Background and objective: Silicosis is one of the oldest occupational lung diseases.However, there are very few studies identifying the anthropometric variables associated with silicosis.The present study aimed at studying the association between body surface area (BSA), pulmonary function indices, and 6-minute walk distance (6MWD) in patients with silicosis. Materials and methods:The study was conducted on 102 male patients of silicosis.Height and weight were measured to calculate BSA.Spirometry and 6 minute-walk tests were performed.Data were analyzed using EPI info V 7 software.Student's t-test of significance (ANOVA) was applied to test the difference between means.Results: There are no significant changes found in the 6-minute walk distance with years of exposure and BSA.Statistically significant lower values of pulmonary function indices were observed in patients with BSA <1.6 sq m.Statistically significant higher values of forced expiratory volume in the first second and forced vital capacity were observed in patients with BSA >1.9 sq m in all categories of exposure. Conclusion:In conclusion, patients of silicosis with >1.9 sq m BSA had higher values of pulmonary function indices.Large body size may be of value in protection from developing occupational lung disease.

Objective: To assess sleep and quality of life among chronic obstructive airway disease patients. Materials and Methods: Patients with primary, mild-to-moderate, stable chronic obstructive airways disease [asthma and chronic obstructive pulmonary disease (COPD)] on treatment visiting outpatient department of a government hospital were interviewed using a predesigned, pretested, semi-structure schedule. The patients were then administered standardized Pittsburgh sleep quality index (PSQI), St. George’s respiratory questionnaire (SGRQ), and Epworth sleepiness scale (ESS) questionnaires. Patients with any other known chronic disease, chest deformity, or long-term oxygen therapy were excluded. Using purposive sampling frame, 120 chest patients (asthma and COPD) and in addition, 30 ambulatory patients without having any underlying chronic respiratory diseases were also recruited for comparison purpose. Results: Mean age was 50.2 years. Mean duration of sleep during night was 5.40 h [±1.6; 95% confidence interval (CI) = 4.98–5.82] for patients with COPD; 5.53 h (±1.6; 95% CI = 5.11–5.95) for patients with asthma, and 6.97 h (±1.0; 95% CI = 6.57–7.36) for control patients (P < 0.001). It was noticed that 63.3% of control patients had at least 6 h of night sleep in comparison to 23.3% of chest patients (P < 0.01). Good PSQI score (up to 5 points) was found in 86.6% of control patients while it was found only in 35.0% of chest patients (P < 0.01); mean PSQI score among asthma was 8.08, 8.06 (COPD), and 3.46 among control patients, respectively. All the control patients (100%) reported good score for quality of life while chest patients reported good score for SGRQ (activity, impact, and symptoms) as 64.1, 83.3, and 82.5%, respectively (P < 0.01). Based on ESS, none of the patients complained of daytime sleepiness. To conclude, poor sleep was noticed in our study sample.

Objective: Evaluation of published original research conducted amongst Indian medical undergraduate students. Methodology: A systematic review was undertaken using keywords "MBBS students" or "medical students" or "health students" or "university students" and "India" through search engines, PUBMED and Google scholar. Considering feasibility, time frame of published original research article was restricted to one-year only i.e. 2016. Research domain, research design, author and other bibliometric details of research manuscript were captured using check-list and analysis carried out using descriptive statistics. Results: A total of 99 suitable original research articles were identified under certain criteria and considered in present analysis. With regard to thematic research domain, highest, 29 (29.2%) articles were related to teaching and learning process followed by 13 (13.1%) to mental health (depression, anxiety, sleep, spirituality) of students; 07 (7.0%) were based on physical fitness/exercise/yoga; and substance abuse (6.0%) amongst medical students etc. Nearly, 86 (86.8%) of articles were cross-sectional descriptive based studies while 13 (13.1%) had intervention based research design. A total of 34 (34.3%) research articles could be labeled as "KAP" (knowledge, attitude and practice) survey. Department wise detail of corresponding author was largely dominated by faculty from pre and para-clinical departments. Highest was community medicine in (35.3%) articles, pharmacology (23.2%), physiology (17.1%), microbiology (6.0%), and biochemistry (4.0%) etc. The studies covered an average sample size of 188.8 MBBS students (20-360, range); 57.5% of research article covered students from only one professional year. However, in 42 (42.4%) articles there was no further mention of gender based sample information. Out of all the references used in research articles, only 57.3% were of recent (2005-2015) origin while the rest were from older time-frame. Conclusion: A systematic evaluation of published original research articles conducted upon MBBS undergraduate students studying in Indian medical colleges was undertaken, probably first of its kind in India. In conclusion, diverse topics of research have been conducted by the teaching faculties and this study provides the over-view of the same

Objective: Evaluation of knowledge, attitude, and practices (KAPs) based published Indian research on selected parameters. Methodology: A bibliometric analysis of Indian KAP research manuscript published in journals indexed in PubMed for the last 2 years and/or published in Indian Journal of Community Medicine (IJCM) and Indian Journal of Public Health (IJPH) for the last 15 years (year 2000–2014) was undertaken under certain criteria. Results: PubMed (n = 196) revealed maximum KAP research undertaken from the states of Karnataka (16.8%) followed by Delhi (9.6%), Maharashtra (9.1%), and more than two states (11.7%). There was poor reflection with no publication of KAP-based research from the states of Chhattisgarh, Himachal Pradesh, Jammu and Kashmir, and Rajasthan, in IJCM and IJPH journals. The geographical representation of country through published manuscript in IJCM was slightly more diverse than IJPH and more than one-fourth manuscripts in IJPH were published from West Bengal only. It was evident that IJCM (n = 71) has published more KAP manuscripts than IJPH (n = 47). Higher proportion of community-based KAP research was published in IJPH (80.8%) than IJCM (57.7%). Highest single research domain in PubMed indexed journals was those related to oral cavity (14.2%) conducted by dental professionals while rest (85.8%) could be largely ascribed to community physician/public health personnel, etc. The first research domain was followed by family planning/contraceptives (6.1%), tobacco control (5.6%), and AIDS-HIV (5.1%), for the year 2013–2014. Highest KAP-based research domain of articles published in IJCM was those related to family planning/contraceptives (10.0%) followed by AIDS-HIV (8.5%) while it was tobacco (16.6%) and AIDS-HIV (14.5%) in IJPH. Number of authors/manuscript was slightly higher in journals indexed in PubMed (4.7) than IJCM (3.8) and IJPH (3.7). The average page/manuscript was higher in PubMed (6.4) indexed journals while it was similar in both Indian journal (IJCM [3.6] and IJPH [3.8]). Approximate time incurred in decision announcement toward acceptance of KAP manuscript (2000–2014) by IJCM from the date of submission was 7 months (median) while for comparison purpose, it was 6 months (median) for a sample of articles published during 2015.Average citations per KAP document within 2 years of publication were 1.9 (IJCM) and 1.2 (IJPH), respectively, in Google scholar. Conclusion: This bibliometric study, probably first of its kind in India, provides objective snap-shot of diverse published research in the country that may also aid scholar to explore new avenues of KAP especially non-communicable diseases in future. In-addition, postgraduate training could lay emphasis on the use of bibliometrics.

This article reviews and describes the theoretical concept of organ donation (OD) and transplantation, historical milestones, need, shortage, status of global activities, health system capacity, survival outcome, and update on legislative environment in India, Central/State contribution and Nongovernment Organizations actively involved in OD.

Hemorrhagic pleural effusion is a common clinical entity still diagnosis is often missed. An unusual and often over-looked cause of pleural effusion is an intra-abdominal process including complication arising due to pancreatitis. We report a rare case of massive left sided hemorrhagic pleural effusion in a patient due to pancreatic pathology.

A study was undertaken to determine the knowledge of doctors (government and private), post-graduate students, interns, and final year medical students about TB and RNTCP on selected parameters. Overall awareness on DOTS-plus (6.3%) and perception on efficacy of intermittent therapy to daily regime (31.5%) was low (Table I). Still, private practitioners have a high (74%) impression of X-ray being the first modality for diagnosing PTB while only 26% correctly mentioned sputum as first investigation (Table II). Table III, provides summary findings of incorrect responses. DOTS categories were not correctly enumerated by 58%, 30%, and 17.7% of private practitioners, undergraduate and PG students respectively. Treatment regimen for both adult and paediatric patients was wrongly described by 68.4% and 51.7% of respondents; life prolongation with DOTS in patients with HIV with PTB was wrongly mentioned by 69.6% and stopping ATT criteria was not correctly mentioned by 44% study participants.

This manuscript reviews and describe the burden of cervical cancer in world and India, epidemiology of HPV infection, screening methods, prevention, control strategy, types of HPV vaccines, schedule, age of administration, dose, route, anatomical site of human papillomavirus vaccination, cold chain, vaccine coverage and roll out plan in Delhi, India.

Objective: To determine proportion of correct inhalation technique amongst patients with asthma and chronic obstructive pulmonary disease. Methodology: A cross-sectional study involving 100 known subjects of either disease condition using inhaler device for atleast one-year reporting at chest OPD of government hospital were interviewed using pre-tested semi-structured interview schedule and inhalation technique determined by standard observation checklist. Each step was given a score of ′one′ if undertaken by patient and ′zero′ in case of non-compliance. Results: There were 62% male patients; 27% were illiterate; 92% were married; 32% were current smokers; average age was 50.3 (±14.5) years; 55% and 45% had asthma and COPD respectively; 60% were on MDI device and 40% were using DPI; 23% reported co-morbid (HT/DM) condition and 27% reported occupational dust exposure while more than one-third (36%) reported hospitalization during last one-year due to disease condition. Inspite of clinical requirement, 45% were not taking inhaler therapy regularly and reasons elicited were lack of knowledge (32%), casual attitude (07%), financial constraints (04%) and stigma (01%). On a positive note, patients undertaking regular visit to doctors were also taking inhaler regularly (P < 0.05). However, these positive practices did not translate into satisfactory inhaler performance. Majority (93%) of patients were not taking inhaler as per standard procedure i.e., only three were found undertaking all the 13-steps for MDI while four were following all the 8-steps for DPI use. Mean score (steps undertaken) for MDI user was 6.71 (±3.3) with a range of 0-13 points and 4.4 (±2.4) with a range of 0-8 score for DPI user. On further evaluation, satisfactory performance (minimum essential steps) with regard to either inhaler device was demonstrated by 25% patients only and found to be statistically associated with those not reporting any co-morbidity (P = 0.02). Conclusion: Proper training and compliance could improve inhalation technique.

A 61-year-old male admitted in chest clinic with complaints of left-sided chest pain, sudden onset breathlessness, and cough since last 15 days. Patient was anex-smoker with no past history of tuberculosis. He was diagnosed with esophageal cancer and received radiotherapy 1 year back. On chest X-ray, left-sided hydropneumothorax was found and intercostal drainage insertion was done. A week later patient complained of extrusion of food particles into intercostal drainage bag. On evaluation, esophageopleural (EP) fistula was confirmed.

Objective: To assess alcohol consumption practices amongst adult males in a rural block area. Materials and Methods: Using multi-stage random sampling frame, at least 12 households were identified from selected anganwadi centers (n = 27), and one resident adult male from each household was interviewed in confidence using pre-designed, pre-tested, semi-structured interview schedule after seeking informed consent. In households with more than one adult male respondent, the elder member was recruited. For operational purpose, a drinker was defined as a person who had consumed at least one alcoholic drink in 1 year immediately preceding the survey. Results: A total of 345 adult males were covered with a mean age of 46.6 (±14.2) years. Nearly 64.6% had 5 years of schooling, 46.4% were farmers, 54.2% lived in joint family system and 59.7% had monthly family income up to Rs 10,000. Nearly 150 (43.5%) subjects had some correct knowledge regarding adverse effects of alcohol consumption. Of all the study subjects, 326 (94.4%) males had consumed at least one alcohol-based drink and of which 66.3% consumed country liquor. Nearly 239 (73.3%) drank at either their respective homes or their friends' homes. Two hundred and eighty-one (86.2%) procured alcohol from a shop within the village; average expenditure per month was Rs 500-900 for 132 (40.5%) respondents; and 38.3% subjects did not consume any snacks with alcohol intake. Drinking had become a habit for 194 (59.5%) males; however, based on self-assessment, 131 (40.2%) considered alcohol consumption as a problem and intended to stop drinking. Conclusion: Within study limitations, high prevalence of alcohol consumption was noted in this study, which may not only eventually lead to health/social issues but also adversely influence the younger generation for easy and early uptake of alcohol.

This article reviews the concept of information education and communication in health sector, IEC process, activities, roles and responsibilities of health staff, stages of behavioural change, stimulus for change, target group of health education, challenges, IEC approaches and methods etc.

A 20-year male college student, nonsmoker, nonalcoholic, average built presented with sudden onset cough since last 1 day along with diffuse swelling in the neck, difficulty in swallowing both liquids and solid since 1 day. There was history of rhinorrhea alternating with nasal block intermittently with change of seasons since last 3-4 years. There was no history of weight lifting, drug intake, tuberculosis or trauma, or family history of allergy. A case report of self-limiting spontaneous pneumomediastinum following a sudden bout of coughing with no underlying lung lesion is being reported.

Background: To assess perception of selected risk factors for cancer and heart attack among visitors of a public hospital. Materials and Methods: Randomly 1651 ambulatory adults were contacted using predesigned, pretested, semi-structure interview schedule comprising selective 12 risk factors for cancer (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in fruits and vegetables (F and V), physical in-activity, environmental pollution, multiple sexual partners, insecticides/pesticides/chemicals, micro-organism, family history) and 11 for heart attack (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in F and V, physical in-activity, hypertension, diabetes mellitus, mental stress, family history). Correct response was awarded one mark and incorrect/do not know response as zero. Results: The study participants comprised of 56.2% attendants and 43.8% patients with mean age of 36.78 (±13.05) years; 71.2% were male, 65% resided in rural area and 32.3% subjects were smoker. A statistically ( P = 0.001) higher odds for smoking was found among less educated (odds ratio [OR]: 1.30), rural (OR: 1.60), male (OR: 2.85), patients (OR: 1.41) of more than 30 years of age (OR: 1.67). Nearly, 64.5% and 82.0% subject responded that tobacco causes the heart attack and cancer while obesity was considered as a risk factor by 68.4% (heart attack) and 28.1% (cancer). Nearly, 70.7% and 32.0% reported diet rich in fat/oil and poor in F and V could lead to heart attack but only 23.5% and 25.8% mentioned respectively for cancer. Mean risk factors identified for heart attack were 6.64 ± 2.29 (range: 0-11) while for cancer it was 5.01 ± 2.33 (range: 0-12). Nearly, 670 (40.58%) and 620 (37.55%) subjects mentioned spontaneously at least one type/anatomical site-specific cancer of male and female respectively; 73.4% believed that cancer does not spread by social activity and 54.2% opined that cancer is treatable if detected early. Conclusion: Overall low to moderate level of awareness was noticed for selected risk factors of heart attack but still better than cancer with ample scope for capacity building of stakeholders.

Objective: To determine time delay from the onset of initial symptoms to diagnosis of primary lung cancer. Materials and Methods: Selected information was captured from 49 consecutive pathologically proven cancer lung patients presenting to a tertiary respiratory centre during 1st January to 30th June 2012 using semi‑structured interview schedule. All patients underwent suitable protocol based diagnostic work‑up and referral. Results: Background profile of patient was as follows: Male:Female = 7.1:1; mean age was 61.2 (±9.7) years; Nine out of 49 (18.4%) patients were illiterate; Forty‑three out of 49 (87.8%) belonged to rural native place; Forty‑three out of 49 (87.7%) were smokers with 25 years as median pack‑years. Histological profile showed that adenocarcinoma (40.8%) was the predominant form followed by small cell carcinoma (32.7%). Time (median) delay in diagnosis was 3.0 days (home remedies/quack therapy), 60.0 days (primary/secondary level) and 8 days at tertiary level. Twenty seven of 49 patients (55.1%) presented in stage‑IV. Higher proportion of patients residing outside the district of study institute had longer delay in diagnosis but did not reach statistical significance (P > 0.05). The most important patient reasons for the delay in diagnosis was procrastinate/did not took symptoms seriously (19/49, 38.7%); no‑body to escort (13/49, 26.5%), long distance (5/49, 10.2%), financial constraints (4/49, 8.1%), preferred local practitioner (2/49, 4.0%), family commitment/marriage (2/49, 4.0%), fear of death (1/49, 2.0%) and no reason cited (3/49, 6.1%). Three patients were inadvertently diagnosed as tuberculosis and hence the delay. Conclusion: Patient presented at a higher stage within a short span of time; however, there is scope of increasing health system capacity at primary/secondary level including sensitization training, health communication and appropriate referral to higher center.

Objective: To determine proportion of patients requiring hospitalization under RNCTP. Methodology: All area-patients registered for treatment under RNTCP at LRS Institute, New Delhi through 16 DOTS centre during the reference period (1st April 2006 to 31st Dec 2006) were listed and those patients requiring hospitalization (up to 31st Dec 2007) at LRS Institute were identified and interviewed by a single investigator using semi-structured proforma with certain inclusion and exclusion criteria’s. The data was entered into master sheet and analysis carried out using software statistical package by computing proportion (%) and chi-square test.Results: It was observed that there were 2,345 patients registered for treatment under RNTCP during the reference period, out of which, 4.22% (99) required hospitalization. The males outnumbered females in absolute numbers, however, gender related hospitalization was similar, 4.08% for males to 4.47% for females (p=0.647). Maximum case load (75.75%) was seen in economically productive age group (15-49 years). The proportion of hospitalization amongst 1-14, 15-49, 50-60 and 61 years & above age group was 2.36%, 4.10%, 5.11% and 8.60% respectively (p=0.08); category II (7.61%) patient admissions was twice than category I (3.65%) patients (pConclusion: The study was undertaken at a respiratory tertiary care centre in a metro city and within the study constraints it highlights disease severity, late presentation and minimum need for TB beds under prevailing socio-economic circumstances in the country.

The Drug Development and Therapeutics (DDT) is an open access peer-reviewed journal committed to publishing high-quality articles in the field of Drug synthesis and development and Therapeutics from industry, Clinicians and Academia.

A 63-year-old male presented with chief complaints of dry cough since 20 days, breathlessness since 20 days, rash since 19 days, high-grade fever with chills and rigors since seven days, and myalgia and joint pain since seven days. On the basis of high clinical suspicion and skin lesion, a diagnosis of scrub typhus was made that was later confirmed by serology. In the context of changing epidemiological, geographical, environmental, human migration, and access to diagnostic laboratories, a differential of scrub typhus should be borne in mind among patients with similar presentations. We report a case of scrub typhus in an urban setting along with a review of literature.

Aim: To describe morbidity and mortality profile of patients discharged from chest ward of a university hospital. Materials and Methods: Prospectively selected information (age, gender, residence, length of stay, outcome and primary diagnosis) of all consecutive in-patients was recorded for six month reference period. Results: Out of 967 patients, mean age was 50.64 years (±15.71); M:F = 3.5:1; 81.3% were from rural area. Primary diagnosis was tuberculosis/sequel among 528 (54.60%) and non-TB among 439 (45.4%) patients (chronic obstructive pulmonary diseases [COPD] - 20.3%; pneumonia - 15.8%; lung cancer - 5.0%; asthma - 1.6%; bronchiectasis - 0.9%, lung abscess - 0.8%, miscellaneous - 1.0%). Total deaths observed was 142 (14.7%) of all discharges and 54.25% of deaths occurred within 48 hours of admission suggesting criticality/late presentation; time distribution of death was similar considering 8-hourly period of 24-h cycle. Average length of stay for all patients was 6.91 (±5.14) days while it was 7.38 (±4.98) days for discharge live and 4.19 (±5.21) days for expired patients. Conclusion: Study provides a snapshot of patients discharged from chest ward that may aid in decision making, improving quality of care and initiation of educational activities at primary level.