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Introduction Advanced cancer patients often require clinic or hospital follow-up for their symptom control to maintain their quality of life. But it becomes difficult for the patients to attend the same due to financial, commutation, and logistic issues. Objective The aim of this study was to audit the telephonic calls of the service and prospectively collected data to understand the quality of service provided to the patients at follow-up. Materials and Methods An ambispective observational study was conducted on the advanced stage cancer patients referred to the palliative care department at Kolhapur Cancer Center, Kolhapur, Maharashtra. We conducted an audit of the 523 telephonic calls of our service—“PALLCARE Seva” from June 2020 to February 2021. Prospectively, we assessed the quality of service based on 125 telephonic calls (n = 125) for this; we designed a questionnaire consisting of 11 items on the 5-point Likert scale for satisfaction by the patients or their caregivers at the follow-up. After a pilot study, the final format of questionnaire was used to collect the data. Results Of the 523 calls attended, we provided 30.11% patients with dosage change of medications for their symptom management, 16.25% patients have liaised with local general practitioners, and 14.34% of cases had to be referred for emergency management to our hospitals. We provided 23.9% of them with emotional and bereavement support and 6.21% with smartphone-based or video-assisted guidance to the patients and caregivers. Conclusions Liaison of general practitioners was possible in more than one-tenth of cases. The core components of our service were politeness and caring attitude, helpfulness, handling doubts regarding the illness, and an opportunity to share thoughts from the patients or caregivers. More than three-fourth of the callers have rated their experience as satisfactory and would recommend this service to other patients in need.

Objectives: Patients with chronic life-limiting or advanced respiratory diseases often suffer from high symptom burden, requiring palliative care to alleviate symptoms, improve quality of life and restore dignity. The present study explored the perception of respiratory physicians and their current practice of integrating palliative care for adult patients with chronic advanced respiratory diseases. Materials and Methods: An exploratory survey method using Google survey forms and SurveyMonkey was emailed to respiratory physicians between December 2020 and May 2021. Results: One hundred and seventy-two respiratory physicians responded to the survey. The majority of respiratory physicians (n = 153; 88.9%) thought that early integration of palliative care early was beneficial. They did not feel referring to palliative care would result in loss of control on patient care (n = 107; 62.21%) and 66 (38.37%) strongly disagreed that the referral would result in a loss of hope in patients. Further exploration into the training needs of respiratory physicians revealed that 121 (70.35%) felt the need for training in end-of-life care. Conclusion: Respiratory physicians in our study had an inclination toward palliative care integration into their routine clinical practice. A majority of them expressed the need to enhance their skills in palliative care. Therefore, concerted efforts at integration and a mutual exchange of knowledge between respiratory physicians and palliative care physicians will ensure that patients with advanced respiratory diseases are provided high-quality palliative care.

Megestrol acetate is one of the pharmacological agents used for cancer-associated fatigue. To date, there are no studies on its use in the treatment of post-COVID-19 (coronavirus disease 2019) fatigue. So, we report a case of metastatic carcinoma lung with a partial response with three cycles of palliative chemotherapy. He was contracted with mild COVID-19 infection post three cycles of his chemotherapy. Post this episode, fatigue was his main and most troublesome symptom. After a thorough clinical history, physical examination, and investigations, type 2 post-COVID-19 syndrome was diagnosed. After explaining the risks and benefits, we started the patient on low-dose megestrol acetate (160 mg/d per oral) with low to moderate benefits. However, upon increasing the dose to 480 mg/d, the benefit on the subjective quality of life was significant. Studies with a larger sample and randomized controlled trials have to be conducted to substantiate the hypothesis and actual effect of megestrol acetate in the treatment of post-COVID-19 fatigue.

Even though the global incidence of tuberculosis (TB) has been showing a declining trend every year, it is still a significant public health problem in India. On the other hand, cancer has also been the reason for considerable mortality and morbidity across this population. The incidence of TB has been reportedly increasing in patients with both pulmonary and non-pulmonary cancers. Incidence of pulmonary TB in head and neck malignancy is around 3.1% to 6.6%. We present a case history of 50 years old with locally advanced recurrent head and neck malignancy with active pulmonary Koch’s. The decision was to provide him supportive care and treating the infection was pragmatic in spite of expected delay in anti-cancer treatment. It is extremely important to come up with a proper protocol for the need of prophylactic treatment, detection and the concurrent treatment of both cancer and TB.

Background: Upper-body subcutaneous adipose tissue, measured by neck circumference (NC), has been positively associated with hypertension (HT). This study was conducted with the objective to correlate and evaluate NC with HT and to define critical cut-off point for screening HT in adult population of central India. Methods: This cross sectional study was carried out in the urban filed practice area of Government Medical College Nagpur. All patients attending OPD during study period, aged >30 years after applying exclusion criteria were included in study. Sample size was calculated to be 182. The socioeconomic details were assessed using questionnaire. Anthropometric measurements and blood pressure were recorded using standard guidelines. Data was analysed using Epi Info 7 and SPSS. Unpaired t test, Pearsons correlation and finally ROC analysis was done. Results: Out of total 206 individuals, 107 were male; majority being aged >50 years. The mean value of NC was 36.43±3.23 cm and 34.84±4.07 cm in hypertensive and non-hypertensives respectively and was seen significantly associated with HT (p=0.02). Positive correlation was seen between SBP and NC in male r=0.27 and in females r=0.26 (p=0.001).On applying ROC, AUC for male and female was 0.652 (p=0.007) and 0.68 (p = 0.002) respectively and the best cutoff for male was 36.5cm and female was 33.5cm with sensitivity of 74% and 72.71% respectively. Conclusions: NC is positively correlated with hypertension. NC >36.5cm for males and >33.5cm for females was the best cut-off levels for screening for HT. NC could be a potential, inexpensive, easy screening tool for screening HT.

Introduction: Upper body obesity has been attributed to increased cardiovascular risk in various studies. Measuring the Neck Circumference (NC) is an easy and inexpensive method to determine the upper body obesity. Aim: To correlate NC with Waist to Hip ratio (W:H ratio) and to find critical cut off points for NC for the screening cardiovascular risk among adults. Materials and Methods: A community based cross-sectional study was conducted among apparently healthy adults in field practice area of a tertiary care hospital in Maharashtra, India. A predesigned and pretested questionnaire was used and following the standard guidelines Waist Circumference (WC), Hip Circumference (HC) and NC were measured. Necessary permissions were sought before the start of the study. Indian standard cut off for W:H ratio was used to classify the cardiovascular risk among the study subjects. Statistical analysis: Epi info 7.1 and Statistical Package for the Social Sciences (SPSS) version 20.00 was used for analysis. Chi square test (For proportions), independent t-test (For mean), Pearson’s correlation coefficient and Receiver Operating Characteristic (ROC) analysis was done. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. Results: Total of 300 study subjects were recruited in the present study . There were equal number of males (n=150) and females (n=150) with the average age of the study population as 44.70±20.24 years. The Pearson’s correlation coefficient between NC and W:H ratio was 0.42 and 0.33 among males and females respectively. Based on receiver operating curve analysis for NC, cut off of 32.5 cm among females and 35.5 cm among males was defined as best critical cut off to screen the adults for cardiovascular risk. Conclusion: A significant association was observed between NC and W:H ratio (p

Background: Tuberculosis is major public health problem especially in the low and middle income countries like India. We conducted a study to assess the knowledge, attitude and practice related to tuberculosis among the patients attending our tertiary care institute. Methods: A cross sectional study was conducted in a tertiary care hospital on the patients attending OPD of tertiary care hospital in Maharashtra. The patients with debilitating illness or bed bound patients and those diagnosed and cured of tuberculosis or were on treatment of tuberculosis were excluded from the study. A pretested and designed questionnaire was used to assess the knowledge, attitude and practice about the cause, clinical features and treatment of tuberculosis. Results: The mean age of the study subjects was 43.34±11.23 years with male: female ratio of 1.45. About 16.67% of the subjects stated that cause of TB is bacteria, 51.33% reported that cough was the most common symptom, 58.67% believed that it spreads from person to person and among the people who said it spreads 58.67% said that it can be preventable. Conclusions: About 1/5 th of the study subjects expressed the cause of TB is bacteria or germs, and more than ½ believed that TB spreads from person to person. About 2/3 rd of the patients felt that TB was a very serious disease; more than ½ of them expressed fear if they were diagnosed with TB but more than ½ of them also expressed rejection if they have a TB patient as a closed one.

Background: Under nutrition is a global public health problem. There are numerous methods of assessment of malnutrition among which CIAF is the most recent, relatively robust since it envisages all the parameters for estimation of nutritional status of the children. So, this study was conducted to find the rates of composite index of anthropometric failure in the children attending the Immunoprophylaxis clinic in a tertiary care hospital of Nagpur and to find associations with the socio demographic variables.Methods: This descriptive cross-sectional study was conducted at the Immunoprophylaxis clinic of a tertiary care institute in Nagpur from September 2016 to January 2017. The study subjects were the children attending the OPD of Immunoprophylaxis clinic of a tertiary care hospital. Necessary permissions were taken before the start of the study. Data was collected using pretested and pre-designed questionnaire. Height and weight were measured using standard guidelines and categorized into groups of CIAF as described by Nandy et al.Results: A total of 460 study subjects were enrolled in the study. The mean age group of the study subjects was 2.47±1.56 years. According to the grades of CIAF, 48.51% were having no failure. Age and gender were factors which were associated with failure status by CIAF.Conclusions: We found high rates of anthropometric failure in our study. The age groups less than 3 years had higher odds of being in failure when compared to more than 3 years age. Further, males had higher odds of being into failure when compared to females. Community based studies are recommended.

Background: Overweight and obesity has become an important public health problem in both developed and developing nations. This is even more alarming as obese children are likely to become obese adults. Methods: A cross sectional study was conducted in a government aided school in urban area of Nagpur, Maharashtra during January 2016 to April 2016. This study was conducted in students of age group of 9 to 15 years to assess the association of birth weight and body mass index of school children. Height and weight of the children were measured according to standard guidelines. BMI was calculated and classified using the percentile charts according to age and gender. Data was collected using EPI Info version 7.2. Descriptive statistics using frequencies and percentages were used. Chi square test was used to indicate the differences between two proportions. Odds ratio was used to define the strength of the association. Results: The mean age of children was 11.92±1.27 and 11.31±1.27 in males and females respectively. In our study, there was a significant positive association between the birth weight and body mass index of the children. Conclusions: We found that the children whose birth weight was lower than 2500 grams were having decreased risk of being overweight/ obese in their later life with an odds ratio of 0.55 (0.34 to 0.90). But, the correlation between the birth weight and body mass index is weakly positive (r=0.063).

Background: Childhood obesity is a serious public health concern in both developed and developing countries. The children share food habits, physical activity habits etc. with their parents either in term of genetic or environmental influences, which affects the body mass index of the children. The objective of this study was to study the association of parental overweight/obesity with overweight/obesity in the children.Methods: A cross-sectional study was conducted in a government aided school in Nagpur during January 2016 to April 2016. Data was collected by a self-administered questionnaire which had information regarding the socio demographic characteristics like age, sex, socio economic status etc. Anthropometric measurements like height and weight of the children and their parents were measured. Necessary permissions were sought before the start of the study.Results: We found a significant association (p

Background: In spite of the interventions being taken, low birth weight still persists as a public health problem in low and middle-income countries. World Health Organization defines low birth weight as birth weight less than 2500 gm. There is a constant search to find newer methods to detect low birth weight babies so that early methods can be instituted. This study was conducted to evaluate calf circumference as procedure to screen low birth weight babies in tertiary care hospital in Nagpur. Methods: A cross sectional study was conducted in tertiary care hospital of Nagpur, Maharashtra for a period of 4 months. The study subjects were babies delivered at the hospital. Birth weight was recorded using a digital weighing scale within 24 hours of the delivery. Length, calf circumference, head and chest circumference were measured according to standard guidelines. Results: Majority of mothers were in the age group of 20 to 24 years of age group, were educated up to primary school and belonged to Hindu religion. The mean calf circumference of low birth weight babies was 9.64±1.13 cm and was 10.96±1.01 cm in normal weight babies. The mean values of calf circumference were significantly lower in low birth weight babies (p

Background: Hypertension is a silent killer and global public health problem. With the advent of globalization affecting the lifestyle of the population, non-communicable diseases like hypertension, diabetes etc. is affecting the young adults (18 to 40 years). The aim of the study was to estimate the prevalence of hypertension and its associated risk factors among young adults (18 to 40 years) attending a tertiary care centre of Nagpur.Methods: This was a cross sectional study on 370 participants of age 18 to 40 years attending the outpatient department of urban health training centre in Nagpur. Data was collected using pretested and pre designed questionnaire and anthropometric measurements were done by standard guidelines. Blood pressure was measured using sphygmomanometer in sitting position. Data was analyzed using Epi info version 7.2. Chi square test/ fisher’s exact test has been used to find the difference between two proportions. Unadjusted odds ratio was calculated for various risk factors studied. Stepwise logistic regression analysis was done to calculate the adjusted odds ratio. Results: The prevalence of hypertension was found to be 23.24%. The prevalence was higher among males (25%) when compared to females (22.3%). Body mass index and waist hip ratio were significantly higher among the hypertensive when compared to normotensive study population (p

Background: Inspiration among and participation of medical students is essential to make the “voluntary blood donation” movement a success. By assessment of knowledge, attitude and practice of blood donation, donor mobilization and retention strategies can be designed and optimally modified. In this study, knowledge about voluntary blood donation in medical interns was undertaken because by the end of their MBBS course they are supposed to have understood the importance of blood donation and become capable motivators for blood donation amongst potential donors in public.Methods: A cross-sectional descriptive study was conducted on 111 interns of Topiwala National Medical College, Mumbai using universal sampling method. Self-administered structured questionnaire was used to collect data.Results: Mean age of interns was 23.13 years with standard deviation of 0.832 of which girls comprised 48.6%. Forty seven point seven percent interns had donated blood before. The correct knowledge was prevalent in 45.0% only. Practice of blood donation amongst interns had male propensity and positive correlation with gender difference (p value 0.001). Most interns (79.3%) donated for moral satisfaction and social responsibility The commonest reason in the non-donors, for not donating was being medically unfit for donating (69.0%).Conclusions: Almost half (55.0%) of the medical students under study didn’t have adequate knowledge on blood safety and donor eligibility. Majority of them intended to donate blood in future however, a very few had ever actually donated blood. Increased awareness about blood donation among medical interns is expected to have amplified effects in the society, as an aware and motivated doctor can motivate and mobilize many others for voluntary non-remunerated blood donation and thus blood safety.

Background: Three fourth of the world’s death burden is shared by low to middle income countries due to non-communicable diseases. Physical inactivity is one of the important preventable risk factor in non-communicable diseases. It amounts to 4 th leading risk factor for global mortality. Hence, this study was conducted to study the physical activity level and its correlates among adult patients attending health training centres in Nagpur. Methods: A cross sectional study was conducted among adult patients attending the health centres of Indira Gandhi Government Medical College. Pregnant women, lactating women, debilitated patients and patients not giving consent were excluded from the study. A preformed and pretested questionnaire was used to conduct the interviews which included socio-demographic variables like age, sex, and educational status. Anthropometric measurements and blood pressure were measured according to the standard guidelines. The physical activity level was calculated using the principles of 1985 FAO/WHO/UNU expert consultation (WHO, 1985). Results: Of 200 study subjects, 59% were having a sedentary lifestyle, 27% were having a moderately active lifestyle and 14% were having a vigorously active lifestyle. A statistically significant increasing trend for sedentary study subjects (p =0.002 with age was found. Those who reported sedentary physical activity levels had 3.42 odds of being hypertensive, 7.44 times odds of being diabetic, 3 times odds of being overweight and 2.41 odds of being obese. The adults in urban areas were having significantly less physical activity levels when compared rural areas. Conclusions: Higher levels of sedentary lifestyle were found in urban areas compared to rural areas. As the age increased the sedentary lifestyle was having a significantly increasing trend. Physical activity was associated with the diabetic status, hypertensive status, and obesity status.

Background: Malnutrition is an important public health problem which involves infants and children. It is a self-perpetuating problem which affects the mental and physical development of the child. The basic tool to quantify this burden is growth assessment in the form of anthropometry which is done under a national program called Integrated Child Development Services (ICDS). Objectives: The present study was conducted to review and compare the prevalence of stunting and wasting, in rural and urban central India. Materials and Methods: A cross-sectional study was conducted on rural (n=100) and urban (n=100), Anganwadi children for two months. All Anganwadi children (3-6 years) who were available at the time of examination and children below three 3 years of age at house visit were included in the study. Children with congenital defects were excluded from the study. A pretested and predesigned questionnaire was used to collect the data. Height and weight were measured according to standard guidelines. Data was analyzed using Epi Info version 7. Results: In our study, the prevalence of stunting was found to be 37% and 22% in rural and urban areas respectively. The prevalence of wasting was found to be 33% and 20% in rural and urban areas respectively. There was a significant difference between grades of stunting (p=0.01) and wasting (p =0.05) among rural and urban children. Conclusion: In spite of the efforts taken by the government to cut down the rates of stunting and wasting through various programs, the effects of malnutrition still persists.