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Muhannad Aloraini
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174684

Abstract:
Background: Tele-intensive care units (tele-ICUs) are promising medical solutions for improving critical care quality, enhancing access to health care, and increasing the productivity of intensivists. King Faisal Specialist Hospital and Research Center (KFSHRC) initiated a tele-ICU implementation in Saudi Arabia during 2009/2010, with the aim of creating 28 tele-ICU-connected hospitals throughout the region by 2014. However, the effect of tele-ICUs on patient outcomes remains unclear. This study assessed the effectiveness of a tele-ICU intervention program on patient outcomes. Methods: A retrospective pre-post study was performed in an adult medical-surgical ICU at a secondary hospital in Eastern Saudi Arabia. Tele-intensivists were located at the KFSHRC. The sample comprised adult patients (≥12 years, as per hospital policy) admitted to the ICU. Patients were allocated into pre-intervention (January 1 to April 29, 2012) and post-intervention (May 1 to August 31, 2012) groups; each group had 178 patients. The tele-ICU was implemented on April 30, 2012. Results: According to a Mann–Whitney U-test, the groups did not differ on length of stay (LOS) (U=16097.50, p=0.78). Medians and interquartile ranges in length of stay for both groups were 2 days. Regarding mortality, 10 (5.6%) pre-intervention patients died, while 12 (6.7%) post-intervention patients died. This difference was not significant (p=0.51). Conclusions: The tele-ICU program did not appear to impact patient outcomes in terms of mortality or LOS.
Shilu M. Zachariah, Sreedevi C., Aswathy S., Prathyusha Kokkayil, Anila A. Mathews
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174630

Abstract:
Background: A study was carried out to investigate an outbreak of viral hepatitis reported by district health authorities from a self-administrative unit, Koppam of Palakkad district in Kerala in the month of November 2016. Methods: An epidemiological investigation was carried out to investigate the outbreak, describe epidemiological features and recommend measures for control. An epidemiological case sheet was prepared, case definition formulated and blood samples were collected to confirm the diagnosis of hepatitis. Environmental samples were collected from wells, soil and tested for hepatitis A virus. Results: 15 blood samples taken from cases of jaundice tested positive for hepatitis A, IgM antibody by ELISA test. More than three fourths 39 (79.6%) of the cases gave a history of having attended the same wedding function prior to the occurrence of symptoms. Attack rate (6.14%) was highest among 15-25 year age group. The water analysis from 3 of the wells in the area showed presence of coliform bacteria. Hepatitis A virus IIIA genotype was isolated from the soil sample of the house of the index case. Consumption of welcome drink was found to be associated significantly with cases than controls (OR 2.77; 95% CI: 1.02-7.52, p<0.05). Conclusions: The hepatitis A (type IIIA) outbreak in Koppam was associated with poor sanitation practices among the people. During a socio-cultural-demographic event like marriage this led to an explosive outbreak. Involving community organizations to generate awareness regarding food sanitation, supported by a system of registration of such events, certification of food handlers can help to prevent future outbreaks.
Harsh Mahajan, Shalini Srivastava, S. Nagesh
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174660

Abstract:
Background: Immunization is one of the most cost-effective interventions to prevent the suffering that comes from avoidable sickness, disability and death. In India, though immunization coverage has improved over the past few years, the country still accounts for the largest number of children who are not immunized i.e. 7.4 million. So, this study was taken up to assess the immunization coverage among children in District Gautam-Budh Nagar of Uttar Pradesh and to decipher the causes behind the partial immunization/non- immunization. Methods: A cross-sectional study was conducted during June-August 2015 in an urban resettlement colony of District Gautam-Budh Nagar in Uttar Pradesh among 210 children aged 12-23 months selected using WHO 30X7 cluster sampling technique. Results: A total of 210 children were covered, of which 72.9% children were fully immunized, 19.0% children were partially immunized, whereas, 8.1% children did not receive even a single dose of any vaccine, thus constituting a total of 27.1% children with partial/no immunization. On bi-variate analysis, significant associ­ation was observed between immunization status among children and caste (p=0.047), mother’s education (p=0.01), father’s education (p=0.000) and socio-economic status (p=0.003). On multi-variate analysis, however, only father’s educational status was found to be significantly associated. The major reasons for partial/non-immunization among children were Ignorance (80.7%) followed by unavailability of vaccines (7.0%). Conclusions: Immunization coverage found in the present study is still way short of the target of universal coverage. Therefore, health planners and policy makers in our country should develop a comprehensive strategy to achieve universal immunization coverage.
Sugunadevi G.
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174647

Abstract:
Background: Quality of care is a priority concern all over the world and all the countries are trying to improve the effectiveness and efficiency of their health care delivery systems. Recognizing the potential to improve the reproductive health status in developing countries, quality of care in reproductive health field has been the priority area of research by WHO.Methods: This study assesses the quality of antenatal care services delivered at subcentre level by comparing with the recommended Structural attributes, Process attributes and Initial outcome attributes. By simple random sampling, ten subcentres under three Block Primary Health Centres in Coimbatore district were included in the study.Results: On observing the quality of client-provider interaction, most of the women were treated with dignity (98.5%), but there were deficiencies in examination for pallor (19.2%), pedal edema (18.5%) and pulse (10.6%) which is very critical for good antenatal care. The exit interview revealed that most clients (98.6%) were satisfied with the antenatal care.Conclusions: The findings of this quality assessment study provide information about training needs for improving the quality of service and serves as a baseline data on status before implementing NRHM.
, Gauthami N.
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174648

Abstract:
Background: Adolescence in the life cycle of a Homosapien organism is a period of transition from childhood to adulthood. The word ‘Adolescent’ has been derived from Latin word ‘Adolescere’ which means ‘to grow to maturity’. The children from the poor scheduled tribes families are not being sent to school because of the tendency of some parents to utilize their services in augmenting their family income. Therefore a provision for educational opportunities forms a very important part of the programme for the welfare of the scheduled tribes. The aim of the present study was to observe menstrual health of the tribal adolescent girls and to describe cultural factors on study population.Methods: Community based cross sectional descriptive study done on 425 tribal adolescent girls residing in 18 habitations of Achampet mandal. Pre designed pre tested semi structured schedule applied on the subjects after a written informed consent.Results: Out of 425 study subjects majority 178 (41.9%) were from early adolescent age i.e. 10-13 years, followed by 144 (33.9%) from mid adolescent age i.e., 14-15 years and 103 (24.2%) from late adolescent age i.e. 16-19 years. Majority illiterate subjects (55.1%) menstrual hygiene was non sanitary. Subjects who had illiterate mothers their menstrual hygiene was non sanitary way (55.1%). Girls in joint families were having sanitary menstrual hygiene.Conclusions: Present study showed education and awareness play key role in maintaining menstrual hygiene. Hygiene education is supposed to be given at all levels. Bad cultural practices supposed be addressed at community level with intervention.
Santhana Lakshmi M., Sugunadevi G.
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174646

Abstract:
Background: Worldwide breast cancer is one of the most common type of non-skin cancer in women and the fifth most common cause of cancer death. As the incidence of breast cancer is rising, there is a current need to educate the women on preventive measures of breast cancer. The objectives of the study were to assess the knowledge on risk factors and on the preventive measures of breast cancer among women aged 20-30 years.Methods: The cross-sectional study was conducted among 200 women aged 20-30 years residing in an urban area in Coimbatore. A questionnaire was designed to assess the awareness levels on risk factors and the preventive measures of Breast cancer among the study participants.Results: The study showed that most of the women (91%) were not aware about the risk factors of breast cancer and only 7.5% knew that lesser duration of breast feeding for <6 months is an important risk factor for breast cancer. 89.5% were not aware about the symptoms of breast cancer. 92.5% were not aware about the preventive measures of breast cancer. None of them were aware of breast self-examination (BSE) as an important early detection measure for breast cancer. Comparing the educational status and the level of awareness on Breast cancer among the study subjects we found that the educational status had significant influence on the level of awareness on breast cancer (p<0.0001).Conclusions: The knowledge on risk factors, symptoms and on the preventive measures of breast cancer among the women aged 20-30 years was very low. To increase the awareness about breast cancer in the community, frequent educational interventions and screening programs needs to be conducted by health workers.
Varun Vijay Gaiki, Manasi Khardekar
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174633

Abstract:
Background: There are limited studies from India on use of ICF in finding out the Disability experienced by PLHIV. We undertook this study to understand the level of disability experienced by the PLHIV attending tertiary healthcare setting. This study mainly focuses on the self-care domain of ICF classification.Methods: Cross sectional, hospital based, conducted with permission from institutional ethics committee. Predesigned standardised ICF questionnaire, with only self care part of it was administered and participants assessed for activity limitation and participation restriction domains of self care.Results: Inactivity limitation block, with regards to washing oneself, caring for body parts and dressing none reported any problem. In regulating menstruation 15 (6.67%) had moderate, 15 (6.67%) had severe and 3 (1.33%) had complete problem while 67 (29.67%) had no problem. In participation restriction, it was observed that participants had difficulties in regulating defecation 47 (20.8%) moderate, 33 (14.66%) severe, 9 (4%) mild whereas 6 (2.67%) complete problem. Overall prevalence was 42.67%. in block of participation restriction, on performance qualifier, overall 149 (66.67%) had problem in eating, 77 (34.22%) had moderate, 36 (16%) severe, 34 (15.1%) had mild and 3 (1.33%) had complete problem. In drinking overall 29.78% participants experienced problems, out of which 31 (13.7%) had moderate, 23 (10.22%) mild 12 (5.33%) and 1 (0.44%) had complete problem.Conclusions: Significant amount of activity limitation in self care observed with reference to toileting, eating drinking. Hence, this parameters to be stressed on in planning National program on AIDS.
Tagaram Ramchandra, N. Pragathi Kumar, Niharika Lakkoju
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174632

Abstract:
Background: Tuberculosis has existed for millennia and remains a major global health problem. It causes ill-health in millions of people each year and in 2015 it was one of the top 10 causes of death worldwide. Understanding the specific reasons for unsuccessful outcomes is important to improve the treatment system. This present study was carried out to find out the effects of socio-demographic factors on TB defaulters under DOTS centre in Warangal District, Telangana state.Methods: A cross sectional study was carried among 103 defaulters of TB patients in 3 TB units (TU) Warangal (urban), Ragunathapally (rural) and Eturunagaram (tribal) out of 7 TB units in Warangal district, attached to District Tuberculosis Centre (DTC) from January 2016 to June 2016 by interview technique utilising a pretested and structured questionnaire to collect the data. Statistical analysis: Percentages, proportions and chi-square test were applied whenever necessary.Results: In present study, males (35%) were more than females (7.8%) and 42.8% were in the age group of 40-55 years, followed by 28.1% were 26-39 years age group. Majority of defaulters were in nuclear family (77.7%) followed by joint family (21.3%). Cost of travel as a reason for default of treatment was seen more in tribal area (16.5%) than rural (12.6%) and urban (4.8%) TUs. The TB patients residing in tribal areas are more prone to default, an important reason being the distance needed to travel to the closest health facility, availability and the need to travel by public transport.Conclusions: Tuberculosis is an infectious disease which has a devastating impact on the economic wellbeing of individual and their families. Most of the defaulters were illiterates residing in tribal area. Cost of travel as a reason for default of treatment was seen more in tribal TU 17(16.5%) than urban and rural TUs.
Mohamed Saleem, , Manimaran Pradeep, Kalifulla Sabeetha
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174629

Abstract:
Background: Chronic obstructive pulmonary disease (COPD) is a major public health problem with increasing prevalence especially in developing countries. Burden of disease estimation is important for decision making, planning, prioritising and allocating funds. It has been found that the recent data on prevalence of COPD is less in south India, especially Tamil Nadu. Hence this study was undertaken in order to estimate the prevalence of COPD in Madurai among adults and its association with socio demographic variables. Methods: This is a community based cross-sectional study done in Kallendiri block of Madurai district with adults aged >30 years of both the sexes as study population. Sample size was 480. Using cluster sampling method, study participants were interviewed with semi-structured questionnaire and peak expiratory flow rate was measured using peak flow meter. Results: Prevalence of COPD was 22.1% among the study population. Males (39.2%) had higher prevalence than females (12.2%). COPD prevalence was significantly higher among increasing age, male sex, illiteracy, low BMI, smokers, inadequate ventilation and those using biomass fuels for cooking. Conclusions: This study has established the fact that COPD is highly prevalent among adults in rural area. For practitioners, the results call for a high index of suspicion of COPD among >30 years with substantial exposure to risk factors. For health policy makers, the results of the current study urge for the development of COPD prevention programs failing which the burden of COPD might result in increased mortality, morbidity and economic burden.
Varun Vijay Gaiki, Manasi Khardekar, Prashant Kokiwar, Sushma Katkuri, V. R. Zare
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174545

Abstract:
Background: Dream of universal health coverage cannot be possible with huge burden of out of pocket expenditures, common in our community. Here attempt was made to find out the pattern of expenditure towards health in the people residing around the field practice area of concerned medical college. Methods: Community based cross sectional survey with predesigned and pretested questionnaire, with stratified random sampling, total of 257 study participants were included in study, which was initiated after ethical clearance and with informed oral consent. Results: With majority in lower socio economic class, 33.85% of population was found to be beneficiaries of one of the other Health insurance, provided through social security measures. On an average, families were spending Rs. 770.08 (±956.24) for monthly health related expenses. This high variation in was observed due to difference in the constitutional structure of families. Outpatient expenses had least burden on families (154.26 (±99.90)) followed by in patient expenses, which included day care for various minor elements. More than 60% reported catastrophic Health expenses, resulting in variety of financial issues in family. Conclusions: Huge burden of OOPE exists in the study area and at the same time, health care expenditure resulting in catastrophic expenses is high. The need of society to provide healthcare at subsidised rates including medicines is emphasised, which to be considered while implementing any policy decision.
Sudha Bala, K. J. Kishore Kumar, M. L. S. Prabha
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174485

Abstract:
Background: Menopause is a universal phenomenon in woman’s life. Severe problems during these period impacts on quality of life. Majority of the rural areas has poor knowledge and poor seeking behaviour due to various factors. Methods: A cross sectional descriptive study was conducted in rural field practice area of Osmania Medical College using pre designed and pretested questionnaire schedule about socio demographic profile, their perceptions of menopause and their related problems; various post menopause related health problems classified using modified menopause rating scale and their health seeking behaviour was assessed. Results: Mean age at menopause was 44.8 yrs. Majority of them (41.8%) perceived their health the same; 37.2% as deteriorated and 4.7% welcomed positively. Common reasons for deterioration were joint pains, eye problems and weight gain. About 35% of them sought health care for any of the postmenopausal health problems. Of these they mostly visited for cardiovascular and skeletal disorders which are long term effects of menopause. Conclusions: Most of the postmenopausal women perceived their health the same and their health seeking behaviour was also less which implies a great need to educate and create awareness about the problems related to menopause.
Guwani Liyanage
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174483

Abstract:
Background: Studying medicine is challenging since medical students undergo many stressors during their long course of studying. Moreover, their final year is probably more stressful with more clinical work and stringent assessments. Aim of this study was to assess the prevalence and sources of psychological distress among final year students in University of Sri Jayewardenepura in Sri Lanka with a well validated screening tool. Methods: This is a cross sectional study of 151 medical students evaluating stress through general health questionnaire (GHQ) with 30 items. Comparison was made with another 257 non-medical undergraduates of the same university. Results: More than half of students (59.6%) in our university had psychological distress. When compared medical students (62.9%) are more distressed than non-medical (56.4%) students. Major source of stress for medical students was academic pressure. Conclusions: Final year medical students have significantly high psychological impairment and the main reason reported by students was academic pressure. It warrants implementation of stress management programs and curriculum based interventions to minimize stress.
Duraimurugan Murugesan, Ramasubramanian R.
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174486

Abstract:
Background: Immunization forms the major focus of child survival program throughout the world. Roughly 3 million children die each year of Vaccine Preventable Diseases (VPDs) with a disproportionate number of these children residing in developing countries. Majority of the population in rural areas depend mainly on Govt. agencies for health care, including immunization. Whereas, in urban areas in spite of multiple agencies providing health care. Hence, the present study was carried out in urban areas of Kanchipuram district to know the current level of immunization status and also the reasons for failure in immunization. The objectives of the study were to assess the immunization coverage among children 12-23 months in municipality areas of Kanchipuram district, to find out the reasons for non immunization or partial immunization and to recommend measures to improve the immunization coverageMethods: 30/7 cluster technique by using immunization program coverage survey household form. Results: Out of 210 study population, 130 (61.5%) were boys and 80 (38.5%) were girls. 115(55%) children were from Hindu community, 47 (22%) Muslims and 48 (23%) Christians. The mothers who were able to show the card to the investigator was 122 (58%), whereas the rest (88) 42% of the mothers were not able to produce the card during the day of survey. The percentage of fully immunized was 160 (76%), partially immunized was 50 (24%). Conclusions: As immunization forms a critical component of primary health care, at most importance needs to be given to the same so that child will not be deprived of the precious drop or prick. Every opportunity should be used to vaccinate eligible children by overcoming the hurdles, to achieve the goal of 100% immunization coverage.
Manika Pal, Lina Bandyopadhyay, Aparajita Dasgupta
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174484

Abstract:
Background: Globally unplanned pregnancy has emerged as a major public health problem with its impact on demography and economy. Despite being the first country to initiate a nationwide family planning program, contraceptives access and utilization are low in India. As per a study conducted in 35 low- and middle-income countries, India contributed the largest number of undesired pregnancy. Our current study was aimed at determining the proportion of unplanned pregnancy and examining its predictors among currently married women aged 15-35 years, residing in a rural area. Methods: A facility based, observational, cross-sectional study was conducted in a rural area of Bengal. 158 participants were selected by purposive sampling and face to face interviews were conducted using structured schedule ensuring confidentiality. Statistically data were summarized with descriptive statistics and adjusted with binary logistic regression analysis in SPSS (version 16). Results: The proportion of unplanned pregnancy was found to be 28.5%. On multivariable logistic regression, it was observed that there was significant association between unplanned pregnancy and low SE status AOR (CI) 2.523 (1.074-5.926), lack of women’s empowerment AOR (CI) 2.971 (1.198-7.367), husbands’ lower level of education AOR (CI) 2.673 (1.041-6.866), and no contraception or traditional method of contraception AOR (CI) 2.391 (1.104-5.180). Conclusions: The study revealed alarmingly high proportion of unplanned pregnancy. In addition to the existing strategies of the national program, emphasis should be on IEC activities. All efforts should be made to educate women on hazards of unsafe abortion and unplanned pregnancy.
Jayanta Saha, Sahana Mazumder (Sen), Amalendu Samanta
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174482

Abstract:
Background: Iron deficiency anaemia is one of the most common nutritional disorders world-wide, especially in India and other developing countries. Young children and women in the reproductive age group are the most vulnerable to iron deficiency anaemia. Part of the reason for this lack of action is the fact that iron deficiency anaemia (IDA) has few overt symptoms. Hence this study have been undertaken to see the impact of nutritional counselling as a controlling measure of IDA.Methods: Rural women of reproductive age group were first screened for anemia and then for IDA. Two groups were formed one experimental group who were given nutritional counselling and another group designated as control group devoid of any such counselling. Baseline haematological indicators were estimated along with dietary surveys in both the groups. Haematological estimation and dietary survey was carried out again after six months and those women in experimental group still found to be anemic were again counselled, the procedure was repeated again at twelve months and at the end of the study that is eighteen months. Data’s were then statistically analysed for finding significant between the groups.Results: Our study showed statistically significant differences in haematological indicators between the experimental and control group at the end of the study. Intake of nutrition also showed statistically significant differences between the experimental and control group at the end of the study.Conclusions: Intervention only with iron and folic supplements is not adequate to tackle iron deficiency anemia problem. Therefore, there is a need to use interventions measures like nutritional education approaches for addressing major preventable causes of anemia.
Dhaneswari Jena, R. M. Tripathy, Srabani Pradhan, Dillip Kumar Mahapatra
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174246

Abstract:
Background: Rabies a dreadful disease can easily be prevented by immediate wound care, vaccination and immunoglobin administration. Prognosis depends on the promptness of initiation, regularity and completion of treatment, determined by patient’s compliance. It partly depends on the patience and devotion of doctor for counselling the patient. The objectives of the study were to assess the treatment compliance of dog bite cases attending tertiary care centre for post exposure prophylaxis (PEP) of Rabies. Methods: It is a record based longitudinal study, conducted in Anti- Rabies Clinic of M.K.C.G Medical College from January 2016 to July 2016. Patients registered on first visit followed up to the 4th dose, the last cases registered on June 15th was followed up to July31st to declare it as completed, delayed or defaulted as decided. Results: Total 1658 cases were registered during the study period. Most of them were male (73.8%) and ≤20 yrs of age. 1222 cases (73.7%) completed treatment, out of which 793 cases completed on schedule and 429 cases delayed the doses. 436 (26.3%) cases had defaulted treatment i.e. missed one or more dose. Significant associations were found between treatment completion status and place of residence, education and age of the participants. Reporting within 1 day of the bite is associated with better compliance to PEP, showing their good health seeking behaviour. Completion rate was significantly higher in category III cases. Conclusions: Intensive counselling needs to be done on day 1 and day 7th day of vaccination.
, Arjun Mehta
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174232

Abstract:
Background: Mosquito borne diseases are a serious public health concern in India. The incidence of Mosquito borne diseases is linked with economic and social development of the community. The objectives of the study were to assess the awareness, knowledge and practices about mosquito borne diseases in study population and explore the various myths about mosquito borne diseases among them.Methods: It is a hospital based cross-sectional study and the study participants will be patients getting admitted for any reason and having fever, in the general medicine male and female ward. This study period was 3 month (January to March 2017). Results: Total 150 patients admitted in male and female medicine ward were included in the study out of them 84 were male and 66 were female patients. It was observed that educated participants had more knowledge about mosquitoes borne diseases. Conclusions: Most of the participants didn’t know that clean water could be a source of breeding of mosquitoes. Many myths are prevalent in the study population about mosquitoes borne diseases.
, Durgesh Prasad Sahoo, Manjusha Dhoble, Abhijit Kherde, Asim Inamdar
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174223

Abstract:
Background: Hypertension is a silent killer and global public health problem. With the advent of globalization affecting the lifestyle of the population, non-communicable diseases like hypertension, diabetes etc. is affecting the young adults (18 to 40 years). The aim of the study was to estimate the prevalence of hypertension and its associated risk factors among young adults (18 to 40 years) attending a tertiary care centre of Nagpur.Methods: This was a cross sectional study on 370 participants of age 18 to 40 years attending the outpatient department of urban health training centre in Nagpur. Data was collected using pretested and pre designed questionnaire and anthropometric measurements were done by standard guidelines. Blood pressure was measured using sphygmomanometer in sitting position. Data was analyzed using Epi info version 7.2. Chi square test/ fisher’s exact test has been used to find the difference between two proportions. Unadjusted odds ratio was calculated for various risk factors studied. Stepwise logistic regression analysis was done to calculate the adjusted odds ratio. Results: The prevalence of hypertension was found to be 23.24%. The prevalence was higher among males (25%) when compared to females (22.3%). Body mass index and waist hip ratio were significantly higher among the hypertensive when compared to normotensive study population (p<0.01). For every one year increase in age, the odds ratio increases by 1.06 (1.02 to 1.09) and the subjects who were overweight were having 2.15 odds of being hypertensive. Conclusions: We found a high prevalence of hypertension among the adults of age group of 18 to 40 years. The population with high body mass index, high waist to hip ratio and age group of 30 to 40 years were found to be associated with hypertension. Early surveillance and prompt treatment forms will help in decreasing the cardiovascular risk of young adults in near future.
, Emmanuel Appiah-Brempong
International Journal of Community Medicine and Public Health, Volume 4, pp 3762-3769; https://doi.org/10.18203/2394-6040.ijcmph20174247

Abstract:
Background: Obesity is one of today's noticeable yet neglected public health problem with serious health consequences such as hypertension, type 2 diabetes that affect individuals of all ages globally. Adolescents are particularly prone to obesity owing to their reduction in physical activity. This study was to determine the prevalence and risk factors of obesity among Senior High School Students in the Adansi North District of Ghana. Methods: A descriptive cross- sectional survey was conducted among 306 adolescents aged 12- 19 years. The adolescents were recruited from the five senior high schools in the district using stratified random sampling technique. Data was collected by the use of structured questionnaire and anthropometric data sheet to calculate for BMI levels. STATA version 11.1, and Microsoft Excel was used to analyze the data collected. Results: Results from the chi-square test indicated that, there was a significant relationship between leisure activities and obesity such as playing computer games (x2=7.5086, df=9, p
, Neval Nandlal, Sushanta Nankissoon, Cherisse Nancoo, Caniecea Nelson, Austell Nkemakolam, Nadine Noel, Kwame Olivers, Ryan Parasram, Mario Rodriguez, et al.
International Journal of Community Medicine and Public Health, Volume 4, pp 3601-3606; https://doi.org/10.18203/2394-6040.ijcmph20174218

Abstract:
Background: This study aims to quantitatively estimate the level of cardiovascular medication adherence in Trinidad’s public health sector and to determine any correlating factors. The study was of a descriptive, cross-sectional design which was performed at a cardiology outpatient clinic located at a northern-central public health care tertiary hospital in Trinidad during the period November 2016 to June 2017. Methods: 595 persons in total were asked to participate, of whom, 535 agreed. Patients that were younger under the age of 18 years and those that declined participation were excluded from the study. Primary endpoints were the percentages of low, medium and high cardiovascular medication adherence. Secondary endpoints were the comorbidity prevalence rates and prevalence of cardiovascular medications prescribed to patients. Results: In total, 595 individuals were asked to participate in the study; of whom, 535 agreed with a resultant 90% response rate. The mean age of the sample population was 63.5 years. Approximately half of the respondents were females and over 75% had only primary and secondary level of education combined as well as a monthly income of <$5,000 Trinidad and Tobago dollars (TTD). Almost 75% of study participants had low and medium adherence levels, and conversely a little more than one-quarter had high adherence levels. There were no significant associations between adherence and any other demographic factor, however there was near-significance with respect to adherence and level of education (p= 0.061). Conclusions: Patients generally displayed a limited level of cardiovascular medication adherence which is likely to translate into a higher rate of cardiovascular events with their potentially devastating sequalae. This study underscores the imperative need of implementing comprehensive interventions to accentuate cardiovascular medication adherence in Trinidad and Tobago. Further comparable studies with reference national data are required to validate these findings.
Ayman F. Al-Dahshan, Noura Al-Kubaisi, Mohamed Abdel Halim Chehab, Nour Al-Hanafi
International Journal of Community Medicine and Public Health, Volume 4, pp 3511-3516; https://doi.org/10.18203/2394-6040.ijcmph20174212

Abstract:
Background: The healthcare industry has focused much attention on patient satisfaction with the quality of healthcare services. However, there remains a lack of research on patient satisfaction towards the implementation of an electronic medical record system at a primary healthcare setting. This study aimed at assessing the level of patient satisfaction regarding primary health care services after the implementation of an electronic medical record (EMR) system. Methods: A descriptive cross-sectional study was conducted at the Al-Wakrah health care center, with a random/convenient sample of 52 patients attending the center. Furthermore, the investigators interviewed the participants, in the waiting area, regarding their satisfaction with the primary health care services provided following the EMR system implementation. A structured interview-based questionnaire for measuring patient satisfaction was employed. Results: The vast majority of participants indicated that the overall service at the health center greatly improved after EMR implementation. Furthermore, most interviewees were totally satisfied with the overall workflow at the health care center such as the time spent at the registration desk (76.9%), before seeing a physician (65.4%), while the physician used the computer (76.9%), physical examination (69.3%), laboratory testing (73.1%), and collecting the medication (65.4%). Regarding health education and informativeness, the participants found that labeling medication bottles was quite informative. However, less than two-thirds (61.5%) of the patients were satisfied with the health education delivered by physicians. Conclusions: The results revealed that although overall patient satisfaction was relatively high, certain aspects of the health care service remained to be a source of dissatisfaction. Thus, this study demonstrated patient acceptance and support for the electronic medical record system at the primary health care setting.
Sujata N. Muneshwar, Mohd. Shafee, Purushottam A. Giri, Pankaj R. Gangwal, Sadaf Doctor
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174267

Abstract:
Background: Cardiovascular diseases are the number one cause of death globally. The cause of heart attacks and strokes are due to combination of risk factors- tobacco use, unhealthy diet, obesity, physical inactivity, alcohol use, hypertension, diabetes and hyperlipidaemia. Most cardiovascular diseases can be prevented by addressing these behavioural risk factors. The objectives were to study the prevalence of cardiovascular risk factors among teaching staff and to know the association of age and gender with cardiovascular risk factors.Methods: A cross-sectional study was carried out amongst teaching staff of IIMSR Medical College, Badnapur, Jalna, Maharashtra during the period of August to October 2016. All teaching staff of IIMSR Medical College was included in this study by purposive sampling method. Total number of staff who was more than 30 years of age was 80. The study was performed on 71 teaching staff as 9 denied participating (71 out of 80). Clinical parameters including weight, height, blood pressure and waist circumference was recorded. Blood sample was also collected. Statistical analysis was done by using appropriate statistical test like mean, percentage, standard deviation, student’s t test and chi square test. Results: Majority participants were male 50 (70.42%). The mean age of male was 42.6±13.4 yrs and female was 37.05±9.64 yrs. The mean weight (76.2±12.9), mean waist circumference (92.0±12.1) and mean BMI (27.02±4.44) were above the normal range amongst male participants. The mean height, mean weight, mean waist circumference, mean SBP, mean DBP, mean RBS, mean creatinine and mean BMI values were higher in males as compared to females. The difference was statistically significant. Hypertension was more common in older age with raised diastolic blood pressure which signifies that age is one of the most important risk factor. Conclusions: This study showed a high prevalence of cardiovascular risk factors and signifies the importance of health awareness among the staff members regarding the various cardiovascular risk factors.
Pramita Muntode Gharde, Syyed Zahiruddin Quazi, Vasant V. Wagh
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174257

Abstract:
Background: A road traffic injury is any injury caused due to crashes originating, terminating or involving a vehicle partially or fully on a public highway.The road crashes are unlike communicable diseases where the role of agent, host and environment is more defined. The aim and objective was to study of the socio-demographic profile of victims of road traffic accidents.Methods: A community based cross-sectional study was conducted from November 2010 to September 2012 in 3 blocks of Wardha district, in Central India. The sample size was estimated using purposive sampling technique. The data was analyzed using EPI-Info version 3.5.4. Results: Out of 385 study subjects, maximum victims were in 30-60 years age group, 320 were males and 16.88% i.e. 65 were females. The total numbers of literate victims were 94.80%. Maximum accidents were seen in victims who were employed in service 151 (39.22%), followed by self employed 27%. Conclusions: Maximum victims were in 30-60 years age group which is the productive age group and male dominance was also observed which means loss of work days leading to loss of wages and loss of family income hence directly affecting the family economy.
Syeda Jesmin Rahman, , Gunjan Nath
International Journal of Community Medicine and Public Health, Volume 4, pp 3854-3858; https://doi.org/10.18203/2394-6040.ijcmph20174263

Abstract:
Background: Numerous factors are associated with the access and utilization of health care services. These factors along with the preferences of the farmers are responsible for the health seeking behavior of farming community. This study aims to understand the health seeking behavior of the farmers and the factors influencing their behaviour in a rural block of Assam. Methods: A community based cross sectional study was done in a rural block of Jorhat district, Assam among a sample of 400 farmers. A pre designed pretested proforma was used to collect the data. Information was obtained on the demographic variables, health seeking behavior and the factors that may affect health seeking behavior. Results were analyzed using percentage and proportions. Results: The study revealed that respiratory tract infection (54.25%) was the most common cause of morbidity among farmers followed by musculoskeletal problems (23.25%) and gastrointestinal tract ailments (11.75%). Majority of the farmers preferred the government health facilities (62%) than the private practitioners (17%) for seeking treatment. Around 64% respondents sought health care only when their health conditions were severely affected. Financial constraints (43.25%) and lack of time (29.25%) was observed to be major impediment in utilization of health care services. Children were given most priority in seeking treatment at the time of illness (68.75%). Conclusions: Government health care facilities were preferred by most respondents due to low cost of services. Behavior seeking healthcare was mostly influenced by financial constraints.
Kavya M. Alalageri, Ranganath Timmanahalli Sobagaih
International Journal of Community Medicine and Public Health, Volume 4, pp 3731-3734; https://doi.org/10.18203/2394-6040.ijcmph20174241

Abstract:
Background: Sleep is a state of body and mind which typically recurs for several hours every night, in which the nervous system is inactive, eyes closed, the postural muscles relaxed and consciousness practically suspended. Lack of sleep has been linked to emotional and physical health effects. Hence this study is proposed to know the sleep pattern and its effects on health and academics of medical students. Methods: A cross sectional study was conducted from June to September 2015 on 200 medical students by convenient sampling using pre-tested, semi-structured, self-administered questionnaire was given to them. Data was entered in excel sheet and analyzed using descriptive statistics. Results: Mean age of students was 20.65±0.56 SD, 68.5% of the students have normal sleep duration hours. 31.5% of them had abnormal sleep, of which 38.09% and 61.91% of them are affected in health and academics respectively. 35% of students watch television/late night movies and hinder their sleep which depicts the younger generation is much attracted towards browsing at night times which affect their sleep pattern. 34.86% of sleep deprived students went for depression followed by agitation which affected their daily routine at a significant level. Conclusions: Sleep is essential for good physical and mental health. Deprivation of sleep can affect day-today activities. Knowledge about sleep hygiene should be taught from school level itself.
, Manisha Arora, Atul Kotwal, Poonam Hooda
International Journal of Community Medicine and Public Health, Volume 4, pp 3859-3863; https://doi.org/10.18203/2394-6040.ijcmph20174264

Abstract:
Background: With the introduction of newer antigens in the childhood immunization programme in several states, the nationwide UIP is eventually going to be further expanded to increase the number of diseases against which children will be protected through the vaccination programme. However, despite the best intentions of the government, a poor awareness of the new vaccines among the caregivers may defeat this purpose and only result in poor coverage and poor uptake. This study was carried out to assess the awareness of mothers regarding the new vaccines introduced in the childhood vaccination programme in Delhi State. Methods: The study was conducted in the immunization clinic of a tertiary care hospital of Delhi. A total sample of 388 mothers was interviewed. The data was analyzed using SPSS ver 20. Results: Only 18.3% (95% CI, 14.76-22.46) of the participants were aware that newer vaccines have been introduced into the programme. 48.2% (95% CI 43.27- 53.16) of the respondents were unaware about the same, while 33.5% (95% CI, 28.99-38.35) claimed to have heard about it but were not sure whether newer vaccines had been introduced. It was observed that as the education status of mothers improved, their awareness regarding newer vaccines in the programme also increased. The knowledge regarding age of administration, number of doses etc. was very poor. However multiple pricks during a single vaccination visit was not a disincentive for the mother to get the child vaccinated. The willingness to buy a vaccine that was not available free of cost from the hospital, increased with increasing education level of the mother. Conclusions: There is a requirement of focused publicity campaigns to increase the awareness and thereby uptake of the new vaccines among caregivers.
Diana Ankunda,
International Journal of Community Medicine and Public Health, Volume 4, pp 3530-3535; https://doi.org/10.18203/2394-6040.ijcmph20174215

Abstract:
Background: Globally, HIV is the leading cause of death among women of the reproductive age and unprotected sex is the main driver of HIV transmission. Lack of accurate and complete knowledge is one of the major causes of increase in the number of new HIV infections among women in Africa. This study was aimed at finding out factors associated with comprehensive knowledge among women in the reproductive age group of 15-49 years in Uganda. Methods: Data used was drawn from 2011 Uganda Demographic Health Survey (UDHS). Logistic regression model was used for analysis. Results: Only (38%) of the respondents had comprehensive knowledge of HIV. Women in lower wealth quintile had less comprehensive knowledge compared to those in the highest quintile (OR=1.28). The study also found out that the older women aged 45-49 were more knowledgeable to HIV (OR=1.46) than young ones. Women who had access to radio were associated with increased odds (OR=1.11) of high knowledge on HIV than those without. High knowledge to HIV was also associated with women who had ever tested for HIV (OR=1.20) and also increased with level of education (OR=1.63 for primary and OR=3.6 for secondary). Conclusions: Factors associated with comprehensive knowledge on HIV include: age of the woman, residence, education level, access to information and HIV response to testing. Programs designed should target young women below 19 years of age, rural women, poor women and uneducated women. Increasing campaigns to encourage more women to have HIV tests and messages using radios will increase comprehensive knowledge.
Abhishek De, Sonali Kar, Bhagabati Charan Das
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174262

Abstract:
Background: Mental health and reproductive health are closely related. Women of reproductive age are most vulnerable. Odisha has poor maternal health indicators. Very few Indian studies comparing urban-rural differences in women’s mental health. Methods: Random sampling from respective field practice areas. GHQ-12 Mental Health screening tool used to assess health status. Pre-tested questionnaire applied to enquire about domestic and familial status, reproductive health morbidities. Results: Proportion of reported extramarital relationships of the respondents’ husband was observed to be more than twice as much in urban as compared to rural areas. Prevalence of domestic violence was found to be 43.2% in urban area as compared to 27.2% in rural areas. Significant differences were seen between urban and rural arms of the study regarding adverse pregnancy outcomes (p<0.001), induced abortion (p<0.0001), menstrual problems (p<0.0004) and gynaecological problems (p=0.0031). In these cases, rural women were observed to have significantly more combined (reproductive and mental health) morbidity than their urban counterparts. Conclusions: Findings of the study indicate that though familial and spousal and social support parameters were more adverse in urban women, reproductive health problems and their association with poor mental health was strikingly more common in the rural populace. This may indicate an erosion of the traditional buffers against adverse mental health outcomes in the rural setting and needs further investigation.
Avinash Pandey, Richa Mishra, Neeraj Markandeywar
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174248

Abstract:
Background: In India, long term data regarding professional outcomes and geographical distribution of enrolled medical graduates is lacking. This adversely impacts policy for efficient healthcare delivery. Methods: A cross sectional survey of students enrolled as medical graduates in year 2001 was done at single point follow up after 17 years. Along with demographic data, gender, seat quota, post-graduate qualification, type of practice, discipline of choice and current geographic locations were collected. Logistical regression model with odds ratio was used to analyse association between variables. Results: 192/200 medical graduates were analysed. Male: female ratio was 119: 73. 109 (56%) had post-graduate degree, 35 (18%) had post-graduate diploma, while another 24 (12.8%) completed super-specialty degree.125 (65%) completed post-graduation in clinical disciplines. 103 (54%) are serving government institutes. 54 (28%) practice in metro cities, while 48 (25%) are in non-metro capital urban locations. Only 44 (23%) are serving rural Indian population, while 17 (9%) are at foreign countries. General medicine (12.5%), obstetrics (8%), paediatrics (8%) anaesthesia (7%) and general surgery (6.7%) were the most common broad clinical specialities. Females had high likelihood to pursue obstetrics/ gynaecology {OR-11.4 (95%CI-2.6-48.7)}; while males were more likely to select medical {OR-0.54 (95% CI-0.25-1.0)} and surgical disciplines {OR- 0.42 (95% CI-0.18-0.98)}. Conclusions: Majority of medical graduates complete post-graduation courses, with preference for clinical disciplines. Less than one fourth of doctors serve rural population.
, Dasari Gayatri, P. Radha Kumari
International Journal of Community Medicine and Public Health, Volume 4, pp 3835-3841; https://doi.org/10.18203/2394-6040.ijcmph20174260

Abstract:
Background: In spite of an extensive primary health care system exists in India, yet it is inadequate in terms of coverage of the population, especially in rural areas and urban slums, and gross underutilization. Assessment of the utilization of health services is important for the health of a nation. Methods: A cross sectional study was conducted during October 2012- September 2013 among 215 families residing in Kotha Jalaripeta fishermen community of urban slums of Visakhapatnam city. A semi-structured questionnaire was used to collect data and was analyzed using SPSS 20 and valid inferences were drawn. Results: Majority (60.9%) of the slum dwellers preferred Government hospitals for adult health problems and (56.3%) for child health problems. Majority (82.4%) of them utilized Government Hospitals for maternal health services and (73.5%) for Inpatient care. Majority (80.9%) of them preferred Anganwadi centers for immunization services. Antenatal care utilization by slum women was found satisfactory. Conclusions: This study revealed a relatively higher utilization of government health services for different health problems when compared to the other studies regarding various aspects and dimensions of health services. But still health problems exist to a great extent and there is an urgent need to improve health services in urban slums.
Sumit Saxena, , , S. B. Gupta
International Journal of Community Medicine and Public Health, Volume 4, pp 3705-3711; https://doi.org/10.18203/2394-6040.ijcmph20174237

Abstract:
Background: One of the key strategies under the National Rural Health Mission is having a community health worker who is an Accredited Social Health Activist (ASHA) for every village with a population of 1000. These ASHA workers should preferably be female, in the 25-45 years age group and have a qualification of at least eighth class. The knowledge about health services of ASHA is crucial for the success of National Health Mission. Methods: A cross sectional study was planned in Bhojipura village. Total 48 villages ASHAs were interviewed using predesigned semi-structured questionnaire including brief socio-demographic information of ASHA along with details of their knowledge regarding child care. Results: Out of 64 ASHA, 25 (39.15) ASHA told that new-born babies given bath immediately after birth. 40 (62.5%) ASHA replied that nothing should be applied on umbilical stump of new-born. Mostly 62 (96.9%) ASHA knew that breastfeeding should be given first to the new-born and 61 (95.3%) ASHA were known that breastfeeding should be initiated within one hour of delivery. Conclusions: Majority of ASHAs know their role and details of their practices in new-born and child care except bathing of new born and additional supplements.
Mohamed Tanveer Ahmed, Jyothi Jadhav, Ranganath Timmanahalli Sobagaiah
International Journal of Community Medicine and Public Health, Volume 4, pp 3842-3845; https://doi.org/10.18203/2394-6040.ijcmph20174261

Abstract:
Background: Developing countries including India are in epidemiologic health transition resulting in increased life expectancy and increase in geriatric population. Geriatric population is considered the most vulnerable population. Many factors such as age, income, education, environment have a significant impact on quality of life. Hence our study aims at assessing the Quality of life and activities of daily living among geriatric population in Bengaluru city. Methods: A cross sectional study was carried out for a period of 3 months - August to October 2016 among 250 geriatric study participants residing in the slums of Bangalore. Data was collected using WHOQOL-BREF scale and Katz Index of Independence of Activities of Daily Living by interview method. Results: Out of 250 study participants, males were 127 (50.8%) and females were 123 (49.2%). Quality of life was found to be average with a mean score of 50.02 (11.13) and with a least score of 44.55 (12.54) for environmental domain. Conclusions: Significant association was found between quality of life and factors like age, functional capacity, education and environment. Improving access of elderly to health facilities, providing health education, psychological support, and modification of environment helps to improve the quality of life among aged population.
Ratnaprabha G. K., Sindhu P., Aswin Kumar, Prakash R. Kengnal, Ashok Kumar M. S.
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174235

Abstract:
Background: Work and family are the most important responsibilities of an adult. The last two decades have been marked by striking changes in the world of work and nature of the family. Work schedules, work orientation, marriage, children and spouse employment patterns may all produce pressures to effectively exhibit ones work role or the family role, which are interdependent. The objectives of the study were to assess work family conflict (WFC) among the working population in a city in Karnataka, and its determinants.Methods: A community based cross sectional study was carried out during August-September 2015 among 400 adult working population of Davangere city, working in different sectors (hospitals, schools, colleges, banks and police department). A pretested structured self-administered questionnaire consisting of socio-demographic details, Carlson’s Work-Family Conflict Scale was used. Data was analyzed using SPSS 10 for frequencies, Chi square test, student’s T test and ANOVA. Results: Out of 400 study participants, 62% were men. Mean scores of work to family conflict was 27.28±5.68 and that of family to work conflict was 25.37±5.61. Time based work to family conflict was more compared to strain and behaviour based. Conflict scores were higher for females, >45 years age, employees who had children, especially child under 5 years of age. WFC was found to be highest among doctors, police and nurses. Conclusions: Work to family conflict was higher than family to work conflict, especially time based.
Mariyam Khwaja, M. Athar Ansari, Saira Mehnaz
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174236

Abstract:
Background: Hypertension is a global public health issue. Hypertensive heart disease is one of the top ten leading causes of death in the world. It was responsible for an estimated 1.1 million deaths worldwide in 2012. To prevent some of the complications of hypertension regular intake of the prescribed treatment in the form of medicines (pills) is essential. Poor compliance to anti-hypertensive therapy is usually associated with bad outcome of the disease and wastage of limited health care resources. With these viewpoints the study aimed to assess the level of compliance of hypertensive patients to their anti-hypertensive medications and to determine the socio-demographic correlates of compliance. Methods: This was community based cross sectional study conducted in urban and rural areas in Aligarh. A total of 350 hypertensive patients were selected using simple random sampling. A pretested semi-structured questionnaire was used. Compliance was measured by Morisky 8-item Medication Adherence scale. Analysis was done using proportions and Chi-square test. Results: The overall compliance of study population was 23.7%. It was found to be significantly associated with gender, education, social class and associated co morbidities. Education, higher social class and duration of hypertension were found to be the main facilitators to adherence. The barriers to adherence were cost of drug and more number of pills per day. Conclusions: Patient education, family counselling and social support networks should be strengthened in health promotion programs in order to enhance compliance of hypertensive patients with the therapeutic regimen and to improve their quality of life.
Dinesh P. V., Annarao Gunderao Kulkarni
International Journal of Community Medicine and Public Health, Volume 4, pp 3685-3690; https://doi.org/10.18203/2394-6040.ijcmph20174234

Abstract:
Background: A double burden of malnutrition in children, in the form of undernutrition and obesity exists in our world. Poverty and various other sociocultural factors act as important determinants of malnutrition. There exist varying prevalence rates in different places. Under nutrition has also a role in dental caries. The objective of this study was to find the prevalence of malnutrition and dental caries among children going to Anganwadi’s in rural Sullia taluk of Karnataka. Methods: Line listing of Anganwadi children was done and by random sampling method, 205 children were selected for study. Nutritional status was assessed by anthropometric measurements and dental examination done according to WHO standards. Results: The prevalence of underweight, wasting and stunting were 27%, 11% and 40% respectively. 49% of children studied had dental caries. Conclusions: According to the classification for assessing severity of malnutrition by prevalence ranges among children, the study area is classified as a high prevalence area for malnutrition according to WHO. Dental caries was present in 49.27% of the children.
Hassan Ali Al Sayegh, Abdulaziz Adel Al Qurini, Abdul Sattar Khan, Sayed Ibrahim
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174213

Abstract:
Background: There is increase in the limitation of daily activity of people with chronic diseases. This may be due to multiple factors one of them is the nature of the lifestyle for instance, patterns of eating that the person is following. It is important to sum the dietary behaviors in specific population to see how much is it associated with chronic diseases. Specially, obesity, cardiovascular diseases, diabetes and sickle cell disease which are endemic diseases in Al-Ahsa. Moreover, no studies have been conducted in this area before. It is known that there is increased obesity, cardiovascular and diabetes prevalence in Al-Ahsa. The study aims to see the association between chronic diseases and eating patterns. Methods: Cross sectional study, self-reported questionnaire distributed to the population under supervision of the data collectors in Al-Ahsa, during the summer of 2017. Results: The most prevalent chronic disease is obesity. Then comes hypertension and G6PD. Obesity showed most association with other chronic diseases. Also, eating frozen canned food show associations with obesity, hypertension, G6PD and diabetes. Conclusions: We concluded that there are certain eating behaviors influences some chronic diseases; there should be a focus on these behaviors to prevent the occurrence of these chronic diseases, especially metabolic diseases. Obesity is the primary concern which may facilitate the developing of hypertension, asthma, diabetes, high cholesterol, G6PD, hypothyroidism, hyperthyroidism, diabetes, sickle cell disease and cardiovascular events.
Arkajyoti Mallick, Santanu Haldar, Soma Sarkar, Santanu Kundu, Samik Sinha, Sanjoy K. Sadhukhan
International Journal of Community Medicine and Public Health, Volume 4, pp 3678-3684; https://doi.org/10.18203/2394-6040.ijcmph20174233

Abstract:
Background: Tuberculosis is still a major public health problem in India and in addition to this, non-adherence to DOTS makes it more difficult to manage and increase risk of drug resistance. The objective was to study the factors associated with defaulter to DOTS among newly diagnosed TB patients treated under RNTCP registered in Hooghly district, West Bengal, India. Methods: A community based unmatched case control study was conducted with the help of predesigned pretested schedule among 99 defaulters and 103 non defaulters aged 15 years and above and registered between 1st April 2013 to 31st March 2014. Data was analyzed using SPSS software (version 20). Univariate analysis was done to find out the association of outcome with different variables under study. Variable with odd ratio 3 or more included in multivariate logistic regression model. Results: If patients were main earning member, smoker, lacking of perception regarding fatality of TB, having information source other than DOTS provider and sub center as treatment center, were found as significantly associated with defaulting in final multivariate regression model. Conclusions: An approach, towards modification of smoking behavior, adequate health education and information dissemination and qualitative improvement of treatment center including training of health staffs are essential for treatment adherence.
Nripendra Singh, Seema Jain, Harivansh Chopra, Arun Kumar, Ganesh Singh, Priyanka Kesarwani
International Journal of Community Medicine and Public Health, Volume 4, pp 3664-3667; https://doi.org/10.18203/2394-6040.ijcmph20174230

Abstract:
Background: The health of the mother and child constitutes one of the most serious health problems affecting the community, particularly in the developing countries like India. Promotion of maternal and child health has been one of the most important aspects. But any program, however, relevant its components were likely to fail unless it succeeds in improving the knowledge and achieving satisfaction of its respondent. Client satisfaction has traditionally been linked to the quality of services given and the extent to which specific needs were met. The objective of the study was to determine the level of satisfaction and correlated factor among mothers visiting primary health care institutions for maternal care services.Methods: A cross sectional study was carried out on 384 women attending 19 urban health post located in Meerut.Results: In present study 76.0% MCH respondent belong to lower socioeconomic class, 46.4% MCH respondent were 6-12th class pass, 33.1% MCH respondent belong to SC/ST category. Satisfaction with behavior of staff was significant associated with socioeconomic class, educational qualification and religion of respondent. Satisfaction with cleanliness is significantly associated with socioeconomic status, type of family, education and caste of client. Satisfaction with availability of drug is significantly associated with socioeconomic status, education, category and religion of respondent. Satisfaction with behavior of doctor is significantly associated with type of family, education and category of respondent.Conclusions: In present study, we observed that satisfaction of MCH respondents were closely related to the services provided at MCH center and with the behavior of health care providers.
, Priti Solanky, Hitesh Shah, Ravikant Patel
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174231

Abstract:
Background: The aims were to study knowledge, perceptions and beliefs regarding swine flu among college students and to study any difference in knowledge between science and commerce students. Methods: A cross sectional study conducted in Science and Commerce College of Valsad city from June-July 2015. Simple random sampling technique used. Total 400 students were randomly selected from both the colleges. The study was started after obtaining the verbal and informed consent from both the college authorities whereas verbal and informed consent was taken from each student. Data collection done by using predesigned, pretested, bilingual language (English and Gujarati) semi structured questionnaire. Students who were present and had given consent to participate in the study been included and those who are absent and not willing to participate are excluded from study. Data were presented in percentages and p value was calculated by Chi-square test. Results: 63.18% and 53.73% commerce, 86% and 84.5% science knows causative agent and other name of swine flu respectively and difference is statistically highly significant. More than 60% of science and commerce students reported cough/sneezing as modes of transmission. 57% science and 40% commerce correctly answer symptoms of swine flu. Television (>35%) was major source of information in both groups. Conclusions: Although students are aware of swine flu but correct knowledge about swine flu is lacking in both the groups. Knowledge regarding key points such as frequent hand washing, avoiding crowding places, vaccine and treatment availability, which is much important during epidemics and pandemics as precautionary measures, was lacking in both the groups.
Shashikant Shivajirao Salunke,
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174228

Abstract:
Background: It was realized that just providing vaccine to achieve targets without giving attention to quality of services doesn’t guarantee a reduction in disease morbidity & mortality. Operational challenges such as logistic supply and microplanning have to be taken into consideration There is also increasing need to ensure that providers stick to service delivery protocols to achieve better health outcomes. Therefore the Study was aimed to assess the immunization sessions. The objective of the study was to evaluate the immunization sessions for logistics and availability of health workers, in the study area.Methods: The study was carried in 21 Grampanchayats covered by Ghatnadur PHC. semi structured preformed questionnaire was used for evaluation. Immunization sessions were also studied for information provided regarding side effects of vaccines.Results: Availability of human resources and logistics for vaccination sessions was more than 80% at all vaccination sessions. Information about side effects was the loophole in vaccine delivery services. Message regarding side effects of vaccines was not conveyed to most of the population.Conclusions: Vaccine delivery services were good in study area. Information about side effects should be conveyed 100% to of the population. The study should be extended to larger area for generalization of results.
Apeksha P. Paunikar, Hrishikesh A. Khadilkar, Mohan K. Doibale, Bina M. Kuril
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174229

Abstract:
Background: Breast cancer accounts for 19-34% of all cancer cases among women in India. There is a high mortality as patients usually present at an advanced stage because of lack of awareness and nonexistent breast cancer screening programs. So the aim of study is to know knowledge, attitude and practices (KAP) of women towards breast cancer in the field practice area of urban health training centre (UHTC). Methods: A cross sectional study included 140 women of age ≥15 years residing in field practice area from October 2016 to January 2017. From four wards in the field practice area, equal samples were drawn from each ward. Data was collected using questionnaires designed to elicit socio-demographic information and knowledge, attitude and practices of these women towards breast cancer. Data analysis was done by Open Epi. Results: Out of 140 women interviewed, 78.57% mentioned at least one of the symptoms of breast cancer but only 37.86% identified painless lump as a symptom. Only 46.43% mentioned any one of the risk factors. More educated and younger age women were more knowledgeable about risk factors. 44.29% participants were aware of early detection measures but very few were actually practicing SBE, CBE. CBE was most common tool identified for detection. Conclusions: Women do have KAP deficits of breast cancer. So community oriented awareness generation programs to educate women about breast cancer, to promote early detection of breast cancer and to bring about the desirable behavioural change among women is needed.
, M. A. Musthaq Pasha, Afsar Fatima, B. Issac Ebenezer
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174227

Abstract:
Background: Hepatitis B is a major health problem worldwide and more serious in India. An estimated 240 million people are chronically infected with hepatitis B. Hepatitis B is an important occupational hazard for health workers. However, it can be prevented by currently available safe and effective vaccine. A Study on Awareness of Hepatitis B Infection and Vaccination among Medical Interns and Nursing interns in Santhiram Medical College, Nandyal, Kurnool, Andhra Pradesh.Methods: A cross-sectional comparative study is done. Students who are present at the time of data collection by a pre structured pre-tested questionnaire given. Data was analyzed by usingSPSS 21 version. Data was presented in proportions and chi-square was done for significance with 95% confidence interval.Results: The study was under taken among the medical interns (80) and nursing interns (70) at Santhiram Medical College, Nandyal. Out of all 150 students 87% all know that the type of infections viral. There is a significant knowledge difference between the medical interns and nursing interns about the knowledge of the modes of transmission i.e. Medical interns have higher knowledge when compared to nursing interns. 97% of medical interns are vaccinated whereas only 50% of nursing interns and also significant difference knowledge about the post exposure prophylaxis 76% in medical interns 19% in nursing interns.Conclusions: This study showed that overall awareness regarding hepatitis B is at a very basic level among the nursing interns when compared to medical interns of the future and measures need to be taken to create complete awareness.
Manish Kumar Gupta, Shweta Singla
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174249

Abstract:
Background: Morbidity due to Soil transmitted helminth (STH) infections can be controlled at a reasonable cost by means of mass deworming using effective drugs. Deworming campaigns targeted at high risk groups, such as school-age children, pre-school children and women of child-bearing age are the mainstay of the control strategy launched by WHO. Methods: A small sector was surveyed on the National Deworming Day (NDD) to record the percentage coverage of children in pre-school and school going children. Children were observed for any of the adverse effects within 24 hrs of taking Albendazole. Results: Out of the total of 1142 children in anganwadis and government schools of the study area, 993 (86.9%) received tablet Albendazole (400 mg) under supervision of teachers. Among these only 3 children (0.26%) reported with adverse effects like vomiting and dizziness. Conclusions: The percentage coverage of children on the NDD was about 87%. Ministries of Health can set up efficient, safe delivery, monitoring and referral systems, in order to minimise the risk and maximise the benefit of periodic deworming and increase the percentage coverage in communities where soil-transmitted helminthiasis is endemic.
Anant Pawar, Durgesh Kumar
International Journal of Community Medicine and Public Health, Volume 4, pp 3793-3795; https://doi.org/10.18203/2394-6040.ijcmph20174252

Abstract:
Background: Low birth weight (LBW) continues to remain a major public health problem worldwide. There are numerous factors contributing to LBW both maternal and foetal. The maternal risk factors are biologically and socially interrelated. The mortality of low birth weight can be reduced if the maternal risk factors are detected early and managed by simple techniques. This study was conducted to study the maternal risk factors associated with low birth weight. Methods: A retrospective record based case control study was conducted. Retrospective data collection was done using registers from medical record section of Obstetrics and Gynaecology department. After applying exclusion criteria and checking for completeness of records, we selected 60 cases and 124 matched controls. Data was entered in Microsoft excel and analyzed using SPSS version 16. Students ‘t’ test, chi-square test and odds ratio were used to find out the factors associated with low birth weight. Results: In the present study, 60 cases and 124 controls were studied. Mean age of mothers in the case group was 24.4±4.7 yrs. and in the control group was 24.8±4.42 yrs. Mean weight of the cases was 62.5±6.89 kg and of the controls was 65.04±7.16 kg. A total of 35% of the cases and 20% of the controls suffered from pregnancy related diseases. Conclusions: Maternal factors like Socio-economic status, weight, haemoglobin and parity were significantly associated with LBW. Maternal diseases like hypertension, diabetes can result in LBW baby.
, Vinayak Kamath, Hemapriya S.
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174251

Abstract:
Background: Physical inactivity is considered as a major independent modifiable risk factor for chronic diseases and is one of the most important causes of obesity. Considering the increasing prevalence of chronic diseases in India, the physical activity plays an important role. Taking this into consideration we conducted a study to assess the physical activity levels using the global physical activity questionnaire among obese and non-obese individuals. Methods: A cross sectional study was conducted among adults 20-60 years age-group in rural and urban field practice areas of a medical college in Puducherry by simple random sampling method to select 237 individuals from each area. The level of physical activity was analysed using the global physical activity questionnaire. Results: Among the study population, 61.39% belong to low physical activity level. Among 97 obese individuals, 53.61% belong to low physical activity and no statistical significance was noted between the levels of physical activity and obesity. The prevalence of obesity was 36.13% among those who reported walking and bicycle usage and statistical significance was noted among obese and non-obese individuals (p<0.001). Statistical significant difference was observed in duration of physical activity (minutes/day) among obese and non-obese individuals. Conclusions: The prevalence of obesity seems to be lower among the people who practice simple day-to-day habits such as walking and usage of bicycles as evidenced from our study. Such simple and replicable behavioural modifications need to be brought about at a societal level, if we want to minimise the danger of the looming obesity epidemic.
Devika P. Jeeragyal, Sasidhar M., Sharvanan E. Udayar, K. R. John, Reddy J. Kalluri
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174226

Abstract:
Background: Tobacco consumption is a major public health issue and is the major risk factor for causes of death. In India, 90% of the oral cancer patients were tobacco chewers. No of women chewing tobacco is also increasing leading to stillbirth, preterm baby and LBW babies. No of children using the tobacco in their early age is an urgent issue to address. Study was done with an objective of exploring the perceived reasons for initiation and continuation of tobacco usage among rural population Kuppam in A.P. Methods: Prevalence study was done at field practice area of Kuppam in A.P. Results: Total 1500 individuals above 15 yrs were studied. The overall prevalence of tobacco use among the subjects was 61.3%. The age at initiation of tobacco use was less than 20 years (54.4%). In our study reasons to start and continue the tobacco usage were, peer pressure 50.4%, influence of family members 16.4%, to overcome the hunger and thirst was 9.6%, relaxation 3%. Conclusions: Hence it is essential for community based smoking cessation activities, health education, behavioral change communication, focus group discussion, legislative measures should be considered as preventive measures.
Jasleen Kaur, Harpreet Singh, Riya Kaur Kalra
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174250

Abstract:
Background: According to the WHO fact sheet 2015, non-communicable diseases kill 38 million people each year globally. This preliminary study was undertaken in order to bring about healthy ageing. Methods: It is an observational study on 100 patients above 60 years of age belonging to the rural/urban community coming to the medicine OPD on a walk-in basis in the Government Medical College, Amritsar. Results: Out of the total 100 patients, 56 were male and 44 were female. Their awareness level was recorded on a self-designed questionnaire. Although 70% of the patients had one or the other disease under study (i.e. diabetes mellitus, hypertension), yet surprisingly their knowledge was limited to the symptoms they suffered from rather than the disease per se. Conclusions: As inferred from this study, the knowledge of the geriatric group about these diseases is limited, so there is an urgent need to create awareness among the patients and their family members as prevention will be far better than the cure in the long run.
Kene E. Maduemem, Muhammad Rizwan, Nnaemeka Akubue, Ioana D. Maris
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174216

Abstract:
Background: The use of oral rehydration therapy (ORT) remains limited despite international guidelines for diarrhoeal disease management. This study was done to assess the perception and practice of ORT among caregivers in the management of diarrhoeal disease. Methods: A descriptive cross-sectional study was conducted in the Paediatric Department of Cork University Hospital, Ireland. The study population consisted of parents/guardians of children attending the Paediatric Day Ward or Paediatric Outpatient Department. A questionnaire consisting of 30 questions was originally designed by the first author to include all the study variables, and was given to the participants. Results: Out of 402 respondents, 76.6% (n=308) could describe diarrhoea correctly and perceived it as a serious illness. 81.3% (n=327) of participants knew about ORT but only 27.2% (n=89) agreed it was an ideal first line of management of diarrhoeal disease. Diarrhoeal episodes in the preceding 12 months were reported predominantly in children under the age of 5 years (p<0.001). Only 8.7% (n=17) of caregivers used ORT for diarrhoeal management. Conclusions: Poor uptake of ORT appears to be due to caregivers’ negative perceptions of ORT. This emphasizes the need for correct and adequate education.
Syed Abid Asghar, Mrinal R. Srivastava, Pratibha Gupta, Zeashan H. Zaidi
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174245

Abstract:
Background: Every year ARI in young children is responsible for an estimated 3.9 million deaths worldwide. About 90 percent deaths are due to Pneumonia which is usually bacterial in origin. By low-cost interventions such as hand washing, breast feeding, accessibility of rapid and attainable methods of early diagnosis of ARI, can help to reduce its burden. Improving the primary medical care services and developing better methods for early detection, treatment and where possible, prevention of acute respiratory infection is the best strategy to control ARI. The aim of the study was to estimate prevalence of ARI among children under-5 years of age attending Rural Health Training Centre of Era’s Lucknow Medical College and Hospital.Methods: The present study was carried out from Nov.2015 to April 2016 covering 305 children below 5 years from RHTC of Era’s Lucknow Medical College and Hospital. Children with acute respiratory infection (ARI) having symptoms like cough, running nose, sore throat, nasal congestion or breathing difficulty were included in the study.Results: Out of 305 children under 5 years, 43 (14%) were diagnosed with ARI. The overall prevalence of ARI was 14% with 95%CI (10.20-18.0). According to social class, prevalence of ARI was higher in low socioeconomic class 42.96%.Statistically no significance between social class and prevalence of ARI was seen with Chi sq test: 0.879, t= 0.928.Overcrowding were present in 33% of cases with 95% CI (17.2-48.80). Inadequate ventilation 48% with 95% CI (31.21-64.79), and uses of smoky chullah 49% with 95% CI (31.21-64.79). Prevalence of ARI was more prevalent in children with malnutrition 52.9%. Statistically high association was seen between ARI status and nutritional status, with Chi squre test:18.3, t≤0.001.Conclusions: The study concludes that malnutrition, low socioeconomic status, poor nutritional status, maternal illiteracy, overcrowding, and inadequate ventilation were the major social and demographic risk factors responsible for ARI in under five children. Minimizing these risk factors and by cost effective interventions one can significantly reduce the prevalence of ARI in the rural community.
, Vandana Gangadharan
International Journal of Community Medicine and Public Health, Volume 4; https://doi.org/10.18203/2394-6040.ijcmph20174244

Abstract:
Background: Globally, nearly 5 million persons die every year from tobacco-related illnesses, with disproporti-onately higher mortality occurring in developing countries. Tobacco is used in a multitude of ways in India. By 2020 India would have the highest rate of rise in tobacco related deaths compared to all other countries. Tobacco use in India is increasing but there are considerable changes in the types and methods by which it is used. According to WHO estimates, 194 million men and 45 million women use tobacco in smoked or smokeless form in India. Tobacco use is the leading preventable cause of death in developed countries and is the second leading cause of death globally. The study was carried out to assess the practice of tobacco use among adults in urban slum. It tries to ascertain the prevalence of tobacco use in the community, identify the various forms of tobacco used. It is a questionnaire based cross sectional descriptive study. Methods: A cross sectional descriptive study using a close-ended, pre tested structured interview schedule was prepared and the investigator conducted the interviews personally at the respondent’s house who were above 18 years of age. Results: The prevalence of tobacco use in any form was found to be 38.78%, the most common age group being 30-44 yrs. Also seeing that initiation of tobacco use took place in the age group 20-29 yrs it highlights the need of starting anti-tobacco campaigns for a younger age group but not leaving out older age groups at the same time. Sex-wise distribution of tobacco use was observed to be 40.23% in males as compared to 36.17% in females. Conclusions: Control of this deadly epidemic requires a decisive, target oriented and a well motivated approach.
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