Objective: The objective was to study the determinants of pre-eclampsia among pregnant women admitted for delivery in a district hospital. Materials and Methods: A case-control study was conducted at District Lady Goschen Hospital, Dakshina Kannada district, Karnataka, South India. The group of pregnant women with pre-eclampsia comprised those with hypertension after the 20th week of gestation with associated proteinuria, and controls were pregnant women not diagnosed with pre-eclampsia. A total of 100 cases and 100 controls were selected for the year 2006. Study variables included mother's age, parity, body mass index, history of chronic hypertension, history of diabetes, history of renal disease, family history of hypertension, and history of pre-eclampsia in earlier pregnancy. Statistical Analysis: Chi-square test, and crude and adjusted odds ratio with 95% confidence intervals were used for statistical analysis. Results: Significant risk factors identified in univariate analysis included prepregnancy body mass index (BMI > 25) (OR = 11.27), history of chronic hypertension (OR = 8.65), history of diabetes (OR = 11.0), history of renal disease (OR = 7.98), family history of hypertension (OR = 5.4), history of pre-eclampsia in earlier pregnancy (OR = 9.63), and multiple pregnancy (OR = 4.85). Multiple logistic regression analysis revealed that the prepregnancy BMI of >25 (OR = 7.56), history of chronic hypertension (OR = 6.69), history of diabetes (OR = 8.66), history of renal disease (OR = 5.6), family history of hypertension (OR = 5.48), and multiple pregnancy (OR = 5.73) are the significant risk factors of pre-eclampsia. Conclusion: Pregnant women at risk of pre-eclampsia should be identified and high-quality antenatal care should be given in order to minimize the complications of pre-eclampsia both for the mother and the fetus.

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Iodine deficiency (ID) is the world's single most important preventable cause of brain damage and mental retardation. Iodine deficiency disorders (IDDs) is a public health problem in 130 countries, affecting 13% of the world population. The simplest solution to prevent the IDD is to consume iodized common salt every day. In India, significant progress has been achieved toward elimination of IDD, in the last 30 years. Satisfactory levels of urinary iodine excretion and iodine content of salt have been documented by the research surveys conducted by research scientists. The results indicate that we are progressing toward elimination of IDD. IDD is due to a nutritional deficiency, which is prima­rily that of iodine, in soil and water. IDD is known to re-appear if the IDD Control Program is not sustained. To ensure that the population continues to have intake of adequate amount of iodine, there is a need of i) periodic surveys to assess the magnitude of the IDD with respect to impact of iodized salt (IS) intervention; ii) strengthening the health and nutrition education activities to create demand for IS and iii) development of a monitoring information system (MIS) for ensuring that the adequately IS is available to the beneficiaries.

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Background: Obesity has reached epidemic proportions globally and is a major contributor to the global burden of chronic diseases. Dietary factors are the major modifiable factors through which many of the external forces promoting weight gain act. Objectives: The objectives were to find the prevalence of overweight and obesity in the urban population of Jamnagar and to explore the effect of dietary factors on the weight status of the people. Materials and Methods: A cross-sectional study was conducted among the adult population of Jamnagar city. Cluster sampling technique was used to select study samples. Data were collected in a prestructured questionnaire by interviewing subjects through house-to-house visits. Data were analyzed in Epi Info and appropriate statistical methods were used. Results: The prevalence of overweight and obesity was found to be 22.04% and 5.20%, respectively. Overweight was more prevalent in females than males. The prevalence rose with an increase in age up to 60 years. Among dietary factors, the total calorie intake and habit of snacking had a positive association with weight gain (P < 0.05). The mean intake of oil was more and the mean intake of vegetables was less among overweight subjects than nonoverweight subjects (P < 0.05). Conclusion: The prevalence of overweight and obesity in the urban population in Jamnagar was found to be 22.04% and 5.20%, respectively. Total calorie intake as well as composition of diet was the important dietary factor affecting weight gain.

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Background: Services are being provided by health functionaries to the community with the objective of fulfilling their satisfaction but sometimes this is not working for the target population. Objectives: The study was conducted to assess the satisfaction of clients' receiving maternal and child health services and to elicit clients' suggestion for improving the services. Materials and Methods: An exit interview was employed to collect data using a predesigned and pretested schedule. Results: Most of the populations were adult clients . In respect of satisfaction, responses of the clients were either satisfactory (54.31%) or good (23.56%) on maternal and child health services; 'poor or very poor around 20% and it was significantly worse in respect of satisfaction'. Most of the clients (63.06 to 73.94%) expressed their responses as satisfactory and good regarding the assessment of doctors and it was significant. Most of them (73.31%) expressed "satisfactory" response on the quality of services given by nursing staffs. Suggestions of clients for improving the level of satisfaction were sought and in this respect, response was little. Conclusions: Mostly satisfactory observations on maternal and child health services were found in respect of clients' satisfaction and there was scope to improve the quality and quantity of services, and accordingly actions may be taken in the working field.

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Background: Large poultry belt is located in the residential areas of rural Haryana in North India. Housefly problem has become a big nuisance in this area. Policy makers require evidence of the association of poultry farming with houseflies and its possible impact on the health of the population. Materials and Methods: A cross-sectional two-group comparison study was conducted. Six villages within 3 km and another six villages beyond 5 km from any poultry farms were selected as the study and the control villages, respectively. We measured indoor and outdoor housefly density and family morbidity in the last 1 month and observed the poultry hygiene and manure management practices. Findings: The mean fly density was 1737 (95% CI 697-2778) houseflies in study villages compared to 100 (95% CI 2-197) houseflies in the control area. The mean all-cause morbidity was also significantly higher in study village families compared to control village families. Poultry farm hygiene and use of insecticides and growth regulators were inadequate. Interpretation : Poultry farms are associated strongly with high fly density and high infectious morbidity in this area. Monitoring and regulation for poultry manure management practices and insecticide use practices need to be strengthened.

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Background: In India, 67,500 infants acquire HIV infection yearly due to mother to child transmission. Objective: The objective was to assess the operational aspect of the Prevention of Parent to Child Transmission (PPTCT) program in a tertiary care hospital and explore its bottleneck. Materials and Methods: A 5-year (2004-2008) prospective evaluation study was conducted among the pregnant women attending Obstetrics Department of a rural tertiary care hospital, since the year of implementation. Indicators were used according to UNAIDS/WHO guideline. Results: Out of 40,140 registered pregnant women, 23,812 were counseled of which 19,794 were agreed to undergo HIV testing and 111 were found HIV positive with a prevalence of 0.56%. Overall HIV counseling and testing rates were 59.32% and 83.13%, respectively. The nevirapine (NVP) dispensing rate of the mother and newborn were 29.72% and 85.4%, respectively. At 18 months of age, 85% babies were found HIV negative in the mother baby pair who received NVP with absolutely formula feeding but it was 42.8% without such intervention. Conclusion: Majority of the pregnant women who came to the labor room directly were deprived of the program (PPTCT) coverage. Although the HIV testing rate reached the WHO target which was excellent, but the NVP dispensing rate lagged far behind.

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Background: The most effective DOTS provider will be the one who is accessible, acceptable to the patient, and accountable to the health system. Objectives: The objective was to assess the effectiveness of the different types of DOTS providers functioning under Revised National Tuberculosis Control Programme (RNTCP). Materials and Methods: A total of 200 patients, treated under RNTCP during September to December 2004, were selected for the study. Results: A total of 105 and 95 patients were under the supervision of tuberculosis health visitors (TBHVs) and non-TBHVs, respectively. During the intensive phase, around 95% of the patients took the medicine under the direct observation in both the groups. Supervision of the first dose of treatment in a week during the continuation phase was significantly better with the TBHV (94.74%) as compared to the non-TBHV (79.31%). However, there was no significant difference in the cure and the completed rate which was 76.19% with the TBHV and 86.13% with the non-TBHV. Conclusion: The available community workforce could be involved in supervising the intermittent short course chemotherapy.

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Background: Occupational gardeners are exposed to various risk factors like dust, allergens, sharp tools, and pesticides, which make them vulnerable to many diseases. This study was designed to survey the health status of this occupational group. Objectives: The objective was to collect sociodemographic and health status information of occupational gardeners. Materials and Methods: The study group comprised 75 male occupational gardeners of the Bhopal city and suburb. A pretested proforma questionnaire was used to record the necessary information like medical history, sociodemographic factors, and findings of clinical investigations. Result and Discussion: This survey reveals that 50% of gardeners are underweight, 31.99% with high normal to high blood pressure, and none with diabetes. The prevalence of vision disturbance (26.66%), eye inflammation (29.33%), stiff nose (21.33%), joint pain, swelling and muscle stiffness (29.33%), and accidental injury (28%) was significantly high among gardeners. Gardeners should be educated to use protective clothing, quit smoking and tobacco consumption, adopt proper body posture, and ensure vaccination.

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Background: Millions of workers are occupationally exposed to dyes in the world, but little is known about their knowledge and attitudes toward the effects of dye on their health. Objectives: The aim of this study was to assess the fabric dyers' and fabric printers' knowledge, attitude, and practice toward the health hazard of dyes. Materials and Methods: The present study was taken up in the Madurai district which is situated in the Southern Tamil Nadu, India. One hundred and forty-two workers employed in small-scale dyeing and printing units participated in a face-to-face confidential interview . Results: The mean age of fabric dyers and fabric printers was 42 years (΁10.7). When enquired about whether dyes affect body organ(s), all the workers agreed that dye(s) will affect skin, but they were not aware that dyes could affect other parts of the body. All the workers believed that safe methods of handling of dyes and disposal of contaminated packaging used for dyes need to be considered. It was found that 34% of the workers were using personal protective equipment (PPE) such as rubber hand gloves during work. Conclusion: The workers had knowledge regarding the occupational hazards, and their attitudinal approach toward the betterment of the work environment is positive.

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