Objectives The examination of retinal microvascular abnormalities through fundus photography is currently the best available non‐invasive technique for assessment of cerebral vascular status. Several studies in the last decade have reported higher incidences of adverse cerebrovascular events in Schizophrenia (SCZ) and bipolar disorder (BD). However, retinal microvasculature abnormalities in SCZ and BD have remained under‐explored, and no study has compared this aspect of SCZ and BD till date. Methods Retinal Images of 100 SCZ patients, BD patients, and healthy volunteers each were acquired by trained individuals using a non‐mydriatic camera with a 40‐degree field of view. The retinal images were quantified using a valid semi‐automated method. The average of left and right eye diameters of the venules and arterioles passing through the extended zone between 0.5 and 2 disc diameters from the optic disc were calculated. Results The groups differed significantly with respect to average diameters of both retinal venules (P < 0.001) and retinal arterioles (P < 0.001), after controlling for age and sex. Both SCZ and BD patients had significantly narrower arterioles and wider venules compared to HV. There were also significant differences between SCZ and BD patients; patients with BD had narrower arterioles and wider venules. Conclusion Considering the affordability and easy accessibility of the investigative procedure, retinal microvascular examination could serve as a potential screening tool to identify individuals at risk for adverse cerebrovascular events. The findings of the current study also provide a strong rationale for further systematic examination of retinal vascular abnormalities in SCZ and BD.
Background Slums are home to nearly one billion people in the world and are expanding at an exponential rate. Devarjeevanahalli is a large notified slum in Bangalore, South India which is characterised by poverty, overcrowding, hazardous living environment and social complexities. The poor living conditions not only affect the health of the people living there but also poses distinctive challenges to conducting health surveys. The purpose of this paper is to report the findings of a household survey that was done to study the health condition of people living in a slum. Methods A community-based cross-sectional survey was designed to determine the prevalence of health conditions using a mobile screening toolkit-THULSI (Toolkit for Healthy Urban Life in Slums Initiative). Devarjeevanahalli slum was chosen purposively as it is fairly representative of any slum in a big city in India. Sample size was calculated as 1100 households and demographic parameters at the household level and parameters related to priority health conditions (hypertension, diabetes mellitus, anaemia and malnutrition) at the individual level were studied. Six zones within the slum were purposively selected and all the contiguous households were selected. The last of the six zones was partially surveyed as the desired sample size was achieved. Results A total of 1186 households were surveyed and 3693 people were screened. More than three fourth (70.4%) of the population were below poverty line. Only one third had a regular job and the average daily income was 5.3$ and 2.6$ in men and women respectively. The prevalence of hypertension (35.5%), diabetes (16.6%) and anaemia (70.9%) was high in the screened slum population. Most of the people (56.5% of hypertensives and 34.4% diabetics) were screened for the first time. Almost half of the children under the age of five years were stunted. Conclusions Poor income security and huge burden of health issues were reported among adults and children in the household health screening in a large notified slum in South India. Most people were unaware of their disease condition prior to the screening. Relatively simple technological solutions enabled the local health team to screen the slum population despite many challenges. Electronic supplementary material The online version of this article (10.1186/s12889-019-6756-7) contains supplementary material, which is available to authorized users.
Background and context: Resource planning is performed ahead of time within outpatient clinics (OPC). Due to local control of operations (department-centric decision-making) and limited resources, OPCs cannot handle high variability and uncertainty in demand. There is always a difference between planning and reality, and this leads to operational problems such as excessive waiting times. The OPCs often react to the situation when problems are encountered and reaction times play an important role in determining patient waiting times. Objectives: To propose a predictive resource planning that incorporates variability in the short term with the OPC-wide perspective, not department-centric. Methodology: The process and patient data were collected from the OPC under study by observation, interviews and from the records of the hospital management information system. A resource planning model (RPM) was developed that matched resources according to demand in short term. A mathematical model with outputs resource plan for a day was formulated utilizing Takt time (the average time a patient needs to move out of the OPC system) management that is used in Toyota Production System (TPS), to allocate resources to all the departments. Using a Discrete Event Simulation Model,
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