Introduction and Aim: One of the greatest pandemics faced by the world was COVID-19 which has added increased strain and psychological impacts on healthcare workers. This study was conducted to find out the impact of overburden due to COVID-19 on the psychological health of doctors and further to know whether it has affected the services provided by them. Materials and Methods: An information sheet which contained the details regarding purpose and nature of the study, questionnaire and consent form were given to each participant. Data was collected through email, WhatsApp, and physical forms. Depression, anxiety, stress, self-efficacy, and perceived social support were assessed using standard questionnaires. Results: Out of the 205 participants, 9 (4%) had a mild depression, 6(3%) had mild anxiety and 6(3%) had mild stress. Female doctors, those involved in fever clinics and inpatient care of COVID patients had significantly higher scores for depression, anxiety and stress when compared to others. Those involved in ICU care of COVID patients had higher General Self Efficacy (GSE) scores. General Self Efficacy (GSE) and Multidimensional Scale of Perceived Social Support (MSPSS) scores showed a positive correlation. Conclusion: Doctors involved in care of COVID-19 patients at fever clinic and inpatient care had several mental health problems. Hence, they along with female doctors need to be periodically screened for these conditions periodically.

Background: Evidence Based Medicine (EBM) has become the latest focus among medical professionals for improved health care. However, the practice of EBM in routine health care and its true impact in day to day practice is uncertain. Aims: This study assessed the perceptions, practice and determined perceived barriers in implementation of EBM among practitioners of private medical colleges. Settings and Design: A cross-sectional study was conducted from January to March 2020, among medical practitioners in Dakshina Kannada district of Karnataka. Methods and Material: After sample size estimation, 160 practitioners were selected by simple random sampling. Informed consent and a self reporting validated questionnaire to asses various aspects of EBM were emailed of them, out of which, 132(82.5%) responded with completely filled in questionnaires. A visual analogue scale was used to determine the attitude of the participants towards EBM. Data obtained was analyzed and represented as proportions. For attitude scale, median and quartiles were obtained. Results: Among the participants 96.2% had heard of EBM, however only 42.5% were trained in EBM. Referring to medical textbooks (75.8%) and CME’s/conferences (72.7%) were most preferred in clinical decision making. Most of them had a welcoming attitude in current promotion of EBM and strongly agreed that practice of EBM improves patient care. Only 27.6% and 29.9% used EBM and Cochrane database of systematic reviews for decision making, respectively. Most perceived barriers in implementation of EBM included inaccessibility (51.2%) and lack of EBM skills (48.0%). Conclusion: The medical practitioners were generally positive towards EBM and had good understanding of the technical terms used as well, which makes it conducive. Key words: Evidence Based Medicine, Medical Practitioners, Perceptions, Practice.

Background: Antenatal period is important for identifying pregnancy related threats and antenatal care (ANC) is one of the most effective health interventions during this period. It provides a unique opportunity for screening and diagnosis, health promotion and disease prevention. This study assessed the antenatal service utilization pattern and its determinants among women.Methods: A community based cross sectional study was conducted in the field practice area of a teaching hospital in Mangalore. Study included 142 women who had delivered in the last one year in the study area, selected using snowball sampling method. A pretested semi-structured validated questionnaire was used to collect the data. Predictors of full ANC were identified using univariate analysis and explanatory variables were entered into multivariate regression model to obtain the adjusted odds ratios to find the association between full ANC coverage and its determinants.Results: Among the participants, 99.3% registered their pregnancy and 78.9% had early registration. Majority, 91.5% had minimum antenatal visits, 83.1% consumed iron and folic acid supplements for more than three months and tetanus toxoid (TT) coverage was 98.6%. Full ANC coverage was found to be 81% and unadjusted analysis showed higher odds of full ANC coverage among housewives, primiparous, women in joint family and among literates. However, multi variable analysis revealed literacy as the major determinant of full ANC.Conclusions: In the present study, majority of the women had adequate antenatal care utilization. Full antenatal coverage was found to be statistically significant among literate women.

Introduction: Leadership skills among medical students, plays an important role in making them competent and bringing success in their clinical practice. Physician’s professional activities require them to be good team leaders. But there is a leadership crisis among medical doctors in India and leadership skills within their curricula. Objectives: To assess the leadership skills among interns and identify possible influencing factors among them. Method: A cross sectional study was conducted among 110 interns in a medical college. Leadership skills were assessed using Modified Leadership Inventory for Medical Education (LIME). Unpaired t test for association of various factors with mean scores of leadership and Karl Pearson’s correlation coefficient for correlation between the scores of subcomponents of leadership skills were used. Results: Among the interns, 77.3% had a chance to be a leader during school/college days but only 20% had undergone leadership training. 87.3% of them had their leadership scores above average, suggesting good leadership skills. Interns who had been a leader in school/college, enrolled in Scouts/ Guides/ NCC and those who underwent leadership training had statistically significant higher mean scores. Majority had positive attitude towards leadership. There was a statistically significant, moderate correlation between the components of leadership skills.Conclusion: Participants had good leadership skills and there was significant association between former leadership experience and current leadership scores. Most of them had positive attitude towards leadership.

Background: Remedial action that a person takes to treat his or her perceived illnesses, is called health-seeking behaviour. Understanding health seeking behaviour (HSB) in a community and the factors which influence their decision, are crucial for planning a “need based” comprehensive health care programmes for the people, especially for underprovided and rural population. The objective of present study was to determine HSB and its determinants in a defined rural population.Methods: A community based cross -sectional study was conducted in rural field practice area of A. J. Institute of Medical Sciences and Research Centre, Mangalore (Karnataka) from 1st October 2017 to 31st July 2018. A total of 866 heads of households were included in the study, using universal sampling method. A pre-tested, validated questionnaire was used to collect the data. p values of <0.05 were considered significant.Results: Among 866 participants, almost all (98.03%) heads of families were males, while majority of them (35.68 %) were farmers. Further, majority (48.15%) of the households preferred to visit government hospitals for their ailments, while among those visiting private practitioners, majority of them (55.54%) preferred Allopath system of medicine. Health insurance subscription rates were found to be low (18.93%). Main determinants of HSB were observed to be cost of treatment, convenience of approach, quality of services and life threatening emergencies.Conclusions:Present study brings out higher utilization of government health care facilities among the study subjects, while cost of treatment and life threatening emergencies were the main predictors of HSB.

Background: Breastfeeding has been a universal practice. A number of factors influence the breastfeeding practices of the mothers. This study was conducted to assess the breast-feeding practices and its association with mother’s education and antenatal counselling.Methods: A community based cross sectional study was conducted among 167 mothers with infants who were residing in field practice area of a medical college. A pretested semi-structured validated questionnaire was administered to assess the breast-feeding practices followed. Towards the end of each interview the investigator observed the mothers as they breast fed their children to assess the appropriateness of positioning and attachment. Chi-square test and Fischer’s exact probability test were used to test the associations.Results: 19.8% of the mothers were illiterate. 64.1% had received antenatal counselling on breast feeding. 62.3% initiated breast feeding within one hour. Colostrum was discarded by 6% of the mothers and 28.7% gave pre-lacteal feeds. 72.3%, 86.1% and 77.3% of them practiced appropriate position of feeding, held their children in the appropriate position and had good attachment to the breast, respectively. Mother’s education had a statistically significant association with pre-lacteal feeds administration, exclusive breastfeeding and breast-feeding position. Antenatal breast-feeding counselling had a statistically significant association with appropriate positioning of the child, attachment and practicing burping.Conclusions: Breast feeding practices in the current study was far from satisfactory. Mother’s education and antenatal breast-feeding counselling had a major role in the feeding practices.

Background: Sepsis still remains an important cause of morbidity and mortality posing a diagnostic challenge to clinicians across the globe.Lack of a single specific and sensitive test paved the way to many researches.Our study evaluated clinical significance of cell population data (CPD) as biomarkers in sepsis.CPD assesses morphological and functional characteristics of leucocytes using automated hematology analyzer. Methods:The study population consisted of 100 healthy subjects and 100 clinically suspected cases of sepsis with quick sequential organ failure assessment (qSOFA) score >2.The various cell population data (CPD) were collected using automated hematology analyzer, Sysmex XN1000 during a span of 6 months from January to June 2018 in a tertiary care center and the results were statistically analyzed using Z test. Result:The WBC count and CPD parameters were assessed.Except for neutrophil , monocyte cell size (NE-FSC, MO-Z) and lymphocyte fluorescence intensity(LY-Y) all other CPD parameters show significant difference (p<0.001) in sepsis group compared to healthy controls. Conclusion:This study suggested utility of CPD parameters which provide details of size and internal structure of leucocytes to be considered as an important biomarker for diagnosis and management of sepsis.

Introduction: Dengue fever is one of the most prevalent and fastest spreading mosquito-borne arboviral infection occurring in tropical and sub-tropical regions around the world and leads to explosive outbreaks in urban areas influenced strongly by rainfall and temperature. Aim: Evaluation of extent of thrombocytopenia in dengue positive patients. To compare the pattern of fall and rise in platelet counts for five consecutive days in dengue positive cases and dengue negative controls. Materials and Methods: The present study was a case control study undertaken in a tertiary care centre in Mangalore for three months. A total of 149 cases of thrombocytopenia were studied, out of which 85 were laboratory confirmed cases of dengue. Dengue cases with platelet value >1 lac/µL and < 1 lac/µL were noted. The remaining 64 cases of thrombocytopenia (platelet< 1 lac/µL) with dengue negative serology tests were used as controls. The pattern of fall and rise in platelet counts in five consecutive days in both dengue positive cases and dengue negative controls were studied. Result: Among the 64 dengue positive thrombocytopenia cases, 34(40%) cases had mild thrombocytopenia (platelet count 51000/µL -1 lac/µL), 25 (29.41%) cases had moderate (20000/µL -50000/µL) thrombocytopenia and 5 cases(5.88%) had severe (< 20000/µL) thrombocytopenia. Among the dengue negative thrombocytopenia control group 39(60.93%) cases had mild thrombocytopenia, 16(25%) patients had moderate thrombocytopenia and 9 (14.06%) patients had severe thrombocytopenia. A graph is plotted comparing the median platelet values in five consecutive days in dengue positive thrombocytopenia cases and dengue negative thrombocytopenia controls. Z-test was used to compare the difference in the platelet values among case and control groups and to know the statistical significance between them. Conclusion: The median platelet values on consecutive days in dengue positive cases shows a gradual increase in platelet values around the time of recovery i.e. 5th day, even without platelet transfusion. In dengue negative thrombocytopenia graph, the median values of platelet count on consecutive days is almost constant till 5th day without any marked rise.

Background: Tobacco kills more than seven million people each year. In India tobacco kills nearly one million people each year and many of these deaths occur among people who are very young. Studies indicate that approximately 70% of all tobacco users would like to quit smoking and tobacco use.Methods: A non-randomized, cross sectional study was conducted in a Medical College in Mangaluru (Karnataka) which included medical students from first year to third year. A module developed by “Quit Tobacco International” was used for the purpose of training and counselling the selected medical students, focusing on the specific effects of tobacco, depicting simulated case scenarios.Results: A total of 404 medical students were included in the study. It was observed that 15.9% males and 5.3% females among first year students, 21.0% males and 5.3% females among second year students and 24.6% males and 9.2% females among third year students had smoked at some point in their life while the among current users, the prevalence of smoking was found to be much higher i.e. 8.7% and 2.6% among first year students, 9.9% and 3.5% among second year students; while it as highest among third year students i.e. 14% and 4.6%; among boys and girls respectively.Conclusions: The study brings out the need for inclusion of structured teaching and training of our medical students on harmful effects of tobacco use and its cessation techniques.

Background: Mosquito-borne diseases are a major public health problem. The boom of construction industry has increased the occurrence of mosquito-borne diseases. This has lead to considerable economic, ecological, and public health impacts. The objective of the present study was to assess the perceptions and practises regarding mosquito bite prevention and also to assess the average monthly expenditure towards mosquito bite prevention. Methodology: A cross sectional study was conducted among the construction workers of an urban field practice of a private medical college. From the randomly selected 15 construction sites, 177 participants were interviewed regarding perceptions practises and expenditure towards mosquito bite prevention methods. Results: Majority of the population belonged to the age group of 16 to 35 years, with mean age of 32 years (sd =10). Majority of the study population resided at Katcha (97%) houses. Most of the respondents perceived mosquitoes as a nuisance (94.9%) and were aware that it transmitted disease. Mosquito net (45%) was the most common method used for mosquito bite prevention followed by coil. Most of the participants stated that artificial and contaminated water collection water collection were present in their surroundings. The mean monthly expenditure for mosquito bite prevention reported in the study was INR 104. Twenty one per cent provided history of mosquito-borne disease in the family in the last one year, of which malaria was the most prevalent disease followed by dengue. Conclusion: Temporary settlements of the construction workers which lack adequate sanitation is a major cause for the occurrence of mosquito-borne diseases.

BACKGROUND:With modernization, rapid urbanization and industrialization, the price that the society is paying is tremendous load of "Non-Communicable" diseases, referred to as "Lifestyle Diseases". Coronary artery disease (CAD), one of the lifestyle diseases that manifests at a younger age can have divesting consequences for an individual, the family and society. Prevention of these diseases can be done by studying the risk factors, analyzing and interpreting them using various statistical methods. OBJECTIVE:To determine, using logistic regression the relative contribution of independent variables according to the intensity of their influence (proven by statistical significance) upon the occurrence of values of the dependent cardio vascular risk scores. Additionally, we wanted to assess whether non parametric smoothing of the cardio vascular risk scores can be used as a better statistical method as compared to the existing methods. MATERIALS AND METHODS:The study includes 498 students in the age group of 18-29 years. FINDINGS:Prevalence of over weight (BMI 23-25 kg/m(2)) and obesity (BMI > 25 Kg/m(2)) was found among individuals of 22 years and above. Non smokers had decreased odds (OR = 0.041, CI = 0.015-0.107) and also increase in LDL Cholesterol (OR = 1.05, CI = 1.021-1.055) and BMI (OR = 1.42, CI = 1.244-1.631) were significantly contributing towards the risk of CVD. Localite students had decreased odds of developing CVD in the next 10 years (OR = 0.27, CI = 0.092-0.799) as compared to students residing in hostel or paying guests.

Introduction The importance of anemia as a major public health problem throughout the world is widely recognized. According to WHO, in developing countries the prevalence of anaemia among pregnant women averages 56%, ranging between 35 to 100% among different regions of the world. Various studies from different regions of the country (India) have reported the prevalence of anaemia to be between 33 and 100%. In India, anaemia is the second most common cause of maternal deaths, accounting for 20% of total maternal deaths.. Results -This cross-sectional study conducted in a rural area in the Dakshina Kannada district of Karnataka showed a overall prevalence of anaemia to be 34.83%. Prevalence was found to be more in the age group of 41-45, among women with parity index more than 4 and among women with birth interval less than 2 years between two births. Conclusion-Significant association between parity index and prevalence of anaemia as found in the present study calls for measures to limit the number of births by improving the family planning services in rural areas