APITHERAPY IN PRIMARY CARE

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Onur ÖZTÜRK, Mustafa Yasin SELÇUK.



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Oyo State Students and Malaria Management

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Abdulfatah Ibrahim, Oluwadamilola Aminat Oluberu, Saheed Opeyemi Usman, Nafisat Oladayo Akintayo-Usman, Ibiwumi Nafisat Isola, Titilope E. Ojediran, Tonubari Fadero.
Background: Malaria is a vector-borne infectious disease caused by eukaryotic protist of genus Plasmodium and transmitted by female Anopheles mosquitoes. Those living mainly in the worlds poorest countries are at risk of malaria as it is more endemic in the tropical and sub-tropical regions. Malaria spread have been linked to environmental changes, malaria vector dynamics, host immune status and individual or community factors such as the socio-economic status, knowledge of malaria and the protective behaviour. Objectives: To assess knowledge, perceptions and practice of malaria management among non-medical students of higher institutions in Oyo State, Nigeria Materials & Methods: An open-ended structured questionnaire was administered consecutively to 1198 consenting non-medical students by interviewer at various higher institutions. The cross-sectional survey questionnaire comprised sections on socio-demographic data, knowledge about causes of malaria and knowledge about malaria management & practice. Results: The mean age (SD) was 21.7 (5.9) years. 530 respondents (44.2%) are male while 668 respondents (55.8%) are female. 1077 students (89.9%) reported that malaria can be cured. 74 students (6.2%) understand malaria prophylaxis to be a preventive treatment of malaria and 211 students (17.6%) said Artemisinin-based Combination Therapies (ACTs) are the most effective among the drugs they have used to treat malaria. Conclusion: Non-medical students have relatively reasonable knowledge about malaria management and practices, although, certain aspects are still not well understood, probably due to the scope of their educational curricula. Hence, there is need to intensify malaria public enlightenment programmes and promote affordable treatment.


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SERUM HBsAg and ANTI-HBs LEVELS WITH HEPATITIS B VACCINATION STATUS in HOSPITAL STAFF ADMITTED FOR HEALTH SCREENING

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Ruhuşen Kutlu, Nur Demirbaş.
ABSTRACT Objective: This study was performed to research the HBsAg and anti-HBs levels with hepatitis B vaccination status in hospital staff admitted to family medicine outpatient clinic for health screening. Method: This descriptive study was was carried out in 519 hospital health staff admitted to family medicine outpatient clinic for health screening between 03.10.2015 and 30.12.2015. Socio-demographic characteristics and hepatitis B vaccination status of the participants were recorded on forms prepared in advance by researchers. Serum HBsAg and anti-HBs levels were measured. Antibody titers of 10 and below were considered negative and these staff were taken to 3 doses of hepatitis B vaccine program. Results: Of the participants, 35.6% (n=185) were female, 64,4% (n=334) were male and the mean age was 35.24 ± 8.35 years. One hundred and sixty two (31.2%) had 0-10 mIU/ml, 14.5% (n=75) had 10-100 mIU/mL levels, 54.3% (n=282) ≥100 mIU/mL of the anti-HBsAg value. The serum HBsAg levels of the hospital staff were found as 97.7% (n=507) negative and 2.3% (n=12) positive. While there was no statistically significant difference between the gender and serum HBsAg levels, a statistically significant difference was found between the ages of the staff and serum HBsAg levels (p


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MUNCHAUSEN HEMOPTYSİS : A Rare Type of Factitious Disorder…

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Ebru Altıntaş, Akatlı Kürşad Özşahin.
Munchausen Syndrome defined by Asher in 1951 is named after fictitious Baron Karl Friedrich Von Munchausen.This syndrome is characterized by constituting diseases, pathological lying, and visiting healt care units many times with many hospitalizations. These patients seek attention of health workers pretending to be sick when in fact they are not. They try to obtain the care and intimacy which they dont have in daily life from health professionals. They can have the support of physicians because they generally have medical information to a degree to define symptoms. Their medical history is generally full of hard to believe tales. The presented case was a 27 year old female with three kids. She attended the outpatient clinic with complaint of hemoptysis, but investigations proved that she created the condition herself with ordinary paint. The etiology of this syndrome which is not fully understood as well as strategies for differential dignosis is discussed and highlights for management of such patients are underlined in the article


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DOMESTIC VIOLENCE OF WORKING CHILDREN IN AN INDUSTRIAL COMPLEX AND RELATED FACTORS: A QUALITATIVE INQUIRY

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Seyhan Hidiroglu, Melda Karavus, Ozlem Tanriover, Turhan Salva, Emel Lüleci, Bulent Herek.
Objective: The aim of this study was to understand the factors related to domestic violence of the working children in the Industry Complex in a district of Istanbul. Method: This qualitative study was carried out with children working in the Industry Complex of Pendik using a convenience sample. These children were working in this Complex under the guidance of Community for Helping the Working Children. Three focus group discussions were held to collect the data each composed of 10 children with one moderator and one reporter. The focus group discussions were held at the work places of these children and during their working hours. In this study, phenomenological approach and thematic analysis was used. Results: In our sample, all the children were males, aged between 14-18 years. The majority were the children of low income families who were not able to graduate from elementary school. Nine themes emerged from the data: perception/explanation of violence at home; to be misinterpreted by the parents; deserving the punishment; feelings towards parents ; thoughts about the financial issues and violence; aggression defined by the children; thoughts about being a parent and how to discipline own children; thoughts about their education; reasons for violence. Children admitted that they became aggressive outside the home after they experienced violence at home. Some of the children believed that the reason for domestic violence was financial problems and agreed that they may apply corporal punishment to discipline their children. Conclusion Acceptance of corporal punishment as a norm would be a risk for domestic violence. As some of the participants of this study mentioned that they may apply corporal punishment to discipline their children. So whole community may use their sources to change the norms.


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THE MAIN PHILOSOPHICAL AND METODOLOGICAL CONSIDERATIONS IN THE EVOLUTION OF PHYSICAL SCIENCES

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Süleyman Bozdemir.
The aim of the study: Since a quarter of a century I have been interested in Philosophy of Sciences as a hobby and from time to time gave lectures on this subject to students of physics as an elective course, in which one of the main subjects of the course was Philosophy and methods of the physical Sciences and I would like to share my experience and knowledge with science readers and to introduce philosophical and methodological ideas that play an active role in the development process of physical sciences for those who want to do research to shed some light on this issue.


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Congenital Diaphragmatic Hernia İn A Patıent Presenting With Fever And Respiratory Distress

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Abdulkadir Kaya, Mevlüt Demir, Mahmut Polat.
Congenital diaphragmatic hernia (CDH) is a congenital patology characterized by developmental defect of the diaphragm in the intrauterine period. The CDH that presents after the first month of age is called late onset CDH. In these paper we report a case with late-onset CDH presenting with different clinical findings who was referred for surgery.


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Habit of Using the Social Media and Correlation of Social Media Addiction, Self Esteem, Perceived Social Support in Adolescent with Attention Deficit Hyperactivity Disorder

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Özlem Uzun, Veli Yıldırım, Erman Uzun.
The aim of this research paper is to determine habit of using the social media and correlation of social media addiction, self-esteem, perceived social support in adolescent with attention deficit hyperactivity disorder. The sample of this research is composed of 75 adolescent who were between 12-18 year-old and diagnosed as attention deficit hyperactivity disorder with respect to DSM-IV criterion by a child and adolescent psychiatry expert. They were applied to Mersin University, Child and adolescent psychiatry polyclinic between March 2016-May 2016. 26 of the participants were female, 49 of them were male. Socio-demographic information form, Rosenberg self-esteem scale and perceived social support scale were carried out to the participants. In this study, information about socio-demographic information of adolescent with ADHD and habits of using social media were presented. The findings of this study revealed that there was a small correlation between social media addiction and self-esteem but there is no correlation between social media addiction and perceived social support in adolescent with ADHD. In order to overcome the tendency of social media addiction in adolescent with ADHD, it is important that patients should comply with treatment, families should handle adolescent period appropriately with proper social support and constructive approaches to support self-esteem of adolescent with ADHD.


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Interventions to Develop Caregivers Competence of Families Caregivers of Patients with Stroke: A Systematic Review

2016-09-26T17-14-53Z
Source: Turkish Journal of Family Medicine & Primary Care
Yasemin DEMİR AVCI, Sebahat GÖZÜM, Zeynep Özer.
Objective: It is to determine interventions performed to develop competence of family caregivers of patients with stroke in coping with caregiving and what are they of these interventions. Method: 20 randomized controlled studies, one of them meta-analysis, were evaluated in accordance with inclusion criteria. All studies were systematized and examined. Results: Types of interventions made to the caregivers were consultancy via phone, e-mail, web aided training, home visits, and group education. The intervention provided to caregivers was found to be effective in 15 of 20 studies included in the study. In other five studies, there was no statistical difference in terms of a measured parameter; whereas, it was found useful for caregivers in at least one of the other measured parameters. Conclusion: The fact that interventions for strengthening caregivers were highly effective points out the requirement of determining cost effective methods in future studies.


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Anemia in patients with type II diabetes mellitus with and without diabetic retinopathy

2016-09-26T11-08-59Z
Source: International Journal of Medical Science and Public Health
Shikha Baisakhiya, Punita Garg, Surjit Singh.
Background: Anemia has been recognized as a chronic complication of diabetes mellitus. Oxidative stress created by chronic hyperglycemia leads to RBC damage and is involved in the pathogenesis of anemia. Anemia induced hypoxia leads to vaso-proliferation in the retina and in turn to development and deterioration of diabetic retinopathy. Objective: The aim of the study was to find out whether anemia is prevalent in cases of type II diabetes mellitus (DM). To find out whether there exist a relationship between anemia and diabetic retinopathy. Materials and Methods: The study was done on total 135 subjects. The control group (Group-A) included 45 age and sex matched healthy subjects. The case group was divided into 2 groups, 45 subjects diagnosed with type II DM without diabetic retinopathy (Group-B) and 45 subjects of type II DM with diabetic retinopathy (Group-C). The mean hemoglobin level, total red blood cell (RBC) count and packed cell volume (PCV) were compared in 2 groups. Result: The mean hemoglobin level in Group-A, B, and C were 14.23±0.83 gm/dl, 12.22±0.11 gm/dl, and 10.44±0.23 gm/dl, respectively (p


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Ultrasonographic evaluation of thyroid lesions in south Gujarat area

2016-09-26T11-08-59Z
Source: International Journal of Medical Science and Public Health
Ekta Desai, Nipa Patidar, Mona Sastri, Avni Bhatt, Dhagash Patel, Mona Chitara, Nehal Diwanji.
Background: Thyroid lesions are a global problem with incidence of thyroid in adults undergoing ultrasonography at 1067%. For thyroid lesion assessment and its management various methods are used like clinical examination, pathological fine needle aspiration cytology, biopsy examination, and radiological examinations like plain X-ray, ultrasonography, and CT Scan. Ultrasound is useful for evaluation of thyroid because it is accessible, non-invasive, no radiation hazards and relatively inexpensive. Ultrasound also helps in defining whether a lesion is benign or malignant. Objectives: To evaluate role of ultrasound in the diagnosis of thyroid lesions and comparing it with pathological diagnosis and to differentiate benign from malignant masses on the basis of sonographic appearance. Materials and Methods: A prospective observational study was carried out by Department of Radiodiagnosis over period of one year. Patients visiting to various departments with thyroid enlargement were included in the study after informed written consent. Information collected from each participant included detailed history, data of general and specific examination, and laboratory parameters. Radiological examinations like plain X-ray, ultrasonography and if required CT scan was done. Radiological findings were correlated with pathological findings. Results: Out of total 50 number of participants 72% were female. 72% of patients had single nodular lesion, while 18% patients had multiple nodular lesions and 10% had diffuse lesion. 34% of participants showed calcification on ultrasonography. 30% patients had hypoechoic and 18% had hyperechoic lesions, while 12% had anechoic lesions. Halo sign was seen in 28% of patients, while comate trail artifact seen in 12% of patients. Sensitivity of radiological diagnosis in this study was 83%, specificity was 73%. Conclusion: Ultrasonography helps in initial evaluation and diagnosis of thyroid lesions. Fine needle aspiration cytology remains the gold standard for diagnosing whether a lesion is benign or malignant. It also helps in differentiation of benign lesions from malignant one.


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ALPHA CYCLODEXTRIN-BASED TRIMETAZIDINE POTENTIOMETRIC SENSORS

2016-09-26T04-35-55Z
Source: Indo American Journal of Pharmaceutical Research
Mahmmoud S. Abd-Elmonem*, Aliaa S. M. Eltantawy, Elmorsy Khaled .
The construction and performance characteristics of novel trimetazidine (TMZ) solid contact potentiometric sensors were introduced. The cited electrodes are based on alpha cyclodextrin (α-CD) as supramolecular receptors which show selectivity towards TMZ. Electrode matrix compositions were optimized on the basis of effects of type and concentration of the sensing ionophore as well as influence of ionic sites and plasticizers. Sensor incorporated with α-CD, potassium tetrakis (4-chlororophenyl) borate (KTClPB) and 2-fluorophenyl 2-nitrophenyl ether (f-PNPE) as membrane plasticizer showed the highest electroanalytical performances. The fabricated sensors work satisfactorily in the concentration range from 1.0×10-7 to 10-2mol L-1 with cationic Nernstian slope value 34.42± 0.57 mV decade-1 corresponding to trimetazidine dihydrochloride. Fast response times of about 3 s and adequate shelf-life (12 weeks) were achieved. Application of cyclodextrin as a recognition elements improved the selectivity of the fabricated sensors compared with tradition ion-association compounds. The fabricated sensors showed satisfactory sensitivity and selectivity towards trimetazidine and can be introduced as suitable tool for the routine quality control analysis of TMZ in its pharmaceutical under batch and FIA potentiometric measurements. FIA allows the analysis of 70 samples h-1 and offer the advantage of simplicity, accuracy and automation feasibility. Comparison of the obtained results with those provided by reference official method revealed adequate accuracy for control assay.


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DEVELOPMENT AND VALIDATION OF HPTLC METHOD FOR ESTIMATION OF VALSARTAN IN BULK AND MARKETED FORMULATION

2016-09-26T04-35-55Z
Source: Indo American Journal of Pharmaceutical Research
Godiyal Shilpa*, Nihalani Girish, Qureshi Rizwan, Jadhav Kisan, Kadam Vilasrao.
A simple, economic, accurate, rapid high performance thin-layer chromatography method has been developed and validated for quantitative estimation of valsartan in bulk and from marketed formulation. The chromatographic separation was carried out on Silica Gel 60 F254 precoated TLC plates using toluene: ethanol: glacial acetic acid (7:3:0.01 v/v) as mobile phase. Detection was carried out densitometrically using UV detector at 251 nm. This system was found to give separation for valsartan with Rf 0.56. The calibration curve was found to be linear between 50 300 ng/spot for valsartan with significantly high value of correlation coefficient (r2 = 0.9926). The limits of detection and quantitation were found to be 1.8548 and 5.6206 ng/spot for valsartan. The accuracy was determined by percentage recovery and was found to be 99.41% for valsartan. The developed HPTLC method was validated as per recommendations given by ICH guidelines Q2 (R1). The developed method was found to be specific, reproducible, selective for estimation of valsartan from bulk and its marketed formulation.


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DRUG UTILIZATION EVALUATION OF AMINOGLYCOSIDES IN A TERTIARY CARE HOSPITAL TELANGANA, INDIA

2016-09-26T04-35-55Z
Source: Indo American Journal of Pharmaceutical Research
Mohd. Mahmood* K. M. Shahbuddin, Nisma Khan, J. Soumya Lahari, S. Vinitha.
BACKGROUND As drug use evaluation helps the healthcare system to understand, interpret and improve the prescribing, administration and use of medication, the study helps to evaluate the rational use of drug therapy in Aminoglycosides METHODS The study design was prospective and concurrent Drug Utilization Evaluation (DUE) study between February 1, 2015 to October 30, 2015. The study included all patients who received Aminoglycosides during nine months period, which consist of phase I (without intervention for 4 months), and phase II with an educational intervention in the intervening period of next 5 months. The DUE criteria and guidelines for all the drugs included in the study were prepared from standard references and utilized for monitoring the patients based on indication for use, dose, dosage form, duration of therapy, side effects, laboratory testing and drug interaction. The drug use guidelines prepared for selected drugs included in the study and circulated to all medical staff of various departments in hospital. In the study justification of drug use, process indicators and outcome indicators were evaluated. RESULTS The results of the study shown that there was increase in inappropriate indication, inappropriate dosing, drug-drug interaction and adverse drug reaction in Phase I (Before intervention) for the drugs included in the study, where as in Phase II (After intervention) a period of 5 months, study results shown decrease in inappropriateness of drug use for indication, dosing, for the drugs included in study compared to Phase I. Adverse drug reaction and Drug-Drug interactions reduced due to implementation of DUE guidelines and through educational interventions.


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FORMULATION AND EVALUATION OF POLYHERBAL PHOTO PROTECTIVE CREAM1

2016-09-26T04-35-55Z
Source: Indo American Journal of Pharmaceutical Research
Swati D. Deshmukh*, Santosh S. Surana, Avish D. Maru Nayana Baste.
The aim of this study was to formulate and evaluate the polyherbal photoprotective cream comprised of herbs such as Curcuma longa (dried rhizomes), Punica granatum (dried seeds) and Camellia sinensis (dried leaves) with suitable cream base. The formulated cream was evaluated for their photo protective effect by determining the sun protection factor (SPF) on the basis of total phenol content and their antioxidant activity. The SPF of formulated herbal cream was found to be more significant than the SPF of individual extract.


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A cross sectional descriptive study of hand washing knowledge and practices among primary school children in Mumbai, Maharashtra, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Priyanka P. Gawai, Sachin A. Taware, Ameeta S. Chatterjee, Harshad P. Thakur.
Background: Hand washing has been widely accepted worldwide as a cost effective intervention to prevent the spread of communicable diseases. However, despite proven effectiveness, practices of hand washing have found to be poor in developing nations. As children are vulnerable to communicable diseases, the present study aims to assess hand washing knowledge and practices among primary school children in municipal schools in Mumbai. Methods: A cross sectional descriptive study was carried out among randomly selected primary school children of municipal corporation schools in Mumbai, India. Two thousand two hundred and eighty three students were interviewed using a structured interview schedule regarding socio-demographic characteristics, history of illness and hand washing knowledge and practices. Results: More than half (54%)of the study population reported a history of illnesses in the past one month, out of which 81.4% reported absenteeism due to illness. Around 34% children were unaware about health related consequences of not washing hands. When asked about the important times when hands ought to be washed, only 18% mentioned after toilet use. Of the 2283 students, a very small percentage of respondents (0.7%) reportedly practiced five steps of hand washing; only 1% practiced four steps of hand washing. Forgetfulness was cited as the primary reason for missing washing hands before eating food (88%) and after toilet use (84%). Conclusions: Knowledge regarding hand washing was found to be inadequate while practices were not up to the recommended standard. This suggests that both behaviour change education and infrastructure improvements are equally important to improve hand washing practices in the long run.


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Knowledge, attitude and practices on biomedical waste and its management among health care workers at a tertiary care hospital in Koppal, Karnataka, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Vijaykumar Mane, Smita M. Nimbannavar, Yuvaraj B. Y..
Background: Biomedical waste carries a higher potential for infection and injury than any other type of waste. Inadequate and inappropriate handling of such waste may have serious public health consequences and a significant impact on the environment. Health care workers are the key workers in the management of biomedical waste and their inadequate knowledge, unfavorable attitude and poor practices are dangerous for their own health and those in the society. The objective of the present study was to assess the knowledge, attitude and practices on biomedical waste and its management among health care workers in the study setting. Methods: A cross sectional study was conducted among 162 health care workers at a tertiary care hospital in Koppal district of Karnataka state. Data was collected using a pretested and semi structured questionnaire after taking an informed consent and analysed using WHO Epi info software. Results: The present study found out that the health care workers had satisfactory level of knowledge, favorable attitude and better practices towards biomedical waste management. However, their practices were not in proportion to the level of their knowledge and attitude. Conclusions: Regular training, continuous monitoring and behaviour change communication are recommended to improve their biomedical waste handling practices.


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Missing stillbirth data: a hospital based study

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Giriraj Kusre, Jenita Baruah.
Background: Stillbirths has remained a neglected issue, invisible in policies and programmes, underfinanced and in urgent need of attention. In India inadequacy has been observed in monitoring of the time and cause of death of unborn infants. So the present study attempts to assess the problem of underreporting and completeness of the information of data in stillbirth registry in a tertiary care hospital in Northeast India and analyse the cause behind it. Methods: The study was carried out from January 2016 to June 2016. Case sheets related with stillbirth born during the period of study were retrieved, detail information regarding address of the mother, her age, gestational age, gravida and parity, medical and obstetrical condition leading to stillbirth, gestational age, weight, sex and condition of the fetus at the time of birth (macerated or fresh) were noted. The information was compared with the data entered in stillbirth registry. Process of entry of stillbirth data was observed and interns and PGs who entered the data were interviewed using a semi structured proforma. Results: Stillbirth rate for the hospital was 27.95/1000 births. All information regarding stillbirth except information regarding condition of the fetus (macerated vs. fresh) were present in case sheet, but only 59.64% of stillbirth had mention of their sex and weight in the register. Conclusions: Lack of training, hectic activity in labour rooms and absence of dedicated staff results in incomplete entry of stillbirth data in the register.


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A comparative study of the nutritional, education and immunisation profile of children visiting tertiary care centre-is there a gender preference or no?

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Ganavi Ramagopal, Lala Umadevi.
Background: Girls in the country are found to be at a higher risk of malnutrition and growth retardation. Status report of Save the Children highlighted that India is having largest gender survival gap in the World. Aim of the study was to study the nutrition, education and immunization profile of children visiting tertiary care centre, to know gender preference is there or no. Methods: A descriptive study was conducted in, CHRI for a period of 6 months, where parents of all Children aged 5 -15 years were subjected to questionnaire regarding the education, immunisation and socio economic status in a predesigned proforma and their nutritional status was assessed using the anthropometric measurements and clinical examination. Results: Out of 1020 children the proportion of boys (49%) and girls (51%). The proportion of fully immunized children in females (63.1%) compared to males (70.4%). The proportion of male children going to government and private schools was 12.4% and 87.6% respectively and 10.8% and 89.2% respectively in females. The proportion of underweight children in males (5.2%), compared to females (4.2%). Conclusions: There was no there was no gender preference with regard nutritional, immunisation or educational status of the children.


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Effectiveness of a structured teaching programme on knowledge of breast cancer and skill of breast self-examination: a quasi- experimental study in rural women

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
John Molly, P. J. Mercy.
Background: The women in rural area lacked knowledge regarding breast cancer and breast self-examination (BSE). The study was designed to investigate the effectiveness of structured teaching programme to enhance knowledge and asses the skill of BSE among mahila mandal women. Methods: Quasi experimental one group pre-test and post-test design with the aid of a questionnaire and interview schedule was conducted among 42 mahila mandal women from three villages under Mugalur Community health and training centre, Karnataka. The pre-test knowledge was assessed using structured interview schedule and BSE skill was assessed by an observation check list. Results: Out of 42 women, most of the participants gained knowledge about breast cancer and developed skill in doing BSE. The mean pre-test knowledge score (7.6±3.0) was less than the post-test knowledge score (24.9±2.7). The mean pre-test skill score (0.7±1.0) was also less than the post-test skill score (12.4±2.0). The paired t value between the pre-test and post-test knowledge and skill score was statistically significant at 0.001 level. No significant association was existed between the selected baseline variables age, education, income, marital status and years of experience in mahila mandal with pre-test knowledge and skill score of breast cancer and BSE. Conclusions: The study concluded that structured teaching programme was an effective strategy in improving the knowledge and skill of women regarding breast cancer and BSE.


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Impact of health education on awareness of HIV/AIDS among school children in rural West Bengal, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Sulagna Das, Amiya Das, Aparajita Dasgupta.
Background: HIV/AIDS is recognized as a national priority health issue. Inadequate knowledge, negative attitudes and risky practices are major obstacles to prevent the spread of HIV. With the above view the following study was undertaken to assess the level of awareness regarding HIV/AIDS among school children, to raise their awareness through health education program and to determine if the education program would bring about positive change in the knowledge of high school students. Methods: An interventional study was conducted in a school with all the class IX and X students. A pre-structured questionnaire was used to assess the existing general knowledge on HIV/ AIDS, its mode of transmission, prevention, and some attitude and beliefs. Thereafter educational intervention was done on the same day with the help of power point presentations and black board. One week after the educational intervention, post-test was conducted to know the change in the knowledge. Results: The study revealed that out of 215 students all of the students had heard about HIV/AIDS but only 53.5% knew that AIDS is caused by a virus. As regards to mode of transmission only 34.4% of the students knew about sexual route. There was overall significant change in knowledge (p


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Osteoarthritis of knee and factors associated with it in middle aged women in a rural area of central Kerala, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Anitha Bhaskar, Binu Areekal, Bindhu Vasudevan, Ajith R., Surekh Ravi, Suraj Sankar.
Background: Osteoarthritis is the fourth leading cause of years lived with disability around the world. Prevalence of osteoarthritis is more in females compared to males. Objective of the study is to find out the prevalence of osteoarthritis of knee in middle aged women and factors associated with it. Methods: A cross -sectional study was conducted in ward 16 of Ettumanoor panchayat. A total of 375 women above 40 years were included in the study. The data was collected at their residences using a semi structured interview schedule which include demographic details and various factors associated with osteoarthritis. Weight, height, waist circumference were measured and knee joint examination was done. Data analyzed by SPSS version 19.0.The factors that were found to have a statistical significant relationship with osteoarthritis were analyzed using logistic regression. Results: The prevalence of knee osteoarthritis in the study sample was 41.6% (95% CI- 41.6±1.25%). Among them 66.2% have bilateral osteoarthritis of knee joint. The factors that had a significant association with osteoarthritis were increasing age (p value of 0.001(OR=2.47(1.61-3.79), attained menopause or not (p value of 0.001(OR=3.15(1.96-5.06), underwent hysterectomy or not (p value of 0.038) (OR=2(1.02-4.04), family history of osteoarthritis (p value of 0.035 (OR=1.61(1.04-2.61), BMI>30 ( p value of 0.027(OR=1.86 (1.03-3.33), and history of trauma to the knee joint (p value of 0.042 (OR=1.51(0.88-2.59). Conclusions: The prevalence of knee osteoarthritis in the study was 41.6% and the factors associated with knee osteoarthritis as per the study were increasing age, attainment of menopause, hysterectomy, family history of osteoarthritis, BMI>30 and history of trauma to the knee joint.


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Study of nutritional anaemia amongst non-pregnant women of reproductive age group in an urban slum of Mumbai, Maharashtra, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Sujata R. Lavangare, Balkrishna B. Adsul.
Background: Anaemia is rampant in India. Nutritional anaemia is one of the most frequently observed deficiencies throughout the world among the women of reproductive age group particularly during pregnancy and very often contributing to maternal deaths. Methods: A cross-sectional study was carried out in field practice area of department of community medicine of a tertiary care teaching hospital i.e. Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai during the period of June 1999 to December 2000. A total of 288 non-pregnant women were included and a pre-designed and pre-tested questionnaire was used for the study. Data was analyzed by using statistical package of social sciences (SPSS) version 17.0. Results: In the present study, out of 288 participants, 134 (46.5%) women were found anaemic. Anaemia was classified into mild 70 (52.2%), moderate 58 (43.3%) and severe 6 (4.5%). Majority 44.1% belongs to the age group of 15 to 24 years and maximum were Hindu i.e. 89.9% and 92% were married and 72.9% belongs to nuclear type of family and 60.4% had primary to secondary level of education followed by 37.2% who were illiterate and 30.5% had marriage below 15 years of age. 62.8% who belong to joint families and 65.4% of illiterate women were anaemic. Conclusions: In present study, prevalence of nutritional anaemia is widely present in women from 15 to 45 years of age. Occupation and education have a direct effect on socio-economic status thus leading to nutritional anaemia. There is a need to promote, educate and increase the awareness regarding the National health programs at the community level.


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Prevalence, progression and associations of corrected refractive errors: a cross-sectional study among students of a Medical College of Odisha, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Jaya Singh Kshatri, Manasee Panda, R. M. Tripathy.
Background: WHO estimates that Refractive errors are a major cause of blindness in the world leading to 42% cases of visual impairment. Refractive errors are a significant issue among young adults; this study was conducted to find out the prevalence, progression and associations of refractive errors in medical students. Methods: This was a cross-sectional study conducted among all the students of MKCG Medical College, Berhampur, Odisha, India. Results: Out of the 506 subjects analysed, 47.4% used spectacles and 2.2% used contact lens. 48.8% of spectacle users and 81.8% of contact lens users were females and the rest males. The mean age of the sample was 22.52 years (SD=1.90). The mean age at which refractive error was diagnosed is 16.47 (SD=3.42) and the duration of corrected refractive errors was 5.90 years (SD=3.90). The most common refractive error prevalent was Myopia (54.5%) followed by combined myopia and astigmatism (31.3%), hypermetropia (8.6%) and astigmatism (5.6%). The corrected refractive error ranged from 0.25 to -12.5 D for Myopics and 0.25 to -2.5 D for Hypermetropia with a median correction of -1.75 D spherical, 0.00 D cylindrical in the right eye and the left eye alike. 73.3% of the subjects reported an increase in refractive errors since diagnosis. There was a significant increase in refractive error in myopia as compared to hypermetropia (χ2=5.20, p=0.023) and no difference between males and females (p=0.91). 26.7% respondents reported selective use of spectacles and 62.5% used bright light for reading purposes. Their most preferred activity during leisure time was mobile phone use (43.8%) followed by laptop/pc use (16.3%). 90% had at least 1 ophthalmological check up in the last 12 months. Significant difference was found among those with and without refractive errors in their Height (p=0.026), time spent reading per day (p=0.001). Significant positive correlation was reported between duration of spectacle use and the increase in dioptre power (r=0.32, p


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Prevalence and severity of sensitization reaction to food and inhalant allergens among allergic patients from Jeddah city: Saudi Arabia

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Mohammed W. Al-Rabia.
Background: The identification of local common allergens could facilitate the diagnosis and treatment of allergic diseases. The aim of this study was to assess the prevalence of common inhalant and food allergens among patients with allergic symptoms in Jeddah city. Methods: This is a cross sectional study which recruited 209 consecutive patients who showed allergic clinical presentation and referred to Alborg Laboratory in Jeddah City, Saudi Arabia. Thirty inhalant and 50 food allergens were assessed using in vitro testing for specific IgE. Blood was drawn to be tested with RIDA Allergy Screen, which provides results within 6 degrees of allergy severity from class I with low reactivity to class VI with very high reactivity Results: Out of the total 209 patients, 136 (65.1%) reacted to either one or more allergens. Among Aeroallergens, mites indoor allergens were the most common which followed by American cockroaches, cat dander, pollens and then molds. The most common indoor allergen was Dermatophagoides pteronyssinus followed by Dermatophagoides farina. The most common allergen of pollens was Cynodon dactylon and the most prevalent mold allergen was Alternaria tenuis. The common food allergen was peanut followed by cocoa, egg white, cow milk, chocolate, wheat flour, Pistachio nut, goat milk and then cod fish. Conclusions: Reactivity to aeroallergens such as house dust mites, grasses, American cockroaches, and cat dander were found to be high. The common food allergens were found to be peanut followed by cocoa, egg white, cow milk, and chocolate among patients testing positive for sIgE.


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Epidemiological study of alcohol and tobacco consumption in people above 15 years of age in rural area of Nagpur, Maharashtra, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Umesh Sinha, Sumit Dutt Bhardwaj.
Background: The World Health Organization predicts that tobacco deaths in India may exceed 1.5 million annually by 2020.Very few community-based studies have been conducted on the prevalence of alcohol use in India. Alcohol consumption has a U- shaped relation with ischemic heart disease and is as well a strong frisk factor for hepatic cirrhosis and many other type of injury. Methods: It was a cross-sectional study, carried out in three villages of a PHC. A total of 3771 study subjects aged 15 years and above were included in the study. It was conducted from July 2007 to December 2009. General information and socio-economic details of study subjects were obtained. Details were recorded about personal habits like smoking, consumption of smokeless tobacco, alcohol. General and systemic examination was carried out and findings were recorded. Results: In the present study, the prevalence of current smokers was 20.5% among males and none among females. In the present study the prevalence of smokeless tobacco use was 48.3% and the prevalence of current consumer of alcohol was 37.7% among males while there were none among the female. Conclusions: we found a low prevalence of smoking tobacco and non-consumption of alcohol among females which can be attributed to the less social acceptability of smoking in this rural part of Nagpur, Maharashtra, India.


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A study on clinical profile of indoor patients receiving anti-tuberculosis treatment at KPC Medical College and Hospital, Kolkata, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Shilpa Karir, Atanu Biswas, Asok Kumar Mandal, Vidya Sagar, Moumita Pal.
Background: India is the biggest contributor of TB cases globally. About 2.5million prevalent cases and 0.22 million deaths from the disease were reported in India in 2015. The objective of this study was to assess the socio-demographic and clinical profile of the indoor patients receiving treatment from the DOTS centre of KPC Medical College and Hospital, Kolkata, India. Methods: An observational, descriptive, record based study was conducted on TB patients admitted in indoor wards under various departments of KPC Medical College and Hospital. Data were analyzed using IBM SPSS (version 20). Results: Of 80 study subjects, 73.8% were male and 25% belonged to 20-30 years age group. Records reflected 41.3% subjects had pulmonary TB, 51.2% had extrapulmonary TB and the rest had both pulmonary and extrapulmonary TB. New cases comprised 91.3% subjects and previously treated cases were 8.7% subjects. HIV status was negative in 67.5% subjects and records were unavailable in 32.5% subjects. Diabetes was present in 27.5% subjects, negative in 67.5% and information was unavailable in 5% cases. Among the patients with known Diabetes status, the result of association between TB-Diabetes and gender of the subjects was found to be statistically significant. Conclusions: Information regarding occupation, investigations other than sputum test, HIV and Diabetes status were not mentioned in some treatment cards; hence emphasis should be given on proper record maintenance. Awareness generation and proper counseling on TB-HIV co-infection among all the patients should be focused on so that all the patients turn up for HIV testing.


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Treatment seeking pattern among infertile couples in a rural area

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Chethana R., Shilpa.
Background: According to DLHS survey Karnataka, women who had primary and secondary infertility constitute 5.9 and 1.7 percent respectively of ever married women between 15-49 years. Main objectives of the study were to describe the socio demographic characteristics prevailing among infertile subjects of the study population and to describe the treatment seeking pattern among the infertile couples of the study population Methods: Cross- sectional descriptive study was conducted at rural field practice area of tertiary hospital, Bangalore, India. Complete enumeration of entire Primary Health center area covering 26,190 populations. In depth interview using a pretested pre-structured questionnaire was conducted enumerating all couples with infertility in the entire Primary Health Centre area and their treatment seeking behaviour. Results: Total population covered under the study is 26,190. Among them number of couples were 5210. Among 5210 couples, total number of eligible couples was 4120. Eligible couples are currently married couples where the women are in the reproductive age group between 15-49 years. Among the eligible couples only 1379 were exposed the risk of pregnancy. Couples who are exposed to risk of pregnancy include those who are cohabitating and not using any approved methods of contraception, where women is not pregnant and not in lactational amenorrhoea. Prevalence of primary infertility is 4.5%.Prevalence of secondary infertility is 3.6%.So the prevalence of infertility is 8.1%. Conclusions: Most common treatment seeking pattern was allopathy followed by traditional healers. Most common reason for not taking treatment was economic hardship among those with primary infertility and in those with secondary infertility was that they wanted to wait for spontaneous conception.


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Study of socio-demographic profile and morbidity pattern of women of reproductive age group attending sexually transmitted infections clinic at an urban health centre in Mumbai, Maharashtra, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Sabita Meher, Sujata R. Lavangare, Ratnendra R. Shinde.
Background: Morbidities related to reproductive health in women are largely under reported or tends to be reported at a late stage in the sexually transmitted infections (STI) clinic. Social stigma, cultural factors and non-priority to reproductive health in the family and non-involvement of the spouse are amongst the factors in the family affecting the compliance for treatment amongst women. Moreover women in most cases are deprived of their own decision-making autonomy with reference to STIs & RTIs. In most cases the woman is the passive empowered partner in acquiring STIs and RTIs. The present study was designed to understand the dynamics of the epidemiological factors compared with extent of compliance to treatment sought amongst women at the RTI/STI Clinic. Methods: A cross-sectional study was carried out at STI clinic located in urban health centre of field practice area of Department of Community Medicine of a tertiary care teaching hospital i.e. Seth G. S. Medical College and KEM Hospital, Mumbai during the period of January 2014 to December 2015. A total of 306 reproductive women were included and a pre-designed and pre-tested questionnaire was used for the study. Data was analyzed by using statistical package of social sciences (SPSS) version 17.0. Results: The morbidity pattern ranking from highest to lowest order showed that 171 (55.9%) women had white discharge, while 46 (15.1%) reported to have burning or pain during urination, 118 (38.6%) were having lower abdominal pain, 32 (10.5%) of women complained of dyspareunia, 12 (3.9%), and 9 (2.9%) women diagnosed as having bleeding after sex and prolapse and 5 (1.6%) had herpetic ulcer & inguinal bubo respectively. The associated medical conditions identified were 20 (6.5%) of women had diabetes, 18 (5.9%) were having hypertension, 21 (6.9%) women were having tuberculosis and 9 (2.9%) were HIV positive. Conclusions: Almost 63% of the women were married before 18 years of age. Most of these married women were homemakers and were literate upto primary and secondary level. Early diagnosis and adequate treatment of STIs/RTIs at the first contact between patients and health care providers is therefore an important public health measure. There is a need to promote, educate and increase the awareness regarding the RTIs/STIs at the community level.


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Self-medication practices in rural Aligarh, Uttar Pradesh, India

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Mohd Tabish Khan, Anees Ahmad, Najam Khalique, Mohammad Athar Ansari, Mohd Maroof, Mohd Najmul Aqib Khan.
Background: Self-medication is the use of medication by a patient on his/her own idea or on the suggestion of pharmacist on the opinion of a lay person instead of taking the advice of consulting a medical practitioner. Self -medication is the rising form of self-care and it is becoming a major problem in making the correct diagnosis. The objective was to study the prevalence of Self-Medication among rural population, to identify common aliment for Self-Medication and to find out reasons of Self-Medication. Methods: A cross sectional descriptive study was carried out in rural field practice area of Rural Health Training Centre, Department of Community Medicine, J.N. Medical College, AMU, Aligarh, Uttar Pradesh, India. A total of 424 adults aged 18 years and above were included in the study. The sample was drawn using systematic random sampling with probability proportionate to size. Data was collected using pretested and predesigned questionnaire. Data was analysed by using SPSS 20. Chi square test was used. P value


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Cross-sectional descriptive study of lifestyle patterns of undergraduate medical students in a metropolitan Medical College

2016-09-26T04-32-14Z
Source: International Journal of Community Medicine and Public Health
Pruthvi H. Patel, Aniruddha A. Malgaonkar, Sundaram Kartikeyan.
Background: Studies report physical inactivity, mental stress, tobacco and alcohol use and unhealthy and untimely dietary habits in a sizeable proportion of medical students. This complete-enumeration, descriptive study was conducted in a metropolitan teaching hospital to assess the dietary habits and lifestyle of undergraduate medical students for designing specific health interventions based on the results of the study. Methods: After obtaining permissions and written informed consent, the participants were interviewed and also asked to self-rate their stress on a scale of zero to nine. Their heights and weights were recorded. Results: Lifestyle patterns of male (n=78) and female (n=94) respondents included vegetarianism (27.9%), skipping breakfast (13.95%), consuming four or more meals daily (61.63%), snacking between meals (43.02%), consumption of caffeinated soft drinks (38.37%) and tea/coffee (84.31%), sleeping for 6-8 hours daily (80.81%) with no gender difference in minimum and maximum sleep hours, lack of physical exercise (65.12%) or outdoor recreation (25.58%) and dominance of internet, television and computers as recreational tools. 60.46% studied only before exams. None were tobacco or alcohol habitual. 94.19% students had regular bowel habits and 68.03% had never suffered from constipation. Self-rated stress was often study-related and only 6.98% sought medical opinion for stress. Menstrual cycles in female respondents were irregular (14.89%), with mood changes (69.15%) and adversely affected studies (19.15%). Conclusions: The same recreational tools utilized by the respondents can be deployed for educational interventions to modify the identified risk factors in this study.


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Brown Tumour Of Hyperparathyroidism, A Benign Latency In The Jaws (A Review of Literature)

2016-09-26T03-59-38Z
Source: National Journal of Integrated Research in Medicine
Lalit Sagara*, Mitsu Meshram*, Jigar Dhuvad**, Sonal Anchlia**, Siddharth Vyas*, Harsh Shah*.
Background: To inculcate awareness about the importance of thorough screening of the patients presenting with giant cell lesions in the jaw bones for clinical, biochemical and radiological features of hyperparathyroidism. Material and Methods: The history, physical examination, laboratory values, imaging and pathologic findings are described in a 32-year-old woman, presenting with brown tumour lesion in mandible, due to primary hyperparathyroidism. A systematic review of published literature from PubMed is added, which highlights the importance of a thorough diagnostic workup and selection of appropriate treatment modality. Results: In the case presented, after Parathyroid adenoma excision, within thirty minutes, the serum values of Parathormone and Calcium returned to normalcy and spontaneous regression of the brown tumour was noted. Also, the review of literature emphasized the need for systemic investigations of suspected giant cell jaw lesions and established that parathyroidectomy can be considered the primary treatment modality for brown tumours of the jaw due to hyperparathyroidism. Conclusion: Radiolucent lesions of the jaws showing giant cells on histopathology should raise suspicion of hyperparathyroidism. This case emphasizes the importance of a detailed systemic investigation for all lesions in the maxillofacial region. [Lalit S NJIRM 2016; 7(4):158-164]


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Knowledge, attitudes and practices among patients with coronary artery disease in Dhaka, Bangladesh

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Abu-Sayeef Mirza, Sadaf Aslam, Kay Perrin, Terrill Curtis, Jennifer Stenback, Jessica Gipson, Sally Alrabaa.
Background: Bangladesh ranks highest among other Southeast Asian countries regarding risk factors for the number one cause of death worldwide: heart disease. Low income citizens tend to have less awareness and understanding about coronary artery disease (CAD) due to a number of socioeconomic barriers. There is a need to assess knowledge and perception about CAD in order to develop baseline data for preventative programs. Methods: This cross sectional survey assessed knowledge, attitudes, and health-seeking practices (KAP) toward CAD among 222 Bangladeshi patients. The 40-point KAP surveys were completed based on systematic random sampling from a government cardiovascular hospital representing a lower income population in Dhaka, Bangladesh. Results: The mean KAP score was 21.45±5.83 with a total possible score being 40. Only 5.86% of the sample was able to demonstrate a high level of proficiency. Men had more knowledge (t (1.962) = 1.334, P = 0.051), but women demonstrated more health-seeking behaviors with stronger statistical significance (t (-2.135) = -0.407, P = 0.034). Several significant chi-square relationships were found between socioeconomic status (SES) and KAP scores. Conclusions: This study demonstrated selective lapses in CAD knowledge, attitude, and practice among Bangladeshi patients with low SES. Future preventative educational interventions would benefit by targeting the deficiencies in KAP revealed in this study.


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Assessment of salt intake behaviour among undergraduate health care students studying in London

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Russell Kabir, Aykut Ozkaya, Sonia Ozkaya.
Background: Excessive salt intake causes high blood pressure and cardiovascular diseases. Salt intake behaviour among health care students is still unexplored. The objective of the present study is to assess the extent of salt intake behaviour among undergraduate health care students studying in a university in London. Methods: This is a descriptive cross-sectional study. The participants of this research are undergraduate business and healthcare management students. Students were invited to complete the online questionnaire by sending the link through emails. Results: A total of 132 students completed their questionnaire. The results reveal that about 70.4% female respondents take salt and about 54% male respondents take salt in their foods. Respondents who are above 35 years of age take less salt compared to those who are less than 35 years of age. Household earning and salt intake behaviour do not show any significant differences. Conclusions: This study just provided a snapshot of salt intake behaviour among the healthcare students but more innovative health promotion approaches may help in future to make people aware of the recommended salt intake and its impact on their health.


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Cross sectional study on obesity prevalence in cardiovascular risk factors

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Bhavani Yamasani, Siva Sakkara Reddy Pattubala, G. Raviprabhu.
Background: Obesity has become a chronic disorder affecting the larger population than any other disease in the world in both developed and developing countries, which lead to both increase in mortality and morbidity. Aim of the study was to study the Central obesity prevalence as cardiovascular risk factor in rural population. Methods: A total of 734 subjects aged 30 years and above of both sexes were selected for the study. Results: Very high prevalence of central obesity was found in males 27.6% compared to that in females 6.1% and the difference is also statistically significant. Subjects with Stress had higher prevalence of central obesity compared to those with no stress 15.4% and the difference is also found to be statistically significant. Subjects with current smoking had higher prevalence of central obesity 25.8% than non-smokers 15.2%. Similarly, subjects with current alcohol intake had higher prevalence (28.8%) than those who were not taking alcohol currently (14.1%). The differences in both the situations are statistically significant. Higher prevalence was found in those with physical exercise (32.8%) than those who do not perform regular physical exercise (13.5%) and the difference is also found to be statistically significant. It is found that the prevalence of medium and high risk was found to be significantly higher in males (41.8%) than in females (5.5%). Conclusions: Obesity is major health hazard leading to both increases in mortality and also major risk factor in other non-communicable diseases. Prevention of obesity should begin from early childhood itself. Early detection can prevent the incidence of major complications. Lack of awareness is found to be major factor which should be stressed upon.


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Determinants influencing health status of welders in a sub-urban slum of Mumbai, Maharashtra, India

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Praveen Davuluri, Dilip Kadam, Ratendra Shinde, Chaitali Borgaonkar, Anurag Dhoundiyal.
Background: One of the jobs that contribute to occupational injuries is the welding process, especially in developing countries. The welders are exposed to risk factors such as metallic fumes, thermal burns, mechanical stress etc. which make them susceptible to certain occupational diseases. Lack of knowledge regarding the personal protective measures puts them at higher risk of occupational hazards. Hence the study was conducted to assess the health status and morbidity patterns in welders and evaluate the epidemiological determinants influencing them. Methods: A cross-sectional study was carried out amongst 113 welders working in the area during the study period of December 2015 to February 2016. Socio-demographic profile and work related problems and addictions details were collected. Data was analysed for descriptive statistics. Results: In this study, 82.3% workers suffered from eye-related symptoms as well as musculoskeletal pain, and 16.8% suffered from dental caries. Majority 21 (18.5%) had either one or more smoking/tobacco habits. Most of the welders (16.8%) gave a history of tobacco chewing followed by 15.9% alcohol. Conclusions: Eye problems and musculoskeletal problems are a major concern among welders. Nearly all workers use at least one protective equipments but still suffer from eye problems which may be due to the poor quality of the equipment. Their poor socio-economic status and health seeking behaviour makes them more vulnerable to occupational injuries.


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Imputation technique: replacing missing values in longitudinal data

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Gladius Jennifer. H.
In longitudinal studies, many cases are found missing in the follow-up data. These missing cases may arise due to item non response or unit non response. A data set with missing observations is often completed by using imputed values. The unit non response is usually carried out by some weighting adjustment. The item non response is made by the method called imputation. Imputation is a technique to replace a missing/incomplete or strange value with a more or less artificial value. There are plenty of methods available to impute the missing values in a longitudinal data. Imputation is useful because they make the data set easier to analyze, ensure consistency between the results from different analyses and reduce non response bias from item non response. But it is not necessary that the imputed value reduces the bias of the data, sometimes they may lead more bias also. It depends on the imputation procedure which we choose and also the form of estimate. The aim of this article is to sensitize doctors and post-graduate medical students about this useful analytical technique.


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Variations in prevalence of diabetes in various occupations: a quantitative and qualitative review

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
T. Naveena.
Diabetes is one of the most dangerous diseases associated with many comorbidities and mortalities in world. This is associated with different risk factors and its occurrence cannot be predicted. The several risk factors include family history, overweight, unhealthy diet, sedentary lifestyle, increasing age, high blood pressure, stress. Prediction of occurrence and worsening of diabetes cannot be made but our duty is to reduce the risk factors to prevent ourselves landing up in such a long-lasting life burdening disease. Occupation determines many of the risk factors like lifestyle and stress factors as they are more or less similar to everyone belonging to a particular occupation. Study on occupational prevalence of diabetes helps us to identify our risk of diabetes and to prevent it. But presently unfortunately there are only 6 articles available on the occupational prevalence of diabetes. They report that there is increased prevalence of diabetes in police personnel and decreased prevalence of diabetes in farmers and construction workers. Though there is an article available on occupational prevalence of diabetes in teachers, conclusions cannot be drawn as the controls were not included in the study. So there is an immediate requirement to conduct research on prevalence of diabetes in various occupations by including controls.


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Presumed consent for organ donation: illusion of a choice

2016-09-26T02-29-25Z
Source: International Journal of Community Medicine and Public Health
Reeta Dar.
India has been following informed consent (opt- in) system of organ donation but soft pressures to shift to presumed consent (opt- out) system are simultaneously palpable. This paper describes presumed consent briefly and explains why the need to shift to this system is felt. The paper challenges the morality of presumed consent system and describes its use as absolutely unethical in view of socio cultural diversity, educational disparity and profound class stratification of our country. The paper throws some light on our own system which, unlike other countries, is not ready for this change. It focuses on thought-provoking issues that are deterrents to achieving increase in organ donation even if presumed consent system is adopted in India. It reflects the outcome of this coercive legal option in some countries. In some countries there was no change in organ donation rates. A few countries witnessed negative repercussions of presumed consent system. Some of these countries had no option except to revert back to opt- in system. The paper tries to give a message to the public and professionals by comparing Spain to India that has high donation rates in the world not because of presumed consent but because of other contributory factors. Spain initiated organ donation and transplant activities much ahead of India and their healthcare services are rated the best in the world. Socio-cultural, religious and political milieu unlike India is conducive to organ donation in Spain. Adequate investments in public health, adequate budget for organ donation and transplantation, excellent infrastructure, availability of public health assistance to 99% population, adequate availability of ICU beds, extending end of life care to all, positive approach to organ donation by majority of people, thorough professionalism and public trust is what makes Spain the best country in organ donation. The same is lacking in India. The paper warns us of this coercive option by drawing a parallel to the coercions that took place when India acted coercively to control population through compulsory sterilization and led to the wrath of masses in 1976. India as on date needs to focus on other issues to increase organ donation rates like development of infrastructure, developing well-functioning national, regional and state level organizations, building in trust of people, identifying potential donors, managing donors, caring for donor families, training manpower, increasing awareness on organ donation and transplantation, reimbursing fees to organ retrieval hospitals, merging efforts of various stakeholders, developing transparent and workable organ sharing policies and regular auditing of brain stem deaths.


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