Relation between 6 minute walk test and spirometric parameters [FEV1 and FVC] in patients with COPD is investigated. There is no published data in India in this respect. Hospital based cross sectional study. Clinical COPD questionnaire score, Forced expiratory volume in first second (FEV1) and Forced expiratory volume (FVC), 6 minute walk distance and 6 minute walk work were calculated and compared. Data was analyzed by SPSS 11. It was observed that 11.1 % had overall clinical copd questionnaire (CCQ) score of more than 3; 62.2% had baseline PaO2 between 60-80 mm Hg;88.9% had baseline PaCO2 lower than or equal to 45 mm Hg; 53.3% had severe COPD according to GOLD spirometry criteria;13.3% had complication of Pulmonary artery hypertension; 64.5% walked more than 300 meters distance and 21.1% (8) of patients with severe copd had significant desaturation during walk test. There was low positive correlation with no statistical significance between FEV1 and 6 MWD (r= 0.280, p= 0.062) and between FVC and 6 minute walk distance(r= 0.289, p= 0.055). Demographic parameters like age, BMI, smoking score, spirometry and baseline paco2 were not correlating with 6 minute walk distance. BMI and FEV1 (forced expiratory volume) were more correlating with 6 minute walk work. Severity of airway obstruction or pulmonary artery hypertension was not predicting significant desaturation during walk test. Measuring walk distance alone is not sufficient for assessment of severity and functional status of COPD the patients. 6 minute walk work, which is the product of walk distance and body weight, is more correlating with severity of the disease.
Background:Health professionals are documented as an important cause for stigmatizing people living with HIV (PLHIV). Since traditional teaching on HIV in India does not address cultural competencies, medical graduates lack sociocultural sensitiveness while addressing the health needs of PLHIV.Aim:The aim of this study is to develop and to implement a module for medical graduates to improve their sociocultural sensitivity toward PLHIV.Methodology:A module was designed and introduced to address the core sensitive issues in HIV among medical graduates with the help of trained faculty. It included community education sessions including interaction with PLHIV to address cross-cultural issues and understand their health needs. Feedback for the perception of faculty and students was obtained. Knowledge and skills improvement was assessed through pre- and post test and direct observation of procedural skills (DOPS).Results:Mean feedback score was high for all the components covered by the module. It was found to be more for “usefulness of module” (4.91 ± 0.27836 on a scale of 5) than other components of the module. Feedback by faculty showed almost perfect agreement on “improvement of student's clinical skills” and “bringing perfection in their future practice” across multiple raters. Multiple response open-ended feedback showed, 78 (19%) responses affirmed improvement in communication skills with training in this module. Pre- and post test mean score for knowledge showed an increase (22.1 to 26.49). Mean skills improvement as per expectations were 86.81 and beyond expectations were 5.34.Conclusions:Training the medical graduates in structured HIV specific module improves their socio-cultural sensitivity toward PLHIV and is perceived useful.
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