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    Table of Contents - Current issue
April-June 2019
Volume 44 | Issue 2
Page Nos. 77-180

Online since Thursday, June 27, 2019

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Competency-based undergraduate curriculum: A critical view Highly accessed article p. 77
Rashmi Sharma, Harsh Bakshi, Pradeep Kumar
DOI:10.4103/ijcm.IJCM_206_19  PMID:31333280
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Preparing short message service reminders to improve treatment adherence among tuberculosis patients in Sleman District, Indonesia p. 81
Fatwa Sari Tetra Dewi, Sudiya Sudiya, Supriyati Supriyati, Purwanta Purwanta, Ema Madyaningrum, Firda Ulfa Aulia, Risma Wardiani, Adi Utarini
DOI:10.4103/ijcm.IJCM_207_18  PMID:31333281
Background: Modern tuberculosis (TB) treatment approaches require innovative adherence strategies. Objectives: This study aimed to explore the feasibility of using short message service (SMS) reminders through mobile phones to improve treatment adherence among TB patients. Materials and Methods: An exploratory sequential design was applied; initially, qualitative data collection was conducted among TB patients and TB program officers. A content analysis was done and messages were then developed. The messages were pretested using focus group discussions (FGDs), and a quantitative method using quasi-experiment on 120 TB patients. All the patients received a standard directly observed therapy short reminder, but only intervention group received daily SMS reminders (n = 60), the data were then analyzed using logistic regression. Results: Reminder messages can be sent directly to young TB patients or indirectly to the relatives of elderly patients. There are four phases of emotional states, which TB patients go through during treatment starting with disappointment and desperation after being diagnosed, grievance during the initiation of treatment, high and then low desire to follow treatment. Reminder messages aimed at improving treatment adherence should correspond to those conditions and motivate, inform, and facilitate TB patients to overcome all the obstacles during treatment. SMS reminders should also be short, informal, and easy to understand. Treatment adherence was significantly higher among the intervention group compared to the control group (odds ratio = 10.73) after controlling for demographics, accessibility, and adverse drug reaction. Conclusions: SMS through mobile phone is a feasible form of media to remind TB patients and to improve adherence to treatment in low-resource facilities.
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Prevalence and its associated determinants of Diabetic Peripheral Neuropathy (DPN) in individuals having type-2 diabetes mellitus in Rural South India Highly accessed article p. 88
Surendra Darivemula, Khadervali Nagoor, Shakeer Khan Patan, N Bayapa Reddy, C Sravana Deepthi, Chandra Sekhar Chittooru
DOI:10.4103/ijcm.IJCM_207_18  PMID:31333281
Background: Diabetic peripheral neuropathy (DPN) is a well-known microvascular complication of type 2 diabetes mellitus attributed to chronic hyperglycemia and is defined as the presence of peripheral nerve dysfunction after exclusion of other causes. Methodology: This was a multicentric facility-based cross-sectional study with the objectives to assess the sociodemographic and economic status of the participants, to estimate the prevalence of the DPN using the screening methods, and to see the association with other factors. A predesigned semi-structured questionnaire, Semmes-Weinstein 10-g monofilament test, ankle reflexes, and vibration perception threshold test was used for the data collection and blood sugars levels were taken from the recent laboratory report. Results: Among 336, 202 (60.1%) were male and 134 (39.9%) were female. The prevalence of the DPN was 39.3% among them 28.9% in males and 10.4% in females, respectively. The other determinants of the participants, 264 (78.6%) had the Glycated hemoglobin (HbA1c) >7, 205 (61%) had a burning foot sensation, 124 (36.9%) of them were had numbness of the foot, almost 50% of them had pricking sensation in the foot and more than one-third (130) of them had callosity over foot. Conclusions: The study showed the severity of DPN was significantly associated with age, sex, duration of diabetes, HbA1c value, hypertension, and body mass index.
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Predictors of weight velocity in the first 6 months of life in a Rural block of West Bengal: A longitudinal study p. 92
Arista Lahiri, Arup Chakraborty
DOI:10.4103/ijcm.IJCM_150_18  PMID:31333283
Background: Monthly weight gain (weight velocity) is important in early infancy, with several factors affecting and interacting within the healthy-born children. The current study aims to estimate on the effects of different factors on the trend of weight gain during the first 6 months of life. Methods: A longitudinal (repeated-measures) study was conducted on the 42 nonlow birth weight healthy children born in selected rural areas during December 2016. Infant feeding attitude, effective breastfeeding, timely feeding, and episodes of diarrheal illnesses were the major predictors along with the age of the children on the weight velocity in a sex-dependent repeated-measures analysis using Generalized Estimating Equations. Results: Mothers of the children were mostly below the mean age of 20.1 years (60.905%), majority being homemakers (71.429%). Majority (73.809%) had a better infant feeding attitude. The mean birth weight for male infants was 2.941 (±0.299) kg and females 2.938 (±0.352) kg. Age of the child, birth weight, timely feeding, and episodes of diarrheal illnesses had statistically significant effect on monthly weight gain. Feeding breast milk only proved advantageous for males. Conclusions: Effectively, only breastfeeding, timely feeding, and prevention of diarrheal episodes were the most important recommendations at the field level.
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Antenatal risk scoring scale for predication of low birth weight and its validity p. 97
Avinash Hindurao Salunkhe, Asha K Pratinidhi, Jyoti A Salunkhe, Satish V Kakade, Vaishali R Mohite, RP Patange
DOI:10.4103/ijcm.IJCM_263_18  PMID:31333284
Background: Prediction of low birth weight (LBW) early during pregnancy may prevent LBW by appropriate interventions. Aims/Objective: The aim of the study is to develop an antenatal risk scoring scale for prediction of LBW. Subject and Methods: Routine and in-depth information on diet, occupation, and rest was collected from November 1, 2013, to November 13, 2015. A cohort of 1876 and subset of 380 pregnant women attending Krishna Hospital Karad, Maharashtra, India. Statistical Analysis: Multivariate analysis and relative risks (RRs) were found out by SPSS version 16 and tested on a separate set of 251 mothers. Results: The frequency of meals of <4, hard work <6 h of sleep and illiteracy, antenatal morbidity, <10 kg weight gain, <40 kg maternal weight, and anemia during the first trimester were the risk factors identified from subset and cohort, respectively. Based on their RRs, a new scoring system with a total score of 24 and cutoff “12” was identified by using receiver operating characteristics (ROC) curve analysis with 98.6% sensitivity and 41.1% specificity as tested on 251-independent individuals. The second cutoff of “15” score was identified based on the prevalence of LBW in babies of these 251 mothers. Conclusions: The identification of low-, moderate-, and high-risk of LBW was possible at <12, between 12 and 15, and >15 scores, respectively, with good sensitivity and specificity.
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Development of risk scoring scale tool for prediction of preterm birth p. 102
Avinash Hindurao Salunkhe, Jyoti A Salunkhe, Vaishali R Mohite, Ujawala More, Asha K Pratinidhi, Satish V Kakade
DOI:10.4103/ijcm.IJCM_262_18  PMID:31333285
Background: Prediction of preterm births in the early stage during pregnancy may reduce prevalence of preterm births by appropriate interventions. Aims/Objective: The aim of the study is to develop an antenatal risk scoring system/scale for prediction of preterm births. Subjects and Methods: From a cohort of 1876 and subset of 380 pregnant women attending Krishna Hospital Karad, Maharashtra, routine antenatal and in-depth information on diet, occupation, and the rest were collected and analyzed using SPSS version 16. A scoring system was developed by multivariate analysis based on the relative risk (RR) and tested on separate set of 251 mothers. Statistical Analysis Used: Bivariate analysis by Chi-square test, backward multivariate regression model, receiver operating characteristic curve (ROC) curve analysis, and calculation of RR for identified risk factors. Sensitivity and specificity of newly developed risk scoring scale. Results: Out of six risk factors from whole cohort (n = 1876) and three risk factors from subsample (n = 380) identified by bivariate analysis. Further four and three risk factors were retained after multivariate analysis from whole and part of cohort, respectively, and risk scores of “7” and “9” were assigned based on RR cutoff levels of three and five were identified separately for whole and part data by ROC curve analyses together making it “8” with 75.5% sensitivity and 85.5% specificity when tested on 251 independent patients. Based on the prevalence of preterm births, low-, moderate-, and high-risk grading was done by identifying as second cutoff value. Conclusions: Identification of low-, moderate-, and high-risk of preterm births was possible at <8, 8, and 9 and equal to ≥10 with high sensitivity at lower cutoff and high specificity at upper cutoff.
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Structured diabetes education program for improving self-care behavior in primary care settings of Puducherry: Evidence from a randomized controlled trial p. 107
Mamta Gehlawat, Subitha Lakshminarayanan, Sitanshu Sekhar Kar
DOI:10.4103/ijcm.IJCM_192_18  PMID:31333286
Context: Diabetes self-management education plays a critical role in improving patients' clinical outcome and quality of life. Aims: This study aims to study the effectiveness of a structured diabetes educational program on improvement of self-care behavior among type 2 diabetics in urban Primary Health Centres (PHCs) of Puducherry. Settings and Design: A community-based open-label parallel-arm randomized controlled trial was conducted in two randomly selected urban PHCs of Puducherry during December 2015–February 2017. Subjects and Methods: Using systematic random sampling, 157 eligible participants were recruited in intervention and control PHCs each. Sociodemographic, disease characteristics, and anthropometric measures were captured using a pretested questionnaire at baseline. Self-care behavior was recorded with Summary of Diabetes Self-Care Activities scale. Intervention consisted of structured diabetes education sessions with distribution of information leaflets and self-care kits to the intervention-arm participants, while control arm received standard care. At the end of 6 months, endline assessment was done for both groups. Data were analyzed by intention-to-treat, per-protocol, and difference-in-difference analysis using STATA. Results: Footcare increased significantly by 1.95 days/week compared to control arm, while a moderate change of 0.49 days/week in diet compliance and a minimal change of 0.10 days/week in physical activity were observed. Medication adherence, regular blood sugar testing, and smoking behavior also showed improvement in intervention arm. Conclusions: A structured education program that is culturally tailored showed an overall improvement in self-care behavior. This research supports the need for structured education program for diabetics to empower them and improve self-care practices. Trial registration: CTRI/2017/06/008772
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“DIABETIC TAX” – Cost of care among persons with type 2 diabetes mellitus in an Urban Underprivileged Area of Bengaluru p. 113
Geethu Mathew, Farah N Fathima, Twinkle Agrawal, Dominic Misquith
DOI:10.4103/ijcm.IJCM_224_18  PMID:31333287
Background: Diabetes mellitus drains a significant percent of the health budget by cost toward direct diabetes care and diabetes-related disabilities. Objectives: The aim of the study is to assess the annual costs incurred by patients with type 2 diabetes mellitus. Methodology: This cross-sectional study was undertaken among 153 diabetic people in an urban underprivileged area of Bengaluru from January 2013 to January 2014. This was a cost of illness study done from the patient's perspective using a structured interview schedule. Results: A diabetic person in an urban underprivileged community in Bengaluru spends 11,489.38 ± 28,341.77 annually for diabetic care. Direct and indirect costs accounted for 95% and 5% of costs. Majority were spent on admission (45.1%), followed by drugs (21.8%), investigations (5.6%), and consultations (4.5%). Nonmedical costs such as food and transport accounted for 18% of the costs. About 50% of them had delayed treatment due to financial constraints. Nearly 25% of patient's income and 10.7% of the family income were spent for diabetic care. Higher education, income, duration of disease, hospital admission, type of treatment, and place of treatment were found to be associated with costs. Conclusion: Estimates of cost will help conceptualize strategies to deal with the situation at local, regional, and national level.
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World Health Organization dimensions of adherence to antiretroviral therapy: A study at antiretroviral therapy centre, Aligarh p. 118
Yasir Alvi, Najam Khalique, Anees Ahmad, Haroon Subhan Khan, Nafis Faizi
DOI:10.4103/ijcm.IJCM_164_18  PMID:31333288
Introduction: With the availability of antiretroviral therapy (ART) and subsequent change in the HIV/AIDS disease dynamic to a chronic manageable disease, adherence studies have received increasing attention. However, there is a paucity of studies that have considered World Health Organization (WHO) dimensions of adherence to ART. Therefore, this study was conducted with the objectives of determining the prevalence of adherence and the association of various factors across five WHO dimensions to adherence. Methods: A cross-sectional study was carried out at the ART Centre, Aligarh. A total of 440 adult patients, taking treatment from the ART Centre, Aligarh were selected. A self-reported instrument of missing pills was used to measure adherence. Various factors across five WHO dimensions were studied. Results: Prevalence of adherence in our study was 81.3%. Among the five dimensions of adherence, distance from home (odds ratio [OR] 0.980; 95% confidence interval [CI] 0.964–0.997) among socioeconomic determinants, frequent adherence counseling (OR 8.737; 95% CI 4.076–18.727) among health system-related, drug regimen (OR 2.202; 95% CI 1.023–4.738) and absence of side effects (OR 3.293; 95% CI 1.473–7.365) among therapy related, absence of substance abuse (OR 2.747; 95% CI 1.209–6.243), and perceived change in health status (OR 4.196; 95% CI 1.613–10.915) among patient-related dimension were found to be significantly associated with adherence to ART, while clinical condition dimension did not play a significant role. Conclusion: The ART adherence rate is still below satisfactory levels for long-term viral load suppression. WHO multidimensional approach – which was found to be quite relevant in our study setting – could be applied to effectively solve the adherence problem in our country.
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Nutritional status, hygiene level, morbidity profile, and their effect on scholastic performance among school children in two subcenter areas of a PHC in Anekal Taluk, Karnataka, India p. 125
Sakthi Arasu, Farah Naaz Fathima, Nitya Raghu, Maria Vasnaik, Tom Mishael, Rahul D'Souza, Twinkle Agrawal
DOI:10.4103/ijcm.IJCM_186_18  PMID:31333289
Background: Various factors such as age, sex, nutrition, hygiene, and morbidity impact the scholastic performance of schoolchildren. Objectives:(1) The objective of the study is to assess the hygiene level, nutritional status, morbidity profile, and scholastic performance of children attending government schools in two select subcenter areas of Karnataka and (2) to study the association of hygiene level, nutritional status, and morbidity profile with scholastic performance. Methodology: A cross-sectional study was done from July to August 2017 among children studying in the government schools of Mugalur and Kuthganahalli subcenters under Sarjapur PHC, Anekal Taluk, Bengaluru urban district. After obtaining permissions, general checkup of the students was done for morbidity pattern, and their anthropometric measurements were documented. Hygiene levels of the students were observed with a checklist to obtain scores that were grouped into good and poor. Attendance and grades were obtained from the class teacher to assess the scholastic performance. Results: Of a total 403 students studied, the mean age was 10.2 years (standard deviation: 2.87) with 51.1% girls. Nutrition status was good in 236 (58.6%) students and 262 (65%) had good hygiene. At the time of examination, 211 (53%) had at least one morbidity, with most common being dental caries (16.3%). Logistic regression showed that odds of girls having better grades is 2.4 times more when compared to boys and 2.1 times more likely in students with good hygiene. Students with good hygiene are 2.1 times more likely to have good attendance. Conclusion: Hygiene status impacts the attendance and grades of the students. Girl students had significantly better grades than the boys.
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Comparative study to determine the prevalence and socio-cultural practices of infertility in Rural and Urban field practice area of Tertiary Care Hospital, Vijayapura, Karnataka p. 129
Rekha Udgiri, Vidya V Patil
DOI:10.4103/ijcm.IJCM_172_18  PMID:31333290
Background: Infertility is an iceberg phenomenon where the majority of couples are undiagnosed. The main challenge in estimating the actual burden of infertility is the paucity of population-based studies. Various sociocultural practices such as believing infertility as curse and seeking healing from supernatural powers are still predominant in the community. Hence, the present study was undertaken to know the prevalence and sociocultural practices of infertility in field practice area. Materials and Methods: A cross-sectional study was conducted in rural and urban field practice areas of tertiary care hospital. A complete enumeration of all the houses was done to list all the eligible couples residing in the area; among them, those at risk of pregnancy were identified so as to find out couples with either primary or secondary infertility. Data were tabulated and analyzed using the SPSS software version 16. The results were expressed in terms of percentages, and Fisher's exact test was used wherever applicable. Results: The prevalence of infertility in rural area was 7.6% and in urban slum, it was 8.8%. Most of them think infertility as a result of past sins and practice unscientific methods to overcome the problem. Conclusion: Infertility stigma is high and there is no proper knowledge about infertility, fertile period and most of them think it as result of past sins.
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Diet, physical activity, and screen time among school students in Manipur p. 134
Markordor Lyngdoh, Brogen Singh Akoijam, RK S. Agui, Kh Sonarjit Singh
DOI:10.4103/ijcm.IJCM_282_18  PMID:31333291
Context: Adolescence is a critical time in the development of lifelong healthy eating and exercise habits. The high prevalence of adolescents exposed to excessive screen time is a matter of concern because of its association with several health problems, such as overweight and obesity, alterations in blood glucose and cholesterol, poor school performance, decreased social interaction, and lower levels of physical activity. Aims: The aim of this study is to identify the lifestyle behaviors of young adolescents focusing on physical activity, diet, and screen time. Settings and Design: A cross-sectional study was conducted among 929 students of Class VII and VIII in schools in Imphal West and Kangpokpi districts of Manipur. Subjects and Methods: Data collection was done by questionnaire method. Statistical Analysis Used: The data were analyzed using IBM SPSS for Windows, Version 21.0. Armonk, NY, USA. Results: Seven in 10 of the students had inadequate physical activity at school and inadequate physical activity outside school. About 56.9% of the students have a smartphone, whereas one-third of them have Facebook and WhatsApp accounts. Only 5.8% were eating a healthy diet. Females and day scholars were less physically active. Males those staying in a nuclear family, less family income, and more number of siblings were found to have unhealthy dietary habits. Conclusions: Less than half of the students were physically active and only six out of 100 the students were eating a healthy diet.
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Addressing maternal mortality in selected Districts of Madhya Pradesh, India – A human rights-based approach p. 138
Manju Toppo, Dinesh Kumar Pal, Devendra Gour, Veena Melwani, Amreen Khan, Soumitra Sethia
DOI:10.4103/ijcm.IJCM_315_18  PMID:31333292
Background: Maternal mortality is an indicator of state of maternal health services, status of women, women's health, and above all developments of nation. Objectives: The objectives of the study were to identify the patterns and causes, medical as well as sociocultural, of maternal death as well as consider and list out the rights realization perspective of the mothers, their immediate families and the community at large. Materials and Methods: A cross-sectional study was conducted in three districts of Madhya Pradesh, India, for 1 year. One hundred and two maternal deaths were covered, and verbal autopsy was conducted. Human right perspective was assessed using questionnaire. Results: Majority (64.7%) of maternal deaths occurred between 18 and 25 years of age. About 50.9% were primigravida, and postpartum hemorrhage was the most common cause. Nearly 53.9% had visited more than one facility before death. Conclusion: Poor antenatal care and lack of human resources posed major reasons for death in all facilities. Rights realization among the beneficiaries was found to be very poor.
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Magnitude of gestational diabetes mellitus, its influencing factors and diagnostic accuracy of capillary blood testing for its detection at a Tertiary Care Centre, Rajkot, Gujarat p. 142
Rajesh K Chudasama, AM Kadri, Apurva Ratnu, Mahima Jain, Chandrakant P Kamariya
DOI:10.4103/ijcm.IJCM_283_18  PMID:31333293
Background: Gestational diabetes mellitus (GDM) occurs during pregnancy which affects mother, fetus, and outcome of pregnancy, hence early detection is necessary. The objective of this study was to ascertain the validity of glucometer over standard biochemical testing for detection of GDM and to estimate prevalence of GDM and its associated risk factors. Materials and Methods: A hospital-based study was conducted at Antenatal clinics of Obstetrics Department, tertiary care hospital, based on the “National Guidelines for Diagnosis and Management of GDM.” Totally 357 pregnant women between 21 and 28 weeks of gestational age agreed were included in the study from January to March 2016. After obtaining written consent, one step procedure was offered to pregnant women by giving 75 g of anhydrous glucose dissolving in 200–250 ml of water. After 2 h, glucose level was estimated by capillary testing with glucometer and venous glucose by glucose oxidase test. Results: GDM was found in 20.4% pregnant women with capillary testing done by glucometer compare to 11.5% with venous blood testing. GDM was found higher among literates, homemakers, Hindus, people living in nuclear family, belongs to middle class, residing in urban area, primigravidae, obese and with gestational age between 21 and 24 weeks. Intermediate agreement (Kappa = 0.42) was found between two methods with sensitivity of 70.7%, specificity of 86.1%, positive predictive value 39.7%, and negative predictive value 95.8%. Conclusion: Intermediate agreement between two methods indicates glucometer testing can be used to screen pregnant women at an early gestational age (21 weeks), at the community level by health-care workers.
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Economic analysis of delivering postpartum intrauterine contraceptive device services in India p. 147
Pankaj Bahuguna, Puneet Khanduja, Shankar Prinja
DOI:10.4103/ijcm.IJCM_253_18  PMID:31333294
Introduction: We estimated the unit costs for implementing postpartum intrauterine contraceptive device (PPIUCD) services from the perspective of both health system and development agencies. Methodology: Seven districts from two Indian states, i.e., Uttarakhand (UK) and Madhya Pradesh (MP), were selected to study the cost of PPIUCD service. Data on costs incurred both by health system and development agencies for PPIUCD service were collected. Unit costs were estimated for providing PPIUCD and IUCD services by state and district level of care in public health-care system. We also estimated unit cost per couple-year protected (CYP) by the level of the health facility. Results: We found that the unit cost per PPIUCD insertion including all costs, i.e., for service delivery and program support, was INR 522 ($8.7) and INR 502 ($8.4) in MP and UK, respectively. Similarly, the unit costs per interval IUCD insertion were INR 287 ($4.8) in UK and INR 281 ($4.7) in MP. Development partners have a share of >50% in overall costs. From a health system's perspective, PPIUCD and interval IUCD cost per CYP at the level of district hospital were INR 440 ($7.3) and INR 449 ($7.5), respectively. Conclusions: In India, PPIUCD, being a low-cost procedure, should be considered as a primary strategy targeted toward pregnancy spacing over other contraceptory methods.
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Impact of anemia on outcome of HIV-infected pediatric patients: A prospective observational study p. 152
Baraturam Bhagrati Bhaisara, Mona Gajre, Mamta Manglani, Minal Wade, Sujata Sharma
DOI:10.4103/ijcm.IJCM_326_18  PMID:31333295
Introduction: Anemia has been widely reported to predict a poorer prognosis for HIV-infected patients, both in terms of progression to AIDS and in survival. This study aimed to determine the etiology of anemia and its immunological correlation in HIV-infected children. Materials and Methods: Four hundred and eighty-nine HIV-infected children were screened, of which 86 HIV-infected children with anemia were enrolled. Standard WHO definitions were used for anemia, HIV staging, and growth parameters. Chi-square test, t-tests, and univariate and multivariate logistic regression analyses were used to analyze the data. Results: Anemia was present in 17.58% (86/489) of HIV-infected children, including 84.6% with moderate anemia, 11.5% with severe anemia, and 2.32% with mild anemia. The mean hemoglobin (Hb) among patients with CD4 count <350 cell/mm3 was lower (7.90 g%) (standard deviation 1.48) compared to those having CD4 >350 cell/mm3 (P = 0.02). Children with severe immunological stage had a significantly lower mean Hb (adjusted estimate: −1.61, 95% confidence interval: −2.65, −0.56) compared to those who had normal immune status. No statistically significant differences in mean Hb at baseline when compared to various demographic and clinical characteristics were observed in unadjusted and adjusted regression models. Conclusion: Hb is an easy and inexpensive tool to measure and can be used for monitoring disease progression in a resource-limited setting.
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Quality of life of caregivers of autistic children and adolescents visiting health facilities in Lucknow City, Uttar Pradesh, India: A cross-sectional study p. 157
Aparna Jain, Naim Ahmed, Pooja Mahour, Vivek Agarwal, Nitesh Kumar Shrivastav, Chandrakanta
DOI:10.4103/ijcm.IJCM_221_18  PMID:31333296
Background: The lifelong responsibility of the autistic children along with the lack of knowledge, lack of treatment, and if treatment is available, it is unaffordable leads to deterioration of quality of life of the parents in several domains. Objectives: The objective is to study the quality of life of principal caregivers of autistic children and adolescents visiting health facilities in Lucknow city. Materials and Methods: The sample included 90 principal caregivers (aged < 60 years) of autistic children and adolescents aged 3–19 years and diagnosed with autism, attending government and private health facilities providing treatment for autism in Lucknow, Uttar Pradesh, India. Results: The quality of life of principal caregivers was found to be influenced most in the physical health domain (with least score). The predictors of quality of life of principal caregivers were type of family and knowledge regarding child's problem. Conclusion and Recommendations: Thus, there is an immense need of increasing awareness through information, education, and communication materials, mass media, and discussions regarding autism.
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Prevalence and risk factors of Vitamin A deficiency in children and women of childbearing age in a Southern Indian Tribal Population: A cross-sectional study p. 162
Divya Elizabeth Muliyil, Anuradha Rose, Sowmiya V Senthamizh, Tara Chatterjee, Jasmin Helan, Gangandeep Kang, Jayaprakash Muliyil
DOI:10.4103/ijcm.IJCM_213_18  PMID:31333297
Background: Night blindness and keratomalacia continue to be a problem among the tribal children and pregnant women residing in Jawadhi hills. Objectives: The objective of the study is to determine the prevalence and risk factors of Vitamin A deficiency (VAD) among children aged 1–8 years and women of reproductive age in a southern Indian tribal population. Materials and Methods: A cross-sectional study was done among children aged 1–8 years and women aged 15–45 years residing in Jawadhi hills. Participants were randomly selected by cluster sampling. Their sociodemographic characteristics and frequency of consumption of Vitamin A rich food were collected through a structured questionnaire. Anthropometric measures and serum retinol levels, using high-performance liquid chromatography, were estimated for all participants. Results: A total of 166 children and 211 women participated in this study. The prevalence of VAD among the children (1–8 years) was 10.2% (95% confidence interval [CI] 5.5%–14.9%) and among women of the reproductive age group was 3.8% (95% CI: 1.2%–6.4%). Dietary intake was not associated with serum retinol levels. Low educational status of the head of the household (adjusted odds ratio [aOR] = 8.9) and pregnancy (aOR = 11.6) was significantly associated with an increased risk of VAD among children and women, respectively. Conclusions: The prevalence of VAD among children is a moderate public health problem. Strategies must focus on pregnant women and children from families with more than four children.
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A review of epidemiology of fall among elderly in India p. 166
Alex Joseph, Dhasarathi Kumar, M Bagavandas
DOI:10.4103/ijcm.IJCM_201_18  PMID:31333298
Background: Injuries have become a major public health concern. Recent data show that globally over 5 million people lose their life due to injury every year. Especially in low- and middle-income countries, people living below the poverty line are drastically scathed due to injuries. Objective: The objective of this paper is to find the magnitude and risk factors of fall among the elderly in India. Materials and Methods: A systematic search was done by using Google Scholar and PubMed. Results: The selected studies revealed that the prevalence of fall ranges from 26% to 37% across various regions, fall injuries are associated with poor vision, vertigo, imbalance, fear of falling, history of fall, presence of osteoarthritis, visual impairment, hearing impairment, and depression. This study has shown the risk of fall was higher among female elderly population. Conclusion: The major contributing factors for fall injuries are aging, visual impairment, previous history of fall, depression, and gait problem. Females have a higher risk of fall comparatively to males.
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Health-related advertisements in print media: A content analysis p. 169
SN Manjunatha, AN Venkatesh Darshan, Jayashree Sajja
DOI:10.4103/ijcm.IJCM_271_18  PMID:31333299
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Assessing health-related quality of life in patients with diabetes mellitus at a Tertiary Care Center in Central Delhi p. 171
Mishita Goel, Sumedh Dhuldhule, Anupam Prakash, Lekharaj Hemraj Ghotekar
DOI:10.4103/ijcm.IJCM_273_18  PMID:31333300
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Study on health problems faced by workers of sericulture industry: A cross-sectional study in the North Coastal Andhra Pradesh p. 173
Mandadi Jyotsna, Mandadi Anusha, Likhitapudi Venkata Reddi Naidu
DOI:10.4103/ijcm.IJCM_300_18  PMID:31333301
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Knowledge and attitude of Indian parous women toward human milk banking p. 175
Maninderjeet Kaur, Seema Raghuvanshi, Harmeet Kaur Kang
DOI:10.4103/ijcm.IJCM_377_18  PMID:31333302
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Impact of health education intervention on consumption of iodized salt in the community in North India p. 177
Mohammad Athar Ansari, Zulfia Khan
DOI:10.4103/ijcm.IJCM_269_18  PMID:31333303
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Public Health Management: Principles and practice p. 179
Viral R Dave
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IAPSM's Text Book of Community Medicine p. 180
RC Goyal
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007