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   2010| April-June  | Volume 35 | Issue 2  
    Online since July 29, 2010

 
 
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SHORT COMMUNICATIONS
A study to evaluate mobile phone dependence among students of a medical college and associated hospital of central India
Sanjay Dixit, Harish Shukla, AK Bhagwat, Arpita Bindal, Abhilasha Goyal, Alia K Zaidi, Akansha Shrivastava
April-June 2010, 35(2):339-341
DOI:10.4103/0970-0218.66878  PMID:20922119
  9,592 941 4
ORIGINAL ARTICLES
Assessment of malnutrition among adolescents: Can BMI be replaced by MUAC
Aparajita Dasgupta, Arindam Butt, Tushar Kanti Saha, Gandhari Basu, Amitava Chattopadhyay, Anindya Mukherjee
April-June 2010, 35(2):276-279
DOI:10.4103/0970-0218.66892  PMID:20922106
Objectives: To find out the magnitude of malnutrition among the adolescents of an urban slum of Kolkata study population. To compare the middle upper arm circumference (MUAC) with that of body mass index (BMI) for determination of nutritional status of the study population. Materials and Methods: This was a school-based descriptive epidemiological study done among adolescent male students aged 10-19 years in the service area of Urban Health Centre, Chetla. The school is an all boy's government aided school and all the students reside in the Chetla slum, the largest slum of Kolkata. Anthropometric measurements of the students of one section selected from each class i.e. class V to XII were recorded. Results: Results showed 47.93% of study population as per BMI and 60.30% as per MUAC were malnourished. Evaluation of screening test showed MUAC as a marker was 94.6% sensitive and 71.2% specific. A correlation between measurements of MUAC and BMI was demonstrated (r=0.822; SE=0.035; 95% CI; P=0.000000; r2 =0.74).
  8,549 1,343 3
Alcohol use and implications for public health: Patterns of use in four communities
N Girish, R Kavita, G Gururaj, Vivek Benegal
April-June 2010, 35(2):238-244
DOI:10.4103/0970-0218.66875  PMID:20922099
Background: Alcohol is one of the leading causes of death and disability globally and in India. Information on quantum and pattern of consumption is crucial to formulate intervention programs. Objectives: To identify the extent and pattern of alcohol use in urban, rural, town and slum populations using a uniform methodology. Materials and Methods: Door-to-door survey was undertaken and simple random sampling methodology was adopted; households were the primary sampling unit. One respondent in each alcohol-user household was randomly chosen for detailed interview. Results: Overall, 13% of males and females consumed alcohol. Proportion of users was greater in town (15.7%) and among 26-45 years (67.4%). Whisky (49%) and arrack (35%) were the preferred types and the preferences differed between rural (arrack) and urban (beer) areas. Nearly half (45%) of rural population were very frequent users (consuming daily or every alternate-days) as against users in town (23%) or slum (20%). Two-thirds were long-term users and the proportions were greater in the rural and town areas. While, overall 17% of the users were heavy-users, frequent-heavy-drinking was more in slum and rural areas. Nearly two-thirds consumed alcohol in liquor-shops, restaurants, bars and pubs. Habituation and peer-pressure were the key reasons for alcohol use. Conclusions: The study documented alcohol use and patterns of use in four different communities particularly in transitional areas using similar methodology. Many of the patterns identified are detrimental to health both immediate and over the long period of time.
  8,111 1,271 4
Patterns of tobacco use across rural, urban, and urban-slum populations in a North Indian community
Vivek Gupta, Kapil Yadav, K Anand
April-June 2010, 35(2):245-251
DOI:10.4103/0970-0218.66877  PMID:20922100
Background: Tobacco is the leading cause of mortality globally and in India. The magnitude and the pattern of tobacco consumption are likely to be influenced by the geographical setting and with rapid urbanization in India there is a need to study this differential pattern. Aim: The aim was to study the rural, urban, and urban-slum differences in patterns of tobacco use. Settings: The study was conducted in Ballabgarh block, Faridabad district, Haryana, and was a community-based cross-sectional study. Materials and Methods: The study was conducted in years 2003-2004 using the WHO STEPS approach with 7891 participants, approximately equal number of males and females, selected using multistage sampling from urban, urban-slum, and rural strata. Statistical Analysis: The analysis was done using the SPSS 12.0 statistical package (SPSS Inc., Chicago, IL, USA). Direct standardization to the WHO world standard population was done to and chi-square and ANOVA tests were used for comparison across three study settings. Results: Self-reported tobacco use among males was as follows: urban 35.2%; urban-slums 48.3%; and rural 52.6% (P value <0.05). Self-reported tobacco use among females was as follows: Urban 3.5%; urban-slums 11.9%; and rural 17.7% (P value <0.05). More males reported daily bidi (tobacco wrapped in temburini leaf) smoking (urban 17.8%, urban-slums 36.7%, rural 44.6%) than cigarette use (urban 9.6%, urban-slums 6.3%, rural 2.9%). Females using smoked tobacco were almost exclusively using bidis (urban 1.7%, 7.9%, 11% in rural). Daily chewed tobacco use had urban, urban-slum, and rural gradients of 12%, 10.5%, and 6.8% in males respectively. Its use was low in females. Conclusion: The antitobacco policies of India need to focus on bidis in antitobacco campaigns. The program activities must find ways to reach the rural and urban-slum populations.
  7,707 1,312 7
Relationship of personal hygiene with nutrition and morbidity profile: A study among primary school children in South Kolkata
Soumya Deb, Sinjita Dutta, Aparajita Dasgupta, Raghunath Misra
April-June 2010, 35(2):280-284
DOI:10.4103/0970-0218.66894  PMID:20922107
Background: Majority of the health problems affecting school children are preventable by promotion of hygienic practices through proper health education by the teachers, who are the first contacts. Objectives: The study was undertaken to find out the status of nutrition and personal hygiene among primary school children and their association with their varied morbidity profiles. Materials and Methods: A descriptive, observational, cross-sectional study was conducted in a primary school situated in the largest slum of Kolkata. Results: The participants included 103 boys and 81 girls, with a mean age of 6.2 years. The mean personal hygiene score of the girls (4.15 ± 0.98) was significantly higher than that of boys (3.2 ± 1.4) [P<0.05]. Most of the boys (54.37%) and girls (74.07%) were normally nourished as per the CDC growth chart. Over 70% of the children were suffering from one or more morbidities, the most common morbidity in both the sexes being pallor, followed by worm infestation. Personal hygiene scores were significantly higher (P<0.05) among those children who were normally nourished as well as those who did not suffer from any morbidity in the last 15 days. Conclusions: Care should be taken to improve the pitiable state of personal hygiene and poor sanitary practices of these school children through coordinated and concerted health education measures by teachers as well as parents.
  7,562 1,285 1
Arsenic contamination of ground water and its health impact on population of district of Nadia, West Bengal, India
Debendra Nath Guha Mazumder, Aloke Ghosh, Kunal Kanti Majumdar, Nilima Ghosh, Chandan Saha, Rathindra Nath Guha Mazumder
April-June 2010, 35(2):331-338
DOI:10.4103/0970-0218.66897  PMID:20922118
Background: The global health impact and disease burden due to chronic arsenic toxicity has not been well studied in West Bengal. Objective: To ascertain these, a scientific epidemiological study was carried out in a district of the state. Materials and Methods: Epidemiological study was carried out by house-to-house survey of arsenic affected villages in the district of Nadia. A stratified multi-stage design has been adopted for this survey for the selection of the participants. A total number of 2297 households of 37 arsenic affected villages in all the 17 blocks were surveyed in the district. Result: Out of 10469 participants examined, prevalence rate of arsenicosis was found to be 15.43%. Out of 0.84 million people suspected to be exposed to arsenic, 0.14 million people are estimated to be suffering from arsenicosis in the district. Highest level of arsenic in drinking water sources was found to be 1362 μg/l, and in 23% cases it was above 100 μg/l. Majority of the population living in the arsenic affected villages were of low socio-economic condition, inadequate education and were farmers or doing physical labour. Chronic lung disease was found in 207 (12.81%) subjects among cases and 69 (0.78%) in controls. Peripheral neuropathy was found in 257 (15.9%) cases and 136 (1.5%) controls. Conclusion: Large number of people in the district of Nadia are showing arsenical skin lesion. However, insufficient education, poverty, lack of awareness and ineffective health care support are major factors causing immense plight to severely arsenic affected people.
  7,793 843 26
BOOK REVIEW
Principles and Practice of Biostatistics by J V Dixit
Pramod K Gupta
April-June 2010, 35(2):371-371
  7,438 523 -
ORIGINAL ARTICLES
Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in North India
Indu Lata, Yashodhara Pradeep, Sujata , Amita Jain
April-June 2010, 35(2):285-289
DOI:10.4103/0970-0218.66855  PMID:20922108
Aims: This study was undertaken to estimate the incidence of bacterial vaginosis (BV) and other vaginal infections during pregnancy and its association with urinary tract infections (UTI) and its consequences on pregnancy outcome, maternal and fetal morbidity and mortality. Settings and Design: Prospective cohort study. Materials and Methods: The present prospective cohort study was conducted on 200 women attending the antenatal clinic (ANC) of a tertiary hospital. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth were collected. BV was detected by both Gram stain and gold standard clinical criteria (Amsel's composite criteria). Statistical analysis used: Data were analyzed using SPSS version 9. Fischer's exact test, chi square tests and Student's' test has been used for analysis. The probability of 5% was considered as significant for continuous variables such as age, period of gestation and birth weight. Odds ratio (OR) and confidence interval (CI) with 95% probability were determined. Results: The incidence of bacterial vaginosis was 41 in 200 patients. Adverse outcomes such as preterm labor, PROM and fetal complications were found more in pregnant women who had bacterial vaginosis (N=41), bacterial vaginosis with UTI (N=14) as compared to those without bacterial vaginosis (N=118). Conclusions: The incidence of poor pregnancy outcome was higher in bacterial vaginosis with UTI. Prevention of BV and UTI is cost effective to minimize the pregnancy-related complications and preterm labor to decrease in perinatal and maternal mortality and morbidity. We recommend all antenatal patients should be screened for the presence of bacterial vaginosis, other infections and UTI.
  6,590 1,016 5
Work-related musculoskeletal disorder: An occupational disorder of the goldsmiths in India
Tirthankar Ghosh, Banibrata Das, Somnath Gangopadhyay
April-June 2010, 35(2):321-325
DOI:10.4103/0970-0218.66890  PMID:20922116
Background: Gold ornament making industries are one of the widespread small-scale industries of India. These industries belong to the unorganized sector of the state. A large number of goldsmiths are working there for prolonged period in cross leg posture at semi-confined workstation. Objectives: The aim of this study is to identify Occupational Disorder of the Goldsmiths in India. Materials and Methods: In the spresent study, 120 male goldsmiths were randomly selected from the Davangere district of Karnataka. A detailed questionnaire study on discomfort feeling was done by the modified Nordic questionnaire, which considering the information about work nature, job stress and discomfort feeling. The existing workstations were assessed by the measurement of work areas. Analysis of body posture by rapid upper limb assessment was done to evaluate the work stress during their job. Results: From the analysis, it was revealed that MSDs were the major problem of the goldsmiths. The activities of the goldsmiths were also highly repetitive. Moreover, the questionnaire study revealed that most of the workers were affected by occupational disorder like pain at neck (80%), shoulder (20%), wrist (45%), and low back (75%) and also eye problem like irritation (30%) and burning sensation (70%). They also perform their job in hazardous postures. It was recorded that the workstations were poorly illuminated (19 Lux) in respect to precision work. Accidents like cut and burn occurred frequently due to the unsafe condition of the workstation. Conclusions: From the observation and analysis of the result it was concluded that health of the goldsmiths were highly affected improper body posture and workload. Twisting, bending, and over-reaching are the resultant of poorly designed workstation. These actions force them into a non-neutral position that increases the overall discomfort and pain at the lower back, neck, and shoulders. Moreover, lack of proper illumination at work site also exerts an additional adverse effect on the health of the goldsmiths.
  6,475 857 3
CME
Censoring in clinical trials: Review of survival analysis techniques
Shankar Prinja, Nidhi Gupta, Ramesh Verma
April-June 2010, 35(2):217-221
DOI:10.4103/0970-0218.66859  PMID:20922095
  6,311 936 2
ORIGINAL ARTICLES
A study on domestic violence against adult and adolescent females in a rural area of West Bengal
Madhutandra Sarkar
April-June 2010, 35(2):311-315
DOI:10.4103/0970-0218.66881  PMID:20922114
Background: Globally, domestic violence against females is common across culture, religion, class and ethnicity. There are various reasons for domestic violence and it might have serious health outcomes. Objectives: The study was undertaken to determine the prevalence, characteristics, reasons and the socio-demographic correlates of domestic violence, if any, and to find out the perceptions of the females to cope with the act of violence and to overcome the situation. Materials and Methods: A cross-sectional observational study was undertaken by interviewing 141 adult and adolescent females residing in a village of West Bengal, with the help of a pre-designed and pre-tested questionnaire. Data were analyzed statistically by simple proportions and tests of significance (Chi-square test). Results: Out of 141 respondents, 33 (23.4%) adult and adolescent females in this village were exposed to domestic violence in the past year. Among the demographic characteristics, statistically significant maximum prevalence was observed among 30-39 years age group, illiterate and unmarried females. For most of the females who were exposed to domestic violence, their husbands acted as the perpetrators (72.73%) and they reported slapping as the specific act of physical assault (72.73%). Majority of the respondents reported that opportunity of education (31.9%), being economically productive (31.9%) and better family income (23.4%) would help them to overcome the situation. Conclusion: This study emphasizes the need for justified female empowerment and this calls for multidisciplinary approach to develop public health measures, which would most effectively address the problem of domestic violence.
  5,931 909 3
Awareness and perceptions of school children about female feticide in urban Ludhiana
Anurag Chaudhary, Mahesh Satija, Sarit Sharma, GPI Singh, RK Soni, RK Sachar
April-June 2010, 35(2):302-304
DOI:10.4103/0970-0218.66873  PMID:20922112
Background: Although the Indian girl child's position is precarious throughout the country, she remains the most vulnerable in Punjab. Objectives: To assess the awareness and perceptions of school children regarding female feticide. Study Design: Cross- sectional study. Materials and Methods: The study involved collection of information regarding knowledge and perception of school students about female feticide using multiple choice questionnaire. A total of 527 students between the age group of 11-18 years of various schools of district Ludhiana, Punjab were the study subjects. They had come to participate in the poster competition on organ donation (SAARC Transplant games), organized by Department of Community Medicine, D.M.C and H, Ludhiana. Results: Out of total 527 students, 97.9% were aware of female feticide. Main source of information was TV (56%), followed by newspaper (33%). Majority of the students (65.2 %) felt that discrimination between boys and girls is prevalent in the society. Regarding perception of school students for curbing this social evil, 37.8% school students were of the view that awareness among the masses is the solution to stop this practice, while 25% of the students responded that equal status to girls will stop this practice of female feticide. Conclusions: The school students had optimum level of awareness about female feticide and almost all of them strongly felt that this harmful practice should be stopped altogether.
  5,923 834 1
Epidemic investigation of the jaundice outbreak in Girdharnagar, Ahmedabad, Gujarat, India, 2008
Naresh T Chauhan, Prakash Prajapati, Atul V Trivedi, A Bhagyalaxmi
April-June 2010, 35(2):294-297
DOI:10.4103/0970-0218.66864  PMID:20922110
Background: Since 1976, seven outbreaks of hepatitis E occurred in Ahmedabad. Clusters of jaundice cases were reported on June 19, 2008, by a civic center, Girdharnagar ward, Ahmedabad. Objectives: The objectives were as follows: (1) to identify the etiological agent, source of outbreak, and mode of transmission; (2) to propose a control measure based on the outbreak investigation. Materials and Methods: We defined a case as an acute illness with (a) a discrete onset of symptoms and (b) jaundice or elevated serum aminotransferase levels, from March to September 2008 in the households of the Girdharnagar ward. We collected data through a door-to-door survey and hospital records. We described the outbreak in terms of time, place, and person. We collected laboratory investigation reports of case patients admitted to the civil hospital. To test our hypothesis we conducted a retrospective cohort study to find out the relative risk for hepatitis. We conducted environment investigation to find out the source of contamination of water supply. Results: A total 233 case patients of hepatitis were identified with the attack rate of 10.9/1000 population. Cases were reported in all the age groups with a higher attack rate in the age group of 20-29 years (18.5/1000). Out of 17 case patients, 16 were positive for the hepatitis E IgM antibody. The attack rate was two times more among those who were exposed to the leaking pipeline than the non-exposed (RR=2.3, 95% CI 1.76, 2.98). Environmental investigation also confirmed the sewage contamination of drinking water in the distribution system. Conclusion: The outbreak was due to hepatitis E virus. We recommended a temporary alternative water supply, repair of the leakages, and water quality surveillance.
  5,685 939 6
Tobacco use among adolescent students and the influence of role models
Rahul Sharma, Vijay L Grover, Sanjay Chaturvedi
April-June 2010, 35(2):272-275
DOI:10.4103/0970-0218.66891  PMID:20922105
Background: Seventy per cent of premature deaths among adults are due to behavioral patterns that emerge in adolescence, including smoking. Objective: The objective was to study the prevalence of tobacco use among adolescent students in South Delhi and its epidemiological correlates. Materials and Methods: This was a cross-sectional study. Setting: Three schools and two colleges of South Delhi were chosen. There were 550 adolescent students aged 14-19. Statistical Analysis: Statistical analysis was done using proportions, the chi-square test, and multivariate logistic regression. Results: A total of 88 (16.0%) students reported having ever tried cigarette or bidi smoking. The prevalence of current smoking was 7.1%. Exactly 10% (55) of the students reported having ever used smokeless forms of tobacco. The prevalence of tobacco use overall was found to be 20.9%, and was significantly higher (P=0.016) among the males than the females. Tobacco use was found to be significantly associated with having seen a brother/sister smoke (OR 5.15), best friend smoke (OR 2.92), and belonging to a nuclear family (OR 1.96). Conclusions: Tobacco use is still an important risk behavior among adolescent students. This study found a strong association of tobacco use by the adolescents with their having seen various role models ever smoking.
  5,442 1,152 6
Increased prevalence of pulmonary tuberculosis in male adults of sahariya tribe of India: A revised survey
PR Sharma, Sanjay Jain, RNK Bamezai, PK Tiwari
April-June 2010, 35(2):267-271
DOI:10.4103/0970-0218.66887  PMID:20922104
Background: A survey made in 1991-92, reported Sahariya, a primitive tribe of India (M. P.), having high prevalence of pulmonary tuberculosis. No follow-up study was undertaken thereafter. Objective: The present study was aimed to know the current status of tuberculosis (TB) in Sahariya after more than a decade of the last survey of 1991-92, as compared to that in Bhil, another primitive tribe living in the same area but never investigated for TB incidence. Materials and Methods: A total of 763 random sputum smears from Sahariya and 169 sputum smears from Bhil were screened for the presence of Mycobacterium tuberculosis (M..tb) in order to evaluate the prevalence of pulmonary tuberculosis in both the tribes. Chi square (c2 ) statistics was performed to study the correlation between age, sex on the one hand and with the prevalence of smear-positive pulmonary TB on the other hand, if any. Results: In Sahariya, the prevalence of smear-positive pulmonary TB was found increased significantly (P<0.005) to 0.454 as against 0.274 estimated in the earlier survey (1991-92). Males, particularly, appeared most affected (P<0.005; 0.382), especially adults (0.260). In contrast, among Bhil, the prevalence was very low. Conclusion: The observed increase in TB prevalence and its gender bias in Sahariya tribe indicate the high incidence rate and faster transmission of infection, especially in male sex.
  5,424 998 9
Body image perception and attempts to change weight among female medical students at Mangalore
D Priya, KS Prasanna, S Sucharitha, Nafisa C Vaz
April-June 2010, 35(2):316-320
DOI:10.4103/0970-0218.66886  PMID:20922115
Background: Assessing body image self-perception has used BMI as an indicator of nutritional status. The visual analogue scale is a highly effective instrument for assessing people's level of dissatisfaction with their body weight while evaluating the perceptual component of body image. Objective: By knowing body mass index of female medical students, to find out their pattern of body image perception and any attempts done to change their weight. Materials and Methods: All the students residing in MBBS ladies hostel were included in this study and a questionnaire regarding body image perception, diet, physical activity and attempts to change weight was instituted. Their responses were collected, tabulated, analyzed and interpreted. Results: Among 147 study subjects, according to BMI, 25(17%) were undernourished while 111(75.5%) and 11(7.5%) were normally nourished and overweight respectively. 35(23.8%) of the subjects felt they were lean, 95(64.6%) felt they were normal and 17(11.6%) felt they were overweight. Regarding image satisfaction, 98(66.7%) of them were satisfied with their image and out of 49 who were not satisfied 30 (20.4 %) wanted to reduce weight. Skipping meals was practiced by 42 (28.6%) of subjects. Conclusion: About 75.5% of the study group were having normal BMI. Most of them perceived their image correctly regarding to their weight. Most of the underweight and all overweight females were not satisfied. Underweight females preferred to gain weight and overweight females preferred to lose weight.
  5,406 940 2
Putting people first: A primary health care success in rural India
Carol Vlassoff, Marcel Tanner, Mitchell Weiss, Shobha Rao
April-June 2010, 35(2):326-330
DOI:10.4103/0970-0218.66896  PMID:20922117
Background: The World Health Report, 2008, contains a global review of primary health care on the 30th anniversary of the Declaration of Alma-Ata. The period covered by the study reported on here corresponds with that of the Report, allowing for a comparison of achievements and challenges in one primary health care centre vis-a-vis the WHO standards. Materials and Methods: This study uses qualitative and quantitative data from a rural primary care facility in Western Maharashtra, collected over three decades. It analyzes the four groups of reforms defined by WHO in the context of the achievements and challenges of the study facility. Results: According to the WHO Report, health systems in developing countries have not responded adequately to people's needs. However, our in-depth observations revealed substantial progress in several areas, including in family planning, safe deliveries, immunization and health promotion. Satisfaction with services in the study area was high. Conclusion: Adequate primary health care is possible, even when all recommended WHO reforms are not fully in place.
  5,283 978 1
Where and how breastfeeding promotion initiatives should focus its attention? A study from rural Wardha
AR Dongre, PR Deshmukh, AP Rawool, BS Garg
April-June 2010, 35(2):226-229
DOI:10.4103/0970-0218.66865  PMID:20922097
Background: In India, the practice of breastfeeding is almost universal, but initiation of breastfeeding is generally quite late and colostrum is discarded. Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy recommended systematic assessment of breastfeeding and emphasized counseling of the mother on proper positioning and attachment of infant to the breast. Objective: To assess breastfeeding among mothers of below six months children in rural Wardha. Materials and Methods: The present cross-sectional study was undertaken in surrounding 23 villages of Kasturba Rural Health Training Center (KRHTC), Anji. Two Auxiliary Nurse Midwives (ANMs) trained in IMNCI paid house visits to 99 mothers during the study period and undertook the assessment of breastfeeding using IMNCI assessment form for young infants. Auxiliary Nurse Midwives observed and recorded the positioning and attachment of infant to the breast as per IMNCI guidelines. The data were entered and analyzed using Epi_Info (version 6.04d) software package. Results: Most of the deliveries 94 (94.9%) took place in the healthcare facilities. Majority 61 (61.6%) newborn babies had received breastfeeding within half an hour. About half of the mothers had any of the feeding problems like feeding less than eight times in 24 h, giving any other food or drinks or is low weight for age. Significantly more mothers with feeding problems had problems in positioning and attachment of infant to the breast as compared with those mothers who did not have any feeding problems. Conclusions: In the settings, where practice of institutional delivery is high, the staff of healthcare facility should ensure education of the mothers regarding position and attachment of infant to the breast before discharge from the healthcare facility. At the village level, Village Health Nutrition Day (VHND) can be utilized for health education of future mothers and support for the breastfeeding mothers. The IMNCI assessment form for young infant should also include assessment of positioning of infant.
  4,798 1,164 8
LETTERS TO EDITOR
Study of knowledge, attitude and practices regarding biomedical waste among paramedical workers
Mohd Shafee, NB Kasturwar, N Nirupama
April-June 2010, 35(2):369-370
DOI:10.4103/0970-0218.66871  PMID:20922133
  4,949 537 5
ORIGINAL ARTICLES
Knowledge and outcome measure of HbA1c testing in Asian Indian patients with type 2 diabetes from a tertiary care center
Deepa Manoharan, Vijay Viswanathan, Satyavani Kumpatla, Srikanth Medempudi
April-June 2010, 35(2):290-293
DOI:10.4103/0970-0218.66858  PMID:20922109
Aim: HbA1c test is considered to be the reliable measure for evaluating long-term glycemic control in type 2 diabetes. The purpose of this study was to evaluate whether knowledge about HbA1c test is associated with a better glycemic control. Materials and Methods: We conducted a cross-sectional survey of 480 (M:F; 287:193) adults with type 2 diabetes attending a tertiary care center during a period of four months. Baseline demographic and clinical data of all the subjects was obtained. Subject's knowledge about HbA1c test and their target goal was assessed using a questionnaire. Recent HbA1c results were obtained from medical records. Results: Seventy four per cent of the subjects had awareness about HbA1c test and about 43% of those who knew HbA1c test also knew their target goal. 33% remember their last HbA1c result. The mean A1C of Group A was significantly lower when compared with Group B (8.1 ± 1.7 vs 9.2 ± 1.9, P<0.0001). Group C had lower A1C levels compared to Group D (7.7 ± 1.4 vs 8.5 ± 1.9, p<0.0001). Patients who kept their HbA1c less than 7% were significantly higher in Group C than in Group D. (37.8 vs 12.7%, p<0.00001). Subjects had good glycemic control with increasing levels of awareness about HbA1c. Conclusion: Majority of the diabetic patients who attended the tertiary care center for diabetes care knew HbA1c test and half of them were aware about their target goal. Awareness about HbA1c had a positive impact on maintenance of better glycemic control.
  4,505 970 4
A study of gender differentials in the prevalence of tuberculosis based on NFHS-2 and NFHS-3 data
PP Sharma, Ashok Kumar, Padam Singh
April-June 2010, 35(2):230-237
DOI:10.4103/0970-0218.66869  PMID:20922098
Background: Worldwide, the case notification rate of tuberculosis has been reported to be higher for men than women. In India also, the prevalence of TB is higher among males as compared to females but it is important to study the trend of gender gap in the prevalence of tuberculosis over the years. Objective: To examine the trend in gender gap in the prevalence of TB over the years. Materials and Methods: The unit level data of NFHS-2 (1998-99) and NFHS-3 (2005-06) has been utilized. Gender gap in the prevalence of TB has been estimated for the two rounds of the surveys. The delta (D), the difference in gender gap in two surveys, has been estimated and decomposed by background characteristics such as place of residence(urban/rural), religion (Hindus/Muslims/others), caste(SC/ST/OBC/others) and standard of living(SLI) (low/medium/high) categories. Main Findings: Overall, the prevalence of TB has remained almost same in the two surveys [432/lakh in NFHS-2 and 418/lakh in NFHJS-3; Z=1.19, P0 =0.275. The gender gap has increased to 217/lakh in NFHS-3 in comparison to 145 per lakh in NFHS-2. The increase in gender gap is significantly higher in rural areas [of 98 per lakh;167/ lakh in NFHS-2 vs 265/lakh in NFHS-3; P<0.05] as compared to corresponding increase in urban areas [of 30 per lakh; 88/ lakh in NFHS-2 vs118/ lakh in NFHS-3, P>0.05]. The increase in delta (D) (difference in gender gap in two surveys) is accounted for as 88% by the rural areas and 12% by the urban areas. Conclusion: The increase in gender gap in the prevalence of TB is more in rural areas as compared to urban areas. The increase in rural areas is mainly contributed by Hindus, SC and ST and low and medium SLI categories and in urban areas, the contribution is mainly by Hindus, other castes and high SLI categories.
  4,426 989 3
CME
HIV/AIDS vaccine: An update
Anita Nath
April-June 2010, 35(2):222-225
DOI:10.4103/0970-0218.66862  PMID:20922096
  4,169 1,060 -
ORIGINAL ARTICLES
Assessment of skeletal and non-skeletal fluorosis in endemic fluoridated areas of Vidharbha Region, India: A survey
Sudhir Rawlani, Shobha Rawlani, Shivlal Rawlani
April-June 2010, 35(2):298-301
DOI:10.4103/0970-0218.66868  PMID:20922111
Objectives: To evaluate skeletal and non-skeletal fluorosis in patients living at endemic fluoridated areas and also the morphological changes in red blood cells (R.B.C.'s). Materials and Methods: The cross-sectional study was conducted at Vidharbha region of Maharashtra, India. An ethical clearance was obtained from the concerned authorities. Fifty families were screened and 204 subjects who had dental/skeletal fluorosis were included in the study. The aims and objectives were explained to the study subjects of the village and biochemical, hematological and radiological assessment was done. The main source of drinking water in this area was tube well. The concentrations of fluoride in two different areas of same village were 4 and 4.5 ppm. Results: Prevalence of skeletal fluorosis and non-skeletal fluorosis in male patients was 56.87% (116) and in female patients (88) it was 43.13%. RBC count in male patients was 5.03 ± 0.49 while in female patients it was 4.70 ± 0.47. With significant difference between male and female patients, P value was 0.003. Hb% in male patients was 12.44 ± 1.76 and in female patients it was 11.31± 1.34, showing significant difference between male and female patients P value 0.038. Alkaline phosphate level in male patients was 289.68 ± 149.09 and in female patients it was 276.68 ± 164.97. ESR count in male patients was found 11.41 ± 8.75 and in female patients it was 13.29 ±7.37. Radiological finding of fluorosis patients shows thickening of inner and outer tables of skull bone in 83.92% of patients and only 7.84% of the patients were suffering from barrowing of long bone.
  4,264 855 1
CME
Community-based monitoring: Key to success of national health programs
Suneela Garg, Ananya Ray Laskar
April-June 2010, 35(2):214-216
DOI:10.4103/0970-0218.66857  PMID:20922094
  3,834 1,071 2
ORIGINAL ARTICLES
Analysis of birth weights of a rural hospital
Shyam V Ashtekar, Madhav B Kulkarni, Vaishali S Sadavarte, Ratna S Ashtekar
April-June 2010, 35(2):252-255
DOI:10.4103/0970-0218.66879  PMID:20922101
Background: Low birth weight remains a major reason behind childhood malnutrition. The NFHS findings show no dent in this problem. Objective: This study was undertaken to explore change in birth weights in a period from 1989 to 2007 and any associations thereof. Materials and Methods: All birth records of a private rural hospital spanning two decades (1989-2007) were analyzed for birth weight, age of mother, gender, birth order of the baby, proportion of pre-term babies and low birth weight babies. Results: No change was observed in the average birth weights (average 2.71 kg) over the period. Although the birth weight shows some expected variance with the age of mother, it was found to have no relation with the baby's birth order and gender. The low birth weight proportion is about 24% and shows little difference before and after the series midpoint of year 1998. Conclusion: The birth weights have hardly changed in this population in the two decades.
  3,841 1,044 3
VIEW POINT
West nile virus: Do we need its surveillance and control program in Punjab State of India?
Tejbir Singh Sandhu, Dalbinder Singh Sidhu, Gursimrat Kaur Sandhu
April-June 2010, 35(2):211-213
DOI:10.4103/0970-0218.66856  PMID:20922093
  3,870 852 -
ORIGINAL ARTICLES
Patient's utilization and perception of the quality of curative care in community health centers of the fifth commune of Bamako
Seydou Fomba, Yang Yang, Huan Zhou, Qiaolan Liu, Pr Ma Xiao
April-June 2010, 35(2):256-261
DOI:10.4103/0970-0218.66882  PMID:20922102
Background: Community health centers are an important component of the health system in Mali. Despite the adhesion of the populations and the commitment of the authorities, many things must be done to improve the quality of care provided in those structures. Objectives: The study aimed to know the patients' utilization and perception of the curative care in the community health centers of Bamako and the physicians' satisfaction of their work condition and perspective in the community health sector. Materials and Methods: A cross-sectional study was conducted in nine community health centers of Bamako in 2008. A total of 270 patients were interviewed through a face-to-face interview. Thirteen physicians took a self-administrated questionnaire relating to their material and financial conditions and their plan for the future. Results: The sample was characterized by the low literacy (32.6%) and socio-economic level (15.9% of steady income).139 patients claimed the nearness as the reason of the choice of the health center whereas only 51 claimed the health staff skill. The women felt more satisfied than men (P=0.005) and illiterates felt more satisfied than bachelors and beyond (p0=0.034). The patients claimed the reduction of waiting time, the improvement of information and the creation of news services. 30.80% of physicians were satisfied from their material and financial conditions, 38.46% were motivated and 76.92% planned to leave their health center. Conclusion: Although a high level of satisfaction regarding the provided service was observed, user reported some shortage in the quality of care and claimed a widening of CSCom capability.
  3,569 871 4
A multi-sectoral approach to capture information on road traffic injuries
Geetha R Menon, G Gururaj, MP Tambe, B Shah
April-June 2010, 35(2):305-310
DOI:10.4103/0970-0218.66876  PMID:20922113
Background: Regularly available data is shown to be inadequate for developing, implementing, and evaluating injury prevention and control programs in India. The present study was undertaken in the hospitals of Bangalore and Pune, to examine the feasibility of gathering information on injuries using multiple sources. Materials and Methods: Stakeholders meeting and training programs were held for the hospital staff, police personnel, and traffic and transport staff, to identify their roles and responsibilities. Prospective data on morbidity and mortality due to injuries were collected by trained staff from Emergency Departments on a pre-tested questionnaire. The information gathered was cross-checked with the hospital and police records. Results: The stakeholders meeting and training programs were able to motivate the departments to provide the correct data. Data on 32188 patients could be extracted from hospital and police records during the study period. Injuries accounted for 16% of the emergency cases. Unintentional injuries were 64%, and 32% were intentional. Road traffic injuries accounted for 44% of all the injuries. One-third of the injured were children and young adults below 25 years. Among the injured, two wheeler riders were 29% and pedestrians were 23%. Conclusion: It was possible to improve the data on injuries by adequate training and a data linking mechanism between the Police, Hospital, and Transport Departments. The problem of road traffic injuries could be highlighted and addressed by a good data capture mechanism.
  3,570 850 1
EDITORIAL COMMENTARY
Tackling diabetes through translation
Badrinarayan Mishra
April-June 2010, 35(2):207-208
DOI:10.4103/0970-0218.66853  PMID:20922091
  3,276 1,033 -
ORIGINAL ARTICLES
Risk factor scenario in an industrial set-up: Need for an effective screening tool to assess the high-risk group
Uma Iyer, Garima Mathur, Nandini Panchanmiya, Swati Dhruv
April-June 2010, 35(2):262-266
DOI:10.4103/0970-0218.66884  PMID:20922103
Background: Industrial and technological revolution has resulted in nutrition transition. This calls for analyzing the risk factor scenario in the industrial population. Objective: The objective was to map the prevalence and assess the risk factors of industrial employees. Materials and Methods: The employees of a large petrochemical industry were enrolled (N=269) for the study. Risk factors were elicited through a structured questionnaire. Parameters monitored were fasting blood sugar and lipid profile. Relative risk was calculated to find out significant predictor variables. Results: The employees had high prevalence of overweight (27%), obesity (22%), central obesity (48.7%), prehypertension (43.2%), hypertension (36.6%), and dyslipidemia (41.4%). They had erroneous dietary habits such as low intake of fruits and vegetables and high fat intake. Most of the employees had low physical activity levels. The prevalence of smoking (13.5%), tobacco (28.2%), and alcohol use (22.2%) were also high with 15.1% having multiple habits. One-fifth of the employees had metabolic syndrome (MS). Seven predictor variables, namely, family history, BMI, WHR, blood pressure, physical inactivity, TG, and TG/H were identified and used to develop the risk score card to identify people at high risk of CVD and DM. Conclusion: Multiple risk factor scenario among the industrial population studied calls for effective intervention strategies and policy changes to combat the burden of non-communicable diseases. The risk score card can be used to screen the high-risk group in the industrial population.
  3,343 839 1
LETTERS TO EDITOR
Low birth weight of newborns: Magnitude of the problem seen in a 100 bed hospital of a rural area in Vellore district, Tamil Nadu (India)
Kavitha Balaji, Sathish Sankar, Balaji Nandagopal
April-June 2010, 35(2):362-364
DOI:10.4103/0970-0218.66861  PMID:20922128
  3,666 380 1
VIEW POINT
Avian flu: Examining role of ducks in Indian context
Rajan R Patil
April-June 2010, 35(2):209-210
DOI:10.4103/0970-0218.66854  PMID:20922092
  3,065 814 2
SHORT COMMUNICATIONS
Community ophthalmology: Revisited
R Jose, AS Rathore, Sandeep Sachdeva
April-June 2010, 35(2):356-358
DOI:10.4103/0970-0218.66893  PMID:20922125
  3,569 290 4
Harassment among women at workplace: A cross-sectional study in coastal South India
B Unnikrishnan, T Rekha, Ganesh Kumar, B Reshmi, P Mithra, B Sanjeev
April-June 2010, 35(2):350-352
DOI:10.4103/0970-0218.66888  PMID:20922123
  3,419 363 -
A study on the perception of general practitioners of a locality in Kolkata regarding RNTCP and DOTS
Aparajita Dasgupta, Amitabha Chattopadhyay
April-June 2010, 35(2):344-346
DOI:10.4103/0970-0218.66883  PMID:20922121
  2,695 535 -
Red tide phenomenon leading to panic attack and mass casualty among children in coastal Kerala
KE Elizabeth, H Gopakumar, Gibby Koshy
April-June 2010, 35(2):342-343
DOI:10.4103/0970-0218.66880  PMID:20922120
  2,686 501 1
Proportion, pattern and need assessment of deformities among registered leprosy affected individuals in Chamrajanagar district
Gautham M Sukumar, NS Shivaraj, M Dayananada
April-June 2010, 35(2):347-349
DOI:10.4103/0970-0218.66885  PMID:20922122
  2,385 407 -
LETTERS TO EDITOR
Use of condoms: Clarifying the message
JP Majra
April-June 2010, 35(2):362-362
DOI:10.4103/0970-0218.66860  PMID:20922127
  2,371 248 -
Risk factors among patients with acute coronary syndrome in rural Kerala
Abraham Samuel Babu, Mohammed Haneef, Anupama Naomi Joseph, Manjula Sukumari Noone
April-June 2010, 35(2):364-365
DOI:10.4103/0970-0218.66863  PMID:20922129
  2,226 210 1
SHORT COMMUNICATIONS
Potentially modifiable micro-environmental and co-morbid factors associated with severe wasting and stunting in children below 3 years of age in Aligarh district
Sandeep Sachdeva, Ali Amir, Mohd. Athar Ansari, Najam Khalique, Zulfia Khan, Seema Alam
April-June 2010, 35(2):353-355
DOI:10.4103/0970-0218.66889  PMID:20922124
  1,947 305 -
Clinical course of development of alcohol and opioid dependence: What are the implications in prevention?
Sahoo Saddichha, Narayana Manjunatha, Christoday Raja Jayant Khess
April-June 2010, 35(2):359-361
DOI:10.4103/0970-0218.66895  PMID:20922126
  1,797 183 -
LETTERS TO EDITOR
Sharp disposal practices in urban dispensaries
Sandeep Sachdeva, Utsuk Datta
April-June 2010, 35(2):365-366
DOI:10.4103/0970-0218.66866  PMID:20922130
  1,709 196 1
Assessment of the quality of service given by health care provider about tuberculosis in RNTCP
Rashmi , B Vijaykumar
April-June 2010, 35(2):368-369
DOI:10.4103/0970-0218.66870  PMID:20922132
  1,651 216 2
Selecting the right toys for your child is not a child's play
Harshal T Pandve
April-June 2010, 35(2):367-368
DOI:10.4103/0970-0218.66867  PMID:20922131
  1,582 104 -
NEWS AND EVENTS
The Hon Julia Gillard MP Deputy Prime Minister

April-June 2010, 35(2):372-372
  1,063 62 -
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007