Background: Global reports show that falls are the major cause of disability injuries among the elders. Developing countries lack the required epidemiological data on the burden of falls and factors that contribute to it.The objectives of the study were to find the burden of fall and its distribution in time, place and person among elders and to identify risk factors associated with fall among elders. Methods: A community–based cross-sectional study of 655 elders (≥ 60 years) was done in a rural area of Coimbatore District by two stage sampling technique. History of fall within the past 6 months was included in the study. Semi-structured pre-tested questionnaire was used to assess factors contributing to falls. The burden of falls was expressed as proportions and percentages. Logistic regression analysis was done to identify risk factors for fall. Results: 26% (95%CI: 22.59-29.32) elders experienced at least one fall. Of the total falls 50.2% occurred outside home and the remaining inside home. Most of the falls occurred during ambulation and at the morning hours (39.1%). Age ≥80 years (OR: 3.28, 95%CI: 1.28-5.98) and dizziness (OR: 3.27, 95%CI: 1.00-10.06) were only found to be significantly associated with fall on multivariate analysis. Conclusions: The occurrence of fall was found to be almost similar to that identified in western countries where fall preventive measures have been implemented. Similar efforts are yet to be initiated here and so this study provides the evidence for the need. Prospective studies through more frequent home visits are needed to confirm the enormity of the problem to suggest policy recommendation.
Background: Certain risk factors present in the immediate housing environment may contribute to falls. Research shows one half to two thirds of falls occur in or around the house of elders. There is a need to keep the houses of elder's age friendly to prevent falls and enable them to do their daily routine comfortably. Objectives: To assess the proportion of elderly (≥60 years) houses that comply with housing standards to prevent falls using fall prevention screening checklist. Method: Observational checklist was prepared from recommended standards of homesafety for fall prevention and modified to screen the individual rooms in rural houses of elders. A total of 655 houses were screened for the study. Results: Common housing risk for fall identified were poor lighting of living room (95%) and bedroom (94%) and absence of light switch near the bed (63%) in the bedroom. 73% of bathroom was located outside the house with 41% having uneven /slippery surface. Only 68.2% had personal toilet of which 66% was present outside the home, 98% had no handrail and absence of western toilet in 62%. Area surrounding the house had stones, leaves and other obstacles in 44% of homes. Conclusion: Overall, using the fall-prevention screening checklist, almost all houses were found to be risky for fall with only very few houses being found to be fall-risk free. Further research has to be done to establish the validity of this tool or to recommend new standards for conditions peculiar to rural India that potentially appear to contribute to fall.
Background: Paederus dermatitis (PD) is common skin condition occurring in South India caused due to contact with Rove beetle. It is often misdiagnosed due to wide difference in its presentation. The aim of this study was to describe the clinical, sociodemographic, and environmental condition of patient’s presenting with PD. Methodology: A descriptive study was done among all patients diagnosed of PD at the Dermatology department of a teaching hospital in Trichy, South India, between January and December 2020. A detailed clinical history, examination of the lesion, and systemic examination was done. Patients were followed-up after 1 week to re-assess the lesion. A total of 117 cases were included in the final analysis. Results: The mean age of patients was 24.54 ± 11.8 years. Female were 51% with 84.6% residing in rural area. Majority of the cases presented between January and May. Presence of thick vegetation (85.5%) and sleeping with windows open (60.7%) were found to be the common risk factors. Most patients reported noticing the lesion in the morning with sudden onset associated with redness and tenderness with a bizarre pattern of lesion. Face, neck, and upper extremity were the most affected sites with burning sensation and itching, experienced by 82.1% and 76.1%, respectively. Ocular involvement with peri-orbital odema was seen among 17% of cases. Post-inflammatory pigmentation was present in 92.1% patients. Conclusion: PD present has a varying degree of skin lesions with absence of the typical linear pattern. Knowledge of its presentation is important to avoid misdiagnosis.
Nonalcoholic pancreatogenic diabetes mellitus (type 3c DM) is an often-misdiagnosed entity usually seen in young men of tropical countries. Although most of the patients present with abdominal pain and symptoms of exocrine pancreatic insufficiency, there is still a subset that does not present with these classical symptoms, which emphasizes the need for special diagnostic considerations. The significance of identifying this subset of diabetic lies not only in the change in management of the disease but also in early detection for pancreatic carcinoma that is more common among those patients. In our case, ultrasound with X-ray played a vital role in diagnosis, prompting us to consider it as an essential part of the investigation panel in all newly diagnosed nonobese diabetic individuals.
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