be an alternative method to estimate the effect of patient in survival analysis, where it will be effective in time consumption in medical field. Keywords: heart diseases, hypertension, Semi-Markov processes, smoking, stroke.
Amitha Prasad,
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 5-9; https://doi.org/10.55349/ijmsnr.20211259

Abstract:
Background: Diabetic Retinopathy is a non-communicable disease and metabolic disorder. It is a public health problem in Worldwide. In this paper, finding influencing factors and how much probability to development of DR among known T2DM patients. Materials and Methods: This was a hospital-based cross-sectional and observational study among T2DM patients, with and without DR in the diabetes clinic with sample of 150 patients. Statistical analysis used chi-square and binary logistic regression analysis was used to identify correlates of DR after controlling of confounders. Results: In this present study, among 150 patients, 39 (26%) patients had DR. Smoking habit was strongly associated with development of DR (AOR=15.39, p=0.002), patients had history of hypertension was associated with DR (AOR=1.10, p=0.016), medication, in that insulin users were strongly associated with DR (AOR=5.72, p=0.002), duration of diabetes mellitus with >10 years was associated with DR (AOR=1.18, p=0.001), total cholesterol with abnormal was 5-fold more increase in risk with the development of DR (AOR=5.86, p=0.065) but not significant, high hba1c with >6.5% was associated with the progression of DR (AOR=1.34, p=0.035), and fasting blood sugar with abnormal was associated with the progression of DR (AOR=1.01, p=0.027) except age but, showed positive association with DR. Probability of developing DR in a T2DM patient was 98%. Conclusion: From this study, we revealed that influencing variables were hba1c, smoking habit, intake of tablet/insulin, duration of DM, history of hypertension and fasting blood sugar. The chance/probability of developing retinopathy was very high among known diabetes patients those who had longer duration of DM. Hence, we have recommended a periodic eye screening is mandatory in T2DM patients. Keywords: diabetes mellitus, diabetic retinopathy, influencing factors, probability, multivariate analysis
, Ezhilan Naganathan, Betty Chacko
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 10-18; https://doi.org/10.55349/ijmsnr.2021121018

Abstract:
Background: Incidence of diabetes mellitus continues to rise, common focus areas for diabetes control are blood glucose levels, diet, and exercise. Controlling these factors are essential for a better quality of life in diabetes patients. Patients with diabetes have an increased risk of asymptomatic bacteriuria and pyuria, cystitis, and, more important, serious upper urinary tract infection. Materials and Methods: This was a hospital based descriptive and cross-sectional study which included 250 Study subjects who were admitted in CSI Kalyani General hospital during the period from July 2017 to July 2018 and who has Diabetic as a comorbidity were interviewed using structured protocol based proforma. Patient underwent routine clinical, pathological and biochemical investigations. Results: In this study, 250 in-patients were included and analyzed. The prevalence of Infection in Diabetes mellitus was 65.6%. There is no significant association between Age, Education, Occupation, HbA1C, Duration and type of treatment and biochemical values. The commonest organism in Urine sample among the study group was E.coli followed by Klebsiella. UTI is more common in females, Respiratory infection is more common in males and it is statistically significant (p<0.009) and it is statistically significant (p<0.007). Conclusion: From this study, we have concluded that patient with diabetes mellitus is at increased risk for common infections due to poor glycemic control and Obesity. Poor glycemic control suppresses the immunity and more prone for infection. Therefore, the challenges will be to attain good glycemic control, change in lifestyle to maintain normal BMI. This will prevent the morbimortality, reduce the long-term complication and maintenance to prolong the life without any sequele. More prospective case control studies on the management of infections in DM patients are needed. Keywords: type 2 diabetes mellitus, infections, clinical profile, hba1c, glycemic control
, Murugan Natesan
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 29-37; https://doi.org/10.55349/ijmsnr.2021122937

Abstract:
Background: Iodine deficiency disorder is common public health problem in developed and developing countries. In Worldwide, nearly 70% of the households only using adequate iodized salt in their regular food. To estimate the household salt utilization, prevalence of goiter, status of iodine deficiency disorder, and to find the iodine level at household level in the study areas. Materials and Methods: We have done a community-based observational study on IDD in the coastal areas of Villupuram District, Tamil Nadu with examined households salt in 1233 households in selected eight villages. All data were analyzed using Chi-Square test. p–value<0.05 was considered as statistically significant. Results: Totally 1233 households were recruited and incorporated in this study. Among 1233 households, male 385 (31.2%) and female 848 (68.8%). The male and female age-group was showed statistically highly significant association with p0.05). Conclusion: From our present study findings, we have concluded that majority of the study population was used iodized salt in their regular food. But, very less adequately iodized salts were available nearby study areas. Nevertheless, majority of the households didn’t know about the benefits about the usage of iodized salt. Health education is needed in to the shopkeepers and local vendors. This will be conducted by non-Governmental organization, Government organization and other nearby medical colleges. Keywords: household salt, utilization, iodine, iodine deficiency disorder, coastal areas
, Senthamarai Kannan Kaliyaperumal, Balasubramaniam Ramakrishnan
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 19-22; https://doi.org/10.55349/ijmsnr.2021121922

Abstract:
Background: The HIV virus carries projection of significant global population with specific estimations of the mathematical results of evolutionary methods which was presented in Tree Hidden Markov model (HMM). Materials and Methods: Hidden Markov models used to model the progression of the disease among HIV infected people. The author predicts a Baum Welch Algorithm method through HMM that can assess an unknown state of transition. Results: The Tree HMM model predicts the break down point starts once patient is infected with the HIV virus as it affects the immune system. The immune system drops more quickly in the initial inter arrival time when compared with the later time interval. The HIV virus length in the nth state within regrouping is uncertain to occur in each state of the given model. A simulation study was done to assess the goodness of fit for the model. Conclusion: The HIV virus length in the nth state within regrouping is uncertain to occur in each state of the given model. The inter arrival censoring between each state is essential in each infected HIV patients. The outcome of this works states that health care expert can use this model for effective patient cares. Keywords: expectation, hidden markov model, human immunodeficiency virus, immune system, transition
, Cardiac Specialty Hospital Specialist Nurse, Nian Hamaamin Ahmed, Dlawer Dhufr Farhad, Cardiac Specialty Hospital Cardiologist
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 22-28; https://doi.org/10.55349/ijmsnr.2021112228

Abstract:
Background: Cardiac catheterization (CC) is the inserting of a thin, hollow catheter into a chamber or vessel; it is done for diagnostic and intervention purposes. Death charges from coronary heart disease have decreased in recent decennium, however, coronary heart disease is still a major cause of morbidity and mortality worldwide especially in developed countries. Coronary heart disease refers to different conditions of failing circulation of the heart and includes myocardial infarction (MI). In this study, we assessed the patients’ knowledge regarding CC. Materials and Methods: A descriptive study was conducted with a purposive sample of 250 patients were selected and included from Cardiac Specialty Hospital in Slemani City, Iraq. This study was carried out between November 2017 and October 2018. A self-conductive questionnaire was used for data collection. Results: Totally 250 patients were included in this study. Among 250 patients, 176 (70.4%) were males and 74 (29.6%) females. The validity of the questionnaire was estimated through a panel of experts related to the field of the study, and its reliability was determined through a pilot study which was carried out on 105 patients who were selected purposively from the patient were admitted those who have undergone the procedure at Cardiac Specialty Hospital in Slemani city. Most 70.4% of the participants were male and the majority 212 (84.8%) were Kurdish and more than a quarter of the patient’s age was in group 60 years and above. Among 250 patients, 202 (80.8%) were married and 117 (46.8 %) of study participants were illiterate, 171 (68.4%) of them were unemployed, and 148 (59.2%) were lived in an urban area. Conclusion: Our present study showed that the majority of participants had a low level of knowledge regarding CC as well as the level of knowledge from post-CC was higher than pre-CC procedure. Key Words: patients’ Knowledge, cardiac catheterization, pre and post-cardiac catheterization, Slemani City, Iraq
, Manish Taywade, Sujata Devi, Saurav Nayak, Dipti Sudha M
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 17-21; https://doi.org/10.55349/ijmsnr.2021111721

Abstract:
Background: One of the commonest complications of poorly controlled Type 2 diabetes mellitus (T2DM) is Diabetic nephropathy (DN), which occurs in 30-40% of DM cases. It is important to identify the high-risk group who are likely to develop DN with the modifiable and non-modifiable risk factors. This study had the objectives to estimate and correlate the levels of the urine albumin creatinine ratio (UACR) with age, anthropometric measures, glycaemic control markers, lipids, and renal function. To estimate each variable as independent and multivariate risk factors. Materials and Methods: It was an observational and cross-sectional study conducted in a tertiary care center in Eastern India. Totally, 221 consecutive ambulatory T2DM subjects were recruited after obtaining their written consent. Results: The diabetics were classified as having diabetic nephropathy by the urine albumin creatinine ratio (ACR) of >30 mg/gm. 53.4% of our study group had DN. There was a significant risk associated with PPBS with p=0.043 (<0.05), serum creatinine with p=0.032 (<0.05), and urine albumin with p=0.0001 (<0.001). In the multivariate regression analysis of all these variables, there was a highly significant likelihood ratio for predicting DN with p=0.0001 (<0.001) with a predictive value of 74.5% in females and 75% in males. Conclusion: The additive factors contributed by the risk factors in the prediction of DN will benefit the DM in the prevention of DN. Keywords: diabetic nephropathy, risk factors, diabetic kidney disease, Asian Indian
Smyrna Gnanasekaran, Mohana Rangam Thirupathi, Ashok Kulasekar
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 3-7; https://doi.org/10.55349/ijmsnr.2021.1112

Abstract:
Background: Over recent years, there are lots of advancements in providing adequate postoperative analgesia for pediatric patients who are undergoing infra-umbilical surgeries. Of which, the caudal block is a type of neuraxial block that is simple, easy to administer with more reliability, thus providing a very effective pain–free period. This study aimed to compare the efficacy of Ropivacaine with dexmedetomidine and dexamethasone in pediatric circumcision surgeries. Materials and Methods: The prospective, randomized, double-blinded study included 60 children (30 children in each group, assigned by computer-generated randomization code). In Group I: 0.25% Ropivacaine 0.5 ml/kg + Dexmedetomidine 1mcg/kg. Group II: 0.25% Ropivacaine 0.5 ml/kg + Dexamethasone 0.1 mg/kg. Results: FLACC score was used to assess the postoperative analgesia. The mean duration of postoperative analgesia was 478.04±61.22min in the Dexmedetomidine group and 530.07±134.04 min in the Dexamethasone group which was statistically significant. The sedation score was better with Dexmedetomidine Group compared to Group Dexamethasone. Conclusion: Our study proved that caudal administration of 0.25% Ropivacaine with Dexamethasone (0.1 mg/kg) resulted in a longer duration (530.07 minutes) of action compared with 0.25% Ropivacaine with Dexmedetomidine (1 mcg/ kg) and the sedation was better with Dexmedetomidine when compared to dexamethasone, without any other significant differences in the hemodynamic parameters and the incidence of adverse events. Keywords: Caudal, Analgesia, Postoperative, Ropivacaine, Dexamethasone, Dexmedetomidine
Jai Thilak Kailathuvalapil
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 8-11; https://doi.org/10.55349/ijmsnr.202111811

Abstract:
Background: Blood transfusion is one of the major concerns following Total Knee Arthroplasty. We assessed the incidence rate of blood transfusion (packed red cells) in our geographical group based on age, gender, preoperative Haemoglobin and following both unilateral and bilateral primary TKA done either in single-stage or sequentially after a week. Materials and Methods: This was a retrospective observational study that included 200 patients who underwent primary TKA unilateral, bilateral done in single-stage and sequential from June 2015 to May 2016. Two doses of parenteral Tranexamic acid and periarticular cocktail injection was given. Transfusion was indicated with postoperative Hgb below 8 g/dl associated with or without clinical signs of tissue hypoperfusion. Results: The study group was 200 patients with the age group of 50-81 years, of which 154 (77%) were female and 46 (23%) were male and had a mean preoperative Hgb level of 12.6 g/dl. 88 (44%) unilateral, 40 (20%) bilateral and 72 (36%) sequential TKA were performed and 7 (7.95%), 12 (30%) and 26 (36%) patients received blood transfusion respectively. Among the transfused 45 patients, 38 patients were bilateral group, of which 30 (66.6%) patients had a preoperative Hgb level of 10–12 g/dl, indicating a high incidence of transfusion in bilateral cases compared to unilateral and with preoperative Hgb levels of 10–12g/dl which was statistically significant with p-value <0.05. Conclusion: In our study, age and gender were not the major factors for blood transfusion, but low preoperative Hgb levels and bilateral single stage and sequential TKA showed a significantly higher incidence of blood transfusion. Keywords: total knee arthroplasty, blood transfusion, preoperative Hgb
Sonali Devarajan, Samyuktha Mylsamy, Tamizhini Venkatachalam,
International Journal of Medical Sciences and Nursing Research, Volume 1, pp 12-16; https://doi.org/10.55349/ijmsnr.2021111216

Abstract:
Background: The COVID-19 pandemic has created a wide range of crises affecting many nations, resulting in adverse health consequences. The implementation of the lock down upended the lifestyle of mostly all people and was associated with disturbed sleep. Our study is to estimate the variation of the sleep-wake cycle during lockdown and after lock down among people of age 15-60 and its impact on Psychological wellbeing. Materials and Methods: We have done a cross-sectional and descriptive study with a sample of 152 participants was formed using convenience sampling method by online google form. They were administered with The Munich Chronotype Questionnaire (MCTQ) and The Flourishing scale. The responses were collected during and after lock down. The data obtained is subjected to descriptive analysis. Results: In this study we have included 304 participants. Out of 304 participants, 151 (49.7%) were male and 153 (50.3%) were female. Flourishing scale scores mean during lockdown was 28.83 ± 4.75 and after lockdown was 41.50 ± 4.42 and the mean value was more in after lockdown period and a paired-t test showed statistically highly significant difference at p-value <0.01. Conclusion: The variation in the sleep-wake cycle was more in adolescents than in other age groups and the Psychological wellbeing of women was affected more than men in all age groups during lockdown. Key Words: lockdown, sleep-wake cycle, psychological wellbeing, age difference, gender difference
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