BackgroundAntibiotic resistance is a major global public health concern, particularly in settings where few treatment options are available. Limited research has been done on antibiotic resistance in Escherichia coli of Indian children at community level. Therefore we studied antibiotic resistance patterns in E. coli isolates from stool samples of children aged 3-14 years from Ujjain, Central India, to investigate associations of resistance with demographic variables.MethodsChildren, 3-14 years of age, were included from 30 randomly selected villages of Palwa demographic surveillance site, Ujjain, India. Parents were interviewed using a questionnaire, and stool samples were collected from participating children. E. coli were isolated from stool samples (n = 529), and susceptibility testing to 18 different antibiotics was done using standard methods.ResultsThe proportions of isolates resistant to various antibiotics were, nalidixic acid, (45%), tetracycline (37%), ampicillin (37%), sulfamethoxazole/trimethoprim (29%) and amoxicillin/clavulanic acid (29%). No isolates were resistant to imipenem. Overall, 72% of isolates were resistant to at least one antibiotic and 33% were multi-drug resistant. High rates of cross-resistance were seen for 15 (83%) of the antibiotics studied. E. coli isolates from children with literate mothers were more resistant to penicillins and fluoroquinolones. ESBL-producers comprised 9% of the isolates.ConclusionAntibiotic resistance and cross-resistance were common in E. coli from stools of children. Resistance rates were associated with maternal literacy.
BackgroundIn recent years, there has been a massive growth in the private medical education sector in South Asia. India’s large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms.MethodsCross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province.ResultsThere were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so.ConclusionThere was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions.
INTRODUCTIONDiabetes mellitus (DM) has become major public health problem in India. It is a metabolic disorder caused by impaired insulin secretion, peripheral insulin resistance or both. It is characterised by raised blood glucose with diminished uptake and metabolism of cellular glucose as well as altered lipid and protein metabolism.1 Diabetes is not only increasing morbidity and mortality but also decreases the quality of life. Also disease and its complications are causing heavy economic burden for patients suffering from it. 2,3ABSTRACT Background: Diabetes is endemic globally with increasing prevalence in both developing and developed countries. Persistent hyperglycaemia of diabetes is associated with micro as well as macro vascular complications like coronary heart disease, stroke, diabetic renal disease, diabetic retinopathy and neuropathy etc. Dyslipidemia contribute to considerable increased risk of atherosclerosis and consequent mortality in diabetic patients. It often precedes onset of diabetes particularly type 2 DM and may persist inspite of adequate control of blood sugar. The objective of the study was to study prevalence and pattern of dyslipidemia in type 2 diabetes mellitus patients attending Rural Health and Training Centre of medical college in Bhopal, Madhya Pradesh. Methods: This was a cross sectional study carried out among 50 Type 2 diabetic mellitus patients attending OPD of Rural Health Training Centre (RHTC) of medical college in Bhopal Madhya Pradesh. Study population included known as well as newly diagnosed type 2 diabetic patients more than 30 years of age attending OPD at RHTC. Results: According to ATP III guidelines dyslipidemia was observed in 43 (86%) study subjects. Hypercholesterolemia was seen in 18 (36%) study subjects. Increased LDL and triglycerides was observed in 33 (66%) and 32 (64%) study subjects respectively. Lower HDL cholesterol values were observed in 26 (52%) study subjects. Out of 43 study subjects having dyslipidemia, 14 (32.6%) study subjects were having isolated single parameter dyslipidemia, while 10 (23.2%) had combined two parameter dyslipidemia and 19 (44.2%) study subjects showed mixed dyslipidemia. Conclusion: Results suggest high (86%) prevalence of dyslipidemia among type 2 diabetes mellitus study subjects. Most common pattern observed was mixed type dyslipidemia. These lipid abnormalities might be the important in view of development of cardiovascular or cerebrovascular diseases. Hence type 2 diabetic patient should undergo the routine monitoring of blood sugar and lipid profile so that any abnormalities can be identified and preventive measures along with interventions can be initiated at the earliest.
you extend it." The number of elderly people is continually increasing in the developing nations owing to evolving age structure. These trends are appearing in many countries including India. In the year 2002, the number of elderly people in the world was estimated to be estimated 605 million, which is expected to rise to more than 1.2 billion by the year 2025. [1] Both the share and size of the elderly population is increasing over time. The absolute number in India increased from 76 million in 2001 to 100 million in 2011. According to the Census 2011, the elderly population aged older than 60 years account for 7.5% of the total population and is projected to rise to 12.4% by the year 2026. In Madhya Pradesh, India, 6.7% population is aged older than 60 years. [2,3] Background: Information on the morbidity profile and health-care support of elderly population is important for planning their health-care facilities. Objective: To study the sociodemographic characteristics, morbidity pattern, and pattern of health-care support among the elderly people in urban area of Bhopal (Madhya Pradesh, India). Materials and Methods: This community-based cross-sectional study was carried out among people aged older than 60 years residing in the field practice area of urban health training centre (UHTC) of a medical college in Bhopal. One hundred fifty study subjects were enrolled in study using simple random sampling method; 30 elderly people were selected from each one of the five localities catered by UHTC. Data were collected with the interview technique by door-to-door survey. Results: Of the 150 study subjects, 86 were men and 64 were women; 35.3% of the elderly people received treatment for their morbidities from the government hospitals, while 26.7% from private clinic/hospital. Children bear the health-care expenses for 40% of elderly while 14% had health insurance; 50% women were dependant on their children, while 44.2% men utilized their savings for health-care expenses. Ninety-eight (65.3%) study subjects were presenting complaints and morbidity. Major presenting complaint was fatigue (48.7%), followed by backache (35.3%). Obesity (39.3%) and hypertension (24.7%) were chief morbid conditions among the elderly. Conclusion: A high prevalence of obesity, hypertension, diabetes, arthritis, and cataract were identified. Economic independence and use of social security measures among the elderly people is very less. Most of the elderly people received treatment services from private setup or not receiving the treatment.
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