Research Question: What is the situation of iodine deficiency disorder (IDD) and salt consumption in Jammu region? Hypothesis: The prevalence of IDD has decreased markedly as a result of medical as well as socio-economic factors. Objective: To assess the magnitude of IDD in Jammu region and also assess the salt consumption patterns in the region. Design: Cross-sectional study. Setting: Primary schools in both urban and rural areas. Study Tools: Clinical examination of study population for goiter, laboratory assessment of casual urine sample for urinary iodine estimation of I ₂ content of salt samples collected from sub-samples of study population. Participants: School children in the age group of 6-12 years were selected for study using WHO 30-cluster methodology, urine samples were collected from 15% of selected children and salt samples from 5% of sub-sample. Ethical Concern: No ethical issues were involved. Results: An overall goiter prevalence of 11.98% was observed in the region. Females had a prevalence of 16.1% and males 10.1%. The median urinary iodine excretion in the region was 96.5 µg/l (range: 29.0-190.0 µg/l). Forty-nine percent of subjects had biochemical iodine deficiency with 6.7% having moderate and 42.53% mild iodine deficiency. In Jammu region, 74.47% of households consume powdered salt with 98.17% powdered salt samples having an I ₂ content of greater than 15 ppm. Conclusion: Iodine deficiency remains a public health problem in the region, though the region seems to be in a state of nutritional transition from iodine deficiency to iodine sufficiency.

Research Question: What are the factors responsible for suicidal attempts? Objectives: To study the socio-demographic factors, methods and reasons for suicidal attempts. Type of Study: Cross-sectional study. Setting: Bapuji and C.G. Hospitals attached to J.J.M. Medical College, Davanagere. Participants: A total of 540 suicidal attempters admitted to emergency wards. Methodology: A pretested proforma was administered to the subjects relating the factors responsible for the attempt. The data thus obtained was compiled and analyzed. Statistical Analysis: Proportions, Z -test and Chi-square test. Results: In this study, 61.3% were males and 38.7% were females. Peak occurrence of suicidal attempts was found in the second and third decades (15-29 years). Hindus constituted about 94.6% of the total suicidal attempters. Almost half (52.2%) of the subjects had education below or up to matriculation and 83% of them were from the lower (classes IV and V) socio-economic groups. Agriculturists, housewives and unskilled workers represented 75% of the total subjects. Fifty-five percent of the subjects were from nuclear families and most (62.4%) of them were married; frequent mode of attempting suicides was by organo-phosphorus compounds (66.3%) followed by overdosage of tablets (17.8%). Common cause was family problem (27.2%) followed by illness (27%).

Objective: To ascertain the response of husbands to their wives' health problems. Materials and Methods: We selected 100 couples through a systematic random sampling from 4 purposively selected villages; these couples were interviewed by a social worker in rural North India through house-to-house survey. The role of husbands during pregnancy, puerperium and during the wives' illness was explored. Their awareness with regard to the reproductive health problems of their wives was also ascertained. Another outpatient department (OPD)-based interview of female (n = 300) patients was conducted; 50 each at health post, subcenter, primary health centers (PHC), community health center (CHC), 50-bed hospital and apex institution. Previous consultation history was also obtained. Results: Husbands escorted their wives to hospital in 30-40% cases. This was mainly for a visit to bigger hospitals in cities/towns. Husbands decided regarding the treatment agency in the majority of cases. In 10% cases, they took time off their work during wives' sickness and helped in household work. Consultation within a week was 100%. The husbands' knowledge regarding the safe period was inadequate. Majority (78%) said that women remained ill more often. Most wives were satisfied with the role of their husbands during their pregnancy or illness. A majority (80%) of husbands favored education of women up to the 10th standard and 87% were in favor of working women. Conclusion: Reasonably favorable attitude of husbands towards their wives' health problems was witnessed. This needs to the carefully nurtured.

Objective: Exposure to blood and body fluids is one of the hidden hazards faced by health care workers (HCWs). The objective of the present study was to estimate the incidence of such exposure in a teaching hospital. Materials and Methods: A cross-sectional study among a random sample of residents, interns, nurses and technicians ( n = 830) was carried out in a teaching hospital to estimate the incidence of exposure to blood and body fluids in the preceding 12-month period. Self-reported occurrence and the circumstances of the same were recorded by face-to-face interviews using a semi-structured questionnaire. Results: The response rate to the study was 89.76%. Occupational exposure to blood and body fluids in the preceding 12 months was reported by 32.75% of the respondents. The self-reported incidence was the highest among the nurses. Needle-stick injury was the most common mode of such exposures (92.21% of total exposures). Index finger and thumb were the commonest sites of exposure. Only 50% of the affected individuals reported the occurrence to concerned hospital authorities. Less than a quarter of the exposed persons underwent post-exposure prophylaxis (PEP) against HIV, although the same was indicated in about 50% of the affected HCWs based on the HIV status of the source patient. Conclusions: Occupational exposure to blood and body fluids was a common occurrence in the study sample. There was gross under-reporting of such incidents leading to a lack of proper PEP against HIV in 50% of those in whom the same appeared to be indicated.

Research question: Do caretakers of children under five years have sufficient knowledge regarding routine immunization (RI)? Objective: To assess the knowledge about RI among caretakers of young children. Settings: Pulse polio immunization centres in East Delhi. Study design: Cross-sectional study. Participants: Six hundred and eighty-two caretakers accompanying children under 5 years to pulse polio booths in November 2006. Study tool: Pre-tested semi-open-ended questionnaire. Statistical analysis: Proportions, Chi-square test. Results: The proportions of respondents who had awareness about different aspects of RI, such as weekday of RI (37.0%), age group for RI (49.1%), number of visits required in the first year of life (27.0%), were all low. When asked to name the four diseases covered under the RI program in Delhi, only 268 (39.3%) could name at least three. The education level of respondents was strongly associated with their knowledge about RI. Conclusion: The need of the hour is to make RI a 'felt need' of the community. Making caretakers more aware about RI is a vital step in achieving this goal.

Objective: To assess the quality of care provided by private practitioners in rural areas of Wardha district. Methodology: The study was carried out in three primary health centres of Wardha district. 20% of the 44 registered private practitioners were selected randomly for the study. The data was collected using checklist through direct observation for the infrastructure. Assessment of quality of services delivered, 10 consecutive patients were observed and also the medical practitioner was interviewed. Supplies and logistics were assessed through observation. Results: All the facilities were sheltered from weather conditions and 90% had adequate waiting space. But, drinking water and adequate IEC material was available in only 20% facilities. Complete history taking and relevant physical examination was done in only 20% cases. Only 20% practitioners recorded blood pressure and 30% recorded temperature in cases with fever. Provisional diagnosis was not written in any of the case and only 20% explained prescription to the patients. Conclusion: There is considerable scope to improve the quality of services of private practitioners. To achieve this quality assurance programs may be initiated along with the training of private medical practitioners.

Background: Mass drug administration (MDA) means once-in-a-year administration of diethyl carbamazine (DEC) tablet to all people (excluding children under 2 years, pregnant women and severely ill persons) in identified endemic areas. It aims at cessation of transmission of lymphatic filariasis. Objective: What has been the coverage and compliance of MDA in Gujarat during the campaign in December 2006? Study Design: Cross-sectional population based house-to-house visit. Setting: Urban and rural areas in Gujarat identified as endemic for filariasis where MDA 2006 was undertaken. Study Variables: Exploratory - Rural and urban districts; Outcome - coverage, compliance, actual coverage, side effects. Analysis: Percentage and proportions. Results: Twenty-six clusters, each comprising 32 households from six endemic districts, yielded an eligible population of 4164. The coverage rate was 85.2% with variation across different areas. The compliance with drug ingestion was 89% with a gap of 11% to be targeted by intensive IEC. The effective coverage (75.8%) was much below the target (85%). Side effects of DEC were minimum, transient and drug-specific. Overall coverage was marginally better in rural areas. The causes of poor coverage and compliance have been discussed and relevant suggestions have been made.

Research Question: What are the socio-demographic profile and risk behavior pattern of seropositive attendees in the voluntary counseling and testing center (VCTC)? Study Design: Retrospective study. Setting: VCTC in the outpatient complex of Kasturba Medical College Hospital, Mangalore, Karnataka. Subjects: Records pertaining to all the 539 and 330 seropositive attendees during the years 2005 and 2006, respectively, were included in the study besides data from 2001 onwards in order to assess the time trend of human immunodeficiency virus (HIV). Study Variables: Age, sex, marital status, religion, educational status, occupation, place of residence and pattern of risk behavior in relation to HIV/AIDS. Statistical Analysis: Analysis was done with SPSS version 11. Statistical test and Chi-square was done, and P < 0.05 was considered statistically significant. Results: The time trend of VCTC attendees reveals a gradual increase except in 2006 showing a sharp decline. Seropositives were around 20% between 2001 and April 2007 with a sharp increase in 2006, i.e., 33.64%. Male seropositivity constituted 60-63%; 81-91% of seropositive attendees belonged to the age group of 15-50 years; 58-70% were married. Only about 3% were illiterates and 20-25% constituted 6 ^th -12 ^th pass-outs. With regard to occupational profile, about 17-27% were housewives, 19-21% were laborers/hotel workers and 7% were entrepreneurs. About 45% were from urban area and nearly one-third hailing from other districts in the border of Karnataka. About 25% were exposed to commercial sex workers; another 21-23% were involved in premarital sex and nearly 38% were indulging in heterosexual activities.