BackgroundChronic low back pain is a common public health problem all over the world. Conservative therapy is prescribed as the initial treatment strategy in chronic low back pain. The cornerstone of conservatism in back care is core muscle strengthening. However, exercises prescribed for the purpose are manifold and some are not easily done by patients in Asian countries. We developed an easy to adhere exercise protocol for core stabilization and tested its effectiveness in south Indian population.MethodsProspective study of 73 patients with chronic low back pain (CLBP) who were subjected to Trivandrum Community-based Core Stabilisation protocol of treatment. The enrolled patients underwent initial Oswestry Disability Index (ODI) evaluation and Keele Start Back (KSB) questionnaire before starting the protocol. Back education was given, and the patient started on stratified exercise protocol. ODI assessment was done weekly. The trend in ODI changes and the factors determining them were assessed using ANOVA. The correlation of quantitative variables like age, initial ODI score, and KSB score with the rate of reduction of ODI was assessed using Pearson’s correlation. Cross-tabulations were done using the chi-square test. Parametric tests were used throughout the analysis as the quantitative study variables found to be linear. Multiple linear regression (for the quantitative outcome) and binary logistic regression (for the dichotomous outcome) were performed.ResultsMean (SD) of ODI score has reduced significantly from 43.4 (16.6) to 24.6 (17.1) over the period of 6 weeks (p value < 0.001). The trend in reduction of ODI scores was significantly more in KSB score less than or equal to 3 compared to KSB more than 3 even after adjusting for the general trend of decreasing ODI score over time. The reduction in ODI scores appeared to be low for advancing age (p = 0.468) and higher KSB scores (p = 0.001).ConclusionThe TRICCS protocol is effective in a community-based approach in achieving satisfactory outcomes in CLBP in a period of 6 weeks. Patients with high KSB scores may require cognitive intervention also.

Introduction The quantum of waste generated from medical care and activities is a global matter of concern. Improper management of biomedical waste (BMW) has a grave health impact on the community, health care professionals, and the environment.1 It is mandatory by law that every medical organization that generates waste should have a system, process, and resources in place for segregating BMW within the organization for proper disposal. The present article deals with the understanding of various costs associated in BMW management process that will help the health care organization to prioritize their spending and focus on areas that require spending to achieve compliance in process of BMW management. Materials and methods Descriptive cross-sectional study was carried out, to study the compliance of BMW management at three different hospitals with respect to Bio-Medical Waste (Management and Handling) Rules, 2011. A retrospective study was conducted to analyze cost data for a 1-year time period. Cost involved in BMW management was analyzed and classified as capital and recurring costs. The study was undertaken in Udupi taluk, and the taluk comprises 11 hospitals (1 Government and 10 private hospitals). The hospitals were selected using convenient sampling as taking permission to conduct the study was difficult. Only three hospitals were permitted to carry out the study. Results and discussion Compliance was found to be better in accredited hospital than in nonaccredited hospital. This could be attributed to strict adherence to standard operating procedures and regular training of staff. Cost involved in BMW management was analyzed as capital and recurring costs. Since most of the hospital outsource final disposal, capital costs are significantly less compared to recurring costs. Among the recurring costs, maximum expenditure is on consumables like color-coded bags. Cost per bed per day for handling BMW was calculated and it was found to be higher in smaller hospitals. How to cite this article Bryal D'souza, Arun MS, Johnson B. Comparative Analysis of Cost of Biomedical Waste Management in Rural India. Int J Res Foundation Hosp Healthc Adm 2016;4(1):11-15.