Context:diabetes mellitus is a global pandemic. The increased platelet activity may play a role in the development of vascular complications of this metabolic disorder. The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Larger platelets are younger and exhibit more activity.Aims:to determine the MPV in diabetics compared to nondiabetics, to see if there is a difference in MPV between diabetics with and without vascular complications, and to determine the correlation of MPV with fasting blood glucose, glycosylated hemoglobin (HbA1c), body-mass index, and duration of diabetes in the diabetic patients.Materials and Methods:platelet counts and MPV were measured in 300 Type 2 diabetic patients and 300 nondiabetic subjects using an automated blood cell counter. The blood glucose levels and HbA1c levels were also measured. Statistical evaluation was performed by SPSS using Student's t test and Pearson correlation tests.Results:the mean platelet counts and MPV were higher in diabetics compared to the nondiabetic subjects [277.46 ± 81 X 109/l vs. 269.79 ± 78 X 109/l (P= 0.256)], 8.29 ± 0.74 fl versus 7.47 ± 0.73 fl (P= 0.001), respectively. MPV showed a strong positive correlation with fasting blood glucose, postprandial glucose and HbA1C levels (P=0.001).Conclusions:our results showed significantly higher MPV in diabetic patients than in the nondiabetic subjects. This indicates that elevated MPV could be either the cause for or due to the effect of the vascular complications. Hence, platelets may play a role and MPV can be used as a simple parameter to assess the vascular events in diabetes.

Background: Isoniazid preventive therapy (IPT) has been shown to reduce the risk of tuberculosis (TB) among people living with HIV (PLHIV). In 2017, India began a nationwide roll-out of IPT, but there is a lack of evidence on the implementation and the challenges. Objectives: Among PLHIV newly initiated on antiretroviral therapy (ART) from January 2017 to June 2018, to: (i) assess the proportion who started and completed IPT and (ii) explore reasons for non-initiation and non-completion from health-care providers' and patients' perspectives. Methods: An explanatory mixed-methods study was conducted in two selected districts of Karnataka, South India. A quantitative phase (cohort analysis of routinely collected program data) was followed by a qualitative phase involving thematic analysis of in-depth interviews with providers (n = 22) and patients (n = 8). Results: Of the 4020 included PLHIV, 3780 (94%) were eligible for IPT, of whom, 1496 (40%, 95% CI: 38%-41%) were initiated on IPT. Among those initiated, 423 (28.3%) were still on IPT at the time of analysis. Among 1073 patients with declared IPT outcomes 870 (81%, 95% CI: 79%-83%) had completed the six-month course of IPT. The main reason for IPT non-initiation and non-completion was frequent drug stock-outs. This required health-care providers to restrict IPT initiation in selected patient subgroups and earmark six-monthly courses for each patient to ensure that, once started, treatment was not interrupted. The other reasons for non-completion were adverse drug effects and loss to follow-up. Conclusion:The combined picture of 'low IPT initiation and high completion' seen in our study mirrors findings from other countries. Drug stock-out was the key challenge, which obliged health-care providers to prioritize 'IPT completion' over 'IPT initiation'. There is an urgent need to improve the procurement and supply chain management of isoniazid.

Introduction:Patient safety is a global concern and is the most important domains of health-care quality. Medical error is a major patient safety concern, causing increase in health-care cost due to mortality, morbidity, or prolonged hospital stay.Aim:The aim of the study was to assess the perceptions on patient safety culture among health-care providers (HCPs) at a public sector tertiary care hospital in South India.Settings and Design:A hospital-based cross-sectional study was conducted 1 year after patient safety initiatives were implemented.Materials and Methods:Participants were selected through proportionate stratified random sampling. The Hospital Survey on Patient Safety Culture was used to assess perception of patient safety culture. Responses were collected on a Likert scale and were categorized into four types as negative, neutral, positive response, and nonresponse.Statistical Analysis Used:The data were entered in EpiData Version 3.1 and analyzed using SPSS Version 17. “Composite positive response rate” for the various dimensions was calculated.Results:The overall response rate in the study was 91.6%. Average composite positive response rate was 58%, and it varied among different cadres of HCPs ranged from 53% to 61%. The dimensions “teamwork within the unit,” “organizational learning and continuous improvement,” and “supervisor or officer-in-charge expectations” showed highest positive responses (80.1%, 77.8%, and 71.5%, respectively).Conclusions:This survey conducted after implementation of patient safety drive showed that, in many dimensions, the patient safety culture has taken roots. The dimensions such as “hand-off and transitions,” “frequency of events reporting,” and “communication openness” had scope for further improvement.

Background:In the stages of change model for smoking cessation, “willingness to quit” forms the starting point.Objective:To determine the prevalence and correlates of willingness to quit among smokers in India from Global Adult Tobacco Survey (GATS), 2009–2010.Methods:Secondary data analysis of GATS, 2009–10, was done to find the correlates of willingness to quit among smokers. All the sociodemographic variables, smoking-related factors such as frequency, previous attempt to quit, and also effect of antitobacco messages delivered to various media were tested for association using multivariable analysis.Results:Of 9627 current smokers analyzed, 50.9% [95% confidence interval (CI): 49.9–51.9] were willing to quit smoking. Multivariable analysis showed that younger age groups [prevalence ratio (PR): 1.31, 95% CI: 1.05–1.65], individuals who have their first smoke after 60 min of wakeup (PR: 1.19, 95% CI: 1.05–1.36), those living in a house with smoking restriction (PR: 1.29, 95% CI: 1.17–1.42), those who received advice to quit from doctor, those who attempted to quit in the past 12 months (PR: 1.28, 95% CI: 1.03–1.60), having knowledge about illness caused due to smoking, and those who have noticed antismoking messages in billboards/hoardings were willing to quit smoking compared to their counterparts (PR: 1.13, 95% CI: 1.04–1.23).Conclusion:Enforcing social restrictions like smoking restriction at house and also brief advice by doctors to quit smoking during any contact with the tobacco user could improve quit rate especially in young tobacco users and those who have attempted to quit before.