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   2016| November-December  | Volume 29 | Issue 6  
    Online since March 17, 2017

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Workplace violence against resident doctors in a tertiary care hospital in Delhi
Tanu Anand, Shekhar Grover, Rajesh Kumar, Madhan Kumar, Gopal Krishna Ingle
November-December 2016, 29(6):344-348
Background. Healthcare workers particularly doctors are at high risk of being victims of verbal and physical violence perpetrated by patients or their relatives. There is a paucity of studies on work-related violence against doctors in India. We aimed to assess the exposure of workplace violence among doctors, its consequences among those who experienced it and its perceived risk factors. Methods. This study was done among doctors working in a tertiary care hospital in Delhi. Data were collected by using a self-administered questionnaire containing items for assessment of workplace violence against doctors, its consequences among those who were assaulted, reporting mechanisms and perceived risk factors. Results. Of the 169 respondents, 104 (61.4%) were men. The mean (SD) age of the study group was 28.6 (4.2) years. Sixty-nine doctors (40.8%) reported being exposed to violence at their workplace in the past 12 months. However, there was no gender-wise difference in the exposure to violence (p=0.86). The point of delivery of emergency services was reported as the most common place for experiencing violence. Verbal abuse was the most common form of violence reported (n=52; 75.4%). Anger, frustration and irritability were the most common symptoms experienced by the doctors who were subjected to violence at the workplace. Only 44.2% of doctors reported the event to the authorities. 'Poor communication skills' was considered to be the most common physician factor responsible for workplace violence against doctors. Conclusions. A large proportion of doctors are victims of violence by their patients or relatives. Violence is being under-reported. There is a need to encourage reporting of violence and prepare healthcare facilities to tackle this emerging issue for the safety of physicians.
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The Mental Healthcare Bill 2016: Exotic in nature, quixotic in scope … but let's take the plunge, shall we?
Nitin Gupta, Debasish Basu
November-December 2016, 29(6):317-320
  2,657 1,381 -
Effectiveness of symptom screening and incidence of tuberculosis among adults and children living with HIV infection in India
C Padmapriyadarsini, PK Bhavani, L Sekar, Anandhachitra , M Selvaraj, N Poornagangadevi, SN Mothi, K Nandagopal, S Vennila, GK Priyadarshini, Mahesh Manisha, G Sanjeeva, Upasna Agarwal, E Suresh, BB Rewari, Soumya Swaminathan
November-December 2016, 29(6):321-325
Background. WHO recommends the use of a simplified symptom-based algorithm for screening for tuberculosis (TB) among people living with HIV (PLHIV). We assessed the feasibility and effectiveness of this algorithm and determined the prevalence and incidence of TB among PLHIV attending antiretroviral treatment (ART) centres in India. Methods. We did a prospective multicentric implementation research study in four states of India. To rule out TB, we administered the WHO symptom-screen algorithm to all PLHIV every month for 6 months. If they were found to be symptomatic any time during this period, they were referred for investigations for TB. A case of TB diagnosed during the first month of screening was taken as a prevalent case while those detected TB in the subsequent 5 months were considered cases of incident TB. We calculated the incidence rate using the person-years method. Results . Between May 2012 and October 2013, a total of 6099 adults and 1662 children living with HIV were screened for TB at the ART centres of four states. Of the 6099 adult PLHIV, 1815 (30%) had at least one symptom suggestive of TB, of whom only 634 (35%) were referred for investigations of TB. Of those referred, 97 (15%) PLHIV were diagnosed with TB. Overall, the prevalence of undiagnosed TB was 0.84 person-years and in the subsequent period, the incidence of TB was 2.4/100 person-years (95% CI 1.90-3.10). Among 1662 children, 434 (26%) had at least one symptom suggestive of TB. But only 57 (13%) children were referred for investigations of TB and 13 (23%) of them were diagnosed with TB. The prevalence of TB among children was 0.5% and its incidence among them was 2.7/100 person-years (95% CI 1.60-4.30). Conclusion. Prevalence and incidence of TB is high among PLHIV attending ART centres. This emphasizes the need to strengthen regular screening for symptoms of TB and further referral of those symptomatic for diagnosis of TB.
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Pharmacotherapy of patients with stable bronchial asthma
Ashutosh Nath Aggarwal
November-December 2016, 29(6):330-337
Several reliever and controller medications are available for managing patients with stable asthma. Inhaled corticosteroids (ICS) are the mainstay of treatment, and can be combined with long-acting beta-agonists (LABA) for patients with moderate or severe disease. An ICS-LABA combination is best administered as a single inhaler used for both maintenance and emergency use. A stepwise approach to therapy has recently been proposed as part of Indian guidelines for management of asthma. Clinicians should advise proper use of inhaled medications, and step up or step down treatment based on adequacy of asthma control.
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Mobile health (mHealth) in mental health: Scope and applications in low-resource settings
Mamta Sood, Rakesh Kumar Chadda, Pushpendra Singh
November-December 2016, 29(6):341-343
  2,255 476 -
Exercise or surgery for meniscal tears: Do we have an answer?
Ravi Mittal
November-December 2016, 29(6):338-339
  1,610 416 -
Finger printing of counterfeit bevacizumab and identifying it before clinical use
Thirumurthy Velpandian, Madhu Nath, Moksha Laxmi, Nabanita Halder
November-December 2016, 29(6):326-329
Background. Bevacizumab is widely used for ophthalmic purposes. Recently, counterfeit bevacizumab has become a matter of concern. We analysed samples of suspected counterfeit formulations of bevacizumab and assessed the possibility of using simple tests in the clinic by ophthalmologists to prevent the use of counterfeit preparations in patients. Methods.We did a protein analysis using Bradford assay and SDS-PAGE to confirm the presence of bevacizumab in 16 samples - 6 suspected and 10 others. The samples were also subjected to physicochemical analysis such as osmolarity, chloride content and pH. The samples tested negative for protein were analysed by mass spectrometry to detect drugs used in place of bevacizumab. We standardized the method of frothing and precipitation analysis for identifying authentic samples of bevacizumab before their clinical use. Results. Five of the 16 samples tested were negative for the presence of bevacizumab. The physicochemical parameters also supported the protein analysis test. However, no ionizable organic compound (other drug[s]) was detected by mass spectrometry. Conclusion. Ophthalmic use of counterfeit bevacizumab can be prevented by simple methods such as the frothing and precipitation tests. These can identify the absence of an active drug.
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Listening catalyses healing
Anna Tharyan, Jenifer Jeba, Ravi Livingstone, Reena George
November-December 2016, 29(6):349-350
  1,452 140 -
Microcephaly not a reliable indicator of congenital Zika virus syndrome in infants
Reeta S Mani
November-December 2016, 29(6):339-340
  890 332 -
The Tamil Nadu Medical Council Awards
MK Mani
November-December 2016, 29(6):352-353
  1,025 149 -
My first lesson in home obstetrics
Ratnakar Bhattacharyya
November-December 2016, 29(6):351-351
  1,048 124 -
The Gene. An intimate history
Sunil K Pandya
November-December 2016, 29(6):356-358
  975 148 -
Advanced Therapies in Pediatric Endocrinology and Diabetology
Rajni Sharma
November-December 2016, 29(6):355-355
  808 136 -

November-December 2016, 29(6):361-361
  617 153 -
Lanarkshire Healthy Weight Strategy
Harpreet S Kohli
November-December 2016, 29(6):353-354
  624 134 -
News from here and there

November-December 2016, 29(6):359-360
  577 107 -