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Biomedical subjects

M Dobe

Publications and source records attributed to M Dobe.

13 recordsLinked to original sources

[Three-week multimodal inpatient treatment of children with chronic pain. First results of the long-term follow-up].

OBJECTIVE: In children and adolescents we investigated the impact of a 3-week inpatient multimodal pain therapy on subjective burden of life, pain intensity, and number of days off from school 3, 6, or 12 months later. METHODS: At the beginning of therapy (inpatient setting) and 3, 6, and 12 months thereafter (outpatient setting) we collected the respective data using standardized questionnaires. For statistical analysis we used Wilcoxon's signed rank test. A p <0.05 was regarded as statistically significant. RESULTS: A total of 72 patients aged 7.5-18.2 years suffering daily pain entered the study, most of them being diagnosed with somatoform pain disease. After 3, 6, and 12 months, 65, 27, and 30 patients could be reevaluated. Mean pain intensity of the week before data acquisition was significantly less than at the beginning (2.9, 2.3, and 2.9 vs 6.3) as was the mean number of days off from school due to pain during the 4-week period before each day of data acquisition (1.8, 1.5, and 1.4 vs 9.2). Mean subjective burden of life was significantly less than at the beginning (24.5, 22.0, and 25.8 vs 37.8). CONCLUSION: Outpatient multimodal pain therapy has a sustained impact on children and adolescents suffering from chronic pain.

Adolescent↗

Future challenges in communication for promoting ORT--an overview.

Oral rehydration therapy (ORT) is a cheap and simple intervention aimed to prevent mortality and morbidity associated with dehydration due to diarrhoea. ORT promotion strategies through programme communication, social mobilisation and social marketing, and advocacy efforts have yielded substantial improvement in the scenario. However, it has also taught us lessons and suggested changes in communication strategies to make the promotion efforts more effective in future.

Communication↗

Utilization of maternal services in west Bengal.

A study was conducted in selected blocks of West Bengal to assess the utilization of available maternal health services specially immunization, antenatal care and other services. Coverage with two doses of tetanus toxoid levels varied between 58.6 to 86.7% but it fell far short of Universal Immunization Programme target of 100%. Drop out rates were slightly higher in the rural areas. It was observed that in 5 out of 7 blocks more than 55% of the deliveries were conducted either at hospital or Primary Health Centre by health personnel. However, untrained dais predominated over the trained dais in conducting deliveries in most of the areas. This indicates the poor availability or utilization of the latter.

Female↗

Geographical distribution of arboviruses in Yugoslavia.

Studies of arboviruses started in Yugoslavia in 1953 following the isolation of TBE virus which caused a severe epidemic that year. Until now the following viruses have been proven to circulate in the country: tick-borne encephalitis (TBE), Crimean-Congo hemorrhagic fever (CCHF), Bhanja (BHA), sandfly fever (SF), Tahyna (TAH), Calovo (CVO), West Nile (WN), dengue (DEN), Jug Bogdanovac (JB), and Hantaviruses. TBE virus is endemic in the north-west part of the country, causing also epidemics in cyclical intervals. Its typical clinical picture is aseptic meningitis, but severe cases with paralysis have also been described. The bite of ticks is confirmed in about 80% of cases. CCF caused a small epidemic with ten clinical cases in Macedonia in 1976. Bhanja virus was isolated on the Dalmatian island of Brac in 1977, the antibody rate there, determined by the HI method, being about 31%. The first human disease in the world was caused by the Yugoslav Bhanja virus strain. Sandfly fever is still active in the country. The Naples type is prevailing and has proved hazardous for newcomers. Hantaviruses have been studied since 1980. They caused severe epidemics (1967, 1980, 1989) and sporadic cases all over the country. Three different strains are in circulation. Further studies are needed for the rest of the above mentioned viruses to learn more about their significance in human pathology.

Arbovirus Infections↗

An overview of multicentric training workshops for public health professionals on reproductive and child health programme in India.

The major emphasis of Reproductive and Child Health (RCH) programme in India is delivery of client-oriented, demand driven and broader ranges of high quality, safe and effective services for children, adolescents, mothers and reproductive age group population at large. Increased client satisfaction is considered as main determinant for improved acceptance of the services. Thus, well trained and motivated health personnel are necessary to deal with highly sensitive, personal health issues of the clients, like contraception, abortion, infertility services etc. The Indian Public Health Association organized total 10 workshops in several places of India (A total 322 members, composed of Medical Administrators (54.7%), Faculty members of Medical Colleges (24.5%), Sociologist and Nutritionists (13.9%) and also public health personnel (6.9%) participated in the workshop). Learning objectives and lesson plans etc. were formulated. Accordingly the contents were incorporated in a module, validated and pretested. The training sessions were conducted by briefing, discussion, group exercise and VIPP method and were evaluated by semi structured. The pre/post assessment schedule and scored scale of feedback from participantsAE were used for evaluation. The pre-post assessment scores revealed wide variations of mean score among the participants of several places. Significant post workshop improvement of knowledge was quite evident, with few exceptions. The group variants of pre and post score of results was considered to be due to heterogeneous groups of participants. Review of objectivity and quality of the questionnaire were felt as necessary.

Adolescent↗

An evaluation of routine immunization coverage in some districts of West Bengal and Assam.

A coverage evaluation survey was carried out in the five districts of West Bengal and Goalpara district of Assam during the period from November 2002 to April 2003 through 40 clusters sampling technique. Results revealed that highest coverage with routine immunization was in Paschim Medinipur (82.5%) followed by Kolkata (71.6%), Malda (65.3%), 24 Parganas South (61.9%) districts of West Bengal. Murshidabad district of West Bengal had only 41.3% coverage while poorest coverage was observed in Goalpara district (27.2%) of Assam. "Not aware of the need for routine immunization" was the main reason for not being vaccinated with all the UIP vaccines. Vaccination was given mainly through government hospitals in Kolkata while it was administered mainly through subcentres in the other rural districts.

Cross-Sectional Studies↗

Evaluation of pulse polio immunization in some districts of West Bengal & Assam.

A cross-sectional non-interventional survey was carried out in 5 districts of West Bengal and one district of Assam to find out the extent of coverage during IPPI. It was observed that in the recent rounds of IPPI, more than 95% coverage was observed in all the surveyed districts excepting in 24 Parganas South where coverage was around 92%. Situation at the Goalpara district further needed attention, as the coverage during February 03 as well as in the past two rounds were 90.13%, 88.13%, and 91.04% respectively. In all these districts booths were the main sites for IPPI dose though 1/3rd to 1/4th of the beneficiaries received immunization at home also. It was also observed that around 10% of the beneficiaries were not administered any PPI dose in the either of the rounds, in 24 Parganas (south) & Murshidabad districts, from where maximum number of Poliomyelitis cases were reported. At Goalpara it was 19%. Main reason for not being covered with PPI doses in either of the rounds in all the districts excepting Kolkata was "Not aware of the need for additional doses". In Kolkata "child sick" was the main reason. Health workers were main source of information of PPI in South 24 Parganas (67.13%), Malda (58.25%) & West Midnapur (54%). At Murshidabad "announcement through mike" (61.25%) was the main source of information while in Kolkata, TV was the main source (67.13%). Miking (56.38%) was the main source of information for PPI at Goalpara district of Assam. It was observed that involvement of multiple methods & media of communication was helpful in disseminating dates & other information of PPI.

Cross-Sectional Studies↗

Positive deviance--the West Bengal experience.

There are 11.1 million children in the age group 0-6 years in West Bengal. Of these, every second child under 3 years of age is underweight, more than four out of ten are stunted, and one out of eight are wasted. The Integrated Child Development Services (ICDS) programme in West Bengal has 355 operational projects covering 53,064 operational anganwadi centers reaching out to more than four million beneficiaries--approximately half of whom are children in the age group 0-3 years. The Department of Women and Child Development (DWCD) is trying to identify and replicate innovative, community-based, sustainable approaches. One such innovative initiative has been the "Keno Parbo Na" project based on the Positive Deviance (PD) approach which aims to reduce and prevent malnutrition among children under 3 years of age by focusing on local solutions and resources, local behaviors and practices. Behavior change is emphasized through participatory learning and community mobilization. The pilot phase of the project has been completed in two districts [Four blocks (2 in each District) and 32 villages/AWCs (8 in each block)] of West Bengal (Murshidabad and South 24 Parganas). The analysis of the project activities so far reveals that the issue of malnutrition and its prevention is now visible in the villages covered. Acceptance of desirable behavioral practices is observed within the community. A steady reduction in the moderate and severe level of malnutrition was noted across four districts. A general preponderance of girl children was noted at the entry stage indicating higher levels of severe and moderate malnutrition among girl children to begin with but also suggesting PD as an important strategy in reducing the gender gap in malnutrition. The boys gain in terms of nutritional status faster than the girls so in the intermediate phase malnourished girls are more in number. However, by the sixth / ninth round, as the malnutrition levels decline substantially, the gender gap tends to close.

Breast Feeding↗