Background Healthcare-associated infections remain a major concern in critical care environments. Hand hygiene (HH) compliance is a key preventive measure, yet maintaining consistent adherence remains challenging. A quality improvement (QI) initiative was undertaken to enhance HH practices among healthcare providers in a tertiary hospital in South India.Methods From August to December 2023, a QI project was implemented in Coronary Care Units (CCU) at KLE's Dr. Prabhakar Kore Hospital. Using the Point of Care Quality Improvement (PoCQI) methodology, a multidisciplinary team applied WHO's multimodal HH strategy through iterative Plan-Do-Study-Act (PDSA) cycles. Interventions included: (1) installation of centralised scrub stations with sterile footwear, (2) bedside multilingual posters, (3) structured staff training with night-shift monitoring and (4) real-time observation with feedback supported by leadership engagement. Weekly HH compliance and infection outcomes were tracked.Results Five PDSA cycles were conducted. Mean HH compliance improved from a baseline of 63.8% to 80.5% by week 20, reflecting a 26.7% relative increase and remained above 78% through week 30, confirming sustained gains postintervention. No methicillin-resistant Staphylococcus aureus, Pseudomonas or Klebsiella infections were reported during the intervention period. Blood culture positivity after 48 hours of CCU stay remained at 0%. Mortality trends varied and showed no consistent pattern attributable to the intervention.Conclusions Integrating WHO's multimodal strategy with PoCQI led to a significant, low-cost improvement in HH compliance in a high-risk setting. This team-led approach demonstrated the impact of QI strategies in implementing cost-effective infection prevention practices in critical care settings.

Background Diabetes mellitus type 2 T2DM is the most typical endocrine disorder. Vitamin B-12 is essential for haemopoietin neurocognitive cardiovascular and DNA synthesis. A deficiency in vitamin B-12 leads to megaloblastic anaemia peripheral neuropathy dementia delirium and cognitive dysfunction.Aim The present study aimed to find the prevalence of vitamin B-12 deficiency in patients with T2DM and study the association of age gender body mass index diet glycaemic control metformin use and alcoholism in T2DM patients.Methods This cross-sectional study included 105 T2DM patients from September 2021 to August 2022. Each study participants clinical history physical examination and routine laboratory investigations were recorded. The blood sample in the fasting state was drawn to estimate the serum vitamin B-12 levels by the electro-chemi-luminescence-immunoassay method ECLIA. The serum values of 200 pgmL were defined as vitamin B-12 deficiency and the Chi-square test and t-test were used for statistical analysis.Results The mean duration of diabetes was 10.34 years. The prevalence of vitamin B-12 deficiency was 22.85 with a mean level of 164.87 pgmL. The gender-specific prevalence was significant in males 27.39 and females 12.50 with P lt0.094. The association between vitamin B-12 and BMI was also substantial with Chi-square 8.57 and P lt0.014.Conclusion Serum vitamin B-12 deficiency was prevalent in 22.85 of T2DM patients. Patients with T2DM can be screened routinely for vitamin B-12 deficiency during their visits to healthcare facilities. Treatment of vitamin B-12 deficiency could be one of the modalities while treating T2DM patients.

Background: Diabetes mellitus patients are more likely to undergo nontraumatic foot or leg amputations because they have decreased circulation to the feet or reduced sensation. This condition may cause ulcerations, infections, and delayed wound healing, leading to amputations. Adequate knowledge and practices regarding foot care will be vital in the prevention of diabetic foot complications. Hence, this study aimed to determine the level of knowledge and practices of foot care among diabetes mellitus patients attending a rural primary health center in Belagavi-South India. Materials and Methods: A cross-sectional study was conducted in the rural field practice area of J.N. Medical College, Belagavi, for 7 months (November 2019 to May 2020). A pretested questionnaire was administered to 461 diabetes patients attending the health center. A written informed consent was obtained from each participant. They were interviewed with a questionnaire consisting of 15 “yes” or “no” questions, each on foot care knowledge and practice. Results: The mean age of the study participants was 50.28 ± 9.48 years. The mean duration of diabetes was 10.69 ± 7.09 years. Majority, i.e., 296 (64.2%) participants showed satisfactory knowledge and 293 (63.6%) showed satisfactory practice. Only 97 (21%) had poor knowledge, 90 (19.5%) had poor practice, 68 (14.8%) patients had good knowledge, and 78 (16.9%) had good practice about diabetic foot care. Conclusions: The low level of knowledge and practice in patients with diabetes regarding foot care necessitates an educational program to increase awareness related to foot complications of diabetes, thereby motivating diabetic patients to incorporate foot care practices in their day-to-day routine.

Background: Obesity and overweight are described as abnormal or excessive fat accumulation that poses a health risk. Obesity has become a global health issue, with obesity being generally recognized as a major risk factor for coronary heart disease, hypertension, diabetes, and a variety of other illnesses. Childhood obesity is one of the major health challenges in every country across the world. The goal of this study was to determine the prevalence of obesity among teenagers and its relationship to sociodemographic parameters.Methods: The estimated sample size is n=204 we included n=215 cases coming to OPD at primary health center Vantamuri. Following the completion of the questionnaire, height and weight parameters were measured and recorded. Weight (kg) was measured using a weighing scale with a 0.1 kg error margin without shoes or heavy clothes; the weighing scale was calibrated regularly using established reference weights.Results: Out of the total n=215 cases included in the study n=98 (45.5%) were males and n=117 (54.4%) were females. In most of the cases in the study n=151 (70.2%) were performing physical activity only sometimes and n=26 (12%) did not perform any physical activity. Only 17.6% of cases performed some form of physical activity frequently. In this study, we found that 34.8% of cases were in the overweight category and 26.9% in the obese category. The incidence of fast-food consumption was every day and frequently found in 29% and 33% respectively.Conclusions: Obesity and overweight are preventable by establishing school-based awareness programs and educating parents about healthy lifestyle management, so indirectly avoiding chronic illness in adulthood. Children should be encouraged to participate more frequently in physical activities.

Purpose of this study was to know cutaneous complications of type2 diabetes mellitus among patients with type 2 diabetes urban areas of Belagavi district, Karnataka. All registered type 2 diabetes mellitus patients attending Urban Health Centre, were subjected to complete systemic examination and dermatological examination between January and December 2016. The presence or absences of skin lesions were noted and follow-up was done to document new manifestations. Among 180 study participants, prevalence of cutaneous manifestations was 48.8% and cumulative incidence was 47.77 per 100 Diabetics. Most common lesion were skin tags (47.7%) and tinea paedis (21.5%).

Hypertension (HTN) is a serious risk factor for cardio-vascular disease which is the leading cause of mortality among type-2 diabetes mellitus (T2DM) patients. There is insufficient data regarding prevalence of hypertension among T2DM patients. The objective of this study was to determine the prevalence of hypertension and its associated factors among T2DM patients attending the preventive diabetes clinic at KLEs Dr Prabhakar Kore Hospital, Belagavi.An institution-based cross-sectional study was conducted from November 2019 to January 2020 done among 522 T2DM patients who presented to the preventive diabetes clinic. Data were collected using an interviewer-administered questionnaire. Written informed consent was obtained from each participant.There were 522 participants with a mean age of 49.81 ± 9.53. Three hundred and sixty-nine (70.7%) of the study participants were 40 years old and above. The prevalence of hypertension among T2DM was 57.7%. The majority (41.8%) of hypertensive patients were stage 1. Age, education status, BMI and tobacco use were significantly associated with HTN in the multivariable analysis.The prevalence of hypertension was high. Patients who are both hypertensive and diabetic are at an increased risk of cardio-vascular disease. Health screening and health promotion will ensure that the patients are prudent regarding their health.

Background: Diabetic complications affects every organ and skin is no exception. Cutaneous signs are extremely valuable to physicians as some alert the diagnosis of diabetes mellitus and reflect on glycemic control and lipid metabolism. To estimate the prevalence of cutaneous lesions in urban areas of Belagavi and to find the associated factors. Methods: Data was collected from type 2 diabetes mellitus patients attending Primary care Urban Health Centre. Current diabetics from the Diabetic Register, maintained in the Urban Health Centres were included, and patients’ medical records were reviewed for information regarding duration, medications and complications of diabetes. Information about socio-demographic profile, general physical examination, systemic and cutaneous examination were recorded using validated, predesigned and pretested proforma. All patients were asked detailed history regarding skin complaints, duration of type 2 diabetes mellitus, family history and treatment of diabetes mellitus. All cases underwent cutaneous examination under natural light. Cases where diagnosis was doubtful were confirmed by the Department of Dermatology at K.L.E.’s Dr. Prabhakar Kore Hospital & Medical Research Centre.Results: Of 180 study participants, average age was 59.88±11.06 years and 74.44% were females. 2.56±0.99 years was the mean duration of diabetes and 89.44% were on oral hypoglycemic agents. Prevalence of cutaneous manifestations was found to 48.88%. The cutaneous lesions were asymptomatic in majority of the participants (48.86%) and progressive 48 (54.5%).Conclusions: Cutaneous manifestation were highly prevalent and requires for the physician to be vigilant.

BACKGROUND: Diabetes is a major disease burden in India, and we are home to the second largest number of diabetes cases in the world with currently over 72 million cases of diabetes. The reported prevalence of obesity in type 2 diabetes mellitus (T2DM) was 60%–90%. Obesity and overweight pose a major risk for chronic diseases and are considered to be a strong risk factor for the development of T2DM. AIMS: The aim of the study was to determine the prevalence of obesity among T2DM patients. MATERIALS AND METHODS: This community-based cross-sectional study was conducted among T2DM patients residing in areas under Ashok Nagar and Rukmini Nagar Urban Health Centres, Belagavi. Three hundred and eighty T2DM patients were included in the study over a period of 1 year (January 1–December 31, 2017). Predesigned and pretested questionnaire was used to collect sociodemographic profile, and patient's height and weight were measured, and body mass index (BMI) was calculated and categorized based on Asian population. STATISTICAL ANALYSIS USED: Statistical analysis was done using the Chi-square test for categorical variables. P < 0.05 was considered statistically significant. RESULTS: The prevalence of generalized obesity (GO), abdominal obesity (AO), and combined obesity (CO) among T2DM patients were 58.68%, 81.84%, and 53.42%, respectively. Multiple logistic regression analysis showed that female gender and hypertension were significantly associated with GO, AO, and CO. Physical inactivity and hyperglycemic state were significantly associated with AO and CO but not with GO. The duration of T2DM was significantly associated with AO but not with GO and CO. CONCLUSIONS: Our study concluded that obesity is a highly prevalent comorbidity in diabetic patients. AO appears to be a better indicator of diabetic risk than BMI. The combination of a low-calorie diet, increased physical activity, and behavioral therapy as the first-line intervention for weight loss should be stressed for the effective management of T2DM.

BACKGROUND AND OBJECTIVES: Awareness of gestational diabetes mellitus (GDM) among pregnant women is poor. However, increasing awareness may help in diagnosis and prevention of maternal and fetal complications. Hence, this study was aimed at evaluating the knowledge in diagnosed GDM pregnant women. METHODOLOGY: This cross-sectional study was conducted from October 2014 to March 2017. A total of 500 registered pregnant women diagnosed to have GDM residing within 5 km of the study area aged more than 18 years who were willing to participate in the study were enrolled in the study. The participants were provided with the questionnaire which was designed to assess their knowledge about GDM. RESULTS: The age of the women ranged from 22 to 44 years with mean age as 27.53 ± 2.42 years and median age as 27 years. The most common age group was 26–30 years which comprised 67.6% of the women. Maximum women had primary education (61%) and were Hindus (54.8%). Most of the women were working (54.8%), resided in slum areas (43.2%), and had body mass index (BMI) between 19.8 and 26 kg/m2 (67%). The mean BMI level was 28.07 ± 4.11 kg/m2. The mean blood sugar levels at diagnosis ranged between 88 and 300 mg/dL and the mean blood sugar level was 201.36 ± 38.67 mg/dL and the median blood sugar level was 190 mg/dL. Majority of the women, that is, 57.6% of the women, had an average knowledge about GDM while 21.8% of the women had good knowledge, 1.6% had excellent, and 19% had poor knowledge. The mean knowledge score was 6.51 ± 3.41. The mean percentage of the knowledge was 36.14% ± 18.94%. Statistically significant association was noted between knowledge about GDM with maternal age and educational status, religion, and occupation (P < 0.050), but the GDM knowledge was independent of that found between place of residence (P = 0.715) and family history of DM (P = 0.661). CONCLUSION: There is poor knowledge about GDM in the study area. Hence, there is need to create awareness of this condition through counseling and use of mass media.

Background: Patients with both diabetes and depression have poor adherence to self-care regimens. Depression is often unrecognized and untreated in diabetes patients. The reported prevalence of depression in patients with diabetes varies widely; a meta-analysis that included 39 studies demonstrated that 31% of patients with diabetes experienced depressive symptoms. Objectives: The objectives of the study were to assess the prevalence of depression among diabetes patients and to study the sociodemographic and clinical factors leading to depression. Materials and Methods: This population-based cross-sectional study was conducted among 600 known diabetic patients in two Urban Health Centers attached to Jawaharlal Nehru Medical College, KLE University Belagavi, India. A predesigned pre-tested questionnaire (Hamilton rating scale for depression) was used to assess depression in diabetics after taking a written informed consent. Results: A total of 48% were found to be under depression. Mild and moderate depression was accounted for 16% each, while severe and very severe depression was seen in 9% and 7% of the total participants, respectively. Conclusions: A positive correlation of depression among diabetics was found for age, marital status, duration of diabetes, and hypertension. Almost all the patients have not consulted a psychiatrist yet and were not on any medications for depression.

The census of 2011 revealed that about 5.3 of the Indian population wasgt 65 years of age. This number has gradually grown up over past few decades and sharply increasing. The prevalence of diabetes is increasing due to the ageing population and increasing obesity in India. We report the burden of diabetes mellitus with severe co-morbidities in elderly patients at the tertiary care centre. During the study period between 2014 and 2017 a total of 726 patients with diabetes mellitus reported at our centre. Out of them male patients were 73.82 n536 and female patients 26.17 n190. The mean age of females was 69.13plusmn4.70 range 65 to gt90 years and in males it was 70.41plusmn5.49 range 65 to gt 95 years. During their regular monthly follow upmicrovascular and macrovascular complications were evaluated among them.The study revealed that there was a high prevalence of hypertension and other severe co-morbidities in elderly diabetes mellitus patients.nbsp

Introduction: Diabetes is one of the most common noncommunicable diseases in the world. There is an epidemic of diabetes in developing and nondeveloping countries. Treatment patterns play a very important role in the control of blood glucose levels of the patient. Methodology: A total of 520 type 2 diabetes mellitus patients in the area of Urban Health Centre, Ashok Nagar, were interviewed with the help of a predesigned and pretested questionnaire. Data were collected by house-to-house visit. Results: Out of the 520 participants, 264 were male and 256 were female. Oral hypoglycemic agents were the most common modality of treatment used followed by a combination of oral hypoglycemic agents and insulin. About 82 participants were not on any treatment and 18 participants were on insulin exclusively. Conclusion: Oral hypoglycemic agents are the most commonly preferred drugs. Insulin therapy has some conservation among patients. Imparting health education and the importance of adherence to treatment is of utmost importance in diabetes patients.

Aims: To determine the prevalence of Thyroid dysfunction among Type 2 Diabetes mellitus. Methodology: A cross-sectional hospital-based study is conducted to find out the prevalence of thyroid dysfunction. 713 type 2 diabetes mellitus (T2DM) subjects were enrolled in the survey. These subjects were investigated for fasting blood sugar (FBS), glycosylated haemoglobin (HbA1c), total triiodothyronine (T3), total thyroxine (T4), and thyroid-stimulating hormone (TSH). Results: Prevalence of thyroid dysfunction in T2DM was found in 16.2%. Gender-specific prevalence found higher in females (25%) compared to males (10.1%) (P < 0.001). Age-specific prevalence found higher in the age group >= 50 yrs. (19%) Compared to other age groups (P = 0.036). Subjects with poor glycaemic control demonstrated higher prevalence (27.9%) (P = 0.012). Subjects with long-standing T2DM had an increased risk for thyroid dysfunction (19.8%) though findings were not statistically significant. (P = 0.42). Conclusion: The prevalence of thyroid dysfunction with T2DM (16.2%) was high in females compared to males and especially hypothyroidism being more typical. Failure to recognise the presence of thyroid dysfunction among T2DM patients may be a primary cause of poor management of diabetes. We recommend universal screening and regular monitoring of thyroid dysfunction in T2DM patients. (C) 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Fibrocalculous pancreatic diabetes has distinctive features like younger age at onset, presence of large intraductal calculi, aggressive course of the disease, and proneness for pancreatic cancer. Pancreatic calculi are the hallmark for the diagnosis. We report a 32-year-old male patient, a known case of diabetes since 2 years, presented with recurrent pain abdomen, malabsorption, and neuropathic symptoms. The diagnosis was established on the basis of clinical examination, biochemical and radiological investigations. He was prescribed two doses of premix insulin and pancreatic enzyme supplements for relief of abdominal pain and steatorrhea.

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD), has been estimated to be between 20% and 30% in the general population, but this value is much higher (approximately 70-80%) in type 2 diabetes patients, who are also at higher risk of developing advanced fibrosis and cirrhosis As a result of epidemic increase in obesity, hyperlipidemia and diabetes mellitus patients, the prevalence of NAFLD in the general population is increasing. Objective of the study: The objective of this study was to determine the prevalence of NAFLD in type 2 diabetes mellitus patients. Methods: A cross sectional hospital based study was conducted on a total 1750 type - 2 diabetes mellitus patients attending Diabetes Centre, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi. Patients with known chronic liver disease and history of alcohol intake were excluded. These patients were evaluated by abdominal ultrasonography to determine the presence of fatty liver. They were divided into fatty liver group and non fatty liver group; and were further evaluated by measurement of body mass index, HbA1c, liver function tests and lipid profile. The data obtained was analyzed using SPSS version 14.0. Results: Out of 1750 patients, screened for the presence of NAFLD, males were 1152 and females 598. Group A comprised NAFLD patients (10.51%) and Group B Non-NAFLD patients (7.02%). Conclusion: Our study showed that the NAFLD is an integral part of cluster of abnormalities such as dysglycemia, dyslipidemia, hypertension and obesity. Age and duration of diabetes are also important contributing factors in occurrence of NAFLD.

Introduction: Diabetes mellitus is a major health problem in India with individual, social and economical consequences. Knowledge, attitude and practice surveys are effective in providing baseline for evaluating intervention programmes. This study was conducted with the aim to know the level of awareness about type 2 diabetes mellitus. Methodology: A cross sectional study conducted to assess the knowledge, attitude and behaviour (KAB) among type 2 diabetes mellitus patients. KAB questionnaire was used to collect data. Results: Out of 1058 patients 992 patients were included for the analysis, rest were excluded due to various reasons. 43.15% were males. Mean age of patients was 55.82 ± 10.2 years. Mean duration of diabetes was 10.2 ± 6.8 years. The mean knowledge score was 4.94, attitude score was 6.29 and behavior score was 1.64. Nearly 38.5% knew definition and types of diabetes. Majority of the participants believed they can control the disease. Dietary modification and exercise among the interviewed subjects was poor. Conclusion: Results revealed good attitude but poor knowledge and practices (behaviour) towards diabetes. We concluded that there is a need for structured programmes to improve attitude and practices of diabetic patients to promote better compliance towards diet, exercise and drug regimen.