Background: Prophylactic milrinone is commonly used to prevent Low Cardiac Output Syndrome (LCOS) after pediatric cardiac surgery. This study compares the use of levosimendan with milrinone when used as the primary inotrope following pediatric cardiac surgery. Subjects and Methods: Forty infants undergoing corrective surgery for congenital heart disease were recruited during the study and randomized into two groups (group L and group M). During rewarming, a loading dose of levosimendan or milrinone was administered followed by a 24-hour infusion of the chosen inotrope. Echocardiographic variables were measured postoperatively. Statistical analysis was done with SPSS-20 computer package. Association between the variables was found by independent t test. P < 0.05 was considered statistically significant. Results: Mean age and weight of the patient in Group L was 8.55 ± 5.83 months and 6.05 ± 2.09 kgs, while that in group M was 6.85 ± 3.57 months and 5.26 ± 2.11 kgs. 4 patients (20%) treated with levosimendan had LCOS in comparison with 6 (30%) patients in those treated with milrinone. Echocardiographic parameters in both groups L and M were comparable (cardiac index 3.47 ± 0.76 vs 3.72 ± 1.05 L/min/m2, EF 66.10 ± 7.82% vs 59.34 ± 10.74%, stroke volume index 25.4 ± 6.3 vs 27.74 ± 10.35 mL/m2). The duration of ventilation, ICU stay and hospital stay were lesser in group L (12.75 ± 9.69, 35.95 ± 12.11, 119.10 ± 46.397 vs 23.60 ± 22.03, 51.20 ± 29.92, 140.20 ± 52.65 hours). Conclusions: The incidence of LCOS was lesser in those patients treated with levosimendan, when compared with those treated with milrinone. Cardiac index and stroke volume index were comparable between the two groups. Thus, levosimendan provides a non-inferior alternative to milrinone when used as the primary inotrope following pediatric cardiac surgery.

The aim of this study is to investigate the possible risk factors of poor sleep quality among patients with type 2 diabetes mellitus on insulin therapy. The factors considered were age, sex, body mass index (BMI), glycosylated haemoglobin (HbA1c), duration of diabetes and depression. A total of 202 diabetic patients aged 20 years or older were included in the study. The results showed that female sex and depression were independent risk factors for poor sleep quality among type 2 diabetics on insulin therapy. Findings may contribute to sleep disorder control in female patients with type 2 diabetes mellitus which has been linked to glycemic control. A. Sathyanarayanan et al. 207 activity are designed to prevent and manage diabetes and its complications. New strategies against the disease are needed. This is vital for the development of more efficient methods to counteract the progress of the disease and channelize our efforts directed at changes which most affect the disease. One component which is shown to have an impact is the relationship between diabetes and sleep quality [2]. Studies in other parts of the country have reported that short sleep duration or poor sleep quality may relate to glucose metabolism. Insulin administration was reported to be an important reason for the prevalence of sleep abnormalities. Data suggest that diabetes is associated with periodic breathing, a respiratory abnormality associated with abnormalities in the central control of ventilation, which in turn affects sleep [3].This can have many ramifications over the course and treatment of the patients who are on chronic insulin therapy. Not many studies have examined the factors associated with poor sleep quality in patients with type 2 diabetes using insulin. A recent study was conducted including 140 type 2 diabetics on insulin therapy. The possible risk factors that were considered in the study were age, sex, BMI, HbA1c, duration of diabetes and global PSQI score [4]. The results of the study showed poor sleep quality in females type 2 diabetes patients with insulin therapy. However, in this study depression was not considered which might confound the findings. In addition, many studies have reported a higher prevalence of depression among patients on insulin therapy [5]- [7]. The aim of the present study is to examine the factors associated with poor sleep quality among type 2 diabetes on insulin therapy. The factors considered were age, sex, BMI, HbA1c, duration of diabetes and depression.

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Background: Mitigation measures to control the novel coronavirus disease 2019 (COVID-19) depends on the public adherence to preventive measures which is influenced by their knowledge and attitude. Aim: To find the knowledge, attitudes and practices (KAP) of the rural population toward COVID-19 and to establish its socio-demographic influencing factors. Material and methods: KAP study regarding Covid-19 was done among the rural population during August 2020 using a semi-structured questionnaire. Results: Among 500 participants, the mean knowledge, attitude and practice score was 21.55± 2.9  ( Range 0- 30 ), 30.0± 2.88 ( Range 12- 36 ) 9.4± 1.25 ( Range 0-13 ) respectively. Higher knowledge was associated with higher education and employed individuals. Favourable attitude was among those aged <35 years and having higher education. Optimistic practices were exhibited by employed individuals and when children <12 years are present in their home. Conclusions: Study participants preceded good knowledge, positive attitude towards COVID-19 but practice is not sufficient enough to win the battle against the dreadful disease due to considerable knowledge- practice gap.

Introduction: India is the first country to implement National Family Program in 1952. Acceptance of contraceptive methods is influenced by various factors at the individual, family, and community level with their roots in the socioeconomic and cultural milieu of Indian society. This study was carried to find the contraceptive prevalence rate among eligible couples as well as to find the factors influencing it in a rural area of Coimbatore. Methodology: The study was carried out using the data extracted from the family health survey conducted by trained field staff for the purpose of furnishing details regarding people residing in the field practice area of Rural Health Training Centre (RHTC), Vedapatti located in Coimbatore district after obtaining Institutional Human Ethical clearance. All eligible couples were included for the study. Contraceptive prevalence is expressed in percentage with 95% Confidence interval. Univariate analysis (Chi-square test) was done to find the association between contraceptive acceptance and independent variables. Strength of association is determined by odds ratio with 95% Confidence Interval (CI). P < 0.05 was considered statistically significant. Results: Contraceptive Prevalence Rate among eligible couples was found to be 75% (95% CI: 73.6–76.4). Most commonly used method among the study participants was tubectomy (81.6%), followed by condoms (11.4%), intrauterine devices (6.3%), and oral contraceptive pills (0.7%). Higher age of the women, religion, educational status of the women, socioeconomic status, working status of the women, number of living children, age at the time of marriage, and age at the time of first child birth were found to have statistical significant association with higher usage of contraception. Conclusion: The contraceptive prevalence rate was found to be higher in this study population and multiple factors were influencing the contraception usage among the eligible couples.