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Σάββατο, 22 Οκτωβρίου 2016

Effect of Field and Experimentally-induced Cases of Frothy Bloat on Physical Examination, Rumen Fermentation Pattern and Blood Constituents in Baladi Egyptian Sheep

2016-10-22T07-22-23Z
Source: International Journal of Livestock Research
Mahmoud Saber Abdulkader.
Rumen fermentation pattern of sheep is greatly affected by several factors. This research studied the effect of field and experimentally-induced cases of frothy bloat on physical examination, blood constituents and rumen fermentation efficiency in Baladi Egyptian sheep. Sixty-six native breed Baladi Egyptian sheep were classified according to clinical presentation into fifty-eight apparently healthy sheep and eight clinically diseased cases of frothy bloat divided into three field cases due to grazing on lush pasture of barseem and five experimental cases induced by ingestion of cabbage leaves. All animals were subjected to detailed case history, comprehensive clinical examination and sampling of blood and rumen liquor for analysis. Results revealed that field and experimentally-induced cases of rumen frothy bloat caused highly significant increase in pulse and respiratory rates with highly significant decrease in rumen motility. Field cases of frothy bloat caused highly significant increase in Holotricha % and monocytes % with highly significant decrease in TPC, Entodinium %, TVFAs, lactic acid, propionic acid, butyric acid, acetic acid, CH4, lymphocytes %, albumin and A/G ratio. Experimentally-induced cases of frothy bloat caused highly significant increase in Hb and MCHC with highly significant decrease in TVFAs, lactic, butyric and acetic acids, A/P ratio, CH4 and CH4/TVFAs %. It could be concluded that barseem lush-pasture bloat has more dramatic effect on rumen fermentation efficiency than bloat due to ingestion of cabbage leaves. Frothy bloat is still field problem of concern despite awareness of sheep farmers. Further investigations are highly recommended from aspects of rumen methane, rumen enzymes and rumen ciliates for therapeutic and productive purposes


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SG 9R Vaccine to control Salmonellosis in poultry breeder flocks in Sri Lanka

2016-10-22T07-22-23Z
Source: International Journal of Livestock Research
Nilukshi Liyanagunawardena, Palika Fernando, Gayani Weerasooriya, Geethanjali Wijewardena, Chandima Samarakoon, Kanchana Abayarathna.
The present study was conducted as a part of a larger project aimed at evaluating the immunity development of SG 9R vaccine. The experimental protocol included three breeder farms in Sri Lanka, where collection of blood was done before and after vaccination, following which serological tests were carried out. Whole Blood Agglutination Test (WBAT) revealed none of the birds to be sero positive while an indirect ELISA indicated statistically significant (p


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A cross-sectional study to assess the immunization coverage and vaccine dropout rates among 12 to 23 months old children in a rural area of Tripura

2016-10-22T05-38-38Z
Source: International Journal of Medical Science and Public Health
Anjan Datta, Chanda Mog, Shampa Das, Srabani Datta.
Background: Vaccine-preventable diseases are major causes of under-5 mortality in India. As per World Health Organization (WHO) estimates, India has the largest dropout rate for three doses of DPT vaccine. Objectives: To assess the immunization coverage and vaccine dropout rates among 12 to 23 months old children of Mohanpur area, Tripura. Materials and Methods: A community-based cross-sectional study has been conducted among 330 children of 12 to 23 months age group from Mohanpur area, under the rural field practice area of Department of Community Medicine, Agartala Government Medical College, using Lot Quality Assurance Sampling (LQAS) technique for a period of one year. A pre-designed, pre-tested questionnaire has been used to collect required information with verification of immunization card and where the card is not available, by examination of scar mark or interviewing the respondent. Data has been analyzed using computer software SPSS version 21.0 and data are expressed in the form of diagrams and tables in percentages. Results: Out of total 330 children between 12-23 months age group surveyed, 59.7% were males and 40.3% were females, and 300 (90.9%) were fully immunized, whereas 29 (8.8%) were partially immunized. This study also reveals BCG-DPT3 dropout rate to be 2.1%, BCG-Measles Dropout rate at 3.9% and DPT3-Measles dropout rate to be 1.8%. Conclusion: Higher coverage of Full immunization and lesser dropout rates for individual vaccines in our study population indicates better access to immunization services by the selected rural population of Tripura.


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Study of acute flaccid paralysis cases at tertiary care hospital Belagavi, Karnataka

2016-10-22T05-38-38Z
Source: International Journal of Medical Science and Public Health
Preet Khona, Abhishek Prayag, Girija S Ashtagi.
Background: Acute Flaccid Paralysis (AFP) surveillance is a key strategy for monitoring the progress of polio eradication and is a sensitive instrument for detecting potential poliomyelitis cases and poliovirus infection. Differential diagnosis of Acute Flaccid Paralysis includes Guillain-Barre Syndrome (GBS), transverse myelitis, traumatic paresis etc. Although these cases are prevailing in the community, the reporting is still inadequate, an understanding of the natural history of AFP is necessary to boost surveillance. Objective: The objective of this study is to ascertain the clinic epidemiological profile of AFP cases admitted in a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted from June 2014 to July 2016 among reported AFP cases to Ashoknagar Urban Health Centre from Pediatric department of KLE Hospital. A total of 41 cases were investigated. A predesigned questionnaire was used to collect data regarding sociodemographic characters, immunization history, travel history, clinical history etc. A detailed clinical examination was done for each case. Hospital records were referred for provisional diagnosis. Results: A total of 41 AFP cases were investigated. Male to female ratio was 1.92:1. The majority of them i.e., 41.4% belonged to age group between 5 to 9 years. Most of the cases i.e., 58.5% were seen during monsoon season. Guillain-Barre (GB) Syndrome constituted around 80% of the cases with most of them presenting as ascending paralysis. Conclusion: The most common cause of AFPs was Guillain-Barre syndrome. There was an increase in the number of cases during Monsoon season. Public-private partnerships help in early reporting and rapid investigation of cases.


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Primary Low Grade Spindle Cell Sarcoma Of The Breast

2016-10-22T04-02-32Z
Source: The Southeast Asian Journal of Case Report and Review
Anne Wilkinson, Radhika Mhatre, Anjali Patrikar.
Spindle cell sarcomas of the breast are very rare accounting for 0.2 to 1 % of all breast malignancies. Sarcomas of the breast differ from the invasive epithelial cancers in their presentation, behavior, management, staging and prognosis. Hence it is important to be aware of these rare lesions. This article describes a case of primary low grade spindle cell sarcoma of the breast in a 70 year old female patient.


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Immunization coverage in the district Sirmaur, Himachal Pradesh, India: evaluation using the 30 x 7 cluster sampling technique

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Anupam Parashar, Anmol Gupta, Narender Mahajan, Vijay Barwal, Devender Verma, Amit Sachdeva, Shishupal Thakur.
Background: Immunization plays an important role in reducing morbidity and mortality in children. Despite all the efforts put in by government for 100% immunization coverage, it was only 53.1% in District Sirmaur among children aged 12-23 months as per District level Health Survey -4. The objectives were to assess the primary immunization coverage among children in District Sirmaur of Himachal Pradesh as compared to NFHS-3 and DLHS-4. Methods: A cross-sectional study was conducted in District Sirmaur using the World Health Organization's 30 X 7 cluster sampling method for evaluation of immunization coverage during the period October 2015- January 2016. Results: A total of 210 children aged 12-23 months were covered for the evaluation, of which 95.20% of the children were fully immunized. However, immunization card was available with 77.14% of them. Zero dose of OPV was given to only 47.62% children and BCG scar was present in 82.38% of the study participants. The most common cause for partial immunization was being unaware of need for immunization. Conclusions: Majority of the children ages 12-23 months were fully immunized. The key to further improvement is to monitor drop out at any stage of vaccination before completion of full course of immunization.


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Diphtheria outbreak in a district in Meghalaya, India: an overview

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Himashree Bhattacharyya, Amrita Sarkar, Gajendra K. Medhi, Star Pala.
Diphtheria is an infectious disease which has continued to cause illness and death in children even after the advent of vaccine and diphtheria anti-toxin. Since, immunization is an important tool against this disease, countries with poor immunization coverage still continue to experience several outbreaks of diphtheria, both reported and unreported. India is one of the worst affected counties of diphtheria and here mortality remains to be high as well due to unavailability of diphtheria anti-toxin. The present article aims to highlight one such outbreak in the remote part of North-eastern region of the country wherein diphtheria anti-toxin is not available in the entire region making the chances of fatality higher. A total of 7 cases of diphtherias were found in the present outbreak. Case fatality rate was 28.6%.6 out of the 7 cases were unvaccinated. Low immunization coverage along with poor living conditions as well as ignorance of community was found to be the major risk factors leading to this outbreak.


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Magic mobile numbers can save lives: a step towards prompt and effective communication

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Sudip Bhattacharya, Jitender Singh Sodhi, Anil Kumar Gupta.
Effective communication is an important part of health care management. The current study brings forth the perspective of effective communication through the timely usage of key mobile number which actually saved the life of a critical patient in trauma centre of our setting. A patient X, 07 years old female child, case of severe Grade IV dog bite with complete avulsion of scalp and in an unconscious state was brought to the Advance Trauma Centre of PGIMER. She was requiring approximately 40,000 IU of immunoglobulin as a life saving measure on an urgent basis which as per the information by routine communication path of general surgery resident was not available in the hospital. The request involved multitude of challenges: The urgency of the life-saving serum at night time, the poor patients unaffordability to procure the serum from outside which was amounting to approximately INR 20000 and above all the limited administrative financial power to senior resident hospital administration for INR 2000. In such a situation of crisis, the use of magic mobile number by the senior resident hospital administration proved to be miraculous. The immunoglobulin was arranged, given to the critically ill patient and actually saved her life. The case report establishes the importance of cross-checking, an important aspect of communication in healthcare management and the prompt use of a contact number from list of 10 contact numbers of the key officials who are manning the various hospital services available in the administrative control room. Though this is an era of telemedicine and pima facie it was a form of communication gap and a simple step involving prompt thinking in the right direction, going back and completing the loop of communication actually proved out to be life-saving. In the context of resource limited settings, if we can improve and innovate in our communication network within the existing hospital framework, it can save lives.


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Bacteriological and physicochemical parameters of some selected borehole water sources in Abakaliki metropolis, Nigeria

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Iroha Chidinma, Okonta Matthew, Ele Grace, Nwakaeze Emmanuel, Ejikeugwu Chika, Iroha Ifeanyichukwu, Ajah Monique, Itumoh Emeka.
Background: Borehole water (groundwater) is the predominant source of water by the inhabitants of Abakaliki metropolis and it is generally considered a safe source of drinking water by the populace. This study was therefore, designed to assess the physicochemical and microbiological quality of borehole water samples in Abakaliki, Ebonyi State, Nigeria. Methods: A total of twenty-five (25) water samples were collected from five (5) different locations (designated as point A, B, C, D and E) in Abakaliki and the temperature readings were taken at the site of collection. The physico-chemical parameters (turbidity, pH, total hardness, dissolved oxygen, electrical conductivity, phosphates, sulphates), microbiological and metal content were determined using standard techniques. Furthermore, the pathogens isolated were subjected to antibiotics susceptibility testing using disc diffusion method. Results: The results of the microbiological study revealed that the bacterial pathogens isolated in this study include E. coli (40%), Staphylococcus aureus (32%), Pseudomonas aeruginosa (16%) and Klebsiella spp (12%). The borehole water was of low turbidity, colourless, odourless, and with ambient temperature. The values of the bacteria counts were 2.4x104 cfu/ml for bacteria pathogen isolated from location A, 2.3x103 cfu/ml for location B and location C, 2.1x104 cfu/ml for location E and 1.0x104 cfu/ml for location D. Antibiotics susceptibility studies showed that all isolated bacteria pathogens were highly resistant to most of the tested antibiotic especially nalidixic acid, ciprofloxacin, gentamicin, cefoxitin, sulphamethoxazole-trimethoprim, tobramycin, ofloxacin and erythromycin. Conclusions: Findings from our study revealed that the borehole water analyzed within Abakaliki metropolis contained bacteria that are of public health importance including E. coli, S. aureus, P. aeruginosa and Klebsiella spp. The physical and chemical parameters of the water samples were found to be within the maximum accepted limits for drinking water with optimal physical and chemical properties. It was also discovered in this study that the isolated bacteria showed reduced susceptibility to some conventional antibiotics. It is therefore recommended that periodic assessment of the physicochemical and microbiological properties of borehole water in this area be carried out on water sources for public use in order to avoid the outbreak of some waterborne infections amongst the populace.


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Utilization pattern of social welfare schemes among women beedi workers in comparison with non-beedi workers

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Vijayalaxmi Mangasuli, Mayur S. Sherkhane.
Background: Social security is basic fundamental human right, felt need and demand of the people for their wellbeing in the society, its fulfillment will contribute in achieving various developmental goals of the nation. In India, beedi industry has one of the largest employers of workers, after agriculture and construction, of which most of them are from socioeconomically backward populations living in urban slums and these people are the one who utilize social welfare and healthcare schemes to the highest level. Thus this study was done to know socio-demographic profile and utilization pattern of social welfare schemes among women working as beedi workers in comparison with non-beedi workers. Methods: Community based cross sectional study among 100 beedi workers and 100 non-beedi workers residing in urban slums, for a period of three months. House to house survey was done and utilization pattern of social welfare schemes were noted. Results: Of the 200 women, maximum 34% beedi workers and 30% non-beedi workers were in the age group of 30-39 years, 90% beedi workers and 66% non-beedi workers were illiterates and 62% beedi worker as well as 82% non-beedi worker belonged to nuclear family. 54% and 42% were from class IV socioeconomic status. 96% of beedi workers were utilizing BPL services compared to 84% of non-beedi workers (χ2=5.355, df=3, p=0.005). In addition, 78% beedi workers were utilizing health and education benefit from beedi worker welfare fund scheme. 68% of the beedi workers were utilizing BPL services, inspite their monthly income was more than 1000Rs compared to 54% non-beedi workers whose monthly income was less than 1000Rs, which was found to be statistically significant (χ2=22.33, df=1, p


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Sleep apnea risk, cognitive and functional impairment: hidden trio’s among elderly: an exploratory study in Mysore, Karnataka, India

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Savitha Rani B. B., Praveen Kulkarni, Sunil Kumar D., Renuka M., Ashok N. C..
Background: Advancement in medical sciences with socioeconomic improvement across the country have led to increased life expectancy among Indians, which has resulted in increased old age dependency ratio. Indian health care delivery system is more deviant towards productive age groups and has side lined the veterans who constitute about 7-8% of our population. Morbidities among elderly are largely preventable and treatable if detected at early stages. Sleep disturbances, cognitive impairment and functional limitation are commonly neglected by elderly and often overlooked, whereas these conditions can severely impair the living status and quality of life among elderly. Methods: This cross sectional study was conducted in the Urban field practice area of Department of Community Medicine, JSS Medical College, Mysore for a period of three months. Details regarding Sociodemographic characteristics, sleep disturbance using STOP-BANG tool, Functional status using IADL Scale and cognitive impairment using MINICOG tool were collected in a pretested structured survey schedule by interview technique. Results: Among 102 of Geriatric subjects included in the present study, majority were in the age group 60-69 years- 72 (70.6%) and least 7 (6.9%) were 80 and above. 48 (49.1%) were males and 54 (52.9%) were females. Majority 43 (42.1%) were having Intermediate risk of sleep apnoea and 27 (26.4%) were having high risk. 44 (43.2%) were found to have subclinical cognitive impairments. Functional status scores will significantly lower among subjects with sleep and cognitive disturbances compared to their normal counterparts. Conclusions: There is a higher burden of sleep apnea, cognitive impairment among elderly which have significant influence on their functional status. Thus there is a need for evolving a strategy to include these screening procedures in the regular health check-up among elderly.


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Spirometric evaluation of the pulmonary functions in the petrol pump workers of Jaipur city, Rajasthan, India

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Rahul, Sangeeta Vyas, Manisha Sankhla, Jitendra Gupta.
Background: With rapid urbanization and economic development, occupational health hazards have grown as one of the major public health challenges. Many groups in the society are at greater risk of developing adverse consequences owing to their working environment, one such group is the petrol pump workers who by virtue of their occupation are continously exposed to the noxious chemical compounds present in gasoline. Hence, this study was undertaken to find out the effects of gasoline vapors on pulmonary function tests among the petrol pump fuel filling attendants working at various petrol pumps of Jaipur city, Rajasthan, India. Methods: Forty non-smokers, non-alcoholic adult males working as petrol pump workers for more than 3 years were considered as the study group. Forty matched healthy males of the institute served as the controls. The Pulmonary functions were assessed using computerized spirometer. Mean±SD values for each parameter were determined for both the study and control groups and compared using an unpaired 't' test. Results: A significant reduction (p


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Domestic violence on women by their husbands in Gadap town, Karachi, Pakistan

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Shaista Rehman, Asim Qureshi.
Background: An important component of domestic violence, often ignored is the realm of passive abuse, leading to violence. Passive abuse is covert, subtle and veiled. This includes victimization, procrastination, forgetfulness, and ambiguity, and neglect, spiritual and intellectual abuse. Objectives of the study were to assess the type and magnitude of domestic violence inflicted on women by their husbands in Gadap town Karachi and to determine the factors perpetuating domestic violence among women in Gadap town, Karachi, Pakistan. Methods: This cross-sectional study , was conducted in Gadap town Karachi from Nov ,1 ,2010 to March 1 ,2011 . A total of100 married /separated / divorced, females aged between 20 to 50 years were interviewed and pre-designed questionnaires were filled. Results: A total of 100 women were included in the study. About 93 % women reported that their husbands quarrel with them. The main issue that flare their husbands was money (65%). 11 percent of the participants reported participation of in-laws. Positive answers to threats and abuses were given by 95% of the women interviewed where as 5% gave negative answer. Frequency of abuse was recorded as often in 85%, where as it was occasional in 15%.Being shouted/yelled by their husband was the most common phenomenon of violence. Eighty six percent reported physical violence and non-consensual sex was found in 56%. Conclusions: Domestic violence is prevalent in Pakistan at an alarming rate. Women are the sufferers and are subjected to physical, psychological and sexual abuse in their home by partners and in-laws. The factors associated with domestic violence in Pakistan are low-economic status of women, lack of awareness about women rights, lack of education, falsified beliefs, imbalanced empowerment issues between males and females and male dominant social structure.


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The prevalence of loneliness and its determinants among geriatric population in Bengaluru City, Karnataka, India

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
R. Anil, K. N. Prasad, M. Puttaswamy.
Background: Loneliness affects all the individuals, but the extent of problem among geriatric population is not really known. This study is conducted to different socio-economic environment, co-morbid conditions and disabilities affecting daily activities related to old age loneliness with an objective to estimate the prevalence of loneliness among elderly aged population and to determine the factors influencing loneliness among them. Methods: A community based, quantitative, descriptive, cross sectional and explorative study was conducted among 370 elderly populations residing in ward 32 in Bengaluru city between July and August 2015. Information was collected using revised UCLA loneliness questionnaire at the doorsteps and analysis was done using SPSS. Results: The prevalence of loneliness with a score of 50 and above was 37.6%, among males and females it was observed 29.6% and 42.7% respectively. The increase in prevalence was proportional to their age group. Elderly people aged 80 years and above were more affected. The problem of loneliness increased as the family size decreases (85.7%), either of the spouse was separated or dead (46.7%), presence of disabilities affecting basic and instrumental daily activities (61% and 39%) and financial dependency (38.5%). Likewise Loneliness decreased as the number of family members aged 60 years and more increased in the family. Conclusions: The prevalence of loneliness was 37.6% among the elderly population. Females were affected more. The factors influencing loneliness are older age group, illiterates, not living with spouse, only person in the family aged 60 years and above, family size of more than five and presence of daily activity disability.


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Assessment of risk of developing type 2 diabetes mellitus in urban slums of central India: a community based cross sectional study

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Ketan R. Dagdiya, Sushma S. Thakre, Subhash B. Thakre.
Background: Diabetes mellitus (DM) is growing in prevalence globally with 171 million people in the year 2000, while it is estimated to rise to 366 million by the year 2030.Fifty percent or more of those with the disease are unaware of their condition. Most of these have non-insulin dependent diabetes mellitus (NIDDM). The onset of NIDDM may occur 4-7 years before the clinical diagnosis of the disease. Early detection and treatment reduce the complications of DM. Objective of the study was to assess the risk of developing of type 2 Diabetes Mellitus in Urban area of Central India. Methods: Cross sectional study done in urban slum adopted area of tertiary care hospital from April 2016 to June 2016.Data collection includes sociodemographic profile and Finnish diabetes risk score. Results: Out off total 150 participants, 45 are males and 105 are females. Mean age was 52.12(±12.70) years and 44.67% belongs to lower middle socioeconomic class. There was a high prevalence of physical inactivity of 53.33%, 24% of overweight (BMI ≥25 kg/m2) and 5.33% of obesity (BMI≥ 30kg/m2), 16% of large waist circumference and positive family history of Diabetes Mellitus of 15.34%. Overall, 11.33% of the participants have a high to very high risk of developing the disease within 10 year, while about 18.66% have moderate to high risk of developing Diabetes Mellitus. Conclusions: This study has shown that 11.33% of urban populations have a high risk of developing Diabetes Mellitus due to high prevalence of physical inactivity, obesity, large waist circumference and family history of Diabetes Mellitus .There is urgent need to implement diabetes prevention strategies.


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Role of exposure to data collection and analysis activities during community orientation program and its effect on knowledge and attitude of medical undergraduate students

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Chethana Thirthahalli, Radhika Kunnavil, Bhanu Manjunath, Nandagudi Srinivasa Murthy.
Background: The current medical education of health professionals is insufficient. There is a need for creating additional settings for health professionals education beyond four walls of medical college. Students during COP learn about research and health problems of community. The objectives was to evaluate role of exposure to data collection and analysis activities during Community orientation program [COP] and its effect on knowledge and attitude of medical undergraduate students of a Medical College. Methods: Interventional study was carried out amongst the 3rd and 4th term undergraduate medical students between December 2014 and February 2015. A pretested semi structured questionnaire was administered on knowledge and attitude. Intervention consisted of didactic lectures and hands on exercises on data collection and data analysis. After 1week of survey, post test was conducted. Results: The study was completed by 125 (82.8%). Lack of training was main barrier felt by 73% in pursuing research. It was noted that 59.2% had satisfactory knowledge score during pre-test, which increased to 78.4% in post test. Favorable attitude was seen among 90.4% of students in post-test. Majority of the students felt intervention to be useful. Conclusions: COP is a good opportunity for inculcating concept of research methodology among students.


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Histopathological spectrum of gallstone disease from cholecystectomy specimen in rural areas of West Bengal, India- an approach of association between gallstone disease and gallbladder carcinoma

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Bikash Mondal, Dhrubajyoti Maulik, Biplab K. Biswas, Gautam N. Sarkar, Debidas Ghosh.
Background: Gallstone disease (GSD) is a common health problem throughout the world and majority of this burden occurs in developing countries. Most of the gallbladder carcinoma (GBC) is associated with GSD but there is till deficit of information on this association. Beside this, there is no study on the spectrum of histopathological pattern of cholecystectomy specimens from GSD patients in rural areas of West Bengal of India. Methods: The study was carried out on GSD patients who were undergone for cholecystectomy at B.S. Medical College & Hospital of West Bengal over a period of three years from January 2013 to December 2015. Histopathological reports of cholecystectomy specimens were analyzed. Results: In the present study, total 786 GSD patients were included where 635 were female and 151 were male. Histopathological findings depicted that chronic cholecystitis was the most prevalent (79.8%) followed by acute-on-chronic cholecystitis (6.1%), cholesterolosis (2.9%) and xanthogranulomatous cholecystitis (1.7%) among the patients. Beside these, hyperplasia, metaplasia, dysplasia and GBC were observed in 2.0%, 4.7%, 2.2% and 0.6% of the patients respectively. The mean ages for patients with chronic cholecystitis, hyperplasia, metaplasia, dysplasia and carcinoma were 34.5, 37.2, 42.9, 43.9 and 53 years respectively. Study also showed that male GSD patients were more prone to pre-malignancy and malignancy (significant at 95% confidence limit). Conclusions: The study revealed that different types of histopathological features were present in the gallbladder of GSD patients where pre-malignant (hyperplasia, metaplasia and dysplasia) and malignant types were remarkable percentages though chronic cholecystitis was the commonest histopathological feature. Study also demonstrated that males with GSD were more prone to pre-malignancy and malignancy. Gradient ages may suggest that GBC was developed from cholecystitis to carcinoma via hyperplasia, metaplasia and dysplasia.


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An assessment of the effect of health education on the use of personal protective equipment among small scale welders (panel beaters) in Akwa Ibom state, Nigeria

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Queen M. Umoren, Uwemedimbuk S. Ekanem, Ofonime E. Johnson, Motilewa O. Olugbemi.
Background: Welding work serves as a means of livelihood for many Nigerians and welders are exposed to a variety of occupational hazards. In Nigeria, high rate of welding injuries has been reported to be due to low or non-use of PPE and this has been attributed to poor knowledge. Several studies have recommended education as a means of educating welders. The aim of the study is to determine the effect of health education intervention on PPE use among oxyacetylene welders. Methods: This is an interventional study with a control. Data was collected using an interviewer administered questionnaire from respondents selected by simple random technique, and was repeated after 3 month after health education intervention. Data was analysed using SPSS version 20, Chi-square analysis was used to determine observed differences between both groups pre- and post-intervention. Results: At pre- intervention, there were significant differences in the level of knowledge and use of some PPE between the two groups. The proportions of respondents that have knowledge of various types of PPE and used them was significantly higher in the intervention group (p


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A cross sectional study on awareness about emergency contraception among medical students in Kannur, Kerala, India

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Mohammad Iliyas C.
Background: Emergency contraception (EC) is the methods of contraception that can be used to prevent pregnancy in the first five days after sexual intercourse. Unwanted pregnancy among young adults poses a major challenge to the reproductive health in developing countries because of unsafe abortions and deaths due to the same. Since medical students are future health care providers and their awareness about EC will help in giving health education to the community. Objectives of the study were to assess the knowledge of emergency contraception among second and third year medical students in a private medical college, Kannur, Kerala, India. Methods: A cross sectional study was conducted on second and third year medical students of a private medical college, Kerala, India. A total of 200 students were interviewed using pre-validated, semi structured questionnaire. Descriptive statistics were used to analyse the data. Results: Among the study population, 58% and 42% were females and males respectively. All students were heard about EC and 78.5% were correctly aware about the correct timing of administration of EC. 52% of them felt that they can get EC directly from any pharmacy store without consultation to a doctor, 93% of the students feel that EC is not an effective routine method of contraception and only 27% said that it will result in more women suffering from STI/HIV. Conclusions: Present study showed that, students were having above average knowledge about EC. Since they are the health care providers in future, giving proper training to them in acquiring good knowledge will help in dispensing the health education to the community especially youth in future.


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Role of spirituality in health care: knowledge, attitude and practices amongst medical professionals in a tertiary care hospital

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
K. Kriti Bhat, M. C. Yadavannavar.
Background: Spirituality has been integral part of medicine and health since ancient age. The extent of spiritual component in medical practice in India is largely unknown. Therefore, the present study was undertaken to assess the extent of knowledge (awareness), attitude and practice among medical professionals regarding the role of spirituality in management of health. Objectives of the study were to study the knowledge, attitude and practices of spirituality in medical practice amongst medical professionals. Methods: A cross-sectional study was conducted in Shri B. M. Patil Medical College Hospital and Research Centre, Vijayapura from November 2015 to December 2015. 150 doctors of all specialties were interviewed using a self-reported multiple choice questionnaire, after obtaining informed consent. Information regarding demographic profile, knowledge, attitude and practices of spirituality in medical practice was collected. Analysis was done using percentages. Results: The response rate was 60% (150/250). More than 80% had a good deal of knowledge of spirituality but were unable to distinguish between spiritual practices and traditional religious rituals. 67% of them felt that spirituality may have resounding effects on psychiatric illnesses in adults. 75% of them practice spirituality in any form of self-health. Majority of the participants agreed that spirituality offers maximum health benefits in chronic diseases. Conclusions: It is evident from this study that there is a wide gap between reality and physicians perception of spirituality. Concepts regarding spirituality and its application in health is lacking. Hence, redefining the place of spirituality in health and disease by way of conducting collaborative research by qualified and dedicated professionals is the need of the hour.


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Cross-sectional comparative study of the effect of refresher training on the knowledge, attitude and practices of urban primary health care providers

2016-10-22T03-07-52Z
Source: International Journal of Community Medicine and Public Health
Aniruddha A. Malgaonkar, Sundaram Kartikeyan.
Background: Primary health care providers, who cater to the basic health care needs in urban and rural areas, ought to have the basic knowledge and a positive attitude in relation to the services they deliver. This cross-sectional, complete-enumeration, before-and-after study was conducted to determine the outcome of refresher training on the knowledge, attitudes and practices of auxiliary nurse midwives (ANMs), and link workers (LWs) in an urban area in Western India. Methods: Each willing participant answered a structured pre-test questionnaire containing 25 questions in the local language (Marathi), following which, Government-approved refresher training (3 days for ANMs and 1 day for LWs) was conducted in the same language. The participants took the same questionnaire after the refresher training (post-test). The pre- and post-test scores were tabulated and statistically analysed. Results: In case of ANMs (n=60), the post-test scores (mean=20.7; SD=1.8) improved over the pre-test scores (mean=17.5; SD=2.76). The LWs (n=170) also bettered their post-test scores (mean=20.9; SD=2.52), over their pre-test scores (mean=14.4; SD=4.41). The degree of improvement in scores varied from marginal to statistically significant. Conclusions: Though the post-test results were encouraging, sustained efforts would be required to bring about the desired attitudes and practices. As a consequence of the widespread use of mobile phones, it is possible to conduct periodic refresher training through mobile phones at a much lower cost.


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IN-VITRO SUSCEPTIBILITY TO TIGECYCLINE IN MULTIDRUG RESISTANT BACTERIAL ISOLATES FROM A TERTIARY CARE HOSPITAL

2016-10-22T02-13-44Z
Source: International Journal of Current Research and Review
Kusuma G.R., Tejashree A., Vijay Kumar G.S..
Objective: The present study was conducted to evaluate the in vitro activity of tigecycline against a contemporary collection of multidrug resistant (MDR) bacterial isolates by disc diffusion and MIC by E-Test method. Methods: A total of 100 non repetitive clinically significant MDR bacterial isolates from urine, pus, sputum endotracheal aspirates, Skin and soft tissue and surgical site infection of patients in a tertiary care teaching hospital in Karnataka, south India from March 2013 to December 2013 were included in the study. MDR bacteria tested for Tigecycline susceptibility were: Methicillin resistant S.aureus (MRSA) (15), ESBL producing Escherichia coli (E.col) (15), Klebsiella pneumoniae (35) and MDR Acinetobacter species (35). Result: Tigecycline was found to be effective against all MRSA, MDR E.coli and Acinetobacter isolates by disc diffusion and E-test method. Among the selected K. pneumoniae isolates all were sensitive by disc diffusion and 34 (97.1%) were found sensitive with the MIC range 0.25- 1.5μg/ml, One (2.9%) isolate was found intermediate resistant with the MIC of 3μg/ml by E-test. Conclusion: To conclude, the present study showed that, tigecycline is a potent antimicrobial agent against MRSA, ESBL producing Enterobacteriaceae Acinetobacter species and disc diffusion is simple to perform, highly reproducible and inexpensive method to predict tigecycline resistance. It is also prudent to reserve tigecycline for life threatening infections.


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Health profile of pregnant women attending urban health centre in Hyderabad, Telangana, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Sultan Rizwan Ahmad, Mehaboobi Shaik, A. Chandrasekhar.
Background: Maternal and child mortality is the outcome of multiple factors. Current maternal mortality in India is 254 per 100,000 live births. Improving the maternal and child health is an important public health goal of government of India. To prevent unwanted outcome of pregnancy, antenatal care (ANC) is most important method for early detection and prompt treatment of complications. Methods: A cross sectional study was conducted among pregnant women attending ANC clinic at urban health centre during September 2015 to November 2015. A pre tested semi-structured questionnaire was used for data collection. Data was collected from 102 pregnant women attained ANC clinic during study period. The data was compiled and analyzed using appropriate statistical tools. Results: In present study majority (46%) of pregnant ladies belong to 20-25 years of age group and 26% had consanguinous marriage. In our study gravida 3, gravida 4 and gravid 5 were 29%, 12% and 5% respectively. 52 % of pregnant ladies had 3 ANC visit, almost 62% of pregnant ladies had done haemoglobin examination and 57% blood grouping testing. Pregnancy outcome were live birth in 82.66 % and abortion in 16.69%. 41% were previous LSCS and 9% were home delivery. In this study we found that high risk pregnancy were 59.8% and main reason of being high risk were previous LSCS (52%), anaemia (40%). Conclusions: High quality antenatal care as well as knowledge and practice of community regarding maternal care during pregnancy are important to unwanted outcome of pregnancy.


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Determinants of uptake of pentavalent vaccine in Benin city, Southern Nigeria

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Esohe Olivia Ogboghodo, Hendrith A. Esene, Obehi H. Okojie.
Background: The Nigerian government in 2012 introduced the pentavalent vaccine into her routine immunization schedule with a view to fast track reduction in child mortality. Despite the advantages of pentavalent vaccine, it has been linked to adverse effects following immunizations including clusters of infant deaths. The objective of the study was to assess knowledge, attitude and experience of care-givers whose under-fives are receiving pentavalent vaccines as determinants of uptake of the vaccine in Benin city. Methods: A descriptive cross-sectional study design was utilized for this study. Data was analyzed using IBM SPSS version 21.0 software. The level of significance was set at p


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Drinking water practices and sanitation in slums of Visakhapatnam, Andhra Pradesh a developing smart city in India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Karun Sandeep Veesa, Chandra Shekhar Dimmala, Obed John Heber Antipas, Venkata Raghava Mohan, Sushil Mathew John.
Background: Inadequate water quality and sanitation contribute to the transmission of faeco- orally transmitted diseases. Methods: This community based cross sectional study assessed drinking water, sanitation and factors associated with reported 2 week recall diarrhea burden among under-five children in slums. 220 households with under-five children were selected across 14 slums of Zone-6, Visakhapatnam by cluster sampling. A WHO drinking water and sanitation questionnaire was used. Hydrogen sulfide (H2S) water quality test was performed at point of source and use. Data subjected to bivariate and multivariate logistic regression analysis. Results: Mean age of mothers and children were 24.4 (SD 3) years and 28.3 (SD 14.5) months. Study finds 33% (20/60) source samples and 34% (75/220) point of use samples were contaminated. Reported diarrhoea episodes was 14% (31/220) (95% CI 9.4 - 18.5%). All public water system samples were contamination free. Higher contamination rates were observed in untreated private water systems. Despite 41.4% (91/220) households using boiling or filtration methods, 26.4% (24/91) of these samples were contaminated. Factors significantly associated with reported diarrhoea were, low SES (OR 2.3, 95% CI 1.0 5.5), unsafe defecation practice (OR 2.2, 95% CI 1.0 4.9) and age less than 2 years (OR 2.4, 95% CI 1.0 5.5). Conclusions: All treated public water supplied by Municipal Corporation was contamination free and use of this supply should be encouraged. Safe child defecation practices and effective household water treatment methods should be promoted in slums.


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Morbidity profile of outdoor patients attending an urban health training center of South Andaman district, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Bhanu Pratap Singh Gaur, Swapan Kumar Paul, Bhabani Pegu.
Background: The study in terms of pattern of illness and seasonal variation in a defined region is an important way to improve the quality of health services delivered to the community. The study objective was to describe the morbidity profile of patients attending the outpatient department (OPD) of urban health and training centre (UHTC) under the Dept. of Community Medicine of a teaching hospital during the year. Methods: This retrospective cross-sectional study was conducted for the duration of one year. The Data were collected from the OPD registers of medical officers from January 2015 to December 2015. Patients who had come to the centre for follow up visits were excluded from the study. Results: A total of 74,276 patients were included in the study after exclusion (39,627 males and 34,649 females). Adults (>14 years) constituted about 79.19%. Overall, respiratory disorders were the major complaints (17.17%), followed by external causes of morbidity and digestive disorders. In case of children, major diseases were wound injury, malnutrition, diseases of ear, nose and throat and skin infection. The prevalence of diseases like hypertension and diabetes were reported less in this study. Conclusions: The study gives an outline of the morbidity profile of patients attending an urban health training centre over a period of one year. This knowledge would help the health care providers and administrators to plan and deliver, enhanced and high quality services as per the community need.


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Assessment of water quality standards in the villages of Kanchipuram district, Tamil Nadu, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Rajkamal R., Muthu Kumar, Madhan Raj, Muthu Rajesh, Jaya Kiruthiga, Joy Bazroy.
Background: Water is the most common yet the most precious resource on earth without which there would be no life on earth. About 1.2 million people in the world still today do not have accessible to safe drinking water. In India only 84% of population has accessible to safe drinking water. Objective: To assess the Physical, Chemical, and Microbiological quality of drinking water in the villages of Kanchipuram district. Methods: A community-based, cross-sectional study was carried out in Chunampet, a rural area in Kanchipuram district of Tamil Nadu in January 2014 among two villages (Villipakkam and Puthirankottai) near Chunampet. Drinking water was collected from the common water sources of both the villages and sent for Physical, Chemical and Microbiological analysis. Results: Out of 20 water samples for physical and chemical assessment all the water samples shows the physical parameters of the water such as PH, electrical conductivity (EC), total dissolved solids (TDS) were within the normal limits. In chemical analysis Water samples shows that Mg, HCO3 levels were above the permissible limits as per BIS guidelines. Ten water samples were taken for biological analysis in which all the samples were heavily contaminated with high coliform count. Conclusions: The study shows that the water samples collected from both the villages are not at acceptable leveland it is not suitable for drinking.


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Diabetes mellitus among arsenic exposed and non-exposed young adults in Bangladesh

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Manzurul Haque Khan, Bipul K. Chanda, Sk Akhtar Ahmad.
Background: Studies in different countries including Bangladesh have found association with arsenic exposure and diabetes mellitus. However, the occurrence of diabetes mellitus amongst the arsenic exposed young adults, remains to be elaborately explored. This study was carried out among the arsenic exposed young adults to assess their glycaemic status. Methods: This was a cross sectional comparative study carried out among the arsenic exposed and non-exposed young adults aged 30 to 39 years. Results: Among the total 1546 respondents, arsenic exposed respondents were 1043(67.5%) and non-exposed respondents were 503 (32.5%). Of the arsenic exposed respondents 494 (47.4%) were suffering from arsenicosis. The arsenic exposed respondents were found to suffer more from DM (5.6%) and IGT (23.0%) compared to those of non-arsenic exposed respondents and the difference was highly significant (χ2= 30.470; p=0.000). While comparing DM and IGT between arsenicosis and non-arsenicosis respondents, significantly (χ2=12.989; p=0.002) a higher proportion of the arsenicosis respondents were found to suffer from DM (7.9%) and IGT (24.9%). Multinomial regression analysis showed, DM and IGT were 3.6 times and 2.5 times more likely to develop among the young adults having arsenicosis compared to those of non-exposed young adults. Conclusions: The study revealed that the arsenic exposed population is at high risk of developing diabetes and IGT in their early adult hood. Among the arsenicosis young adults the situation is more threatening; the prevalence is more than twice compared to that of arsenic non-exposed young adults.


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Compliance to rabies immunoglobulin in post-exposure prophylaxis of category III animal bite cases attending antirabies clinic of government tertiary care hospital, Solapur, Maharashtra, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Lagdir L. Gaikwad, Shivshakti D. Pawar.
Background: In India since 1985, every year 25000-50000 human rabies deaths have been reported which accounted for 60% of global mortality. The rabies immunoglobulin (RIG) in particular are life-saving in severe (WHO category III) rabies exposures, Hence present study with objectives to assess treatment compliance of rabies immunoglobulin in animal bite cases and to study reason behind not taking RIG is undertaken. Methods: A cross sectional study was conducted among all 460 WHO category III animal bite cases attending ARV clinic at government tertiary care hospital, Solapur during the month of March 2016. After obtaining verbal informed consent, a predesigned questionnaire was used, the assessment of treatment compliance of RIG was considered by asking and confirming with hospital records, those couldnt traced were contacted by using telephone survey method. Data was analysed by using statistical software SPSS 16.0 version. Results: A total 460 category III animal bite victims were interviewed from ARV clinic, 80.4% cases were completed rabies immunoglobulin treatment as compared to 19.6% defaulted RIG. The majority of cases were males 68.5%, children ≤15years were 33.5%, 75.0% from urban area, 77% cases belongs to below poverty line category, 35.9% had bite mark on left lower limb. The main animals responsible for bites were dogs (95.2%). The predominant reason behind not taking RIG was lack of money (67.7%). Conclusions: The present study showed maximum compliance to rabies immunoglobulin in Category III animal bite cases however economic constrain was prime hurdle followed by small injury in not taking RIG.


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Epidemiological correlates of tobacco consumption among women in reproductive age group- a community based cross sectional study in the rural area of Belgaum District, Karnataka, South India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Namratha Kulkarni, Shilpa K., Vijaya A. Naik, Mallapur M. D..
Background: Tobacco kills both men and women but sex-specific differences exist. The disease burden, health care costs as well as other social losses resulting from premature deaths attributable to tobacco consumption are rapidly increasing not only in men but even among children, teenagers, women of reproductive age group. The use of multiple forms of tobacco in India complicates the efforts to reduce its overall impact on public health. This study was done to know the socio demographic correlates of tobacco consumption among the rural women in the reproductive age group. Methods: A community based cross sectional study, conducted from January 2011 to December 2011 among 1200 rural women aged between 15 years to 49 years residing in Primary Health Centre (PHC) Vantmuri area, Belgaum, Karnataka, India. Statistical analysis was done using rates, ratios and chi square tests. Results: Tobacco consumption was seen in 9.7% of the study participants. Amongst the users, tobacco consumption was more i.e. 38 (19.3%) in women belonging to the older age group of 45 to 49 years. A very high prevalence of tobacco use of 98 (15.9%) was observed out of 615 study participants who were illiterate suggesting that women with no education are at a higher risk of consuming tobacco than the women with high school education. A high proportion 100 (10.2%) of people consuming tobacco was seen in women belonging to Class V socio economic class. Conclusions: Prevalence of tobacco consumption was quite high. Poor and illiterate women living in rural area are at the maximum risk of using tobacco. There is a need for appropriate interventions to create awareness among the women about the hazards of tobacco use and to help them eventually to stop tobacco consumption. There is a need for appropriate intervention to create awareness among the women about the hazards of tobacco use and to help them eventually to stop tobacco consumption.


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Immunization status and knowledge regarding newer vaccines among mothers in a rural area of Rangareddy District, Telangana, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Vijay Kumar M., Anjaneyulu G., Venkata Navya Sree, Gautham Sai W. M..
Background: India was one of the first countries to adopt the World Health Organizations Expanded Programme of Immunization (EPI). Many newer vaccines have been added recently in the national immunization schedule some of which are being implemented in a phased manner throughout India. Methods: A community based cross sectional study was done at Yenkapally and Peddamangalaram villages by household survey. Fifty children and their mothers were selected for the study by convenient sampling technique. A pre designed, pre tested questionnaire was used to get the relevant information by adopting interview technique. Questionnaire pertained to socio demographic information, immunization status and knowledge regarding newer vaccines. Results: Out of the 50 children, about three fourths (74%) were completely immunized and 26% were partially immunized. About one third of the mothers were aware about pentavalent vaccination, one fourth were aware about IPV and extreme low level of awareness (2%) was seen regarding rota virus vaccine. Conclusions: Present study found that one fourth of the children were partially immunized with majority missing the booster doses and a very low level of awareness was seen among mothers regarding various newer vaccines.


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Assessment of the use of impregnated bed nets in prevent and control sand fly bites in endemic area with visceral leishmaniasis, Eastern Sudan-2013

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Mustafa Mohammed Mustafa, Nagwa Suliman Ahammed, Ustaz Mohamed Awad Alkareem, Imad Eldin Elgack, Nazar Abdalla, Majida Elhady.
Background: Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania. Sand flies, (members of the Phylum Arthropoda and belonging to the class Insecta) transmit leishmaniasis. Animals as reservoirs of infection include dogs, monkeys, and ponies. It was also found that other animals such as hyenas, and jackals could not be ruled out as potential reservoirs. Methods: An epidemiological - cross sectional study conducted in Sudan, during the period 2011-2013, among the students in Gadaref university, aimed to determine the effectiveness of impregnated bed nets as control and protective measures for sand fly bites. The study included students coming from outside the study area, with no history of coetaneous Leishmaniasis. 155 students in first year were included in this study as study group (90) were male and (65) were female. Results: The study revealed highly percentage regarding the effectiveness of bed nets in preventing insect access due to students answers with 92.1% male and 96.3% female, versus 7.9% and 3.7% with negative answers respectively. No infection by coetaneous or visceral Leishmaniasis were reported post intervention among study group while (11) cases where reported in control group. Conclusions: The preventive measures such as impregnated bed nets are very effective in control of infection.


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Aerobic bacterial isolates from mobiles of health care workers in a tertiary care hospital of North Kerala, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Jamaluddeen C. V., Syed Mustaq Ahmed, Shakir V. P. A.
Background: Mobile phones have gained so much importance in day today life that we dont want to stay apart from them at any time, so is the condition with the health care workers who tend to carry them and attend to calls while doing procedures and in other patient care activities many studies have shown that mobile phones can carry dangerous pathogens on them which can be a risk to the patients in order to highlight this fact we carried out this study in our hospital setup. Methods: A six months study was undertaken in our institute after obtaining permission from the institutional ethical committee. Mobile phones were swabbed over the screen, keypad, sides and external cover with sterile cotton swabs moistened with normal saline. And immediately inoculated on the culture media and processed as per the standard protocol. Results: out of the 100 mobiles phones that were screened for aerobic bacterial colonization 88 (88%) showed bacterial isolates. Among the 93 isolates from the mobile phones the highest number of isolate were from pseudomonas species 42 (45.16%) followed by coagulase negative Staphylococcus (CONS) 19 (63.3%) , profession wise mobile phones of technicians showed the highest isolates 41 (44.08%) followed by Doctors 30 isolates (32.25%). Conclusions: Our study showed that mobile phones can act as vehicles of transmission for bacterial pathogens as also proved by various studies so it is important to maintain the mobile phones in a hygienic way so they dont play a role in transmission of pathogens as these instruments cannot be totally avoided and their importance in health care is immense.


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Status of sanitation and hygiene practices in the context of "Swachh Bharat Abhiyan" in two districts of India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Pushpanjali Swain, Sristhi Pathela.
Background: For every human being potable drinking water, sanitation and healthy hygiene practices are important to sustain healthy life. This paper focuses on urban slums and rural segments of India as these areas are mostly deprived of these essential amenities. Swachh Bharat Abhiyan came into existence to ensure that each and every citizen of India should get the access to these basic necessities. Our study therefore highlights the key issues which may act as a hindrance to the progress of this Abhiyan in rural and urban parts of India. Methods: A total sample of 190 households was selected for the study from district Ghaziabad, Uttar Pradesh and district Jabalpur, Madhya Pradesh. One adult respondent was selected from each household randomly for the study. The statistical data was analyzed and represented by graphs and tables. Results: Study finding shows that 76% of total respondent were not aware about the Swachh Bharat Abhiyan and 56% were not aware about the significance of keeping good sanitary conditions. It was also observed that among the total respondents only 54% were defecating in the toilet and 8% of respondents dont wash their hands after defecation and 11% of the respondents never wash their hands before meals. As observed, only 33% of female respondents were using sanitary pads during their mensuration. Conclusions: The study findings support the need for creating immediate awareness in these communities. It also highlighted the urgent need for effective basic sanitation facilities. This would be very relevant for the Swachh Bharat Abhiyan.


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Effect of nutrition education among pregnant women with low body mass index: a community based intervention

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Sherin Daniel, Grana Pu Selvi Gnanaraj, Emershia Sharmine.
Background: Indian women are chronically undernourished (36%) and anemic (55%) which has consequences on women during their adolescence, pregnancy, and lactation (NFHS-3). The main objectives were to assess the effect of nutrition education on dietary awareness and practice among undernourished pregnant women. Methods: Phase 1 included key informant interview capturing information on food frequency and dietary diversity (24 hour dietary recall). Based on the key informant interview and anecdotal evidences a hypothesis was generated and an experimental study was planned to test the hypotheses. Fifty pregnant women in their first trimester of pregnancy having body mass index (BMI) less than 18.5 were selected from 12 villages to be part of the intervention group. Non-intervention group comprised of age matched women in first trimester with low BMI selected from the neighbouring villages. Phase 2 effect of nutrition education was assessed on mean weight gain in third trimester of pregnancy practice of minimum meal frequency (3 meals a day), adoption of dietary diversity through 24 hour recall method, proportion of change evidenced in hand washing practice were measured. Results: Women enrolled in the intervention had a mean weight gain of 8.7 kg, with more than 3 ante natal care (ANC) visits having regular monthly attendance at ICDS center for awareness programs. Behavioral modification was evidenced by practicing a minimum of 3 meals or more during pregnancy, with consumption of vegetables, lentils and greens in their daily diet along with cereals. Regular hand washing before the meals and after using the toilet were self-reported by the women. Conclusions: Prospective weight gain among women in intervention had significance over those in the non- intervention group by 2.1kg. Women in the intervention group reflected behavioral change by practicing minimum meal of 3 or more, proper hand washing before meals and after toilet and adequate rest. However birth weight on other hand is weakly associated with maternal weight gain between the two arms of the study.


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Evaluation of impact of computer usage on various tear parameters in normal healthy tertiary hospital based population in Uttarakhand, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Anuradha Raj, Renu Dhasmana, Harsh Bahadur.
Background: Computers have become an integral part of routine day to day life. Increased usage of computers lead to dry eye due to reductions in the blink rate and its amplitude. The purpose of the study was to analyse changes in the lower tear meniscus by optical coherence tomography (OCT) and to correlate them with other subjective tear parameters. Methods: In this study 203 normal healthy subjects of age below 40 years with refractive errors were enrolled in this random prospective cross-sectional study. The subjects with computer usage for three hours or more in a day were considered as computer users and rest as nonusers. All subjects underwent routine ophthalmological examination along with dry eye work up. Fourier domain -OCT system (RT-Vue software version 4.7; Optovue, Inc., Fremont, CA) was used to measure lower tear meniscus height (TMH) and tear meniscus area (TMA) in all subjects. Results: Males and females were 116 (57.14%) and 87 (42.85%) respectively with mean age of 34.38 years. Out of 203, 84(41.37% ) were computer users and 119 (58.62% ) were computer non-users. The mean ±SD of Schirmers in computer users and non-users were 21.64±5.68mm and 20.03±4.97mm respectively and the difference was non-signicant (p=0.07). The mean±SD value of tear film break up time (TBUT), slit lamp based TMH and OCT based TMH in computer users were 10.87±1.59 sec, 582.14±176.41mm and 236.49±91.00µm which were having statistically significant differences (p=0.005, 0.001 and 0.024) respectively as compared to computer non-users. Conclusions: TBUT, OCT based TMH and TMA are significantly influenced by computer usage in normal healthy individuals.


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Predictors of knowledge regarding Ebola virus disease among medical and nursing students in a Nigerian teaching hospital

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Lawan Gana Balami, Suriani Ismail, Suhainizam Muhamad Saliluddin, Sani Hyedima Garba.
Background: The Ebola virus disease is one of the deadliest re-emerging diseases; the 2014 outbreak has been devastating with thousands of deaths resulting in global panic. Methods: A cross-sectional study was conducted involving 423 under-graduate medical and nursing students from University of Maiduguri Teaching Hospital using multi-stage stratified random sampling. Data was collected using a pretested self-administered questionnaire and analyzed using IBM-SPSS version 22. Chi-square was used for association between categorical variables while Spearmans correlation was used for correlation between continuous variables. Multiple Logistic regressions were used to determine independent predictors of knowledge. Results: Mean knowledge score was 30.4±6.4, only 40.9% had good knowledge. Predictors of knowledge were Age (AOR=1.164, 95% CI=1.07-1.26), Field of study (AOR=4.64, 95% CI=2.33-9.23) and Year of studies (AOR=2.27, 95% CI = 1.06-4.84). Conclusions: There is still poor knowledge regarding this disease and the need for improvements.


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Menstrual problems of school going unmarried adolescent girls and their treatment seeking behavior in Chandigarh, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Dinesh Kumar, Naveen K. Goel, Munesh K. Sharma, Gurleen Kaur.
Background: Menstruation is a vital part of the reproductive health of a woman. There is evident neglect of problems related to menstruation especially in young girls. Lack of awareness and non-availability of adolescent friendly health facilities and other factors hinder the treatment seeking behavior of adolescent girls. The objectives were to assess the prevalence and patterns of menstrual problems among school-going adolescent girls and to investigate their treatment seeking behavior for menstrual problems. Methods: Present study is based on part of a detailed survey under ICMR sponsored project. A stratified multistage sampling design was adopted for selection of participants from the 12 of Chandigarh. A total of 655 girls who had attained menarche were selected. Information on background and menstrual characteristics was collected through personal interviews conducted in privacy using semi -structured survey schedule. Results: About 36% of 655 surveyed girls attained menarche prior to age of 13 years. Prior knowledge regarding menses was reported by 80% girls and mother was the main source of information. Overall prevalence of menstrual problem in the present study was found 64.6%. Abdominal pain was the most common menstrual problem reported by 62.6% of participants having menstrual problems. Excessive menstrual flow was reported by 10.4% girls. Pre-menstrual problems were reported by 57.4% participants. Treatment seeking behaviour of the girls was poor and only about 25% of girls having menstrual problems approached for treatment. Reliance on home remedies followed by shyness / hesitation came out to be the major reasons of not approaching for treatment in the present study. Use of painkiller in the present study was found to be 34.8%. Conclusions: Study concludes that menstrual problems among girls are highly prevalent. Adolescent girls should be offered possible treatment options with adolescent friendly approach. Reproductive health education in the school curriculum should be introduced for improving awareness regarding menstrual care practices. Mentorship program in the school set-up may result in desired improvements providing adolescent friendly health services for sharing their menstrual and other problems.


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Causes of neonatal death and associated health seeking behaviour in Barpeta district, Assam, India: a community based study

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Swapna D. Kakoty, Mustaque Ahmed, Debadeep Kalita.
Background: Infant mortality rate (IMR) is an important indicator of health status and socioeconomic progress of a country. Assam is one of the states of India with a high Infant mortality rate. Information regarding neonatal or infant death mostly is gathered from hospital based studies or large nationally representative studies. Information at the district level is obtained only from the various annual health surveys or the routine reporting system. However these studies do not report health seeking behaviour. In this background, the present study was undertaken to know causes of neonatal deaths as well as health seeking behaviour of families in Barpeta district. Methods: All neonatal deaths occurring in the district in the first quarter of 2016 were identified. Verbal autopsy was conducted within a month of reported death by using predesigned pretested verbal autopsy questionnaire. A sample size of 90 was purposively selected. Secondary records available with the family were examined. Results: One fourth of deaths took place on day 1 and 80% died within the first week. Infection namely pneumonia and septicaemia accounted for 47.7% of death followed by asphyxia and respiratory distress syndrome. About 46% of mother had history of prolonged or complicated delivery. Around 54% deliveries were conducted in institutions and only 59% of neonates were taken for treatment. Conclusions: Infection, asphyxia and low birth weight were most common causes of neonatal death. Early identification of complication and prompt referral has to be promoted by increasing home visit by community workers and removing bottlenecks in transportation.


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Seroprevalence of hepatitis B among pregnant women in Kigali, Rwanda

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Mochama M. Nyamusi, Onesmus T. Marete, Wilson R. Waweru.
Background: Hepatitis B virus belongs to the family Hepadnaviridae. It is the commonest cause of chronic viral hepatitis. It is responsible for up to 80% of primary liver cancers. Despite the existence of a safe and effective vaccine, HBV infections still remain a global public health problem. Pregnant women who are carriers of the virus pose a significant risk to their unborn babies. Early diagnosis in this group can provide an avenue for prevention of mother to child transmission which will in turn lead to a reduction in the number of chronic carriers who act as a source of new infections. Methods: The study was a multicenter, hospital based cross-sectional study. Data collection was using a questionnaire-guided interview followed by HBsAg determination using SD bioline test device. Data entry and statistical analysis was done using SPSS version 16. A p-value of less than 0.05 was considered significant. Results: The prevalence of Hepatitis B among pregnant women in Kigali is 3.1%.The study findings also indicated that the mean age of the participants was 28.03 years with a standard deviation of 5.6 years. Majority of the women (37.4%) were between 25 and 29 years. About two thirds of the recruited women resided in urban area while a third was from rural area. Most of the women (61.3%) had attained primary level formal education with only a few with tertiary level education (7.9%). 6% of them had no formal education. Majority of these women (95%) were in marriage unions a majority of which were monogamous. Conclusions: The findings indicate an intermediate endemicity of HBV among the pregnant women in Kigali at 3.1% prevalence, the lowest among the East African countries. This is among the first Hepatitis B prevalence studies among the pregnant women, hence it provides baseline data that can be useful in contributing to knowledge of the disease characteristics, stimulate further research on the disease and also contribute to informing policy on control measures.


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Clinico-epidemiological study of Hansen’s disease patients attending a tertiary care centre in South India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Avinash Appasaheb Patil, Mayur Shahurao Sherkhane.
Background: Leprosy (also known as Hansens diseaese) is a chronic disease caused by a slow multiplying bacillus, Mycobacterium leprae (M. leprae). Incubation period of the disease is about 5 years, but the symptoms can take as long as 20 years to appear. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and also the eyes. Leprosy is curable with multidrug therapy (MDT). Although not highly infectious, leprosy is transmitted via droplets, from nose and mouth, during close and frequent contacts with untreated cases. The main objectives were to describe the clinico-epidemiological profile of Hansens disease patients. Methods: Hospital based cross-sectional study using convenience sampling method was carried out. A total of 114 patients were enrolled in the study. Results: Around 25.27% of males presented with ulcer at the time of examination whereas in females, the common mode of presentation was the hypo-pigmented patch (48.47%). Out of the total 114 patients 55% had already developed residual disability at the time of examination. The mean age at onset of illness for males was 34 years and 31.60 years for females. About 25% of the patients gave positive history of contact with Hansens disease patient and the most common source of contact was another family member with the disease. On clinical examination most common nerve involved was ulnar nerve followed by lateral popliteal nerve. Conclusions: Study recommends periodic nerve examination of patients with hypopigmented patches to identify any abnormality in nerve and patients also need to be educated on self-care.


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Effect of counselling on adherence to post-exposure anti-rabies vaccination schedule among patients attending anti-rabies clinic in a tertiary care hospital, Bengaluru, Karnataka, India

2016-10-22T01-09-52Z
Source: International Journal of Community Medicine and Public Health
Subathra Vengatesan, Kishore S. Gudegowda, Ranganath T. Sobagiah, Anil K. Krishnappa.
Background: Rabies is 100% preventable disease. Complete post-exposure prophylaxis is necessary among the animal bite victims for complete protection. But it takes about 1 month to complete the schedule therefore drop-outs arise. Proper counselling can be given to make them adherent. Therefore this study is done to determine the compliance rate in two different groups with and without Information Education and Communication (IEC) material counselling and also to determine the constraints for compliance to anti-rabies vaccination (ARV). Methods: A non-randomized trial was conducted in the anti-rabies clinic of Victoria Hospital, Bengaluru from March 1st to June 30th 2016. All the new cases were given routine oral counselling without IEC material during March and April month (Group I) and with IEC material during May and June month (Group II). The number of study subjects was 459 (169 + 290) after excluding those patients who could not be contacted through telephone, re-exposure and pre-exposure vaccination cases. Data was collected on record basis and through telephonic conversation. Descriptive statistics and chi-square test was used to analyze the data. Results: 119 (70.4%) from group I (169) and 263 (90.7%) from group II (290) were compliant to complete course of ARV. Compliance rate had increased by 20.3% in Group-II. Conclusions: Counselling with IEC material had made a significant impact on patients attitude and behaviour thereby reducing drop-outs.


http://ift.tt/2erMru6