(Family Medicine) : Dr. Sandip Ganesh Patil

.
(Family Medicine)
CHRISTIAN MEDICAL COLLEG

VELLORE , INDIA
DEPARTMENT OF DISTANCE EDUC
DR. SANDIP GANESH PATIL

Reg. No. 431315126
Adm. No. 1341-TEMP-2013
IPPC India Priscribing and cilinical

behaviour database in Primary Care
Project Report
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Priscribing and cilinical behaviour

database in Primary Care
Among People Living In

Muktainagar Tehsil Area,
Dist - Jalgaon, Maharashtra, India
By,
Dr. Sandip Ganesh Patil

Reg. No. 431315126
For,
M.Med. - 2013
(Master in Medicine in FamilyMedicine)
CMC, Vellore
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M.Med. (Family Medicine) IPPC

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Table of Contents
ABSTRACT...............................................................................................................................4
INTRODUCTION......................................................................................................................6
AIMS AND OBJECTIVES........................................................................................................8
Aim.........................................................................................................................................8
Objectives...............................................................................................................................8
MATERIAL AND METHODS..................................................................................................9
RESULT AND DISCUSSIONS...............................................................................................10
Three most common diagnoses............................................................................................10
Reasons which makes these illnesses common....................................................................11
Low socio-economic condition of patient........................................................................11
Socioeconomic status.......................................................................................................12
Nutritional status of the patient........................................................................................14
Gender Male/Female.....................................................................................................16
Water Source....................................................................................................................17
Use of toilets....................................................................................................................19
Housing condition............................................................................................................20
Overcrowding...................................................................................................................22
Smoking and other environmental pollutions..................................................................24
Hand washing...................................................................................................................25
When should one wash hands?..................................................................................25
Drug Prescription.................................................................................................................27
MEASURE TO DEAL WITH COMMON PROBLEM IDENTIFIED IN THIS STUDY......29
SUMMARY & CONCLUSION.............................................................................................36
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ABSTRACT
Research Question: What are the prescribing and clinical behavior trends in primary care set
up in India?
Objective: To study the prescribing and clinical behavior trends in primary care.
Study Design: Community based Cross-sectional study.
Setting: People living in Muktainagar tehsil area and attending government hospital OPD
(Sub-district hospital Muktainagar).
Study Tools: Pre tested semi structure questionnaire.
Participants: Actual Study was conducted among 100 patients who attended government
hospital OPD (Sub-district hospital Muktainagar) during the April 2015 and May 2015
Ethical Concern: No ethical issues were involved.
Inclusion Criteria: Any patients attending OPD. First 5 patients studied for 20 consecutive
working days.
Exclusion criteria: None
Study Period: April 2015 and May 2015.
Results:
Following were the most common diagnoses among studied patients
1. Acute Gastro-enteritis (AGE)
2. Upper Respiratory Tract Infections (URTI)
3. Malarial fever
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This project was carried out in Government hospital where in all types of patient visit for
their health related concerns. Project aims to study the prescribing behavior of the
practitioners and the common illnesses that affect a community and the factors that influences
their occurrence.
It was observed that AGE, URTI and malaria are the most commonly occurring diseases and
the reason for this being poor sanitation, environmental pollution, overcrowding, low
socioeconomic status of the families etc.
Lot of work need to be done at the community level to improve the health of the community
residing in Muktainagar Tehsil right from safe drinking water to sewage drainage system and
all of this is possible only with collaborative efforts from the practitioners in the community,
active participation of the community and efforts from the policy makers.
Once again we will have to focus on the preventive part to bring about the change in the
health scenario of the Muktainagar Tehsil.
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INTRODUCTION
Patient with various illnesses visit day to day busy OPD more so in the government hospital.
Some illnesses are more common than the others. As a family physician it is important to find
out why there is a bias of certain illnesses occurring more commonly than the others, in an
attempt to find out the reasons behind this bias. This will supplement the act of prevention of
these illnesses, which should be the primary focus of every family physician.
Occurrence of illnesses depends on various factors, some of them are modifiable some are
not. We are more concerned with the factors that one can modify to bring about the change in
the health status of the patient at individual level and community at large. As opposed to the
western countries, India has majority of the disease load due to infectious diseases and our
existing health system and the current health expenditure focuses more on the treatment of
these diseases and very little on the prevention and disability limitation part. Family
physicians can play a major role in making the patients understand the importance of
prevention and ensuring their active participation in the process.
Prescribing medicines is another important issue in day to day practice. There is increasing
irrational use of drugs mainly because India does not have any SOPs regarding the treatment
of the disease and it is left to the better judgment of the physician. With pharma companies
invading the arena and influencing the prescribers behavior there is tendency to prescribe one
brand more than the others. Due to lacunae in the existing FDA system more and more sub-
standard medications are flooding the market and physicians are falling prey to it. With poor
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implementation of food and drug policies the number of such incidences is increasing day by
day.
The World Health Organization (WHO) has provided the essential drugs list for all countries.
Essential drugs was proposed by WHO in 1977 and defined as drugs with availability,
safety, effectiveness, and rational use. WHO reported that more than 50% of all medicines
were prescribed inappropriately. Some studies showed that importance of rational prescribing
in developing countries is higher.
The onus of rational prescription of drugs lies on the family physician. Family physician can
make decisions about the appropriate use of health resources. They can, with their active
participation and a little extra effort can reduce health expenditures and improve the health
outcomes.
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AIMS AND OBJECTIVES
Aim
To study current prescribing and clinical behavior trends in primary care set ups in India,
in Muktainagar Tehsil.
Objectives
1. To find out most common diagnoses in specified area.
2. To study the causes for these common ailments.
3. To study and find out methods to tackle the problem in holistic way as family
physician.
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MATERIAL AND METHODS
The cross sectional study was conducted among people living in Muktainagar tehsil area and
attending government hospital OPD (Sub-district hospital Muktainagar) during the April
2015 and May 2015.
There were total 100 patients who attended our private clinic during the April 2015 and May
2015.
Data collected during the regular OPD hours as first 5 patients daily for 20 consecutive days.
Parents or relatives brought their children or patient for illness or general checkup. At the
same time pre-formed questionnaire was filled after asking relevant detailed history and
current information.
Analysis was done by percentage and Proportion.
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RESULT AND DISCUSSIONS
Three most common diagnoses
1) Acute Gastroenteritis (AGE)
2) Upper Respiratory Track Infection (URTI)
3) Malarial Fever
Most common diagnoses
35%
30%
30%
25%
25%
20%
15%
11%
10%
5%
0%
AGE URTI Malarial Fever
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Its important to note that these 3 most common illnesses constitute 66% of the disease load.
So specific intervention targeted at these disease alone can dramatically change the health
scenario in Muktainagar tehsil.
Reasons which makes these illnesses common
Of the various risk factors that can affect the occurrence of the disease this study mainly
focuses on the modifiable risk factors and does not take into account the agent factor into the
consideration.
Risk FACTORS affecting occurrence of illness commonly encountered
during study
Low socio-economic condition of patient
Nutritional status of the patient
Gender Male vs Females
Water Source
Use of toilets
Housing condition
Overcrowding
Hand washing
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Socioeconomic status
There is a direct correlation between the socioeconomic condition of the family and the
occurrence of the disease. Families with per capita income less than 2000 per month are
repeatedly visiting the hospital for common illnesses as compared to those with per capita
income more than 2000 per month
Poor socioeconomic condition leads to,
Poor patient compliance
Poor sanitation
Health negligence
Financial constraints
Overcrowding
Low socio-economic condition is a vicious cycle where in lack of purchasing power leads to
negligence toward minor ailments which may lead to the advanced disease eventually and
puts the family under more financial constraint there by worsening the socio-economic
condition.
Of the 66 cases affected by common illnesses about 40 cases are from the low socio-
economic families with per capita income of less than Rs. 2000. As evident, malaria mainly
affects the families with less income due to poor sanitary environment and overcrowding.
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Given below is the occurrence of the common illness vis--vis the per capita income of the
family
Per capita AGE URTI Malaria

income in Rs
<2000 18 15 7 40
2000-5000 8 5 2 15
>5000 4 5 1 10
350.00%
300.00%
250.00%
200.00%
Malaria
150.00% URTI
AGE
100.00%
50.00%
0.00%
<2000
2000-5000
>5000
Bar diagram showing distribution of common illnesses as per the per capita income of the
family
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Nutritional status of the patient
Malnourishment exposes the body to infection and results in lower immunity. It also
increases the duration of recovery. Malnourishment leads to decreased cellular immunity
which results in repeated respiratory and gastrointestinal infections.
Vicious cycle
Infection decreased appetite malnourishment increased susceptibility to infections
Out of 100 patient studied 25 were found to be malnourished (Low weight for age), out of 25
patients 12 were suffering with RTI and 5 with AGE.
AGE URTI MALARIA

Malnourished (25) 15 9 4
Well nourished (75) 15 16 7
Above data suggest that incidence AGE is 60% among Malnourished Vs 20 % among well
nourished. This is due the fact that local and cellular immunity is affected in malnourished
patients making their mucosal lining susceptible to infection.
Malnourished patient have poor immunity and hence take more time to recover from the
illness and during this period the organism can develop resistance making it more virulent
and thereby also exposing the otherwise healthy contacts of the family to the infection.
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History of AGE and URTI in family was an independent risk factor for multiple family
members getting affected at the same time. This is due to the fact that family eats and drinks
from the same vessel and close contact with the members exposes to the URTI. Most of URTI
are caused by viral infections that are highly contagious and likely to occur in many members
of the family.
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Gender Male/Female
Of the total sample size 56 were females and 44 were males.
It was observed that females were more commonly affected by infectious diseases while
males were more commonly affected by trauma to various parts of the body compared to the
other gender. The reasons for these biases are not clear. It may be due to the fact that males
work outdoor and hence are more likely to be affected by trauma to the various parts of the
body including complaints of knee pain and backache.
Though the rate of occurrence of the common illness in females is more it is just marginally
more than the males
Incidence of illness among Male Vs. Female
17
15
18
16
13
14
12 10
Males
10 6
Females
8
5
6
4
Females
2
Males
0
AGE URTI Malaria
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Water Source
AGE (Acute gastroenteritis) is a food borne disease. If the faeco-oral hygiene is not
maintained the patient is exposed to various GI tract infections.
Of these drinking water is of special concern as food most of the time is served hot and
people with low social-economic status barely have outside food. The fact that AGE is the
most commonly occurring illness asks for special probe in the source of drinking water. The
source of drinking water for 98% of the patient is government water supply through tap
water. They consume water without any treatment like boiling or filtration or chlorination.
The government water supply is supposed to be pretreated with chlorine befor supplying but
the fact that AGE is still constituting 30% of the disease load demands further enquiry into
the methods and frequency of the process and its quality check measures.
Nearly 25% of the sewage water of the town is ultimately drained into the river in
Muktainagar Tehsil without any prior treatment. The data shows that treatment of water
before drinking drastically decreases the occurrence of AGE.
AGE cases
Some treatment before drinking (40) 5

No treatment before drinking (60) 25
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Incidence of AGE amongst cases using pretreated drinking water vs those using
non-treated drinking water
AGE
41.66%
45.00%
40.00%
35.00%
30.00% 12.50%
25.00%
20.00%
15.00%
10.00% AGE
5.00%
0.00%
Only 12.5% of the patient using pretreated water for drinking has AGE while about 41.66%
of the patient not using any treatment option for water before drinking have AGE.
Its also important to note that only 40% of the people use some or the other method of
treating the water before drinking.
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Use of toilets
With the government incentives for building toilet and campaign to discourage the open
defecation the use of toilet has almost become universal. Only 1 family out of the 100
families under scrutiny practice open defecation.
Open defecation is not a menace to the society but it spreads all sorts of GI tract infection by
the way of infecting the water directly or by infecting the food indirectly through flies.
There are still important steps to be taken in this direction by stressing the importance of hand
washing after every act of defecation and urination.
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Housing condition
Housing conditions are one of the major factor that will decide not only the occurrence but
also the outcome of the disease under scrutiny and more so in case of the infectious diseases.
India is a land of farmers and they still prefer the Kuccha house as compared to the Pucca
houses. This leads to poor sanitation and overcrowding.
Pucca houses mentioned here are made up of wood, bricks, cement, iron rods and steel.
Kuccha houses mentioned here are made up of wood bricks cement but it has roof made up of
tin or other material but not as modern slab of cement. It also includes houses made up of
wood, mud, straw and dry leaves.
Pie chart showing the distribution of type of houses of the patients
Houses
26
Kuccha Houses Pucca Houses
74
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Impact of the type of house on the occurrence of the disease
No. of Families AGE URTI Malaria

Kuccha Houses 26 10 8 8
Pukka Houses 74 20 17 3
It was observed that the incidence of occurrence of all the three common illnesses was more
in families living in the kuccha houses as compared to the families living in the pucca houses.
Special point to be noted is that the incidence of malaria for people living in kuccha house is
way higher than those living in pucca houses. This is due to the fact that kuccha house is in a
crowded community where the drainage system is not good and more often than not there is
stagnation of water providing good breeding ground for the mosquitos.
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Overcrowding
Overcrowding is one of the most important risk factor for occurrence and spread of the
disease. It adds to the communicability of the disease. Overcrowding among families affects
the health of the members adversely. Overcrowding itself leads to poor sanitation and lack of
fresh air, exposing the patient to newer infections and quicker transmission of the illnesses.
As it was not possible in this study to identify the exact size of the house and per capita
availability of area, so we have recorded the number of family members and analyzed the
data.
AGE URTI Malaria Total No. of patients

with three most common
illnesses
No. of family 30 25 11 66
members
4 5 4 3 12
5 to 6 14 9 2 25
7 11 12 6 29
It was observed that as the family size increases the rate of occurrence of the illness also
increase. This is due to the various factors mentioned above.
Among the families with less than or equal to 4 members living together the rate of
occurrence of the illness is least with only about 12% getting affected as compared to the
43% with families having 7 or more members living under one roof.
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Overcrowding impact on occurrence of illness

50.00%
43.93%
45.00%
40.00% 37.87%
35.00%
30.00% Common illnesses
25.00%
20.00% 18.18%
15.00%
10.00%
5.00%
0.00%
<4 5 to 6 7
Analysis suggests that incidence common illnesses increases with increase in number of
members in family. Most probable cause for this is lack of attention towards individual
member of the family supplemented by overcrowding and poor sanitation.
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Smoking and other environmental pollutions
Only 10 out of 100 patients gave history of smoking on a regular basis and the incidence of
URTI in these 10 cases was 30% which was considerably higher as compared to the non-
smoking population. The smoking not only affects the person who smokes but also affects the
people around him wo passively inhales the smoke.
There are not industries around the tehsil so the effect of industrial smoke and the industrial
waste disposal was not taken into consideration
Many families still use kerosene or biofuel like dried cow dung and dry wood as fuel to cook
food and heat the water as its easily available and cheap. This also adds to the incidence of
respiratory tract problems especially in children who can easily develop URTI or allergy or
even Bronchial asthma. These are burnt in simple stoves with very incomplete combustion
generating a lot of toxic products that adversely affect specific and non-specific local
defenses of the respiratory tract.
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Hand washing
Hand washing is most effective measure to prevent illnesses specifically GI related illnesses.
Hand washing technique and frequency both are very much important.
When should one wash hands?
Before, during, and after preparing food
Before eating food
Before and after caring for someone who is sick
Before and after treating a cut or wound
After using the toilet
After changing diapers or cleaning up a child who has used the toilet
After blowing your nose, coughing, or sneezing
After touching an animal, animal feed, or animal waste
After touching garbage
In this study it was observed that very few patient practice at least some part of the hand
washing while other do not practice hand washing at all except for after the act of defecation.
Whats important to note is that people do not practice hand washing even after the act of
urination, there by ingesting and infecting the other food articles with the hands.
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Only 10% of the patients routinely practice hand washing after the use of lavatories and
before ingestion of meal. Interesting fact about these 10 cases is that all of their families per
capita monthly income is >5000 rupees and are literate to the level of at least !2th std i.e.
HSC. This shows a direct correlation between the education and hygienic practices.
None of the patient new about the timings of hand washing neither do they know about the
correct technique of hand washing. They have never been educated or advised by anyone
about hand washing.
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Drug Prescription
Drug prescription depends not only on the illness of the patient but there are other Factors
which directly or indirectly influence the prescription behavior like demographics of the
patient, prescribers bias, pharma promotions and incentives etc. The discrepancies in the
prescription are due to lacunae in the current treatment guidelines and not having standard
operating protocols for a particular disease.
It was observed that out of the 84 cases with infectious origin all were given one or the other
antibiotic along with other medication. All the cases of AGE, URTI and Malaria were given
antibiotics.
Though Not AGE cases need antibiotics and they can be treated with ORS and supportive
therapy alone still antibiotics were prescribed to these patient in view of avoiding further
deterioration of the health condition, prevention of superadded infection on compromised
immunity levels, quicker recovery etc. With due consideration to the living conditions of the
patient and their families, antibiotics have been used widely to avoid further spread of the
disease to the contacts.
All the cases of URTI have been prescribed antibiotics. Although most of the URTI are viral
in origin but to avoid the superadded infection with bacteria antibiotics have n=been used.
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There is increasing demand from the patient for giving at least one injectable on the OPD
basis. It was observed that 64 of the 100 cases were given one or the other Injectable on OPD
basis.
Prescription of antibiotics data
Prescrition Behaviour
90% 84%
80%
70%
60%
50%
40%
30% 16%
20%
10%
0% Prescrition Behaviour
Prescription of antibiotics leads to early recovery and less chances of complications. It
decreases the need for repeat visit. Due to high level of environmental pollution and exposure
to dust even viral URTI becomes secondarily bacterial in 2-3 days in substantial number of
patients, which can be prevented by use of antibiotics as prophylactic and curative.
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MEASURE TO DEAL WITH COMMON

PROBLEM IDENTIFIED IN THIS STUDY
Health education
Single most important step that can reduce the burden of diseases
Including Health education as a part of every consultation
Spreading the awareness through ARSH clinics
Organising special meet at school and college levels to provide health education
Including health education in the regular syllabus of the student
Educating the Government sanitation department about effective measures to control
and curb the spread of infections from the infectious material
Stressing the importance of good personal hygiene and sanitation to every patient
Making literature regarding use of toilets, benefits of hand washing, safe drinking
water available in the waiting area
Educating the patient regarding his current condition and discussing with him what
might have been the cause of this illness and how he can avoid it next time will ensure
the empowerment of the patient and will ensure his active participation in the process
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Health Promotion
Hand washing poster and distribute pamphlet
Every hospital in the community should have poster in the waiting area for educating
the patients about the most common illnesses
Celebrating health days at the community level to spread awareness and increase the
participation of the community
Community function should be utilized to spread awareness about the healthy
practices and importance of participation of community as a whole to effect the health
outcome of the community positively
Touch point promotions can be used to remind and stress about the healthy practices
like having hand washing poster in all the public lavatories, having small hand
washing reminder on all the handles of the public lavatories and public restaurents
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Inclusive Policy
Ensure the participation of all the sections of the society for better outcome
Policy makers should be included in the campaigns for eg. Water supply department
should be educated about proper water treatment before supplying to the public,
sanitation department should be educated about how to prevent mosquito breeding
grounds
Only with participation of all the sections of the community and their collaborative
efforts can the health status of the community be lifted
Working in collaboration with policy makers and pointing out any specificities of the
neighborhood that might be affecting the health outcome of the residents of that
neighborhood for eg. Stagnant sewage water in a locality might be causing more cases
of malaria in that locality. With the help of policy makers this can dealt with
Working with education provider and bringing about change in inculcating healthy
habits in children at school and also ensuring the balanced nutrition provision to the
children through mid-day mean scheme
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Specific Measures
Specific measures need to be taken in Muktainagar tehsil to reduce the number of patient
getting infected. These are directed to a particular cause based on the data available from the
study
1. Proper treatment of water before supplying to the public
AGE is the most common illness affecting the patients and since all the people are
drinking from the tap water from the government supply, it would be very effective if
we could ensure the proper chlorination of the water before it is being supplied. This
alone will reduce the number of cases drastically
2. Avoiding sewage water drainage into the river water
In Muktainagar tehsil the water supply of the government is from the Tapi river and
also about 25-30% of the sewage water of the town is drained into the river. This
increases the chances of infection through feco-oral route. Health stats should be
provided to the policy makers and steps need to be taken to curb the drainage of
sewage water into the river. Drainage system of the town needs to be improved and
diverted elsewhere away from the source of drinking water
3. Regular emptying of the gutters and covering them
The stagnant water in the gutters which are just in front of almost all the houses and
are open are the most important breeding grounds for mosquitos. These should be
drained regularly so that the water in the gutter is free flowing and not stagnant and
also wherever possible the gutters should be closed.
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4. Pollution control measures
There is hardly any implementation of the traffic rules in the town with almost none
of the vehicles having PUC. These vehicles emit lot of polluted gases which are
hazardous to children as well as one of the important causes of Respiratory tract
illness. Traffic should be monitored and traffic police should be made available at the
major traffic sites with special attention to emission of gases
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Medical fraternity meets
Doctors residing in the Muktainagar tehsil should meet at least quarterly and discusses about
the common illnesses they are encountering in their OPDs and what can be done to overcome
these illnesses from a treatment as well as prevention point of view. They can also include the
policy makers in these meets. Meets can be arranged at the beginning of the specific season
like rainy season or on emergency basis in the time of epidemics.
Early Diagnosis
Clinicians in the area should be well equipped clinically and technologically to diagnose the
disease early. This will prevent the unnecessary complications and health expenditure as well
as the load of the physicians. At the same time unnecessary investigations should be avoided.
Prompt Treatment
All the physicians in the area should follow a strict protocols about the treatment of the
common illness which should be finalized during the Medical fraternity meeting. Any
resistance to antibiotics encountered during the practice should be notified to the physicians
in the vicinity
Early referral
Muktainagar being a small town not much of the medical facilities are available in the town
and there may arise a need to refer the patient. The referral if needed should be prompt and
patient should not be lost to referral. It takes 2 hours from the town to go to the next best
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P a g e | 35
health facility and hence the transportation should be available 24*7 for referring the patients.
In cases of emergency even Private practitioners can use Government Ambulance by paying
the due charges in our town
Early detection of Complication and Disability Limitation
Complications if any should be detected early to prevent and limit the disability of the patient
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SUMMARY & CONCLUSION
Muktainagar tehsil is town place with people from all the economic strata but more with low
socioeconomic status. The most common illnesses encountered in this community are
a. Acut Gastro-Enterities (AGE)

b. Upper Respiratory Tract Infection (URTI)
c. Malarial Fever
The low socioeconomic conditions of the patient exposes to the array of other risk factors like
overcrowding, financial constraints etc and has emerged to be the most significant risk factor
with 80% of the patient with common illnesses belonging to low socioeconomic strata.
With AGE and Malaria in the list suggest the poor water sanitation in the community. Only
40% of the patient use pretreated water for drinking. Nearly 42% of the cases of common
illnesses are amongst the patients who do not use any form of water treatment measures
before drinking. About 25% of the towns sewage water is drained into the river from where
drinking water is supplied to all the townsmen.
Poor hygienic condition is one the important reasons of spread of these common illnesses.
None of the patient new about correct timings and technique of hand washing and only 10%
regularly practice hand washing after the use of lavatories and before meal. Overcrowding
leads to poor hygiene and spread of infections. Nearly 80% of the patient from the common
illness group were from the families whose family size was more than or equal to 5.
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P a g e | 37
Other factors that contribute to the occurrence of these common illnesses in some or the other
way are poor nutritional status of the patient, environmental pollution, poor sanitation etc.
Though the quantum of the problem looks big it can be dealt with by focusing on prevention
and active community participation with collaborative efforts from physicians, community
members and policy makers
Educating the community members through various touch points and providing them with
literature regarding the measures to be taken is most important step. Making posters and
pamphlets available in the waiting area. Specifically targeting the young generation for health
education through ARSH clinics, Schools and colleges. Celebrating health days and ensuring
community participation
Poor community sanitation needs to be strictly dealt with. Make provision of safe drinking
water to everyone in the community. Avoid the disposal of sewage water in the river.
Regular emptying of the gutter to avoid stagnation of water and to ensure that there is no
stagnated water in the vicinity of ones home.
On a broader perspective more employment opportunities should be made available to bring
about the financial upliftment of the community as a whole.
Early diagnosis, prompt treatment and disability limitation still remains the pillars of
secondary and tertiary prevention.
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There is a wide spread use of antibiotics with all the cases of infections and fever. All the
cases under the study having some kind of infection were treated with one or the other
antibiotics. Also nearly 64% of the patient has been given injectable in one or the other form.
To improve the health scenario in the Muktainagar tehsil it is paramount that Healthcare
workers, Policy makers and community members work in tandem. This is the basic
foundation on which a healthy community can be build.
There is a need for strict SOPs for common illnesses to avoid irrational use of scares
resources and to avoid the unnecessary load on the health expenditure. Also government
needs to start spending more on the prevention part of the disease
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(Family Medicine) : Dr. Sandip Ganesh Patil

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CHRISTIAN MEDICAL COLLEG

DR. SANDIP GANESH PATIL

IPPC India Priscribing and cilinical

Priscribing and cilinical behaviour

Among People Living In

Dr. Sandip Ganesh Patil

M.Med. (Family Medicine) IPPC

M.Med. (Family Medicine) IPPC

Study Design: Community based Cross-sectional study.

Study Tools: Pre tested semi structure questionnaire.

Ethical Concern: No ethical issues were involved.

Exclusion criteria: None

Study Period: April 2015 and May 2015.

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socioeconomic status of the families etc.

health scenario of the Muktainagar Tehsil.

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prevention and ensuring their active participation in the process.

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in developing countries is higher.

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AIMS AND OBJECTIVES

1. To find out most common diagnoses in specified area.

2. To study the causes for these common ailments.

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MATERIAL AND METHODS

2015 and May 2015.

Analysis was done by percentage and Proportion.

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RESULT AND DISCUSSIONS

Three most common diagnoses

1) Acute Gastroenteritis (AGE)

2) Upper Respiratory Track Infection (URTI)

Most common diagnoses

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scenario in Muktainagar tehsil.

Reasons which makes these illnesses common

Risk FACTORS affecting occurrence of illness commonly encountered

Low socio-economic condition of patient

Nutritional status of the patient

Gender Male vs Females

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income more than 2000 per month

Poor socioeconomic condition leads to,

Poor patient compliance

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Per capita AGE URTI Malaria

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Nutritional status of the patient

increases the duration of recovery. Malnourishment leads to decreased cellular immunity

which results in repeated respiratory and gastrointestinal infections.

Infection decreased appetite malnourishment increased susceptibility to infections

patients 12 were suffering with RTI and 5 with AGE.

AGE URTI MALARIA

patients making their mucosal lining susceptible to infection.

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Of the total sample size 56 were females and 44 were males.

body including complaints of knee pain and backache.

more than the males

Incidence of illness among Male Vs. Female

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