Πέμπτη, 24 Νοεμβρίου 2016



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A study on water supply and sanitation at a slum in Kolkata

2016-11-24T11-17-33Z
Source: International Journal of Medical Science and Public Health
Arkaprabha Sau.
Background: Rapid urbanization in India leads to development of slums in urban area. These increasing number of slum dwellers are the key concerns for the urban planner. This study will help us to know the present scenario of accesses to safe drinking water and availability of adequate sanitation at a slum in Kolkata. Objectives: (1) To estimate the accessibility of safe drinking water to the households at that slum and (2) to estimate the availability of sanitary latrine to the households. Materials and Methods: An observational descriptive study with cross-sectional design was conducted at Bagbazar Slum, Kolkata, West Bengal. The study period was from 1st April 2016 to 30th April 2016. During the study period, there were total 450 households living at that area. 200 households were selected by simple random sampling. Each household was selected using Random Number table. One adult member from each household was interviewed at their home using predesigned and pretested. Statistical analysis was performed using Microsoft Excel 2016 software. Results: About 94% of the selected households were using piped water supplied by Kolkata Municipal Corporation and 6% were using bottled water for drinking purpose. 78% households had to use shared sanitary latrine into their household premises, but 8 (4%) households did not have any latrine facility. Conclusions: All the household had access to safe drinking water. There is a need for improvement in sanitation facility at that slum.


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Perceptions of the community about epilepsy in rural Tamil Nadu, India

2016-11-24T11-17-33Z
Source: International Journal of Medical Science and Public Health
Prasad Tukaram Dhikale, Muruganandham R, Amol Rambhau Dongre.
Background: There is no qualitative research on communitys perception about epilepsy available from India. However, some quantitative surveys were done among school children, local community, and patients of epilepsy. Caregivers and family members support is crucial for better compliance and care of epileptic patients. Objectives: The purpose was to study the perceptions of the community members of the age group 18-60 years about epilepsy in rural Villupuram, India. This can improve the quality of life of epileptic patients. Materials and Methods: It was a qualitative descriptive study in which four Focus Group Discussions were conducted; two among male and female group each. A vignette was used as a stimulus material to evoke discussion among participants. Results: The text information was coded using 22 codes which were merged into 5 major categories which were (1) perceived causes, (2) modes of spread, (3) perceived prognosis, (4) suggested treatment options, and (5) social inclusions and exclusions. Although participants felt that the epileptic patients can undergo education, earn a livelihood by employment and seek allopathic medication for treatment, there were some misconceptions about the causes of epilepsy. Patients with female gender were reported to experience more stigma and discrimination than male. Conclusion: The study gives insight into the variety of perceptions on different aspects of epilepsy. The misconceptions in the community about epilepsy can affect nutrition, maternal and child health, hygiene, health care seeking, compliance to treatment of the epileptic patients leading to poor quality of life. The results demonstrated a need for educational and awareness programs among family and community members about the causes, modes of spread, treatment of epilepsy. The findings of the present study can direct the future quantitative research in community settings in India.


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Chimney Graft Endovascular Repair Of Para-Anastomotic Pseudoaneurysm After Mycotic Infrarenal Aortic Aneurysmectomy

2016-11-24T07-21-45Z
Source: The Southeast Asian Journal of Case Report and Review
Ismazizi Zaharudin, Hanif Hussein , Zainal Ariffin Azizi.
Para-anastomotic aneurysms are either true aneurysms or pseudoaneurysms. The latter tend to be asymptomatic until rupture. Para-anastomotic aneurysms (PASA)should be approached surgically either endovascular or open surgery despite the high morbidity and mortality associated with their treatment. This report describes the case of a 73-year-old man who presented with a para-anastomotic pseudoaneurysm( PASA ) secondary to mycotic infrarenal aortic aneurysmectomy. We chose to use an endovascular approach, and results were good. Endovascular techniques are increasingly becoming the method of choice in the treatment of para-anastomotic pseudoaneurysms.


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Placebo controlled comparative study of oral midazolam and oral ketamine as a premedication in paediatric age group

2016-11-24T04-57-13Z
Source: International Journal of Advances in Medicine
Somnath Longani, Krishna Pratap Mall, Dipak Raval.
Background: Preanaesthetic medication can play an important part in the anaesthetic care of infants and children. It plays a vital role during induction and maintenance of anaesthesia as well as in post-operative period. Methods: Ninety pediatric patients of ASA status I and II operated for routine surgical procedures at GGH, Jamnagar, Gujarat were studied for the comparision of oral midazolam and oral ketamine as a premedication. The paediatric patients were divided into 3 groups, group M oral midazolam, group K oral ketamine and group P placebo (honey) of 30 patients each. Results: All the patients were given general anaesthesia with injection sodium thiopentone 4 to 5 mg/kg and inj. succinylcholine 1.5 mg/kg and maintained with inj. vecuronium and traces of halothane. Paracetamol rectal suppository 10 to 15 mg/kg was inserted before reversal for post-operative analgesia. All patients were reversed with inj. neostigmine 50 μg/kg and inj. glycopyrrolate 8 μg/kg given intravenously slowly. Intraoperative pulse rate, blood pressure, SPO2 and ECG were recorded. Post operatively apart from vitals sedation score and anxiety score were recorded. The result analysed showed that sedation and anxiolysis was better in ketamine group both during separation from parents and I.V. cannulation. Recovery in smooth in ketamine group where as recovery in midazolam group was associated with irritability and crying. Conclusions: Oral ketamine is better premedication than oral midazolam in paediatric patients.


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An uncalled guest in the nose: a living leech

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Basavaraj P. Belaldavar, Nagalotimath Umesh, Sinha Mohit, Mounika Kalakuntla.
Foreign bodies in the nasal cavity are commonly encountered as a cause of epistaxis; especially in children. Leeches are most common parasite found in hilly areas in India, particularly in rainy season. However, nasal leech infestation (animate foreign body) as a cause of unilateral persistent epistaxis is very rare. We, herein present a case of nasal hirudiniasis in a 30 year old female. She presented with history of recurrent epistaxis with moving sensation and itching in the left nose. Examination of nose showed a moving fleshy mass, which was a leech and was removed with a Lucs forceps In developing countries, leech infestation as a cause of epistaxis should be suspected in patients with lower socioeconomic status or in those living in leech predominant areas, rural areas who give history of drinking polluted water from, or bathing in, stagnant ponds and puddles.


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Dengue fever and its epidemiological characteristics: a study from Eastern India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Sudeb Mukherjee, Kaushik Manna, Pritam Chatterjee, Pramathanath Datta, Suhana Datta.
Background: Dengue fever (DF) has become a major global public health problem. In India, epidemics are becoming more frequent. Dengue infection ranges from mild illness to a severe form of haemorrhagic fever and shock syndrome which may prove fatal. Early recognition and meticulous management are very important to save precious lives from this killer disease. Methods: Total 82 patients (63 male, 19 female) admitted with diagnosis of dengue fever were analysed in details from clinical features to outcomes. Results: Fever was the most consistent symptoms. Biochemical abnormalities in liver function test were very evident. Bleeding manifestations has no correlation with platelet count. Platelet transfusion was needed in very few patients. Conclusions: High suspicion, early investigations and diagnosis is very important to prevent fatal complications of dengue fever and adequate hydration is one of the most effective treatments.


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Knowledge and attitudes towards tea garden labour with special reference to tuberculosis of Dibrugarh district, Assam, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Anand Sharma, Christ Forth Sangma.
Background: Tuberculosis (TB) is preventable and curable though it is a global burden which remains enormous. TB is one of the major public health problems in tea garden labour. Low level of knowledge and attitudes towards TB could affect the health-seeking behavior of patients and sustain the transmission of the disease within the community. Methods: A population based cross-sectional study was carried out to assess the knowledge, attitude of tea garden labour of Dibrugarh district, Assam, India. Results: 100 TB patients were interviewed in nine tea garden DOTS centre. Male and female distribution was 53% and 57% respectively. More than half of them were illiterate and 60 of them having 5-6 family size live in a congested environment. Chest pain i.e. 79% is the most common symptom experienced by the TB diagnosis which is followed by cough i.e. 76% and 33% were aware that it could spread through sneezing/cough. Tea garden hospital/tertiary centre was mentioned as a source of information about TB. Although most of them were positive about getting family support, 87% mentioned of separate utensils for food or drink and 88% got motivate by them to initiate treatment. Conclusions: Knowledge regarding mode of transmission, symptoms and etiology were not sound properly among the tea garden labour. They need proper awareness regarding cause, transmission, prevention, etc.


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Investigation of an outbreak of malaria in a non- endemic coastal area, Kerala, Southern India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Sandhya Raveendran, Rakesh P. S., Soumya Dev, Prathibha Prasannakumar, Nithin Vijayakumar.
Background: Kollam district, Kerala state, Southern India was free of indigenous transmission of malaria for years. Three cases of malaria were reported to the district surveillance unit of integrated disease surveillance project from coastal areas within town limits of Kollam district on 19th September 2015. Methods: An outbreak investigation was initiated which included stimulated reporting from all hospitals, mass and contact survey, entomological assessment and exploratory interview with cases. Results: A total of six cases of malaria were identified from a total population of 3785. All cases were males. All cases were P. falciparum and P. vivax (mixed) type malaria. Anopheles stephensi breeding sites were found in abandoned boats, near the temporary huts at the seashore, where all the cases used to sleep during night. Median duration of date of symptom onset to the date of diagnosis as malaria was nine days (range 5-18 days). Half of the patients had at least three visits to a health care facility before a diagnosis of malaria was made. Conclusions: There was a delay in diagnosing malaria and hence continuous and ongoing sensitization may be needed to keep the index of suspicion high among clinicians. Success in preventing malaria resurgence in Kerala requires a paradigm shift from a focus on reactive temporary short term response to a proactive long term planned and comprehensive strategy.


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Risk factors for preterm birth: a community based longitudinal study in rural Mysuru, Karnataka, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Rashmi A., Narayanamurthy M. R., Vidya G. S., Vidyalaxmi K., Renuka M..
Background: Preterm birth is defined as birth of the baby before 37th completed week counting from first day of the last menstrual period. Preterm infants constitute two-third of low birth weight babies. Estimated 15 million babies are born too early every year. Almost 1 million children die each year due to complications of preterm birth. Methods: A Community based longitudinal study was conducted for the period of one year (March 2015- February 2016). All the antenatal mothers who completed 24 weeks of gestation, who were available for follow- up till 1week after the delivery were included in the study. Registration of the mothers was done for the period of 6 months, follow up was done till their 1st week of the delivery. During the first visit, a pretested semi structured proforma was administered which includes details regarding socio demographic background, major risk factors etc. Mothers were examined and Information pertaining to basic investigations was collected. Mothers were followed up till the delivery and details regarding delivery and birth weight were collected. Minimum of 3 visits were made before declaring lost follow up. Data collected was entered in MS office excel sheet and analyzed using Statistical Package for Social Sciences(SPSS) software version 22.0. Results: Out of 257 registered mothers, 246 mothers had live birth. 11 mothers lost to follow-up. Total numbers of preterm birth out of 246 deliveries were 5 (2%) 95% CI (0.22-3.78%). Gestational diabetes mellitus, Education of the mother and type of the family was found to be statistically significant (p


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Correlates of metabolic syndrome and prevalence among urban population of Agra, Uttar Pradesh, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Suneel Kumar Kaushal, Vinita Gupta, Gyan Prakash, S. K. Misra.
Background: Chronic non-communicable diseases (NCD) are increasing among the adult population in both developed and developing countries, resulting diabetes, cardiovascular diseases with high morbidity and mortality. Due to increase in life expectancy and change in life style and behavior of people and clustering of metabolic abnormalities in individuals leads to development of metabolic syndrome. To estimate the prevalence of metabolic syndrome and their associated risks factors belonging the age group of 18 years and above of urban Agra population. Methods: Cross sectional study was carried out among 18 years and above age group of urban population of Agra, Uttar Pradesh, India. A multi stage simple random sampling technique is used to reach the subjects. Results: Prevalence of metabolic syndrome was found 37.1% in study subjects, more common in females (65.9%). The metabolic syndrome was also found higher in the educated group between class 8 to class 12 and among socio economic status III. Higher risk showed by serum triglyceride component of metabolic syndrome among study group. Conclusions: The prevalence of metabolic syndrome in female study population is higher as compared to the male study population in every selected bio social characteristics.


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Evaluation of effect of intravitreal injection bevacizumab in treatment of choroidal neovascualr membrane of the eye

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Jignesh J. Jethva, Neepa R. Gohil, Nilesh V. Parekh, Sandip D. Patil.
Background: Age-related macular degeneration (ARMD) is the leading cause of irreversible blindness in individuals over 50 years in developed countries. The objective was to study the effect of intravitreal bevacizumab in patients of choroidal neovascular membrane of eye by visual acuity and fluorescence angiography photograph. Methods: Non-randomized, open label, prospective analysis of 30 eyes in 30 patients with choroidal neovascualr diagnosed by direct ophthalmoscope and slit lamp 90D biomicroscopy. Visual acuity of the clinically diagnosed patient was taken by ETDRS (early treatment diabetic retinopathy system) visual acuity chart. Fundus fluorescence angiography was done by topcon retinal camera. Now all patients regardless of type were given 3 injections of 0.05 ml of injection bevacizumab intravitreally at infratemporal site 3.5 mm and 4 mm away from the limbus in pseudophakic and phakic eye repectively at interval of 1 month. After 1 month of last dose, patient was assessed with ETDRS chart for visual acuity, FFA for anatomical changes. FFA was done before and after giving 3 injection of bevacizumab at monthly interval. Patients were asked for regular follow-up and patients were examined after 6 hours, 48 hours and 7 days for any early and late complications. Results: There was significant improvement of visual acuity after intravitreal bevacizumab treatment (before 1.196 log MAR and after 0.95067 log MAR with p value is 0.0001, paired t-test with t=6.333 with 29 degree of freedom) in cases of choroidal neovascular membrane. Gain in visual acuity was accompanied by a significant decrease in leakage in fluorescein angiography (FFA) Conclusions: We present evidence that intravitreal bevacizumab is an effective treatment for choroidal neovascular membrane.


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Prevalence of hypertension and pre-hypertension among adolescent school children in Thiruvananthapuram, Kerala, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Lawrence Tony, Binu Areekal, Anish Thekkumkara Surendran Nair, Reshmi Ramachandran, Rekha Rachel Philip, R. S. Rajasi, Vijayakumar K..
Background: The foundations of hypertension in a person are laid in childhood and adolescence. The phenomenon of tracking of blood pressure is one where those children and adolescents who are in a high blood pressure category tend to fall in the same category when they become adults. Early diagnosis of hypertension and prehypertension in children and adolescents will help in reducing the prevalence of hypertension and its complications in the future adult population of any country. The objective of this study was to find out the prevalence of hypertension and pre-hypertension among school children 13-17 years in Thiruvananthapuram City Corporation, Kerala. Methods: A two stage sampling technique was applied; in the first stage the schools were stratified as government, aided and unaided schools using probability proportionate to size. In the second stage, from the selected schools one division or class from each standard was identified at random as a cluster and all the eligible children in the selected cluster were studied. A single BP measurement was taken using a standardized digital sphygmomanometer (OMRON IA1). Hypertension and prehypertension was defined as per national high blood pressure education program (USA), working group on hypertension control in children and adolescents blood pressure tables. The data was entered in MS excel and further analysis was done using SPSS 16.0 version software and proportions of outcomes were analyzed. Results: The total number of children studied were 2438, Boys 1274 (52.3%, 95% CI 50.28-54.32) and girls 1164 (47.7%, 95% CI 45.68-49.72). The prevalence of hypertension was found to be 21.4% (95% CI 19.64% - 22.96%). The overall prevalence of systolic hypertension is slightly high among the girls (19.4%) than the boys (18.2%), (P value>0.05). The prevalence of pre-hypertension among the study subjects was 21.3 % (19.65-22.95%). The prevalence of systolic pre-hypertension was found to be 21.4% (95% CI 19.74%- 23.06%) and diastolic pre-hypertension 5.3% (95% CI 4.4%-6.2%). Conclusions: The overall prevalence of pre-hypertension and hypertension was 42.6%. These facts show us that preventive interventions are urgent.


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Study of socio demographic factors among persons affected by leprosy in Kurnool division of Kurnool district, Andhra Pradesh, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Visweswara Rao Guthi, Sreedevi Arepalli, Praveena Ganapa.
Background: Leprosy is an age old disease. Leprosy is an important cause of preventable disability. Physical impairment associated with leprosy is usually secondary to nerve damage. The aim of the present study was to study the socio demographic factors among persons affected by leprosy and to determine the association between socio demographic factors and WHO grade of disability. Methods: This is a community based crosssectional study conducted in administrative limits of Kurnool division of Kurnool district from November 2013-May 2014. Information collected was socio demographic variables like age, sex, religion, educational status, marital status, income, socioeconomic status, type and size of family. Results: 65/276 (23.56%) of the study subjects had disabilities. Out of which 9.06% had only Grade 1 and 14.50% had Grade 2 disability. 10.14% of study subjects had sensory impairment in hands, 5.79% had sensory impairment in feet and 2.90% had sensory impairment in both hands and feet. Grade 1 & Grade 2 disability was more common in >60 years of age (32.26%), males (16.67%), unskilled workers (23.63%), Illiterates (21.56%) and lower socio economic status (20.37%). Conclusions: Disability among persons affected by leprosy was more common in geriatric age compared to other age groups. As age increases the number of deformed cases also increased. Deformities were more among male patients, multi bacillary cases, doing unskilled occupations that have more chance of getting injuries and illiterates and poor socio economic group patients. Sensory Impairment was more common in hands compared to feet.


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Barriers that prevent health science students from donating blood in an African setting

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Julius Ojulong, Jean Claude H. Muhoza, Leonel Monteiro.
Background: Developing countries face significant challenges in collecting sufficient blood to meet the demands from patients. A healthy, active and willing big population of students can be potential pool for blood donors to meet the safe blood requirements for a country. The aim of this study was conducted to find barriers to blood donation in health science students in the University of Namibia. Methods: A descriptive cross sectional study carried out at Faculty of Health Sciences University of Namibia (UNAM), Windhoek where students were recruited for the study. A pre-tested questionnaire was handed out to faculty of health sciences students chosen by systematic random sampling and data was analyzed using statistical package for social sciences version 21 (IBM Corporation, USA). Results: Out of the 311 students who were recruited in this study nursing students were the majority (166), followed by medicine (72), radiology (38) and pharmacy (32). Seventy two percent of the students (224) had never donated blood while only 28% donated blood on a regular basis. Variety of reasons advanced by students as to why they were not likely to donate blood were fear of needles 21.5%; % lack of information about blood donation 14.8%; underweight 13.2%; were not interested 10% and 8.7% gave medical reasons. The study showed that blood donation is associated with gender, field of study and age. Conclusions: Increasing awareness of the importance of blood donation is the most important strategy to increase the number of blood donors. Health programs need to target behavior change using diverse approaches including the use of current blood donors and student leaders as change agents.


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A cross-sectional study regarding usage of mobile phone and internet facilities through mobile handsets and its role in empowering adolescent school going girls in a peri-urban area of Tripura, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Anjan Datta, Shib Sekhar Datta, Nabarun Karmakar, Kaushik Nag, Kaushik Tripura, Partha Bhattacharjee.
Background: In India lack of access and control over resources severely constrain the capabilities of adolescent girls and limits their empowerment in wider society. As adolescents now-a-days are adopting new digital technologies almost as quickly as they are being introduced, this present study was aimed at assessing the use of mobile phone and internet facilities in mobile handset and its role in empowering adolescent school girls in a peri-urban area of Tripura, India. Methods: A school based cross-sectional study was conducted among purposively selected166 girls between Class VI to Class XI of Madhuban (East) Higher Secondary School, Dukli during January-February 2016. Data was collected using pre-designed and pre-tested questionnaire and qualitative information was collected through two focus group discussions (FGDs). Data were analysed using computer software SPSS version 20.0. Results: The study reveals 18.1% subjects were having their own mobile handsets and majority of them (60%) were using it for communicating with others. The main reason for not having a mobile phone is they did not feel its required (52%). The main uses of mobile phones were; calling (46.7%), texting (16.7%), social networking (13.3%), gaming (16.7%) and others (6.7%). Significant association was found in this study between age of adolescent girls and ownership of mobile phone, usage of internet, smart phone usage. Conclusions: This study reveals that majority of the adolescent girls were having their own mobile handset, neither majority were using mobile phones; but believed mobile phones and internet could help in their empowerment.


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Awareness of cervical cancer and its risk factors among female students of a pre university college in Bangalore, Karnataka, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Monisha T. S., Santosh A..
Background: Cervical cancer is a serious public health problem. It is the commonest cancer among women in rural India, and India has the largest burden of cervical cancer patients in the world. Primary intervention focusing on creating awareness in the community will make a difference in present situation of cervical cancer in the country. Objective of the study was to assess the awareness of cervical cancer and its risk factors, Pap smear testing and HPV vaccine among female students of a pre university College. Methods: A cross sectional study was conducted among female students of a pre University College, near to Raja Rajeshwari Medical College and Hospital. The study was carried out for duration of two months, May and June 2016. A pre tested, semi-structured questionnaire was designed to evaluate their basic awareness on cervical cancer. After the data collection Health education on cervical cancer was given to the students. Results: Out of 98 students who participated in this study 53 (54%) students were 1st year and 45 (46%) were 2nd year students. Awareness about role of hereditary factor as a risk of cervical cancer was present in 19% of the students and 36% of the students reported that having multiple sexual partners is a risk factor for cervix cancer.45% were not aware of the fact that poor personal hygiene could also be a risk factor. 66% were not aware about HPV vaccine. There was no statistically significant association between place of residence and awareness level and there was a statistically significant difference in the awareness level and the year of study (p


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Effectiveness of objective structured practical examination as a formative assessment tool as compared to traditional method for M. B. B. S students

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Nisha Ram Relwani, Rishikesh A. Wadke, Seema Anjenaya, Pradeep N. Sawardekar.
Background: Most of medical colleges in India follow Traditional Practical Examination for evaluation of practical or clinical skills wherein students are assessed only for knowledge and not for attitude and skill. Traditional methods have several flaws like inter-examiner marks variation, examiners subjectivity, varying difficulty level of different experiments, etc. which prevents uniform marking. These flaws could be minimized by newer methods like OSPE. Objective of the study was to know the effectiveness of objective structured practical examination (O.S.P.E) as a formative assessment tool as compared to traditional methods for M.B.B.S students and to know the perception of participating students and faculties towards OSPE. Methods: A cross sectional comparative study was carried out on 63 MBBS students. Students were subjected to Traditional Practical Examination followed by OSPE. Mean marks for all students were calculated by both the methods. A Likerts scale based questionnaire on OSPE was distributed among the students and faculties to know their views and perceptions towards OSPE. The results were analysed by SPSS version 20.0. Results: Average marks scored by the students in OSPE (18.74±4.395) were higher as compared to Traditional Practical Examination (13.81±3.814) which was statistically significant. 74.4% of the students and 65.4% faculties strongly agreed that OSPE is fairer in comparison to Traditional Practical Examination. 90.5% students strongly agreed that variability of examiner & patient can be removed to a large extent by OSPE. Conclusions: OSPE was found to be a more effective assessment tool than traditional method. As regards perception, both students and faculties strongly agreed that OSPE is fairer assessment tool compared to traditional practical examination.


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Assessment of level of knowledge of basic life support algorithm among medical and nursing students in a tertiary care teaching hospital

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Bindhu Vausedvan, Anupa Lucas, Geetha Devi M., Anitha Bhaskar, Binu Areekal.
Background: Every person should know about basic life support resuscitation (BLS) skill, but its knowledge is vital for medical and paramedical personnel. Structured training & retraining is required for its efficient execution which is lacking in the current medical curriculum. Basic situation analysis regarding the students knowledge regarding BLS is necessary to develop a effective training programme. Objective of the study was to assess the knowledge of BLS resuscitation algorithm among medical and nursing students of Medical College Kottayam, Kerala and to find whether there is any difference in the knowledge level of medical& nursing students about BLS. Methods: A cross-sectional Analytic study was conducted among the medical and nursing students of Govt. Medical College, Kottayam. 575 medical students and 236 nursing students who joined the course from 2010 -2013 were included in the study. Data was collected using structured questionnaire which collected information regarding the basic demographic factors, knowledge regarding the BLS resuscitation algorithm, their opinion regarding the causes of lack of knowledge & starting of a structured curse of BLS in their curriculum. Results: Median knowledge score was 7 with an inter-quartile range of 4. Average knowledge score was significantly higher among nursing students (8.5±2.8 Vs 6.6±2.5; p value-0.001). Highest knowledge level was seen among those who had seen the BLS previously (15.2% Vs 4.5%; p value- 0.001) or attended the BLS workshop previously (8.1% Vs7.3%; p value-0.001). Final year medical and first year nursing students were having higher knowledge as compared to other students. Conclusions: Knowledge regarding the BLS was less among the students of Government Medical College, Kottayam, Kerala, India nursing students were having higher knowledge than Medical students.


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A cross-sectional study to assess the perceptions and experiences of tuberculosis patients about directly observed treatment in an urban slum, in Mumbai, Maharashtra, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Gautam Bhagwan Sawase, Shrikala Acharya, R. R. Shinde.
Background: India accounts for one-fifth of the global incident cases of Tuberculosis. The country presently has the world's largest directly observed treatment, short course (DOTS) programme that has shown impressive results. However, to sustain the high treatment adherence & cure rates, awareness among patients about regular and complete treatment and availability of accessible DOT services are vital, especially in urban slum areas. The objectives were (1) to study the socio- demographic profile of patients diagnosed at Urban Health Center; (2) to assess their knowledge and perceptions about TB treatment; (3) to ascertain the accessibility of DOT services and the problems faced at DOT center and; (4) to find willingness of patients for private practitioner as a DOT provider. Methods: The cross sectional study is being conducted among TB patients diagnosed & taking DOT treatment at Urban health center, located in Malvani slums in Mumbai. All the patients (65), willing to participate, over 3 months of duration are included. A semi-structured and pretested questionnaire is used to interview the patients after obtaining their consent. The data is analyzed using SPSS version 16. Results: 76.9% of the patients were in economically productive age group (15-45 year), disease distribution was found slightly higher in males. Among total patients 35.4% were house wives, 20% were unemployed & 9% were students. All patients were aware that they are suffering from TB. 92.5% of new patients were as 96% among re-treatment category were aware about duration of treatment. 33.84% patients faced poor accessibility to take DOT from the existing DOT center. 33.8% patients preferred to take DOT from private practitioners in their area. Conclusions: Almost 1/3 patients cited inconvenience in accessing DOT services due to their work hours, long distance and expressed willingness for community DOT providers including private practitioner. These patients, in the circumstances, may not pursue Directly Observed Treatment under supervision, resulting in poor treatment adherence and drug resistance.


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Positive thinking and health status among adults in a tertiary care hospital of Delhi, India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Mongjam Meghachandra Singh, Sanchit Duhan, Sumita Sandhu, Reeta Devi.
Background: The positive emotions are important to the science of well-being simply because positive emotions are markers of optimal well-being. The positive emotions produce optimal functioning, not just within the present but over the long term as well and also as a means to achieving psychological growth and improved psychological and physical well-being over time. Methods: It was a cross sectional study conducted in a tertiary hospital of New Delhi. The aim was to study the satisfaction with life and positive/negative emotions. A total of 170 subjects were enrolled randomly from out-patient department (OPD) patients (85 patients and 85 who were apparently healthy and did not have any complaint related to health). They were assessed with pre- tested questionnaire. Comparisons between patients and controls were done using chi-square test and p


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Breastfeeding to reduce postpartum weight retention

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Rinela Padmawati, Djaswadi Dasuki, Toto Sudargo.
Background: Postpartum weight retention is regarded as a major public health problem because of its contribution to the incidence of obesity. Evidence regarding the effect of breastfeeding on postpartum weight retention reduction is still controversial and limited. In 3 to 6 months of postpartum, not all women will be losing weight, so that efforts are required to reduce postpartum weight retention. This study to determine the effect of breastfeeding on postpartum weight retention. Methods: This was an observational study with a prospective cohort design. The duration of this study for three months after childbirth. The study population was all lactating mothers in Cirebon Municipality. Samples were taken with a purposive sampling technique in Cirebon with a sample size of 80 people. The data used were primary and secondary data and the instrument used were a questionnaire and adult weight scale. Data were processed using univariate analysis, bivariate analysis with ANOVA and t-test, and multivariate analysis with linear regression. Results: Postpartum weight retention was much more in partially breastfeeding mothers compared with those who breastfed fully (p=0.0021). Breastfeeding can reduce postpartum weight retention at 2.57kg. Breastfeeding after being controlled with food intake, weight gain during pregnancy, and physical activity showed a significant association with postpartum weight retention and can reduce postpartum weight retention at 2.26kg (p =0.000). Conclusions: Breastfeeding could reduce postpartum weight retention. Weight gain during pregnancy, food intake, and physical activity might influence postpartum weight retention.


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Socio-demographic profile of TB-HIV co-infected adults and it’s association with tuberculosis treatment outcome, in a South Indian city

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Arun Mohan M. V., Tejaswi H. J., Ranganath T. S..
Background: Human immune deficiency virus (HIV) and tuberculosis (TB) are major public health challenges and are intricately linked to other public health challenges like malnutrition, unemployment, alcoholism, drug abuse, poverty, homelessness and even mortality. In 2013, 360,000 deaths from HIV associated TB equivalent to 25% of all TB deaths, and around 25% of the estimated 1.5 million deaths from HIV/AIDS .Prognosis in these diseases depends on factors such as health seeking behavior and compliance to drug regimen which further depend upon various socio-demographic factors, hence it is decided to study the socio-demographic correlates of TB-HIV co-infected adults and their association with TB treatment outcome in Bangalore Municipality area. Methods: A longitudinal observational study was carried out, from November 1st 2010 to December 30th 2011, on HIV-TB co-infected adults receiving Revised National TB control programs (RNTCP) Directly Observed Treatment Short-course (DOTS) from 5 randomly selected Tuberculosis units of Bangalore Municipality area, by interview method using a questionnaire. Results: Majority of the 162 HIV-TB co-infected adults studied were males (74%), belonging to fourth decade of life, and most came from low socio-economic stratum and most were educated only till middle school (70%). Most common occupation was unskilled labour (17.3%), and among women, 58% were house wives. Disability due to the diseases had led to unemployment of many who were earlier employed. Most patients belonged to Hindu (80.2%) religion, live in nuclear families (67.9%), and come from urban slums (55.8%). Three fourths of the patients were either currently married (103, 63.6%) or had been married. TB treatment success rate was 90.5%. Although there were differences in the proportion of successful and unsuccessful outcomes of TB treatment among groups pertaining to socio-demographic attributes of patients, none of these differences were statistically significant. Conclusions: HIV-TB co-infection was common among males, middle aged adults, low socio-economic class, those with low education and among unskilled labourers, but none of these socio-demographic attributes had significant relation with the TB treatment outcome.


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A study of pattern of psychogenic morbidity and associated biosocial factors in school going adolescent girls

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Ratandeep Lamba, Sanjeev Kumar, Ravi Rana.
Background: Psychiatric & psychogenic problems in children in India are rising and reported-cases represent only the tip of the iceberg, large number remains unreported. During adolescence, children need special care as they undergo a complex process of emotional, physical and social changes. At times, failure to adjust with these changes leads to mental health problems. Both, girls and boys are susceptible to suffer from these problems but, for adolescent girls, the problem gets compounded due to multitude social factors. Adolescents are the future citizens of a country and it is imperative to systematically address their needs. The present study was planned to study psychosocial problems in school going adolescent girls & biosocial factors related to it. Methods: The study population comprised of the adolescent girls attending Queen Victoria, Girls Inter College located in the heart of Agra city. 880 school girls of age group 10-19 years whose parents or guardians gave written voluntary consent participated in the study, comprised the study population. To identify psychogenic morbidity Youth Self-report & M. I. N. I. International neuropsychiatric interview were used. Socio-demographic details of the girls were collected on a socio-demographic data sheet prepared for this study & conclusions were drawn. Results: Psychogenic morbidities were found in 13.5% (119/880) of the school going adolescent girls (10-19 years). Highest psychiatric illnesses were in those who were 17 (20.4%) followed by 16 (15.2%) & 15 (14%) years of age respectively. Conclusions: According to ICD 10 criteria, 34 (28.6%) of the girls belonged to neurotic stress related & somatoform disorders wherein anxiety disorders (generalised anxiety disorder, phobias & OCD) were the most common. 29 (24.3%) of the girls had mood & affective disorders.


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Clinical and epidemiological profile of chronic kidney disease patients in a tertiary care referral centre in South India

2016-11-24T04-45-51Z
Source: International Journal of Community Medicine and Public Health
Swaraj Sathyan, Sunil George, Poornima Vijayan, Jayakumar M..
Background: The clinical course of CKD (chronic kidney disease) is typically a progressive loss of nephron function ultimately leading to end stage renal disease (ESRD) requiring some form of renal replacement therapy. As this puts a significant burden on global resources, planning for prevention of CKD by early identification of kidney damage by identifying and screening high-risk individuals is the most practical solution. Aim: To study the clinico-epidemiological profile of newly diagnosed cases of CKD. Methods: This study was conducted between January 2008 and June 2008 at a Government tertiary referral institution in South India. All newly diagnosed cases of CKD based on the National Kidney foundation definition were included in this study. Results: Of the total 333 patients included in the study, 217 (65%) were males and 116 (35%) were females. Majority (275, 82.59%) of the patients were between 21-60 years of age. Chronic glomerulonephritis was by far the most common etiological diagnosis (51%) followed by diabetic nephropathy (22%) and hypertensive nephrosclerosis (7%) . About 24% had diabetes mellitus while 84% of the patients had hypertension. Dyspnea (75.68%), symptoms suggestive of volume overload in 242 (72.7%) and Oliguria (69%) were the chief presenting complaint. An overwhelming majority of the patients in the study presented in stage 5 CKD (264, 79.2%). 167 (50.15%) patients were found to have some form of cardiovascular disease. Cigarette smoking was prevalent in 32.7%, alcohol consumption in 6.91%, NSAID use in 5.1% and herbominerals in 4.5% .The mean hemoglobin in the study was 8.42 g/dl. Mean phosphate level in the study was 5.94 mg/dl. There was significant statistical correlation between hemoglobin level and stage of CKD and also between serum phosphate level and stage of CKD. Conclusions: Early detection of CKD by screening of high risk individuals will go a long way in retarding the progression of ESRD. This will help in bringing down the huge burden due to mismatch between demand and availability of resources for renal replacement therapy in developing countries like India, especially for patients belonging to lower socioeconomic group.


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Application of latent class analysis to estimate susceptibility to adverse health outcomes based on several risk factors

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Ankita Dey, Arun K. Chakraborty, Kunal K. Majumdar, Asok K. Mandal.
Background: The study demonstrates the use of latent class analysis (LCA) to segregate population in two latent classes e.g. susceptible or not susceptible to adverse health outcomes according to the observed risk factors as a method of medical diagnosis. Methods: The present study uses a secondary data set on 420 patients referred to the University of California, Los Angeles (UCLA). Adult Cardiac Imaging and Hemodynamics Laboratories for Dobutamine stress echocardiography (DSE) between March1991 & March1996. LCA is used for estimating the individual item-response probabilities in each latent group and also the latent class sizes. The observed variables or indicators of the latent subgroups are the common risk factors viz. history of smoking, history of cardiac issues etc. The interaction effect of hypertension & diabetes is also included in the analysis. Results: Based on the behaviour of the estimates of latent class model parameters, the unobserved groups are identified and named. Proportion of individuals falling in each latent class are approximately 0.20 & 0.80 respectively. The susceptibility to adverse health outcomes in future is the most in male individuals having a positive history of hypertension and/or diabetes, as the corresponding indicators have higher positive item-response probabilities (0.72 & 0.83 respectively) than the rest. Conclusions: The study briefly explains the application of LCA for identifying subgroups according to susceptibility to adverse health effects in a large population. Assessment of common risk factors in predicting latent class sizes provides estimates of probabilities for being a member in each class. The importance of the combined effect of hypertension & diabetes in predicting future health problems related to cardiac issues is highlighted. Class assignments of individuals according to their pattern of response are also listed.


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A study of leprosy patients attended tertiary care hospital

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Yugantara R. Kadam, Renuka S. Ashtekar, Vishrabdha R. Pawar, Aniruddha N. Pimpale.
Background: Recorded leprosy case load has come down from to less than one case per 10,000 populations at national level in December 2005. Considerable changes in the epidemiological pattern of the disease have been observed due to the historical trend of the disease; the impact of interventions; the efficacy of chemotherapy and the role of improved health services. This study was planned to know the pattern of leprosy cases attending tertiary care hospital, their treatment & outcome. Methods: It is a retrospective study conducted from Bharati Vidyapeeth Deemed University Medical College & Hospital from 2007 till December 2015. Study-subjects include patients with leprosy and sample size includes all the patients of leprosy from January 2007 to December 2015. The study-tools: records, biopsy tissue blocks. Statistical analysis: percentages. Results: There were total 42 cases. Total 9.5% were children. Male to female ratio was 1.33:1. Two (4.8%) patients gave family history of leprosy, 23 (54.8%) were from rural area. Clinically 16.66% patients had single patch, 50% had nerve involvement. The most common type was borderline tuberculoid leprosy (35.7%). Out of these 42 cases 22 cases had completed the treatment, 14 on treatment. Six patients were defaulted. Conclusions: Early diagnosis & treatment of leprosy is happening as none of the cases had disability. History of contact in study subject was not common & presence of leprosy in paediatric age group indicates continued transmission. However there is a need of strong follow-up system for defaulters.


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Prevalence and knowledge of tuberculosis among the residents of urban slums of Shillong, Meghalaya, India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Amrita Sarkar, Himashree Bhattacharyya, Kaushik Talukdar, Gajendra Kumar Medhi, Star Pala.
Background: The present survey on tuberculosis (TB) was carried out to fill up the lagging information on TB in Meghalaya and also to serve as a base for further research on various aspects of Tb in this state. The aims and objectives were to study prevalence of TB and TB suspects in urban slums of Shillong and to assess the knowledge about tuberculosis among the participants of the study. Methods: The present community-based, cross-sectional study was conducted during January 2016 to March 2016 in urban slums of Shillong, India. Results: Out of 330 persons interviewed, 8 had TB during the past 5 years making the period prevalence to be 24/1000 population. Prevalence of TB suspects was 18/1000 population and that of pulmonary TB cases was found to be 15/1000 population. The female/ male case ratio was 3:1. The highest TB load (62.5%) was found in the most productive age group of 20-29 years and 83% of the cases in the women were in their reproductive age group. Treatment initiation rate was 87.5% and treatment success rate was 87.5%. Defaulter rate was 12.5% and reason for default was side-effects from medication. The study revealed that 75% of the participants had heard about TB, 65.99% knew about the mode of transmission of the disease, 76.11% knew about the symptoms, 85.44% claimed the disease was curable with proper treatment, 42.51% had heard about DOTS, 52.63% claimed that the disease is preventable and 32.39% knew about BCG vaccine. The most common source of knowledge about Tb was television (34.82%). Conclusions: A high prevalence of TB was observed in the present study.


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An epidemiological study of prevalence of hypertension and its risk factors in a rural community of Nellore, Andhra Pradesh, India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Manoj Kumar Singh, Bhaskar Singamsetty, Jithendra Kandati.
Background: Hypertension [HTN] is responsible for 57% of stroke deaths and 24% of coronary heart disease [CHD] deaths in India. As per the statistics of Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, the overall prevalence of hypertension in India by 2020 will be 159.46/1000 population. Hypertension will be the major cause of death and disability by the end of 2020. The prevalence of hypertension is increasing in both rural and urban communities. The objectives of the study were to assess the prevalence of hypertension and its associate risk factors in a rural population. Methods: A cross sectional study was conducted by the Department of community medicine in the rural field practice area of a Medical college of Nellore from October 2013 to September 2015. The socio demographic variables and risk factors were obtained by interviewing the subjects in the study and collected in a predesigned questionnaire sheet. The sample size was calculated by prevalence of HTN in previous studies and 1025 subjects were included. The blood pressure was assessed and classified using recent JNC 7 and WHO criteria to grade hypertension. Results: In the study the prevalence of pre-hypertension was 42.63% (437 subjects), stage-I hypertension was 26.15% (268 subjects) and stage-II hypertension was 10.34%. The peak age of prevalence of HTN in both males and females was 60-69 years. Significant association was observed between age, low socio economic index, high salt intake (>10gms/day)) with hypertension. A linear trend of association was seen with tobacco and alcohol use, obesity (BMI>25) and waist-hip ratio more than the cut-off value (p value


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Evaluation of dry eye in computer users

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Sandip D. Patil, Harish R. Trivedi, Nilesh V. Parekh, Jignesh J. Jethva.
Background: Increased use of computers led to an increase in the number of patients complaining about ocular and non-ocular symptoms related to computer use. One of such computer associated ill-effect is, Computer Vision Syndrome manifesting as dry eye. This study was done to find out prevalence of dry eye. Methods: Computer users were grouped in Group A > 2hours to ≤ 4 hours, Group B >4 hours to ≤ 6 hours, Group C > 6 hours to ≤ 8 hours according to their exposure to computer per day. Dry eye evaluation was done with ocular surface disease index questionnaire, tear meniscus height, and tear film brake up time, schirmer test. One way analysis of variance test was used to compare mean values, find p values and ensuring statistical significance. Results: In our study prevalence among the males and females was found to be of 25%. The prevalence of dry eye among 20 to 30 and 31 to 40 years of age is 13.04% and 51.64 % suggesting that the prevalence of dry eye increases as the years of computer exposure increases. The overall prevalence of dry eye in computer users was found to be 25% with prevalence of 9.3%, 18.18% and 45.71% in groups A, B and C respectively. Conclusions: It seems prevalence of dry eye is increasing with increase in duration of computer use per day. OSDI together with TBUT, schirmer-1 test cab be performed easily and used to support diagnosis of dry eye.


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Comparison of forced expiratory volume among the smokers and non-smokers in brick kiln workers

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Seema P., Damayanthi M. N..
Background: Smoking is a common habit prevalent both in urban and rural areas. It has an impact on the impairment of Lung function. Pulmonary function test is a routine procedure for the assessment and monitoring of the Respiratory diseases. This study was undertaken to see the effect of smoking on lung function. The objectives were to compare the effect of smoking on pulmonary function test (FEV1) among the smokers and non-smokers men working in brick kiln factory. Methods: The study was carried out in three brick factories which comes under the purview urban health training center, Agara Rajarajeswari medical college, Bangalore .It is a cross sectional study conducted for two months. Study participants include all adult men aged above 19 years working in the brick factory. The sample technique & size were 100 subjects with purposive sampling. Data Collection: Using Pre-designed questionnaire, information on Socio-demographic profile, history of Smoking, anthropometric measurements height, weight, FEV1 recording using Wrights Peak Flow Meter. Data analysis used was SPSS v19. Results: Mean FEV1 among the smokers was 2.13±1.00 and 2.40±0.51 among the non- smokers; FEV1 was ranging between 150-300 liters in 88.9% of those who had smoked for more than 10yrs of duration, FEV1 value among the smokers was reduced compared to non smokers, which was statistically significant (p


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Risk factors of cardiovascular diseases among auto-rickshaw drivers of Kannur, North Kerala: a cross-sectional study

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Girish H. O., Priya Senan, Raghavendraswamy Koppad, Venugopalan P. P..
Background: Cardiovascular diseases (CVDs) are one of the leading causes of death in all developed countries. CVD is predicted to become the major cause of morbidity and mortality by 2020. The main objectives were to know the magnitude of risk factors of cardio vascular diseases (CVDs) among auto-rickshaw drivers. Methods: A cross-sectional descriptive study was conducted involving 330 auto-rickshaw drivers at Kannur city of Kerala using a pre-designed and pre-tested questionnaire & anthropometric measurements. Results: All the study population were males. The cardiovascular risk factors were current smokers 35.45%, current alcohol consumption 43.6%, overweight & obesity 40.6% central obesity 32.1% & hypertension 21.8%. Conclusions: High proportion of risk factors was observed in auto-rickshaw drivers which put them for increased risk of CVDs. Early precautionary measures, regular medical check-up & prompt interventions are necessary for managing risk factors.


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A study incorporating action research to enhance community based medical education

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Abhishek N. Ingole, Purushottam A. Giri, Abhay B. Mudey.
Background: Action research is a natural way of acting and researching at the same time and intends finding the solution to local problems encountered by the researcher team. Action research adds to the enthusiasm of community based interventions and learning when implemented by students as a part of community based learning. Methods: A medical education research was carried out involving 40 medical students visiting adopted village under CCHCP of JNMC Sawangi (Meghe) during the period of January to June 2015. Students were assessed on various skills associated with conducting action research, responses towards its utility and its felt need in community based learning was assessed on a five-point likert scale and consensus score was calculated based on the responses. Results: The study reported significant increase in the excellent test score and good test score and decrease in average test score and poor test score. So the performance of students improved from pre-test to post-test. Normalized gain (g) was 0.59, considered moderately effective. Conclusions: Students agreed to having achieved various skills in conducting research with good consensus scores and also agreed to a strong need to incorporate action research in community based medical education.


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A comparative study of breast feeding practices in working women

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Pradnya P. Sathe, Shubhalaxmi D. Kotnis, Mangulikar S. K..
Background: Breast milk is ideal food for infants until 6 months after birth. In India, breast feeding practices vary according to different socio-demographic factors. This study was aimed to study and compare different factors affecting breast feeding practices in sugarcane workers and paramedical staff. The objectives were objectives to study socio-demographic factors affecting breast feeding practices in sugarcane workers and paramedical staff, to compare factors affecting breast feeding practices in these groups and to suggest recommendations based on study findings. Methods: A cross sectional study was done on 100 women from 2 groups of working women, 50 from paramedical staff and 50 from sugarcane workers. They were interviewed personally using predesigned and pretested questionnaire. All women working at the time of their postnatal period were included in the study. Statistical analysis used: Z test for difference in two proportions was used for statistical analysis. Results: In Group A i.e. unskilled labourers, breast feeding was seen for prolonged duration (up to 2-3 years.) Whereas in Group B, breast feeding was for shorter duration (lasting up to 1 year in most women). Conclusions: There was significant difference in breast feeding practices in the two groups.


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A study on prevalence of occupational exposure to HIV among medical interns and their knowledge, attitude and practice of post-exposure prophylaxis for HIV in a teaching hospital

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Raghavendra N., R. G. Viveki.
Background: Every day thousands of healthcare workers around the world suffer accidental occupational exposures while managing patients. Interns take maximum load of providing medical care in the in-patient and out-patient departments of any medical college and are thus at a great risk of occupational exposure to all kinds of blood borne pathogens including human immunodeficiency virus (HIV). We aimed to assess the prevalence of occupational exposure to HIV among medical interns and their knowledge, attitude and practice regarding post exposure prophylaxis of HIV. Methods: A cross-sectional study was conducted among all (94) medical Interns who were working in BIMS hospital Belagavi, Karnataka, India during September and October 2015. Data was collected using self-administered questionnaire, which had 18 questions to assess knowledge and 8 questions to assess attitude and 13 questions to assess practice related to occupational exposure and utilization of post exposure prophylaxis (PEP) for HIV. Results: Majority of them i.e., 59 (62.7%) had adequate knowledge and 91 (96.80%) had good attitude towards occupational exposure to HIV and PEP for HIV whereas practice was poor. Out of 94 study participants, 16 (17%) had occupational exposure to HIV out of which 5 (5.13%) had taken PEP for HIV but none of them completed the course. Conclusions: There is considerable gap between knowledge and practice against occupational exposure to HIV and inadequate knowledge of post-exposure prophylaxis of HIV emphasizes the need for continuous onsite training of interns with supportive supervision and monitoring of their activities.


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Neck circumference: a potential anthropometric marker for screening of hypertension in adult population of central India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Niniya J., Chaitanya R. Patil, Prakash R. Bhatkule, Suresh N. Ughade, Uday W. Narlawar.
Background: Upper-body subcutaneous adipose tissue, measured by neck circumference (NC), has been positively associated with hypertension (HT). This study was conducted with the objective to correlate and evaluate NC with HT and to define critical cut-off point for screening HT in adult population of central India. Methods: This cross sectional study was carried out in the urban filed practice area of Government Medical College Nagpur. All patients attending OPD during study period, aged >30 years after applying exclusion criteria were included in study. Sample size was calculated to be 182. The socioeconomic details were assessed using questionnaire. Anthropometric measurements and blood pressure were recorded using standard guidelines. Data was analysed using Epi Info 7 and SPSS. Unpaired t test, Pearsons correlation and finally ROC analysis was done. Results: Out of total 206 individuals, 107 were male; majority being aged >50 years. The mean value of NC was 36.43±3.23 cm and 34.84±4.07 cm in hypertensive and non-hypertensives respectively and was seen significantly associated with HT (p=0.02). Positive correlation was seen between SBP and NC in male r=0.27 and in females r=0.26 (p=0.001).On applying ROC, AUC for male and female was 0.652 (p=0.007) and 0.68 (p = 0.002) respectively and the best cutoff for male was 36.5cm and female was 33.5cm with sensitivity of 74% and 72.71% respectively. Conclusions: NC is positively correlated with hypertension. NC >36.5cm for males and >33.5cm for females was the best cut-off levels for screening for HT. NC could be a potential, inexpensive, easy screening tool for screening HT.


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Prevalence of hearing impairment in school children (aged 8-14 years) in the villages of Vadamavanthal, Tamil Nadu, India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Prasan Norman, Mahendran Chandran, Thirunaaukarasu Dhandapani.
Background: Children with hearing loss, congenital or acquired, have minimum or no schooling. There are lots of school dropouts in children who have hearing impairment due to trouble keeping up with their peers. This not only affects the economic development but also the social development in communities and countries. The importance of hard of hearing is often largely underestimated since it is an invisible disability. It is mostly asymptomatic, and thus easily overlooked .Not many parents understand about it, till the childs teacher mentions it to them. Methods: A cross sectional study was conducted to estimate the prevalence of hearing impairment in school children aged 8years to 14 years in the schools in Vadamavanthal area during the months of January 2013 to July 2013. The students were interviewed through pre-tested questionnaire and aural examination was done by a qualified otolaryngologist. Results: This study was conducted among 700 school children of age 8 to 14 years. 216 (30.9%) school children were suffering from hearing impairment. It was more prevalent in the age group of 8 years followed by the age group of 14 years. Conclusions: Simple measures like regular screening for ear diseases and hearing assessment done at the school level can help identify hearing impairment. Hearing impairment leads to poor academic achievement and affect the childs vocational choices in future.


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Sociodemographic profile of non-fatal road traffic accident cases admitted in tertiary care hospital in Central India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Yogesh Balaso Patil, Mohan Khamgaonkar.
Background: Road traffic injuries remain an important public health problem at world, regional and national levels. Data on magnitude of problems and risk factors involved are essential to developing a systemic approach to road safety. Only by systematic and data-led management of the leading road injury problems will significant reductions in exposure to crash risk and in the severity of crashes be achieved. Hence in the background of high epidemiologic proportions of road traffic accidents and the fact that very few exploratory studies were reported from central India, the present study was undertaken to study sociodemographic profile associated with road traffic accident. The main objective was to study socio-demographic profile of road traffic accident cases admitted in tertiary care hospital. Methods: The present hospital based cross sectional study was carried out in tertiary care hospital of the city in central India. Road traffic accident cases admitted in tertiary care hospital in city during period of one year (20th May 2014-22nd May 2015) were included in the study with predefined inclusion and exclusion criteria. Socio-demographic characteristics of study subjects was recorded in the proforma. Results: It was observed that majority of accident cases (29.67%) were in the age group of 21-30 years. Male: female ratio was found to be 5.38: 1. Majority of accident cases (86%) were from upper lower and lower class. Out of total accident cases majority were drivers (42.33%), followed by passengers (30%) and pedestrians (27.66%). 35.43% drivers were alcohol consumers. It was also observed that 16.33% were under the influence of alcohol at time of accident. Conclusions: It was also observed that 16.33% were under the influence of alcohol at time of accident.


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A study of determinants of infant feeding practices in a resettlement colony of Delhi, India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Neelima Thakur, Anita Gupta, Pragti Chhabra, Jai P. Dadhich.
Background: Optimal infant and young child feeding practices, especially exclusive breastfeeding for the first 6 months, could contribute significantly in reducing childhood malnutrition and improving child survival. The present study is designed to assess the prevalence of feeding practices among the mothers in an urban resettlement colony of Delhi Methods: A community based cross- sectional study was carried out in a resettlement colony of East Delhi among mothers with infants less than 6 months of age. Mothers were enrolled from Anganwadi Centres using systematic random sampling and a questionnaire was used to record information on feeding practices. Statistical analysis used: Chi square test, t test and multiple logistic regression analysis was done. Results: A total of 350 children were included. Breastfeeding (BF) was initiated within 1 h of birth in 51.7% of children. Pre-lacteal feeds were given by 18.5% of mothers. The prevalence of exclusive BF (EBF) for less than 6 months was 42% (147/350). One third (117/350) of mothers gave artificial feeding to their infants. Exclusive breastfeeding decreased with increasing age of infants and was significantly lower in families with higher income and who gave pre-lacteal feeding. Similarly, introduction of artificial feeding was significantly higher in families with higher income and working mothers Conclusions: In the present study the infant feeding practices in the resettlement colony were not satisfactory. There is need for skilled, sustained and practical help to the pregnant and lactating mothers by skilled counsellors at health facilities.


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Relationship between various social and demographic factors and its relation with treatment outcome in category II cases of tuberculosis in corporation area of Jamnagar, Gujarat, India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Meet Chauhan, J. P. Mehta, Trusha Kansagara, Prashant Dave, Mehul Patel.
Background: Tuberculosis is a social disease with medical aspect. It has also been described as barometer of social welfare. India is the second-most populous country in the world. One fourth of the global incident TB cases occur in India annually. Various social and demographic factors are variably related to poor adherence. Methods: A longitudinal study was designed and all category II TB patients registered for DOTS treatment during period from July 2014 to December 2014 (2 Quarter), of corporation area in tuberculosis register of district TB centre were included in present study. Considering exclusion criteria total 89 patients were studied in present study. Results: Out of 89 patients median age (+SD) of the patients were 38±16.1 years , 75.28% were male, around 40.45% were labourers, around 29.31% patients were illiterate, over all treatment success is 59 (66.29%). Out of 63 literate patients, 79.36% patients were successfully treated, while Among 26 illiterate patients, only 34.61% patients were successfully treated. Treatment outcome lower class (Modified B.G. Prasad classification class IV and class V) having only 53.70% treatment success rate. Conclusions: The findings of this study suggest that improvement in quality of life is necessary for better outcome. Future programme or research should focus on improvement of quality of life as well as reducing the duration of treatment for better compliance with.


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Prevalence of hypothyroidism amongst college girls of Bhopal, Madhya Pradesh, India: a cross sectional study

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Padma Bhatia, Manju Dubey, Yachana Choudhary.
Background: Endocrine disorders are common amongst Indian population, out of which thyroid disorders represent an important subset of these endocrine disorders. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid disease. Hypothyroidism in young women is linked to menstrual irregularities, polycystic ovaries and infertility. Also, several studies have highlighted the importance of diagnosing and treating hypothyroidism in pregnancy. So, this study was done to assess the prevalence of hypothyroidism in young women attending college who are going to become pregnant in future. Methods: This was a cross-sectional study done in government PG girls college of Bhopal, Madhya Pradesh, from October 2015 to December 2015 (3 months). The study population was the college girls in the age group 17-25 years. After taking permission from principal of the college, a survey was conducted on 249 students of M.L.B Girls College, Bhopal using a semi - structured questionnaire. It was followed by clinical examination of 249 girls and recognizing the high risk group by Zulewskis Scoring Criteria for thyroid dysfunction. Those who were having score of >5 points were taken for TSH estimation to confirm the diagnosis. Girls with history of hypothyroidism and receiving treatment were also included to calculate the prevalence. The data thus obtained was tabulated and analysis was done using MS Excel 2013. Results: Out of 249 girls, 32 girls have score >5. Thus, prevalence by clinical score came out to be 11%. Prevalence by TSH estimation came out to be 7.63%. Conclusions: Since prevalence of hypothyroidism in the college going age group came out to be 7.6% in our study, which is quite prominent and who are destined to conceive in the years to come, hence thyroid screening should be included in medical check-up in all colleges.


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Study of prevalence of hypertension in young adult population of age group 20 to 40 years in an urban slum of Mumbai, Maharashtra, India

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Amrin Y. Tadvi, Janardhan R. Bandi.
Background: Hypertension is a growing health problem in Asia, while most studies describe hypertension in older adults and elderly. There is paucity of data on hypertension in teenagers and young adults, as they are deemed to be at lower risk of developing the disease. With the growing problem of hypertension in worldwide there is concern that hypertension in young population may also be on a rise. But those cases remain undetected because of inadequate screening in this age group. So, theres a need to study the prevalence of hypertension in young population. Methods: A cross-sectional study was carried out in the field practice area (Shivaji Nagar urban health centre) of the T. N. Medical College, Mumbai during the period of July 2014 to June 2015. A total 450 participants in the age group of 20 to 40 years using systematic sampling technique from Shivaji Nagar area were interviewed and examined. A pre-tested interview tool was used to collect necessary information. Blood pressure 140/90 mmHg (hypertension). Results: Out of the 450 participants, 322 (71.6%) participants had normal blood pressure and 55 (12.2%) participants had pre-hypertension, 64 (14.2%) participants had stage I hypertension and 9 (2.0%) participants had stage II hypertension. Conclusions: Prevalence of hypertension and pre-hypertension was 16.2% and 12.2% respectively. Various factors like gender, increasing age, low physical activity (exercise), high BMI, history of addiction, history of extra salt intake and family history of hypertension was associated with hypertension.


http://ift.tt/2fIu1kN

Factors influencing knowledge and practice of birth preparedness and complication readiness in sub-saharan Africa: a narrative review of cross-sectional studies

2016-11-24T02-40-43Z
Source: International Journal of Community Medicine and Public Health
Joshua Sumankuuro, Judith Crockett, Shaoyu Wang.
Birth preparedness and complication readiness (BP/CR) is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. The study assessed knowledge on and practice of BP/CR among expectant mothers, partners and community. A systematic search of peer reviewed journals in English language quantitative and qualitative studies published between 2010 and 2015 was undertaken using Primo search, Ovid and Scopus databases. Knowledge of birth preparedness was higher than knowledge of pregnancy danger signs (complication readiness) in many studies, whilst implementation of BP/CR interventions was lower than level of knowledge in all studies. Education, parity, antenatal care visits, age, place of residence and gender were better predictors of knowledge on BP/CR; financial difficulties, employment status, knowledge of danger signs, distance to health facility, the involvement of men and community perceptions were significant determinants of BP/CR practice. Relevant studies are welcomed on the perceptions and challenges of translating BP/CR knowledge into practice in hard-to-reach communities in sub-Saharan Africa.


http://ift.tt/2fUYoaD

Necrotising Pneumonia In Etiology of Massive Hemoptysis : A case report

2016-11-24T01-42-48Z
Source: Journal of Contemporary Medicine
Fulsen Bozkuş, Nurhan Atilla, Selma Ateş.
Necrotising pneumonia (NP) is characterized by necrosis within infected lung tissue. Sometimes it is misnomered as cavitating pneumonia as it is not always complicated with cavitation. Long lasting fever and clinic detoriation of the patient can be the clues of NP. By means of cavitation, hemoptysis and negative culture; tuberculosis should be considered in differential diagnosis. False negative cultures are also problematic in treatment. In this case study, we aimed to present a case with massive hemptysis diagnosed as NP.


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