Background: Street sweepers play an important role in maintaining the health and hygiene within the cities. This job exposes the street sweepers to a variety of risk factors such as dust, toxins and diesel exhaust pollution, which make them vulnerable to develop certain occupational diseases. Therefore, it was thought necessary to study the morbidity profile in this occupational group. Objectives: To study the prevalence of morbidities among street sweepers and comparison group. Study Design: A cross-sectional study with a comparison group. Study Setting: Nagpur Municipal Corporation, Nagpur. Subjects: The study included two groups: (1) A study group comprising 273 street sweepers. (2) A comparison group comprising 142 class IV workers working in the office buildings of Nagpur Municipal Corporation, Nagpur. Materials and Methods: A pretested proforma was used to record the necessary information such as clinical history, sociodemographic factors, findings of clinical examination and investigations performed. Results and Conclusions: The important morbidities detected among street sweepers were the following: anemia (20.5%), hypertension (9.5%), upper respiratory tract infections (URTI) (7.3%) and chronic bronchitis (5.9%). In the comparison group, important morbidities detected were the following: anemia (20.4%), hypertension (11.3%), hyperacidity (9.9%), URTI (7.0%) and refractive error (7.0%). Chronic bronchitis was detected in two subjects (1.4%) of the comparison group. The prevalence of chronic bronchitis was significantly high among street sweepers than that of subjects of the comparison group. Therefore, it is recommended that further studies with a larger sample size be undertaken to identify the factors responsible for higher prevalence of chronic bronchitis among the street sweepers.

Objectives: To study the prevalence of respiratory morbidity and its associated factors in urban Delhi. Study Design and Setting: A cross-sectional, house-to-house survey was conducted in an urban upper middle class locality. Materials and Methods: All the residents aged 18 years or more were administered a questionnaire to identify the major symptoms of chronic respiratory tract disease - chronic cough, chronic phlegm, dyspnea and wheezing. The prevalence of all these symptoms in different groups was calculated. Chi square test and logistic regression were applied to determine the significant factors. Results: A total of 3465 individuals were interviewed of which 1756 (50.68%) were males and 1709 (49.3%) were females. Only 9.05% of the men smoked. The overall prevalence of chronic cough, chronic phlegm and dyspnea was 2.0%, 1.2% and 3.4%, respectively. The prevalence of wheezing was 3.2%. All the symptoms increased with age ( P < 0.05). No significant difference was observed in these symptoms between males and females. Less educated and retired individuals were more likely to have respiratory symptoms. The prevalence of chronic cough, chronic phlegm, dyspnea and wheezing was 5.8%, 2.9%, 9.9% and 8.7%, respectively, among smokers, which was significantly higher than that observed in nonsmokers. Logistic regression analysis revealed that age and smoking remained significant factors for occurrence of all the respiratory symptoms.

Background: Study of the chronology of criteria of dependence in alcohol dependence syndrome (ADS) can enable us design strategies for the prevention for ADS, which aims at reducing the occurrence of ADS. Objective: To study the age-wise and order-wise chronologies of ICD-10 (DCR) dependence criteria in individuals with ADS. Materials and Methods: Consecutively admitted and consenting inpatients with ICD-10 (DCR) diagnosis of ADS were evaluated in a structured interview after detoxification using Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA)-II. Results: The total sample size was 81. The mean ages at the first onset of alcohol use, development of the first criterion and International Statistical Classification of Diseases and Related Health Problems 10 ^th Revision (ICD-10) dependence was 18.72 years (SD, 6.84), 24.33 years (SD, 9.21) and 27.51 years (SD, 9.28), respectively. In age-wise chronology, tolerance, loss of control and craving were present in 97.53%, 80.24% and 79%, respectively, of our study sample. In order-wise chronology, either craving (16%) or tolerance (71.6%) was present as the first criterion and the presence of craving (16%), tolerance (21%) or loss of control (18.5%) was observed in the first criterion in 55.5% of the subjects. Conclusions: Knowledge of chronology, its frequencies and time duration between various milestones in the development of the dependence criteria may enable the selection of the target population at an early stage. The pattern of development of dependence may provide us with an opportunity for interventions to reduce the incidence of ADS, as a step toward primary prevention. Adequate training of the primary care personnel and early psychiatric referral may help in the reduction in the incidence of ADS.

Background: Injuries account for approximately 11% of all hospital admissions in Sri Lanka. However, no published data are available with regard to the community incidence of injuries in Sri Lanka. Objectives: To determine the community incidence of major intentional and unintentional physical injuries in a rural community in Sri Lanka. Materials and Methods: A rural community consisting of 225 families with 1029 inhabitants was studied. Data on major injuries for a period of one year were collected retrospectively. Results: There were 85 major injuries in the community during the year of study. This gives a major injury incidence of 82.6 per 1000 person years. This is three times the incidence based on hospital-derived data. Animal bites being the most common cause of injury was noted in 2.3% of the population followed by falls in 1.6%, contact with objects in 1.5%, cut injuries in 1% and road trauma in 1%. Conclusions: This study shows a higher incidence of major physical injuries (both intentional and unintentional) in the community than figures derived from hospital data. The prevention of injuries in a community such as the one studied here should be aimed at animal bites, falls, contacts with objects, cut injuries and road trauma.

Objectives: To estimate the prevalence of anemia among adolescent females and to study the socio-demographic factors associated with anemia. Materials and Methods: A cross-sectional survey was conducted in an urban area under Urban Health Training Center, Department of Preventive and Social Medicine, Government Medical College and Hospital, Nagpur. A total of 296 adolescent females (10-19 years old) were included in this study. The study took place from October 2002 to March 2003 (6 months). Statistical analyses were done using percentage, standard error of proportion, Chi-square test, and Student's 't' test. Results: The prevalence of anemia was found to be 35.1%. A significant association of anemia was found with socio-economic status and literacy status of parents. Mean height and weight of subjects with anemia was significantly less than subjects without anemia. Conclusions: A high prevalence of anemia among adolescent females was found, which was higher in the lower socio-economic strata and among those whose parents were less educated. It was seen that anemia affects the overall nutritional status of adolescent females.

Context: It is well-known that every health problem, not only presents itself with different epidemiological profiles in different population settings, but is also perceived and managed differently. Having knowledge of these variations in its presentations and perceptions in different population settings, for example, in urban and rural settings, will be useful for its successful management. Aim: To study differences in epidemiological profiles, perceptions, socio economic losses, and quality-of-life losses and management of dysmenorrhoea in different settings for effective management. Design and Setting: A comparative cross-sectional study among adolescent school girls (101 girls in urban areas and 79 girls in rural areas) in the district of Karimnagar. Materials and Methods: A cross-sectional survey using a pretested questionnaire was conducted among 180 adolescent girls in urban and rural settings. Statistical Analyses Used: Proportions and X ² test. Results: The prevalence of dysmenorrhoea is 54% (53% in girls in urban areas and 56% in girls in rural areas) (X ² _df = 0.1, P = 0.05). Sickness absenteeism (28-48%), socio economic losses, and perceived quality of life losses are more prevalent among girls in urban areas than in girls in rural areas. Girls in rural areas resort to physical labor and other natural methods to obtain relief while the girls in urban areas are mainly depending on medications. Conclusions: Dysmenorrhoea can also be managed effectively by natural methods without resorting to medicines, provided one is psychologically prepared to face it without anxiety.

Research Question: This study attempts to assess the community perception and client satisfaction of primary health care services provided by mobile health clinics. Objectives: To assess the awareness of the community about mobile health clinic services and its utilization in an urban area and to assess the client satisfaction of those who have utilized the services. Study Design: A cross-sectional community-based study. Setting: Dr. Ambedkar Nagar, urban resettlement colony of New Delhi. Study Period: July 2006 and September 2006. Participants: For exit interviews, patients who have utilized the mobile health clinic; for community interviews, an adult member present in the family. Materials and Methods: For the community survey, two blocks were randomly chosen and the interview was carried out by house visits. For exit interviews, patients were selected randomly from those attending the mobile health clinic. Statistical Analysis: Descriptive statistical analysis. Results and Conclusions: A total of 377 interviews were conducted (295 community interviews and 82 exit interviews). It was seen that 82% were aware of the mobile health clinic but more than two-thirds preferred private practitioners; reasons given were that they have more trust in private practitioners, convenient timings, and less waiting time. Approximately two-thirds to three-fourths of the clients were satisfied with the mobile health clinic services. Client satisfaction is an important measure of the quality of health care and needs to be addressed in order to improve the utilization of primary health care services in urban areas.

Aims: To study the strengths, weaknesses, opportunities, and threats of the Total Sanitation Campaign (TSC) in the Yavatmal district of Maharashtra. Methodology: Data was collected in December 2006 through interviews with stakeholders, house-to-house surveys, focus group discussions, and transect walks. Information in each category was finalized in a meeting after brainstorming and discussion with the TSC cell members. Results: The strengths of the campaign were innovations in Information Education and Communication, motivation through incentives, competitive spirit, active participation and partnerships, involvement of women, and universal coverage. The main weaknesses of the program were the absence of Rural Sanitary Marts/Production Centers, poor maintenance of Women Sanitary Complexes, lack of facilities for monitoring/ follow-up and a temporary focus of the campaign approach. There is an opportunity to tap additional resources, learn from other experiences, and institute back-up agencies to support and guide the community in the post-TSC phase. A change in administration and local leadership and loss of priority and interest needed to sustain the momentum while scaling up the interventions are possible threats for the program.