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In large chunk of population vitamin D deficiency is subclinical which is characterized by non specific musculoskeletal clinical manifestations4 erectile dysfunction prescription pills cialis 2.5 mg low cost. However erectile dysfunction in diabetes treatment order 20 mg cialis with amex, there is limited data available about deficiency of vitamin D in rural population of our country impotence mayo buy generic cialis 5mg line. Factors such as low sunlight exposure erectile dysfunction treatment herbal remedy discount 20 mg cialis free shipping, age related decrease in vitamin D synthesis in the skin, and diet low in vitamin D are the main causes of vitamin D deficiency. In rural areas, large proportion of men and women work as farmers and are exposed to more sunlight whereas people living in urban areas generally work indoor and do not get adequate exposure to sunlight5. On the other hand, melanin pigment, produced by melanocytes Corresponding Author: Ajai Kumar Garg Associate Professor, Department of Medicine, Government Institute of Medical Sciences, Greater Noida e-mail: drajaigarg@yahoo. Therefore persons with dark skin are more likely to have vitamin D deficiency and need more direct sunlight to have optimum amount vitamin D synthesis by skin7,8. This plasma membrane previtamin D3 is isomerized to vitamin D at skin temperature. Results In the present study out of 80 subjects 38 had rural background whereas 42 subjects belonged to urban class. In this study 34 subjects belonged to 21-40 and 41-60 year age group each, 11 subjects belonged to >60 year age group, whereas only 1 belonged to < 20 year age. Severe vitamin D deficiency was found in 25% (20/80), vitamin D deficiency was found in 48. Vitamin D deficiency in rural area was comparable to urban population and it was as common in males as in females. Table 1: Number of subjects in both the groups Patient Profile Male Female Total Rural 9 29 38 Urban 18 24 42 Total 27 53 80 Material and Method the present study was conducted in the department of medicine, Government Institute of Medical Sciences, Greater Noida for a period of one year. Patients with history of diabetes mellitus, chronic liver disease, chronic kidney disease, thyroid disorders, malignancy, chronic diarrhea, or any other chronic illness, were excluded from the study. Patients taking vitamin D or with past history of Vitamin D supplementation were excluded from the study. Patients who were bed ridden and forced to stay indoor due to any chronic condition or otherwise were also excluded from this study. Table 2: Average vitamin D level in ng/ml in both groups Patient Profile Male Female Total average Rural 12. High prevalence of vitamin D deficiency in patients with type 2 diabetes mellitus has been observed by some studies. He also observed that higher education and unmarried status were inversely related to vitamin D levels in both male and female11. Interestingly in the present study maximum number of subjects with vitamin D deficiency belonged to 20-60 years and fewer subjects belonged to above 60 years of age. The possible reason for this observation may be increasing awareness about vitamin D deficiency in the society and increasing medical attention in the form of calcium and vitamin D supplementation received by elderly people. Financial support and sponsorship: Nil Conflict of Interest: Nil Ethical Clearance: Taken from institutional ethical committee. Systemic review on Vitamin D level in apparently healthy Indian population and analysis of its associated factors. Vitamin D deficiency- A clinical Spectrum: Is there a symptomatic nonosteomalacic state Lifestyle differences in urban and rural areas affected the level of vitamin D in women with single nucleotide polymorphism in North Sumatera. Conclusion In this small study it is concluded that vitamin D deficiency is as common in rural population as in urban population of Gautam Buddh Nagar district of national capital region, although deficiency of this vitamin is more prevalent in females than in males. One of the reasons of vitamin D deficiency in rural India could be the decreased synthesis of vitamin D because of high melanin skin pigment and reduced intake of dietary products rich in vitamin D. Therefore apparently healthy subjects of rural population particularly women with nonspecific symptoms of bodyache and weakness should be evaluated for vitamin D deficiency and if 7. However, innumerable myths and taboos perceive menstruation as a negative phenomenon and lead to pessimistic attitudes toward this biological experience and women going through it. The culture of silence around menstruation increases the perception of menstruation as something shameful that needs to be hidden, and may reinforce misunderstandings and negative attitudes toward it. Proper menstrual hygiene management is the most significant and crucial aspect of female health but has been grossly neglected not just in developing countries but across the globe. The paper presents ground assessment of the knowledge, beliefs, and source of information regarding menstruation among the adolescent school girls and also identifies the status of menstrual hygiene among them. This study was undertaken, under the Innovation Project of Delhi University in the year 2015-16.

Implementing malaria elimination interventions such as preventing water clogging erectile dysfunction protocol free order cialis 20mg amex, cleaning the water bodies etc and increasing awareness for use of prevention practices might help in reducing malaria burden in Mangalore erectile dysfunction medication natural cheap 2.5 mg cialis with mastercard. Thus erectile dysfunction doctor denver cheap 10 mg cialis, awareness and malaria preventive measures have to be concentrated mainly before and during the rainy season during which the number of cases are higher impotence following prostate surgery buy 5 mg cialis amex. Hence the results may help in targeting a seasonally focused malaria interventions to specific target population like construction workers. Further strategies have to be developed to create public awareness mainly among the construction workers and implement protective measures to reduce the risk of transmission. Secondly, the study period is one year which is a little short to study the prevalence trends. Thirdly, doing a community based study would give clearer insight of seasonal variation. Relevance of the study In Mangalore, malaria is highly endemic and a huge health burden to the society. Despite this, very limited data has been documented regarding the malaria cases, contributing factors and its association with seasonal variations in Mangalore region. This study depicts that in Mangalore a complex relationship exists between rainfall, temperature, occupation and malaria and further adds to the scientific evidence. Temporal changes in land cover types and the incidence of malaria in Mangalore, India. Malaria prevalence in Mangalore city area in the southwestern coastal region of India. Malarial trend in Dakshina Kannada, Karnataka: an epidemiological assessment from 2004 to 2013. Construction site workers malaria knowledge and treatment-seeking pattern in a highly endemic urban area of India. Accessed June 4 2019 526Indian Journal of Public Health Research & Development, January 2020, Vol. College of Nursing,Sangli Abstract Introduction Interactions with caregivers of patients with severe mental illness like schizophrenia and bipolar affective disorder have revealed negative feelings about the disability status of their relative and burden related to caring for their relative with mental illness. Many caregivers have expressed that the patient`s disability status affects the family pattern, roles of family members, prosperity of the family and relationship among the family members. Patient outcome and compliance with treatment are also dependent on optimal care giving and addressing family`s needs. Addressing the burden perceived by caregiver and improving their coping can assist with good clinical care of patients with severe mental illness and hence these study to assess the burden perceived by caregiver and their coping. Materials and Method: the researcher used quantitative research approach to assess burden and coping strategies. Total two scale namely Zarit burden interview and Rating scale for assessing coping strategies to collect data. Results and Conclusion: In this study found the level burden among the care givers of affective disorders patients have experienced 60(50%)were had moderate to severe level of burden,29(24. Broadly speaking, the emotions can be described as two main types Affect which is a short-lived emotional response to an idea or an event, and Mood, which is a sustained and pervasive emotional response which colors the whole psychic life1. Care giving is a chronic stressor and different coping methods are used to handle such a situation. The present study Indian Journal of Public Health Research & Development, January 2020, Vol. The study also tries to assess the relationship between the burdens experienced by the caregivers of both these groups of patients with the coping strategies adopted by them. It was a hospital based cross sectional and comparative study, conducted in the Department of Psychiatry, Assam Medical College and Hospital with a sample size of 30 primary caregivers of equal number of patients of Chronic Schizophrenia and 30 Primary caregivers of equal number of Bipolar Affective Disorder patients. Appropriate statistical tests were used for analysis of obtained data setting significance threshold at p coping (90%) followed by external attribution and magical thinking. Total two scale used namely Zarit burden interview and Rating scale for assessing coping strategies to collect data. The caregivers of affective disorders patients may experience some level of burden and the caregivers of affective disorders patients may use some coping strategies. No 1 2 3 4 Level of Burden No or little burden Mild to moderate burden Moderate to severe burden Severe Burden Score 0-20 21-40 41-60 61-88 Frequency 13 18 60 29 Percentage% 10. No 1 2 3 Strategies Inadequate coping strategies Moderately adequate coping strategies Adequate coping strategies Score 01-24 25-50 51-75 Frequency 08 19 93 Percentage % 6.

This reinforces the need for educating the oral medicine graduates to serve as a partner to physicians thereby enhancing the level of care provided to patients [9] erectile dysfunction over 60 purchase 10mg cialis with visa. Various studies have reported the medical problems in these patients and the rate of occurrence demonstrates the importance of general medicine knowledge and training in handling such patients [12-14] erectile dysfunction uncircumcised cialis 20mg low cost. Inclusion of Special Care Dentistry in the Oral Medicine curriculum does pose challenges in obtaining national consensus erectile dysfunction 18 years old cialis 20mg generic. Studies to identify types of patients impotence at 50 20 mg cialis amex, services available 408Indian Journal of Public Health Research & Development, January 2020, Vol. Although studies have confirmed safety and benefits of Smartphone use in healthcare, adequate training and awareness of possibilities and limitations is imperative. This can be an adjunct in doctor-doctor and doctor-patient communication and help in referral and documentation [16, 17]. Discussion this preliminary study was an attempt to investigate the current status Oral Medicine education and clinical practice across India. Our objective was to assess the practitioner and practice characteristics, investigate the types of patients treated, and the opinion of oral medicine specialists in on recommending changes and improvement in training and curriculum. Our findings suggest that oral medicine specialists in India treat a wide variety of patients including oral mucosal lesions, mucocutaneous diseases, salivary gland disorders, temporomandibular joint disorders, and oral manifestations of systemic diseases. Fewer respondents reported participation in multidisciplinary clinics, the presence of a Special Care Dentistry curriculum in the Oral Medicine postgraduate training. But almost all respondents considered provision of dental care for medically compromised patients, physically and mentally disabled patients to be a part of Oral Medicine Practice [4]. The diversity in practice characteristics can be attributed to regional variations in opinions among specialists, different systems of training and clinical practice. There is increasing evidence that oral health has a significant effect on overall systemic health and that there are inadequacies in the interrelationships between dental and non-dental health care providers. It is time for dental education to establish integration of dental and medical training and practice in order to increase oral health knowledge among medical professionals and to increase the knowledge of oral-systemic health interface and a working knowledge of General Medicine among dental professionals. Oral Medicine Specialists may be considered the best choice for this integration because of its close connection with general health and systemic disease [18, 19]. Oral Medicine graduates should be competent enough to understand the interactions between, oral health, nutrition, general health, drug interactions, oral effects of systemic diseases, and also be familiar with provision of dental care to severely ill and physically/mentally challenged patients in a hospital setup. Training in Special Care Dentistry can provide the specialists the ability to handle challenges associated with treating physically/medically/mentally compromised patients including the management of medical emergencies, management of anxiety, management of frail/elderly patients, patients with severe systemic disease, patients in long term care facilities, treatment under general anaesthesia and sedation, and provision of dental treatment in different setups like hospitals, intensive care units, nursing homes, special schools and general practice [15, 20]. Older trends of procedure driven/mechanical dentistry are gradually being replaced by a more preventive/regenerative approach. Oral medicine is the best choice to handle the noninvasive and preventive aspects of future oral healthcare and for the integration into the medical field [21, 22]. Future studies are recommended to obtain a more detailed report of the status of oral medicine in India. Efforts at defining the scope of oral medicine practice in India and improvements in training and education can help modeling future graduates and inspire more students to choose oral medicine as a career. An international survey of oral medicine practice: Proceedings from the 5th World Workshop in Oral Medicine. Awareness of Oral Medicine Specialty among Medical practitioners in and around the locality of Chennai: A Survey. Changing oral care needs in the United States: the continuing need for oral medicine. WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations. Dentistry in Japan should become a specialty of medicine with dentists educated as oral physicians. Inclusion of oral-systemic health in predoctoral/undergraduate curricula of pharmacy, nursing, and medical schools around the world: a preliminary study. Profile of the dentist in the oral healthcare team in countries with developed economies. Scandinavian Fellowship for Oral Pathology and Oral Medicine: statement on oral pathology and oral medicine in the European Dental Curriculum. Oral conditions of 1,049 patients referred to a universitybased oral medicine and orofacial pain center.

The study attempted to examine the following null hypothesis that H0: There is no significant association between demographic variables with the knowledge on child birth preparation among primigravid mothers in a selected Study Findings: the majoriy (85 erectile dysfunction doctor karachi 2.5 mg cialis with mastercard. The review of literature enabled the investigator to develop methodology of the study literature review was done and organized as studies related to knowledge on child birth preparation among primigravid mothers erectile dysfunction self injection buy cheap cialis 2.5mg on-line. The main study was done in a selected tertiary care hospital at Kelambakkam erectile dysfunction icd 9 code 2013 cialis 10 mg discount, Kanchipuram District impotence in the sun also rises discount cialis 5 mg, Tamil Nadu, India. The self-administered questionnaire was used to collect the data regarding demographic variables and the knowledge on child birth preparation among primigravid mothers. The data gathered were analyzed by using descriptive and inferential statistical method. Findings: Findings of the study were presented under the following headings based on the study objectives Objective 1: Assess the level of knowledge on child birth preparation. There is no significant association between the age and level of knowledge of child birth preparation. There is no significant association between the age at marriage and level of knowledge of child birth preparation. There is no significant association between the type of family and level of knowledge of child birth preparation. There is no significant association between the dietary pattern and level of knowledge of child birth preparation. There is no significant association between the area and level of knowledge of child birth preparation. There is no significant association between the occupation and level of knowledge of child birth preparation. There is no significant association between the monthly income and level of knowledge of child birth preparation. There is significant association between the trimester and level of knowledge of child birth preparation. Implication: the findings of the study have implication in Nursing services and research. Nursing Service: Community health nurse conduct educational programs to improve knowledge on child birth preparation. Lozano R, Wang H etal: Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. This study helps us to understand the need for child birth preparation to the primigravid mothers, it becomes necessary to involve the primigravid mothers as and when during pregnancy and it can also able to prevent the complications, miscarriage and fetal death during pregnancy. Lateral Periodontal Cyst Masquerading Dentigerous Cyst: A Rare Case Report Indian Journal of Public Health Research & Development, January 2020, Vol. Because of the typical clinical and radiologic attributes, the present case was clinically misdiagnosed as Dentigerous cyst which was later confirmed histopathologically as Lateral periodontal cyst. Lateral periodontal Cyst is defined as non-keratinized developmental cyst located lateral to the root of a vital tooth. This case report presents a unique case of lateral periodontal cyst present in 58-year-old female patient. Atypical presentation of lateral periodontal cyst as is presented in this case report should be considered by the histopathologist while interpreting microscopic preparations of odontogenic cysts. Keywords: Lateral periodontal Cyst; Dentigerous cyst; Histopathology; Orthopantomograph. This cyst is most frequently associated with mandibular premolars but has been reported to occur at the other areas. Radiographs of the lateral periodontal cyst show a wellcircumscribed round or ovoid radiolucent area, usually with a sclerotic margin. Case Report: 58-year-old female patient reported with the chief complaint of mild pain and swelling in the lower left back tooth region with oozing of pus for 5 days (Figure 1). Patient gives a history of extraction of lower left second premolar one year back. Orthopantomograph revealed four supernumerary impacted teeth in the lower left pre molar region with unilocular radiolucency encircling the crown of impacted teeth and involving the root of 34 (Figure 2). Microscopic sections(Figure3) of the submitted biopsy specimens showed non keratinized squamous epithelial lining of uneven thickness supported by delicately collagenous connective tissue wall, which is infiltrated with minimal focal collection of chronic inflammatory cells. At areas focal nodular thickening of epithelial cells with many glycogen rich clear cells is observed.

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