A PSBH PROJECT

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A PSBH PROJECT MUNICIPAL MEDICAL WARDUNDER
MICROSCOPE
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BY,SANJANA CHAWALAKANAN CHHATRAPATIVINOD
DARJIAMIT DESAI

• GUIDED BY,
• DR. BHAVNA KUMPAVAT
• PSM DEPARTMENT

• DR. K.N. TRIVEDI
• H.O.D OF PSM DEPARTMENT

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INTRODUCTION
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• India , now on a verge of being the largest
  population of the world, still now suffering from
  the same problems of old world that the
  communicable diseases also due to in revolution
  of rapid development fast progress it starts
  developing the new threat of problems called
  non-communicable disease.
• As on one hand the fast growing spread of
  A.I.D.S.through out the country have raised much
  panic situation for a new communicable disease,
  also oldest problems like PLAGUE,MALARIA,TUBERCULO
  SIS, PNUMONITIS many others are still
  prevalent in varying magnitude. Also the problems
  imported from out side like chikungunya dengue
  has given a big hit to health care system .

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• NON-COMMUNICABLE diseases as by its nature of
  long latent period slow developing nature but
  long lasting after effect have demand special
  attention specially in countries like India that
  is spending only 4.8 (in us-) of its GDP(gross
  domestic production) for health promotion which
  is lower in comparison of many other countries of
  south-east Asia.
• Per capita expenditure on health.
• INDIA-82
• MALDIVES-364

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• Compare with all other countries, INDIA suffers
  the highest loss in potentially productive years
  of life, because of non communicable diseases
  that is between 35 to 65 years.

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WORLDS LEADING CAUSE OF DEATH for 2030.(public
library of science medicine journal)

• 1.Ischemic Heart Diseases
• 2.Cerebro vascular Diseases
• 3.HIV / A.I.D.S.
• 4.COPD
• 5.Lower respiratory infection

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RESEARCH QUESTION
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Will the case study of 250 patients admitted to
medical wards of municipal hospitals named VSGH,
LGGH SCLGH during the time period of 1st july
to 31st july by taking history of their current
and past illness lifestyle give an idea about
the morbidity pattern of community its
responsible factor?
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AIMS OBJECTIVES
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• To detect the proportional relationship between
  Communicable Diseases Non Communicable
  Diseases.
• To know the effect of
• Addiction
• Past history
• on disease pattern.
• To detect the health seeking behavior in the
  community.

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METHODOLOGY
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DESIGN OF STUDY This is Cross Sectional study as
there was no follow up with the subjects. Also,
this was an analytical study as the data from
record section was obtained analyzed. STUDY
AREAThe area of study is medical ward of VSGH,
LGGH SCLGH. SUBJECTS Patients admitted in
medical wards of 3 municipal hospitals like VSGH,
LGGH SCLGH. SAMPLE SIZE It includes all
patients admitted between 1st july to 31st
july,2006 in medical wards of 3 municipal
hospitals like VSGH, LGGH SCLGH.
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SAMPLING TECHNIQUE
Purposely sampling. STUDY
PERIODThe study was made for period of 1
month from 1st july to 31st july. STUDY
MATERIALS a pre designed pretested
questionnaire. PROCEDUREAfter taking the
permission from concerned autorities, data
collection was done using pre-designed ,
performed and pretested questionnaire and from
the case papers of the patients admitted in
medicine wards of 3 hospitals. Thus data was
collected and complied. The status of patient at
the time of admission was taken in to
considerationfor this study. After compliation,
the data was computerized, refined and analyzed
using spss software.
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ETHICAL CONSIDERATION Informed consent was
obtained from the Concerned Authorities and from
patients. RESOURCES
MAN POWERVolunteers 4
MATERIALSpretest qustionnarrie
History form
Copies from
registers
3 CDs
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OBSERVATION AND DISCUSSION
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3 TABLE DISTRIBUTION OF CURRENT ILLNESS OF
PATIENTS ACCORDING TO SEX

• CDS ARE MORE COMMON IN MALE.
• NCDS ARE MORE COMMON IN FEMALE.
• CHI-SQUARE VALUE - 6.42

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• CDS ARE MORE OBSERVED IN MALE.
• NCDS ARE MORE OBSERVED IN FEMALE.

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TABLE 4 DISTRIBUTION OF CURRENT ILLNESS OF
PATIENTS ACCORDING
TO HOSPITALS.

• CDS ARE MORE OBSERVED IN LG HOSPITAL.
• NCDS ARE MORE OBSERVED IN VS SCL HOSPITALS.

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HISTORY OF HYPERTENSION IS SEEN TO BE RAISED
AFTER AGE OF 30.
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HISTORY OF DM IS SEEN TO BE RAISED AFTER AGE OF
40.
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TABLE 5 DISTRIBUTION OF PAST HISTORY OF
PATIENTS.

• CURRENT ILLNESS OF NCDS HAVE SIGNIFICANT RELATION
  WITH THE PAST HISTORY OF SAME NCDS.
• CHI-SQUARE VALUE 10.52

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TABLE 11 DISTRIBUTION OF PAST HISTORY OF
HYPERTENSION ACCORDING TO SMOKING

• 72.7 CASES OF HYPERTENSION ARE SMOKERS
• Chi square value 5.09.

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TABLE 10 DISTRIBUTION OF PAST HISTORY OF COPD
ACCORDING TO SMOKING

• 70 CASES OF COPD ARE SMOKERS

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TABLE 12 DISTRIBUTION OF PAST HISTORY OF IHD
ACCORDING TO SMOKING

• 76.9 CASES OF IHD ARE SMOKERS.

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TABLE 9 DISTRIBUTION OF PRE ADMISSION
MEDICATION ACCORDING TO SEX

• CHI-SQUARE VALUE 17.45
• MALES ARE TAKING MORE PRE ADDMISSION MEDICATION
  COMPARE TO FEMALES FOR BOTH CDS NCDS.

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• PROPORTION OF PATIENTS TAKING PRE ADMISSION
  MEDICATION IS MORE FOR COMMUNICABLE DISEASES.
• CHI SQUARE VALUE 15.24

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CONCLUSIONS
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• Males are at greater risk of non communicable
  disease than female before 40 year.
• Female are at greater risk of non- communicable
  disease than male after age of 40 years.
• Age is the single most common risk factor for non
  communicable disease , then comes
  
  
  
  
  1. positive family history
• 2. personal habits like diet , addiction ,etc.

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• Communicable disease are more common for male of
  age group 20 -30 years.
• Females are more negligent for their health , and
  have less access to pre admission medication than
  male.
• Undiagnosed fever, malaria are leading among CDs,
  followed by TB and gastroenteritis.
• For NCDs , COPD is chief complain followed by HT,
  and other heart problems.
• Anemia is more common in female due to
  negligence about their food.

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SUMMARY
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• Total patients taken from 3
  municipal hospitals were 250, among
  them
• 1) 86 from L.G.G.H. (44 male,42 female)
• 2) 79 from S.C.L.G.H. (38 male, 41 female)
• 3) 85 from V.S.G.H. (43 male ,42 female).
• Among 125 male -71 were smoker .43.2
  of male were below 40 year of age. communicable
  disease are more in male (60.8) specially among
  those between 20-40years of age.
• Among 125 female -17 were chewing
  tobacco.40.8 of female were below 40 years
  ,non-communicable disease are more in
  female.(55.2) specially after 40 years of age.
• There is stable rise in diabetes hypertension
  after age 40 for both sex.

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LIMITATIONS OF STUDY
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• Smaller sample size.
• For municipal hospitals only.
• Hospital based study, not community based.
• Only medical wards are included

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RECOMMANDATIONS
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• As there is constant rise in non communicable
  disease after the age of 40 years so that the
  preventive measure should be taken before that.
• Female should have more access to health
  facility.
• Smoking is single most injurious factor for non
  communicable disease so it should be prohibited.
• All people should have regular health checkup
  after age 40 years for non communicable diseases
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• Communicable disease should be manage at early
  age of life.

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FUTURE PLANS
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• Further evaluation of non-communicable diseases
  for association causation.
• To determine social effect of non-communicable
  diseases.
• Inclusion of both private municipal hospitals.

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ANNEXURES
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1)Name 2)Age 3)Sex 4)Address 5)Religion
6)Occupation 7)Income 8)History
1)Current illness 2)Current
illness duration 3)Days of
admission 4)Preadmission
medication 5)Preadmission duration
6)Treatment 9)Past history of
1)Same illness 2)Other major
illness -
COPD
-HYPERTENSION
-DIABETES
-OPERATION
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10)Family history 1)
Same illness 2)Other
major illness
11)Personal history 1)
Diet 2) Addiction
- Type
- Duration
- Frequency 12)Water
supply