Background: Menstruation and menstrual practices are still clouded by taboos and socio-cultural restrictions resulting in adolescent girls remaining ignorant of the scientific facts and hygienic health practices, which sometimes result into adverse health outcomes. Objectives: (i) To elicit the beliefs, conception and source of information regarding menstruation among the study population and (ii) to find out the status of menstrual hygiene among adolescent girls. Materials and Methods: A descriptive, cross-sectional study was conducted among 160 adolescent girls of a secondary school situated in the field practice area of Rural Health Unit and Training Center, Singur, West Bengal, with the help of a pre-designed and pre-tested questionnaire. Data were analyzed statistically by simple proportions. Results: Out of 160 respondents, 108 (67.5%) girls were aware about menstruation prior to attainment of menarche. Mother was the first informant regarding menstruation in case of 60 (37.5%) girls. One hundred and thirty-eight (86.25%) girls believed it as a physiological process. Seventy-eight (48.75%) girls knew the use of sanitary pad during menstruation. Regarding practices, only 18 (11.25%) girls used sanitary pads during menstruation. For cleaning purpose, 156 (97.5%) girls used both soap and water. Regarding restrictions practiced, 136 (85%) girls practised different restrictions during menstruation. Conclusions: Menstrual hygiene, a very important risk factor for reproductive tract infections, is a vital aspect of health education for adolescent girls. Educational television programmes, trained school nurses/health personnel, motivated school teachers and knowledgeable parents can play a very important role in transmitting the vital message of correct menstrual hygiene to the adolescent girl of today.

Portfolio-based learning is recognized in medical education. It helps students to assess themselves as per the key learning objectives and outcomes expected out of them. The faculty could also get feedback regarding individual student's progress toward learning outcomes and facilitate the students achieve the same. This article addresses the process of portfolio development and assesses from students feedbacks, if portfolio-based learning is an improvement over record-based study in community-based field studies. The results of this study shows that involving students in framing objectives, developing a mechanism for self-introspection and self-assessment by the students and a mechanism by which faculty can monitor each student's progress toward the defined objectives can significantly enhance the learnability of the students.

Background: Injuries are a major cause of death and disability among the adolescents in the world. Objective: To study risk behavior related to interpersonal violence amongst school- and college-going adolescents in South Delhi and its epidemiological correlates. Study Design: Cross-sectional study. Setting: Three schools and two colleges in South Delhi. Participants: Five hundred and fifty adolescents aged 14-19 years. Statistical Analysis: Proportions, Chi-square test, multivariate logistic regression. Results: Among the study participants, 65 (11.8%) reported having carried a weapon in past 30 days. Seventy-four (13.5%) respondents had threatened or injured someone with a weapon in past 12 months. Almost one in every two boys (49.1%) reported being involved in a physical fight in past 12 months. Involvement in interpersonal violence was found to be significantly more amongst males than females. Adolescents who were working part time were more likely to be 'at risk' (67.5%) than those not working (48.5%). In logistic regression analysis, the significant correlates of interpersonal violence were male gender, lower age, number of close friends, having seen role models smoke/drink, and residing in resettlement colonies, slums or villages. The findings regarding violence-related behaviors among adolescents are remarkably similar to those in other countries.

Background: Emergence of polyantimicrobial resistant strains of hospital pathogens has presented a challenge in the provision of good quality in-patient care. Inappropriate use of antibiotics in the hospital is largely responsible for this catastrophe. Bacteriological surveillance of the cases of nosocomial infections is crucial for framing an evidence-based antimicrobial policy for a hospital. Materials and Methods: A prospective study was undertaken among 498 patients from medicine and surgery wards in a tertiary teaching hospital in Goa. The patients were followed up clinico-bacteriologically for the occurrence of nosocomial infections (NI). Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: The overall infection rate was 33.93 ± 4.16 infections per 100 patients. Urinary tract infection was the most common NI (26.63%), followed by surgical site infection (23.67%), wound infection (23%) and nosocomial pneumonia (18.34%). Ninety-seven percent of the isolates were bacterial, while the others were fungal. More than 80% of the NIs were caused by Gram-negative bacteria, predominantly Pseudomonas aeruginosa, Escherichia coli and Aceinetobacter baumanii . Almost 70% of the isolates were resistant to all the antibiotics for which susceptibility was tested; the rest were sensitive to amikacin, cefoperazone-sulbactam and other antibiotics including methicillin, co-trimoxazole, teicoplenin, vancomycin and rifampicin, either singly or in combination. The proportion of MRSA was 71.4%. Resistance to a particular antibiotic was found to be directly proportional to the antibiotic usage in the study setting. Conclusion: Surveillance of nosocomial infections with emphasis on the microbiologic surveillance and frequent antimicrobial audit are critical towards curbing the evil of polyantimicrobial resistant nosocomial infections in a hospital.

General Practitioners (GPs) provide first contact care of children and pregnant mothers in the community. This study ascertained the prescribing pattern of anthelmintics to children and pregnant women by a sample of GPs from the district of Colombo. Two hundred medical practitioners engaged in full-time General Practice (100 urban and 100 rural), were selected randomly. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 183 GPs aged between 26 and 72 years (median 38) participated with 94 coming from urban areas. Seventy percent of the GPs were male. Almost 13% of GPs from urban areas had a Postgraduate degree in comparison to 4.5% from the rural areas ( P < 0.05). Over 50% of GPs had 6-20 years of service and over 30% treated 16-30 patients daily. Seventy-three percent of GPs from rural areas accessed health-related reading material either daily or weekly in contrast to only 40% from urban areas ( P < 0.001). All GPs prescribed anthelmintics to children. Pyrantel pamoate was the preferred anthelmintic used for children by both groups. Approximately 55% and 64% of GPs from urban and rural areas, respectively, prescribed anthelmintics during pregnancy. A majority of GPs prescribed drugs after the first trimester. However, 25% from urban areas gave drugs during any trimester ( P < 0.001). Regression analysis revealed that GPs with postgraduate qualifications, those having frequent access to health-related material and those seeing more than 30 patients daily, prescribed anthelmintics to pregnant women more often. Although routine de-worming of pregnant women and children should occur through government antenatal and well-baby clinics, and through the schools de-worming programme, it may not happen due to various reasons. Thus, GPs play a vital role in achieving good coverage of anthelmintics among children and pregnant women. Making available clear national guidelines on prescribing anthelmintics in Sri Lanka would improve the prescribing patterns of anthelmintics among GPs.

Objectives: Is use of tobacco a major health problem among medical students? To find out the factors associated with the use of tobacco. Materials and Methods: A cross-sectional study was done on 250 undergraduate male medical students using a pre-designed, pre-tested questionnaire to study about the problem and various correlates of the tobacco use. Data was collected and analysed using Excel and SPSS software. Results: Among the tobacco users (28.8%), smoking was found in 87.5% and tobacco chewing in the form of gutka, khaini, gulmanjan (locally available forms of tobacco) in 37.5% as the predominant means of the use of tobacco. The mean age of our sample was 23.5 years. The residential background, i.e., rural or urban, and religion were not significantly associated with the use of tobacco in the present study. Hostellers were found to be more frequent tobacco users as compared to day-scholars. There was a familial aggregation of the use of tobacco. The factor initiating the use of tobacco was usually peer pressure. Conclusion: Tobacco use is a significant problem among the male medical students and we need to take steps to stop its use by them so as to prevent them from being exposed to its hazardous effects. This will also make their role in the advocacy of the smoking cessation activities more trustworthy.

Context: Domestic accidents are worldwide public health problems. The consequences of a domestic accident may prove disastrous as it may result in disability and loss of productivity. In this context, the present study was carried out to characterize the occurrence of domestic accidents in a semi-urban community. Aims: To study the incidence of domestic accident in a semi-urban community and its association with various epidemiological factors. Settings and Design: Community-based cross-sectional study of 796 households consisting of 4086 individuals residing in a semi-urban area. Materials and Methods: Complete information from 796 households consisting of 4086 individuals was collected through semi-structured, pre-tested questionnaire. Domestic accident was considered when any of these individuals had met with an accident inside the house or in the immediate surroundings of the house during the last 6 months from the date of survey. The collected data were tabulated and analyzed. Statistical Analysis Used: Simple proportions and Chi-squared test. Results: The incidence of domestic accidents was found to be 1.7%. The most common accident reported was fall. Occurrence of falls was found to be associated with age and overcrowding. Other accidents noted were burns, scalds, electrocution, injuries and accidental poisoning. Accidents were reported in significantly higher proportion in extreme age groups and in females. Higher proportion of accidents occurred during the morning and evening hours. About 10.1% were treated at home, 72.5% as outdoor patients and 17.4% as indoor patients. The mean duration of hospital stay was found to be 2 weeks. Full recovery was observed in 82.6% cases, whereas permanent disability was found in only 2.9% subjects, while 14.5% reported chronic pain after the accident. No death related to domestic accident was reported in the present study. Conclusions: Domestic accidents are more common in extreme age groups and in females. The reasons may be the higher amount of time spent at home and greater participation in daily home activities. Falls being the most frequent type of accidents, proper designing of house and adequate illumination may help in reducing their occurrence, as the majority of accidents occurred during the morning and evening hours in our study.

Background: Early diagnosis of hypertension (HT) is an important strategy in its control. Tracking of blood pressure (BP) has been found useful in identifying persons with potential HT, particularly in youngsters. A cohort of 756 subjects (with baseline information as a cross-sectional study in 2002) was followed up in 2006 to comment on the distribution of BP and its attributes. Objectives: To track BP distribution in a cohort of adolescents and young adults, and assess the persistence of high/low normotensives; to measure the incidence of HT and study the relationship of BP with age, sex, socioeconomic status, BMI, physical exercise, salt intake, smoking and alcohol consumption. Materials and Methods: The baseline study cohort (2002) of 756 subjects (19-24 years) in urban field area of Department of Preventive and Social Medicine, JIPMER, was followed up between May and November 2006 by house visits for measurement of sociodemographic variables, anthropometry, salt intake, physical activity and BP. Results: A total of 555 subjects from the 2002 cohort were contacted (73.4%), in that 54.5% subjects who were below 5 ^th percentile, 93.6% subjects between 5 ^th and 95 ^th percentiles and 72% of those above 95 ^th percentile previously persisted in the same cut-offs for systolic blood pressure (SBP). The corresponding figures for diastolic blood pressure (DBP) were 46.2, 92.2 and 74.1%, respectively. Shift from one cut-off to another was not significant for both SBP and DBP, proving the tracking phenomenon. Annual incidence of HT was 9.8/1000. Baseline BP was the significant predictor of current BP for the entire cohort; BMI and salt intake were significant predictors only in certain sections of the study cohort. Conclusions: Early diagnosis of hypertension even among adolescents/young adults is an important preventive measure, as tracking exists in the population.