The Journal of Community Health Management

154-159

Authors: Donald S. Christian, Mansi Patel

Medical or Clinical Audit is a tool that evaluates quality of care and patient satisfaction in clinical practice. It deals with many things like data, documents, resources, performance, standards etc. It is a cyclical process. The paper describes medical audit in relation to its contribution to health care services and the improvement of care. The research from various sources across the globe was evaluated. The barriers and facilitators of clinical audit were identified. Despite of the fact that it has some pros and cons, medical audit should become an integral part of the medical management. The process and the types of medical audit were also analyzed in the article. The differences between audit and feedback were also determined.

168-178

Authors: Abhishek Dixit, Diksha Prakash, Samir Kumar, Mousumi Mutsuddi, OPS Maurya, S P Singh, Abhishek Chand

Aim: To investigate the role of the methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism in a large cohort of patients with POAG. Methods: genetic analysis of 80 patients of POAG and 80 controls was done for MTHFR 677C>T polymorphism using PCR. Results: The C677T genotype is found to be very significantly associated with POAG) as compared to the controls. There is a significant difference in the frequency of distribution of genotype. The homozygous mutant genotype (TT) is also 1.25% more in cases as compared to controls. Conclusion: There is significant association of MTHFR 677C>T polymorphism with POAG.

187-194

Authors: Samir Kumar, Diksha Prakash, Reshmee Boodoo, OPS Maurya, Sanjay Singh, Abhishek Chandra

Aim: To estimate Intracameral concentration of Moxifloxacin applied topically in different schedule. Methods: Measurement of moxifloxacin was done in Aqueous aspirated before cataract extraction of different patients instilling topical drug in different schedule. Results: Significant difference was found between drug concentration of two groups, one instilling single drop of drug 30 min before surgery( 1.20 ± 0.43 µg/ml) and other, instilling 4 drops a day before and one drop on day of surgery (1.80 ± 0.34 µg/ml). Conclusion: Instilling moxifloxacin drops 1 day before cataract surgery results in higher concentration and is effective in endophthalmitis prevention.

199-204

Authors: Amitabha Dan, Kunal Kanti De, Pasi A R, M Jalaluddeen

Background: As per National Rural Health Mission (NRHM), India launched ASHA programme in the year 2006, to bridge the gap between health services and the underserved population of community. We conducted a study in Murshidabad district of West Bengal to describe socio-demographic profile, recruitment process and perceived reason for joining the health services. Methods: We conducted a cross sectional study among 237 ASHAs and the result was analysed in Epi info. Results – Of the total 237 ASHAs interviewed, one third (n=79) ASHAs were Muslims in that district where two third of the population belonged to the same religious community and one third were not local residents of their areas. More than 90% of the ASHAs were recruited by village pradhan and or village panchayat. Majority (44%) joined for financial benefits. Majority (67%) of the ASHA had to serve more than 1000 populations and only 10% of the ASHA were trained in module 6 & 7. Conclusion: Recruitment process of ASHA was not in line with the prescribed guideline and reasons for joining the services as perceived by ASHAs was not matching with the programme objective.

209-224

Authors: Subrata Chanda

Background: World Health Organization has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about six million people across the world each year with many of these deaths occurring prematurely. This total includes about 600,000 people are also estimated to die from the effects of second-hand smoke.1 The provision of educational interventions in combination with systematic outreach practice-based support could be an effective strategy to engage smokers in smoking cessation activities2. As the evidence for harmful effects of tobacco use has mounted, epidemiological research has progressed from simply identifying health risks associated with smoking to more detailed studies of the long-term effects of different smoking behaviours on mortality and morbidity.3. Search methods: Electronic database searches were conducted using the following keywords; smoking cessation education intervention randomized controlled trials. Studies were included if they were used- (1) randomized or controlled designs, (2) controlled before and after trials designs, and (3) designs that presented objective and (4) interpretable measures of smokers behaviour and smokers quit rates, (5) articles written in the English language. An effect size (ES) was calculated for every outcome measure reported, risk ratio, calculated as: (number of quitters in intervention group/ number randomized to intervention group) / (number of quitters in control group/ number randomized to control group).4 Meta-analysis is performed using a Mantel-Haenszel fixed-effect method to estimate a pooled risk ratio with 95% confidence intervals.5 Results: A total of 26 trials met the inclusion criteria for comparisons in this review. The study failed to detect evidence that education based strategies was more effective than a similar intensity of non educational format. There was limited evidence that the addition of Education Based interventions (EBIs) to other forms of treatment, such as nicotine replacement, produced extra benefit. Conclusions: There is not enough evidence to evaluate whether Education Based interventions (EBIs) are more effective than other non educational intervention. Identifying the most effective and cost-effective education based intervention for different populations of smokers is still an area for research. However Education Based interventions (EBIs) are likely to be effective when used independent of pharmacotherapy.