JMRH Vol. 5 No. 1 (October 2018)

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    Contextualizing the Relevance of Antimicrobial Resistance in the Drug Prescription and Consumption Pattern of a Tertiary Level Hospital
    (Chitkara University Publications, 2018-10-08) B. Bhardwaj; A. Mahajan; M. Singh; R. Roy; R. Sharma
    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 looks into 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 the antibacterial. 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.
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    Awareness and Compliance in Contact Lens Wearers: Case Study
    (Chitkara University Publications, 2018-10-08) Raj Kumar; Deepak Gupta
    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.
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    A Method: Fornix Depth Measurement in Ophthalmic Socket
    (Chitkara University Publications, 2018-10-08) Raj Kumar; Kavita Bhatnagar; Ashok Kumar Khurana; Naveen Meena; Himanshu Tripathi
    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.
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    Functioning of ASHAs under National Health Mission in Punjab: An Appraisal
    (Chitkara University Publications, 2018-10-08) Pawan Kumar Sharma; Poonam Sandhir
    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, PRI members 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.
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    Healthcare Expenditure on Childbirth in India: Two Part Model Analysis
    (Chitkara University Publications, 2018-10-08) Sumit Kumar; Mandeep Kaur
    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.