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Introduction: The relationship between occurrence of sepsis and Body Mass Index (BMI) has been studied by treating BMI as a categorical variable based on the standard categories developed by the World Health Organisation (WHO). This technique masks the actual form of the relationship that exist between BMI and sepsis. Aim: To determine the shape of the association between BMI and probability of sepsis after adjusting the effect of gender, age, ethnicity and co-morbidities among critically-ill patients and to identify an appropriate technique to elucidate this association. Materials and Methods: The study was based on the data extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database, a real-world dataset. A robust Poisson regression model and a Restricted Cubic Spline (RCS) regression model were applied to model the data. Results: The study revealed a non linear relationship between BMI and occurrence of sepsis. From the RCS plot, an increased risk of sepsis was observed among underweight and obese males and a similar pattern was observed among those with hypertension. BMI, age, and hypertension were found to be significant in the robust Poisson model (RR 1.01, 95% CI 1.00-1.02, RR 1.01, 95% CI 1.00-1.02, and RR 0.76, 95% CI 0.69-0.84, p

Introduction: Erectile Dysfunction (ED) is one of the distressing comorbidities associated with Chronic Obstructive Pulmonary Disease (COPD). There is a paucity of literature on the association of erectile function and marital quality in Indian COPD population. Aim: To find out whether Erectile Dysfunction (ED) affects the marital quality in COPD subjects. Materials and Methods: This cross-sectional study included 87 stable COPD patients, aged more than 40, who were married and staying with their partners. The patients were screened for psychiatric comorbidity using General Health Questionnaire28 (GHQ) and Hospital Anxiety and Depression Scale (HADS). Erectile dysfunction was assessed using International Index of Erectile Function (IIEF) questionnaire. The patients were grouped into those having and not having ED. ‘Marital quality’ and ‘relationship and sexuality’ scales were used to compare the groups. Results: Among the 87 study participants, 37 had ED while 50 were non-ED. The ‘Marital Quality’ and ‘Relationship and Sexuality’ scores were significantly lower in the non-ED group and ED group respectively (p-value ≤ 0.001). Age had no significant correlation to IIEF (0.164), ‘Marital Quality’ (0.14) and ‘Relationship and Sexuality’ (-0.094). There was a significant positive correlation between FEV1 values and ‘‘Relationship and Sexuality’ scores (0.228), but none to ‘Marital Quality’ (0.58) and IIEF (-0.204) scores. Conclusion: The study confirms that erectile function is a significant predictor of marital quality in COPD. The marital relationship and sexuality are found to be related to lung function.

Introduction: Coronary Artery Disease (CAD) occurs due to atherosclerosis which results in progressive narrowing of coronary artery lumen. N-Terminal pro Brain Natriuretic Peptide (NT-proBNP) has been used as a marker of heart failure. However, its role in stable coronary artery disease without left ventricular dysfunction is limited. Aim: To measure and compare the serum NT-proBNP levels in stable coronary artery patients and controls and to correlate serum NT-proBNP levels with severity of CAD. Materials and Methods: The present study was conducted in Department of Biochemistry in collaboration with Department of Cardiology Kasturba Medical College, Manipal after the approval from Institutional Ethics Committee. A written consent was obtained from 86 study subjects (controls 36, cases 50). Serum NT-proBNP was measured using ELISA kit. Severity of CAD was graded by angiogram based Gensini scoring system. Mann-Whitney U-tests and spearman’s correlations were used. Serum NT-proBNP was expressed in median and interquartile range. The p-value

Introduction: The time of examination is a stressful period where stress is on its highest levels. To some extent, low level of stress can help in motivating the students, however on the contrary more stress can be discouraging. It will make students exhausted, overwhelmed and confused. Aim: To assess examination anxiety and explore the factors influencing the examination anxiety. Materials and Methods: The present exploratory study was conducted among 341 undergraduate nursing students enrolled in selected colleges of nursing. The data were collected by using a demographic proforma used to collect the background information and test anxiety scale to assess examination anxiety and a Likert’s scale to explore the factors influencing examination anxiety. Factors were identified by exploratory factor analysis using extraction method of principal component analysis with varimax rotation. Data were analysed using SPSS version 16.0. Demographic proforma and test anxiety score was analysed using frequency and percentage. Results: Majority (90.3%) of the samples were females. Maximum number of participants (95%) had English as their medium of instruction in Preuniversity College. Most (61%) of subjects were normal or had no test anxiety, 25% had mild test anxiety, 12% had moderate test anxiety, and 2% subjects had severe test anxiety. Factor analysis identified four factors (Learning Process, Perceptions related to examination, Learning pattern, Over expectations related to learning outcome) that influence examination anxiety. Conclusion: The study findings will help the teaching faculty to take into consideration these factors during examination and help students to overcome anxiety.

Introduction: Adherence to antihypertensives is not to be assumed just because people seek help. It is a complex issue and requires individualised care. Individuals above the age of 60 years have double the risk of cardiovascular diseases for each rise in 20 mmHg Systolic Blood Pressure (SBP) or 10 mmHg Diastolic Blood Pressure (DBP). Aim: To identify the antihypertensive prescription pattern among elderly hypertensives and to explore the reasons for non adherence to antihypertensives expressed by the elderly hypertensive patients on assessment using the Morisky Medication Adherence Scale (MMAS-8). Materials and Methods: The study was conducted using the cross sectional survey design. A total of 800 elderly hypertensives attending Medicine Outpatients Department (OPDs) of a tertiary care hospital, Karnataka, were surveyed using purposive sampling technique from July 2013 to July 2015. The tools used were demographic and clinical proforma, scale on lifestyle practices and MMAS-8 (r=0.83). Results: The study findings revealed that most of the participants 205 (25.6%) were on calcium antagonists. Majority 309 (38.6%) were found to be non adherent to antihypertensives. About 59.4% were following the life style practices required for the control of BP. The majority i.e., 249 (31.1%) expressed that forgetfulness is the major factor for their non adherence. Conclusion: With the mainstay of pharmacotherapy for hypertension, lifestyle modifications play a vital role in the management of hypertension.

Introduction: Nursing education expects the students to be competent enough to render quality care for their patients in hospital as well as community setting. To reach the level of expected competency, the students must undergo vigorous training during their undergraduate education. The learning experience of the students is influenced by many factors. Aim: To identify the factors, affecting learning as perceived by the students. Materials and Methods: This descriptive survey was conducted among 414 undergraduate nursing students enrolled in selected Nursing Colleges. Background information was collected using Demographic Proforma and the factors affecting learning were identified using Likert Scale. Factors were identified by exploratory factor analysis using extraction method of principal component analysis with varimax rotation. Results: Majority (73.7%) of the samples were between 22-25 years of age, 93.2% were females, most (38.9%) were studying in the fourth year of nursing, 50% of the students enrolled in the study had chosen nursing as a career due to job security in future, 58.7% students did not spent time every day for their studies and majority (89.1%) had English as their medium of instruction in Pre-university college. Factor analysis identified five factors (Learning environment, Supportive services, Teacher characteristics, Learner challenges and Personal factors) that affect the student learning. Conclusion: From the present study it can be concluded that perception of students do have an influence on factors affecting learning. The study findings will help the faculty members to bring in changes for the best learning outcome.

Introduction: Falls are important health issues among the elderly people. Most falls in elderly result from abnormal balance control mechanisms. Balance and muscle force generation are directly related, and are associated with age related muscular changes. Studies addressing fall prevention have focused on various group and individualised strength training. However, evidence on strengthening of key muscles necessary for maintaining balance and postural control is lacking. Objectives: To evaluate the effectiveness of individualised progressive resistance strength training (PRT) programme in improving balance for forward limits of stability in elderly with balance impairment, compared to traditional balance exercise (TBE), and combination of both (COMBI). Materials and Methods: This randomised controlled trial included three groups; 18 subjects in each aged ≥ 65 years, from the elderly care centres of Mangalore city in Southern India (between June 2008 and December 2012). Block randomisation technique was used and allocation concealment was done using sequentially arranged sealed opaque envelopes. The TBE group received 8 component traditional balance exercise; 4 times a week for 6 months. The PRT group received resistance training for the key muscles of lower extremities, using DeLormes and Watkins protocol. The COMBI group received PRT and TBE alternately (2 days of PRT and 2 days of TBE per week). Functional reach test (FRT) was used for measurement of forward limits of stability. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 15. Results: For functional reach, PRT group had steady progression from baseline to 6 months (p

Introduction: Facilitation of child development is usually emphasized in the form of early intervention classes and practical demonstrations. However, non-adherence to home program for such interventions has been reported due to various reasons. Aim: To develop and validate an educational leaflet as a supplement guide for caregivers to promote better development of their child during 4-6 months of age. Materials and Methods: An in-depth literature review and focus group discussion with the experts was conducted to formulate the content of leaflet. Initial framework consisted of introduction, main text with pictorial representation and instructions about facilitation of various milestones, do’s–don’ts and disclaimer. Validation was done through a questionnaire consisting of 9 questions pertaining to completeness, understandability, legibility, clarity and utility of educational material for caregivers and a section for comments. Leaflet with enclosed questionnaire was distributed to 14 validators (2 neonatologists, 4 paediatricians and 8 physiotherapists), along with a covering letter stating the purpose and relevance of this educational material, and the importance of their participation in validation process. Scoring was done on 5 point Likert scale for each item in the material. Results: Responses from the 14 evaluators were collected and analysed. Item level content validity index (I-CVI) was calculated for individual items which ranged from 0.73 – 1. Scale level Content Validity Index (S-CVI) was calculated for complete nine items and it was found to be 0.91. Validators expressed their views to include a column on normal milestones across 4-6 months of age and also to highlight the significance of performing each activity mentioned in the leaflet. These suggestions were incorporated in consensus with the subject experts and the final draft was made. Conclusion: Educational leaflet for caregivers of 4-6 months preterm infants has been developed and validated. It can be provided as a supplement guide to the caregivers to facilitate better development of their child.

Introduction: Postpartum is the most neglected period in reproductive cycle of woman. Prevalence of anaemia in developing countries ranges from 50-95%. Aim: To estimate the prevalence of anaemia among postnatal mothers. Setting and design: A community based cross-sectional study among recently delivered mothers residing in field practice area of Department of Community Medicine, Kasturba Medical College, Manipal, India. Materials and Methods: The study sample included 401 respondents who were selected using stratified random sampling with proportionate allocation from all rural health centres. Data was collected by personal interviews followed by haemoglobin estimation by indirect cyanomethaemoglobin method. Results: The prevalence of postnatal anaemia was 26.5% (Anaemia = Hb