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   2009| April-June  | Volume 34 | Issue 2  
    Online since May 8, 2009

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Health and social problems of the elderly: A cross-sectional study in Udupi Taluk, Karnataka
A Lena, K Ashok, M Padma, V Kamath, A Kamath
April-June 2009, 34(2):131-134
DOI:10.4103/0970-0218.51236  PMID:19966960
Background: Change in socio-economic status and various health problems adversely affect an individual's way of life during old age. Objectives: To study the health and social problems of the elderly and their attitude towards life. Materials and Methods : Descriptive study carried out in the Field practice area of the Department of Community Medicine in South India. A total of 213 elderly patients (60 years old and above) who attended the outreach clinics were interviewed using a pre-tested schedule. Findings were described in terms of proportions and percentages to study the socio-economic status of the samples and its correlation to social problems. Results: Around 73% of the patients belonged to the age group of 60-69 years old. Nearly half of the respondents were illiterate. Around 48% felt they were not happy in life. A majority of them had health problems such as hypertension followed by arthritis, diabetes, asthma, cataract, and anemia. About 68% of the patients said that the attitude of people towards the elderly was that of neglect. Conclusions: The results of the study showed that there is a need for geriatric counseling centers that can take care of their physical and psychological needs. The stringent rules for eligibility to social security schemes should be made more flexible to cover a larger population.
  32,363 1,691 11
Awareness and perception regarding eye donation in students of a nursing college in Bangalore
Anita Gupta, Sudhir Jain, Tanu Jain, Karan Gupta
April-June 2009, 34(2):122-125
DOI:10.4103/0970-0218.51235  PMID:19966958
Context: Corneal diseases constitute a significant cause of visual impairment and blindness in the developing world. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate number of corneas collected. Well-informed nursing students could be expected to influence eye donation rates. Aims: To assess the awareness and perception of 188 first- and second-year nursing students towards eye donation in Bangalore. Settings and Design: Cross-sectional study design. Materials and Methods: A pretested, semi-structured questionnaire. Statistical Analysis Used: Data were analyzed using the Epi-Info software package, Version 6.04. Results: The majority (96.8%) of students knew that eyes can be donated after death but only 38.2% knew that the ideal time of donation was within 6 hours of death. Most participants (85.1%) were either willing or had already donated their eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.6% of students. Perceived reasons for not pledging eyes by the students were: the unacceptable idea of separating the eyes from the body (67.9%), lack of awareness (42.8%), objection by family members (28.5%), and unsuitability to donate because of health problem (10.7%). Conclusion: This study revealed that nursing students were well aware of eye donations and most of them were inclined to sign-up for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. The nursing students could be actively involved as volunteers in eye donation campaigns and they can act as counsellors for eye donors. They can also contribute by participating in creating awareness and motivating people to become eye donors.
  14,364 1,073 5
A comparison of the nutritional status of adolescents from selected schools of South India and UAE : A cross-sectional study
Ghalib J Haboubi, Rizwana B Shaikh
April-June 2009, 34(2):108-111
DOI:10.4103/0970-0218.51230  PMID:19966955
Objective: To assess the nutritional status of adolescents of Indian origin living in India and the United Arab Emirates to see how variable the prevalence is of stunting and wasting among adolescents of the same ethnic background living in different socio-economic and demographic environments. Materials and Methods : A cross-sectional survey. Setting: Schools in South India and the United Arab Emirates. Participants: A total of 2459 adolescent boys and girls between the ages of 10 and 16 years old. Results and Discussion: Anthropometric measurements from 2459 adolescents between the ages of 10-16 years old, 1200 from India and 1259 from UAE, were collected. The subjects were divided into six age groups with 1-year intervals. Adolescents falling below the age and gender-specific 5 th percentile and 3 rd percentile of the WHO recommended standards were defined as having thinness and stunting accordingly. Regardless of gender, the rate of stunting was higher in Indian adolescents from India (25.5-51%) when compared with Indian adolescents in UAE (3.1-21%). Thinness was also more in those in India (42-75.4%). When compared with adolescents living in the UAE (4.5-14.4%). The study was done in two groups having a common ethnicity but living in different socio-economic environments. With the results of this study, we can say that improved economic conditions favor better expression of genetic potential for physical growth.
  6,105 735 6
Augmenting BMI and waist-height ratio for establishing more efficient obesity percentiles among school-going children
Seeja Thomachan Panjikkaran, KS Kumari
April-June 2009, 34(2):135-139
DOI:10.4103/0970-0218.51233  PMID:19714259
Research Questions: 1. Are all the existing methods for estimating the obesity and overweight in school going children in India equally efficient? 2. How to derive more efficient obesity percentiles to determine obesity and overweight status in school-going children aged 7-12 years old? Objectives: 1. To investigate and analyze the prevalence rate of obesity and overweight children in India, using the established standards. 2. To compare the efficiency among the tools with the expected levels in the Indian population. 3. To establish and demonstrate the higher efficiency of the proposed percentile chart. Study Design: A cross-sectional study using a completely randomized design. Settings: Government, private-aided, unaided, and central schools in the Thrissur district of Kerala. Participants: A total of 1500 boys and 1500 girls aged 7-12 years old. Results: BMI percentiles, waist circumference percentiles, and waist to height ratio are the ruling methodologies in establishing the obese and overweight relations in school-going children. Each one suffers from the disadvantage of not considering either one or more of the obesity contributing factors in human growth dynamics, the major being waist circumference and weight. A new methodology for mitigating this defect through considering BMI and waist circumference simultaneously for establishing still efficient percentiles to arrive at obesity and overweight status is detailed here. Age-wise centiles for obesity and overweight status separately for boys and girls aged 7-12 years old were established. Comparative efficiency of this methodology over BMI had shown that this could mitigate the inability of BMI to consider waist circumference. Also, this had the advantage of considering body weight in obesity analysis, which is the major handicap in waist to height ratio. An analysis using a population of 1500 boys and 1500 girls has yielded 3.6% obese and 6.2% overweight samples, which is well within the accepted range for Indian school-going children. Conclusion: The percentiles for school-going children based on age and sex were derived by comparing all other accepted standards used for measurement of obesity and overweight status. Hence, augmenting BMI and waist to height ratio is considered to be the most reliable method for establishing obesity percentiles among school-going children.
  5,870 756 6
Poor perinatal care practices in urban slums: Possible role of social mobilization networks
Zulfia Khan, Saira Mehnaz, Najam Khalique, Mohd Athar Ansari, Abdul Razzaque Siddiqui
April-June 2009, 34(2):102-107
DOI:10.4103/0970-0218.51229  PMID:19966954
Background: Making perinatal care accessible to women in marginalized periurban areas poses a public health problem. Many women do not utilize institutional care in spite of physical accessibility. Home-based care by traditional birth attendants (TBA) is hazardous. Inappropriate early neonatal feeding practices are common. Many barriers to perinatal care can be overcome by social mobilization and capacity building at the community level. Objectives: To determine the existing perinatal practices in an urban slum and to identify barriers to utilization of health services by mothers. Study Design: This is a cross-sectional descriptive study. Setting and Participants: The high-risk periurban areas of Nabi Nagar, Aligarh has a population of 40,000 living in 5,480 households. Mothers delivering babies in September 2007 were identified from records of social mobilization workers (Community Mobilization Coordinators or CMCs) already working in an NGO in the area. A total of 92 mothers were interviewed at home. Current perinatal practices and reasons for utilizing or not utilizing health services were the topics of inquiry. Statistical Analysis: Data was tabulated and analyzed using SPSS 12. Results: Analyses revealed that 80.4% of mothers had received antenatal care. However, this did not translate into safe delivery practices as more than 60% of the women had home deliveries conducted by traditional untrained or trained birth attendants. Reasons for preferring home deliveries were mostly tradition (41.9%) or related to economics (30.7%). A total of 56% of the deliveries were conducted in the squatting position and in 25% of the cases, the umbilical cord was cut using the edge of a broken cup. Although breast-feeding was universal, inappropriate early neonatal feeding practices were common. Prelacteal feeds were given to nearly 50% of the babies and feeding was delayed beyond 24 hours in 8% of the cases. Several mothers had breastfeeding problems. Conclusion: Barriers to utilization of available services leads to hazardous perinatal practices in urban slums.
  5,055 648 17
A comparison of sexual outcomes in primiparous women experiencing vaginal and caesarean births
M Khajehei, S Ziyadlou, Rad M Safari, HR Tabatabaee, F Kashefi
April-June 2009, 34(2):126-130
DOI:10.4103/0970-0218.51237  PMID:19966959
Background and Objective: We conducted this study to evaluate and compare postpartum sexual functioning after vaginal and caesarean births. Materials and Methods: This was a cross-sectional study that was carried out in postnatal health care in a hospital. A total of 50 primiprous women who had given birth 6-12 months ago and came to the hospital for postnatal care were asked to join the study. Forty of the women completed the entire questionnaire. Among these women, 20 delivered spontaneously with mediolateral episiotomy and 20 had elective caesarean section. Sexual function was evaluated by a validated, self-created questionnaire. A statistical evaluation was carried out by SPSS v.11. A two-part self-created validated questionnaire for data collection was administered regarding sexual function prior to pregnancy and 6-12 months postpartum. Results: The median time to restart intercourse in the normal vaginal delivery with episiotomy (NVD/epi) group was 40 days and in the caesarean section (C/S) group was 10 days postpartum. The most common problems in the NVD/epi group was decreased libido (80%), sexual dissatisfaction (65%), and vaginal looseness (55%). In the C/S group, the most common problems were vaginal dryness (85%), sexual dissatisfaction (60%), and decreased libido (35%). There were clinically significant differences between the two groups regarding sexual outcomes, but these differences were not statically significant. Conclusion: Postnatal sexual problems were very common after both NVD/epi and C/S. Because sexual problems are so prevalent during the postpartum period, clinicians should draw more attention to the women's sexual life and try to improve their quality of life after delivery.
  5,321 293 5
Assessment of immunization status in the slums of Surat by 15 clusters multi indicators cluster survey technique
Rashmi Sharma, Vikas K Desai, Abhay Kavishvar
April-June 2009, 34(2):152-155
DOI:10.4103/0970-0218.51222  PMID:19966964
Research Question: What is the immunization status of children in the slums of Surat and what changes has it undergone in recent times? Objective: To assess the immunization status of children between the ages of 12 and 23 months in the slums of Surat and to compare it with the MICS from previous years. Study Design: This was a community-based cross-sectional study conducted in 15 clusters. Settings: 15 urban slums selected out of a total of 299 slums using the cluster sampling method. Study Tool: The Multi Indicator Cluster Sampling (MICS) method was used for sample selection and the proforma designed by UNICEF was used as a study tool. Statistical Analysis: Simple proportions and a Chi-square test. Results: Only 25% of the children between the ages of 12 and 23 months were fully immunized; coverage was highest for BCG (75%) and lowest for measles (29.9%). As far as the dropout rate is concerned, it was 60.2%, 31.9%, and 31.5% for BCG to measles, DPT 1 to DPT 3 , and OPV 1 to OPV 3 , respectively. Vitamin A was taken by only 28.9% of the subjects. Between the two, female children were more disadvantaged in terms of vaccination. When compared with the coverage of 1997 and 1998, the current coverage is poor, more so in relation to DPT and OPV.
  4,649 637 9
Consumer satisfaction about hospital services: A study from the outpatient department of a private medical college hospital at Mangalore
KS Prasanna, MA Bashith, S Sucharitha
April-June 2009, 34(2):156-159
DOI:10.4103/0970-0218.51220  PMID:19966965
Background: Consumer satisfaction is an important parameter for assessing the quality of patient care services. There is a need to assess the health care systems regarding the consumer satisfaction as often as possible. Objectives: To assess the consumer satisfaction regarding the services provided in our outpatient department in terms of clinical care, availability of services, waiting time, and cost. Materials and Methods: A 27-item pre-tested questionnaire was given to 100 patients (caretakers in pediatric patients) at the end of their O.P.D visit from 3 to 4 pm for 5 days from November 7, 2005 to November 11, 2005. The items in the questionnaire referred to particulars of the patients such as age, sex, occupation, department requested, lab, and medical stores. While analyzing, they were grouped into categories like availability, clinical care, waiting time, and cost. The responses were expressed in proportions. Results: The availability of services and clinical care was found to be satisfactory. 81% of the respondents found the communication by the doctor good, 97% of the respondents were satisfied about the explanation of the disease by the doctor The average time required for consulting the doctor was 46.5 20.9 min. But when time spent in pharmacy was considered, it was not significantly satisfactory. The cost of investigation was significantly moderate or high in 97% of the respondents. Conclusions: Recommendations are required for reduction of time spent in the pharmacy and the cost of investigations to improve consumer satisfaction.
  4,618 450 6
Public Health and Preventive Medicine - "The RED BOOK"
Amarjeet Singh
April-June 2009, 34(2):167-168
  4,422 377 -
Malaria in Assam: A challenge
Maninder Pal Singh Pardal, Rajvir Bhalwar, Vijay Kumar Mehta, Ajay Mahendraker, Ashwini Kumar Mehta
April-June 2009, 34(2):94-96
DOI:10.4103/0970-0218.51225  PMID:19966952
Research Question: What is the trend of malaria and proportion of Plasmodium falciparum infections amongst troops of the Army units deployed in Assam over the last 5 years? Study Design: Retrospective cross -sectional descriptive study. Setting: Army units deployed in the state of Assam over the last 5 years. Participants: Population of army units deployed in the state of Assam over the last 5 years. Statistical Analysis: Percentage, Chi square. Results: Malaria contributed to 3.60% to 7% of all hospital admissions over the period of 5 years. The overall malaria incidence showed a significantly increasing trend during the study period. (Chi square for linear trend = 5.19; P = 0.023). Out of these, P falciparum contributed 86% to 98%. The proportion of P falciparum infections showed a significantly increasing trend from 2005 to 2006. (Yate's corrected Chi square = 7.123; P = 0.008).
  3,975 391 5
Practical observations from an epidemiological investigation of a measles outbreak in a district of India
Ashok Mishra, Subodh Mishra, Chandrakant Lahariya, Pankaj Jain, Rahul S Bhadoriya, Dhiraj Shrivastav, Neera Marathe
April-June 2009, 34(2):117-121
DOI:10.4103/0970-0218.51234  PMID:19966957
Background: Measles is a major cause of childhood morbidity and mortality, accounting for nearly half of the morbidity associated with global vaccine preventable diseases. Regular outbreaks of Measles are reported in India, of which only a few are investigated. This study was conducted in the Shivpuri District of Madhya Pradesh (India) to investigate and asses various epidemiological factors associated with measles outbreak. Materials and Methods: A cross-sectional study was carried out in 30 randomly selected sub-centers in 8 blocks of the Shivpuri District of Madhya Pradesh, covering 212 villages, selected by cluster sampling. The villages, which had reported measles cases, were extensively investigated by the field teams through extensive house-to-house surveys during 12-19 May 2004. Results: A total of 1204 cases with 14 deaths were reported with an attack rate of 6.2% and a case fatality rate of 1.2%. In this study, 17.7% of the cases reported post-measles complications with diarrhea as the most common post measles complication. The routine measles vaccine and Vitamin A supplementation in the area was also less than 30%. Conclusions: The majority of the cases had occurred in the unvaccinated children and in under 5 year old population. There are repeated outbreaks and a long delay in reporting of the cases. The occurrence of cases, in a reasonable proportion of the vaccinated population, points toward the fact that there is a possibility of a vaccine failure in older children. This study calls for an improved surveillance system, an improvement in the cold chain, and enhancements for measles vaccination if India is to achieve the goal of measles elimination.
  3,478 453 6
Outbreak of gastroenteritis in Tibetan transit school, dharamshala, Himachal Pradesh, India, 2006
Surender Nikhil Gupta, Naveen Gupta
April-June 2009, 34(2):97-101
DOI:10.4103/0970-0218.51227  PMID:19966953
Background: On 28 th June, 2006, 55 cases of the gastroenteritis were reported among the hostellers of the Tibetan Transit School, Dharamshala. We investigated the outbreak to identify the source, propose control and preventive measures. Materials and Methods: We defined a case of the gastroenteritis as the occurrence of more than three smelly loose motions between 28 th June to 2 nd July, 2006 among some sections of the resident hostellers. We determined age and sex specific attack rate. We hypothesized it as a food borne beef meat outbreak. We conducted the case control study and collected the information about the food items consumed inside and outside the hostel at dinner using the standardized questionnaire. We calculated floor wise incidences of four hostels, odds ratios and attributable fractions. We interviewed food handlers. We lifted the seven rectal stool, four water and three samples from floor, kitchen and meat chopper room for culture and sensitivity. Results: 116 cases patients of 802 hostellers met the case definition. The maximum attack rate (16%) was in the youngest group (15-20yrs) and nil in staff and 31-40 years age group with 5 overall attack rate as 14%. Sex specific attack rate was more (18%) in females. The floor wise incidences of the case patients were the highest in 2nd and 3rd floors, occupied by the youngest group. The median age was 20 yrs (Range 17-40 yrs). The most common symptoms were watery diarrhea (71/116, 61%) and bloody diarrhea-(45/116, 39%); abdominal pains- (87/116, 75%). Of the six food/water items examined, the food specific attack rate was highly statistically significant in the beef meat eaters (82% with PAF 71%), and Odds Ratio 19.19 (95% C.I. as 9.3-140). The food handlers & their cooking conditions in the kitchen were unhygienic. The food was not available for testing. Escherichia coli were detected in the samples from rectal stools, kitchen and meat chopper room. No fatality was reported. Conclusion/Recommendation: The beef meat purchased from outside was implicated for the explosive common source outbreak. The school authorities were counseled for hygienic food handling.
  3,524 350 2
Physical hazards in employment and pregnancy outcome
Bratati Banerjee
April-June 2009, 34(2):89-93
DOI:10.4103/0970-0218.51224  PMID:19966951
  3,164 463 2
Multiple micronutrient supplements will not reduce incidence of low birthweight
Umesh Kapil
April-June 2009, 34(2):85-86
DOI:10.4103/0970-0218.51221  PMID:19966949
  3,023 537 7
Status of iodized salt coverage in urban slums of Cuttack City, Orissa
Ansuman Panigrahi, Kaushik Mishra, Bijayeeni Mohapatra
April-June 2009, 34(2):145-147
DOI:10.4103/0970-0218.51228  PMID:19966962
Background: For sustainable elimination of iodine deficiency disorders (IDD), it is necessary to consume adequately iodized salt on a regular basis and optimal iodine nutrition can be achieved through universal salt iodization. Objective: To assess the extent of use of adequately iodized salt in the urban slums of Cuttack. Materials and Methods: Using a stratified random multi-stage cluster sampling design, a cross-sectional study involving 336 households and 33 retail shops selected randomly from 11 slums of Cuttack was conducted in 2005. A predesigned pretested schedule was used to obtain relevant information and salt iodine was estimated qualitatively by using a spot testing kit and quantitatively using the iodometric titration method. Statistical Analysis: Proportion, Chi-square test. Results: Only 60.1% of the households in urban slums of Cuttack were using adequately iodized salt i.e., the iodine level in the salt was ≥15 ppm. Iodine deficiency was significantly marked in sample salts collected from katcha houses as compared with salts collected from pucca houses. Households with low financial status were using noniodized/inadequately-iodized salt. Both crystalline and refined salts were sold at all retail shops. Crystalline salts collected from all retailers had an iodine content <15 ppm and refined salts collected from one retailer had iodine content <15 ppm. About 48.5% of salt samples collected from retail shops were adequately iodized. Conclusion: In the urban slums of Cuttack, retailers were selling crystalline salts, which were inadequately iodized- this would be a setback in the progress towards eliminating IDD.
  3,214 337 1
A study on doctors' perspective on PNDT act
KM Dhaduk, DV Parmar, BS Yadav, Sudha Yadav
April-June 2009, 34(2):160-161
DOI:10.4103/0970-0218.51219  PMID:19966966
  3,048 390 1
Spousal communication, changes in partner attitude, and contraceptive use among the Yorubas of Southwest Nigeria
Peter O Ogunjuyigbe, Ebenezer O Ojofeitimi, Ayotunde Liasu
April-June 2009, 34(2):112-116
DOI:10.4103/0970-0218.51232  PMID:19966956
Objective: This paper highlights the relevance of spousal communication on males' attitude towards their partners' contraceptive use. Design: This was a cross-sectional study. Materials and Methods: Data for the study were obtained from a survey carried out in three states, Oyo, Osun, and Ondo, mainly inhabited by the Yorubas. Results: The results show that men have a significant role to play in the adoption of contraception. About 37% of the respondents reported joint decision making on when to have another child, 40.8% on whether to stop having children, and 44% on what to do to stop childbearing. Communication between a husband and wife on reproductive matters was also recognized as a factor that may influence male participation in family planning. Conclusion: This study has shown that the male partner may be highly motivated to obtain contraceptives. The results therefore suggest that male involvement in family planning should be encouraged through inter-spousal communication.
  3,112 310 5
Outcome of alcohol dependence: The role of continued care
Pratima Murthy, Prabhat Chand, MG Harish, K Thennarasu, S Prathima, Karappuchamy , N Janakiramiah
April-June 2009, 34(2):148-151
DOI:10.4103/0970-0218.51226  PMID:19966963
Aims: This study attempted to determine the effects of continued care on subjects with alcohol dependence. Materials and Methods: Study patients were recruited from a slum in Bangalore. The control group comprised individuals from a lower socio-economic status. Both groups received identical treatment from a specialised de-addiction facility. The study group also received weekly continued care in the community, either at a clinic located within the slum or through home visits. Those patients without stable jobs were referred for employment. The control group was given routine hospital follow-up visits. Both groups were evaluated on the Alcohol Problem Questionnaire and quantity/frequency of drinking at baseline and every 3 month interval for one year after discharge. Results: Both groups showed improvement in terms of reduction of drinking at 3 months, with the study group showing a 64% improvement with respect to the number of non drinking days and the control group showed a 50% improvement. However, at 6 months, 9 months, and 12 months, the study group continued to maintain these gains while the control group showed a downward slide (differences significant at P <0.05). At the end of 12 months, the study group maintained a 53% improvement with respect to the number of non drinking days as compared with baseline, while the control group had an improvement of only 28%. Conclusions: Follow-up support and continued care appear to significantly improve longer-term recovery in alcohol dependents.
  2,790 357 4
Musculoskeletal disorders: Epidemiology and treatment seeking behavior of secondary school students in a Nigerian community
Olayinka O Adegbehingbe, Adesegun O Fatusi, Caleb A Adegbenro, Opeyemi O Adeitan, Ganiyu O Abass, Akintomiwa O Akintunde
April-June 2009, 34(2):140-144
DOI:10.4103/0970-0218.51231  PMID:19966961
  2,605 187 -
Can we transplant conceptual frameworks of healthcare quality evaluation from developed countries into developing countries?
Sudha Ramani
April-June 2009, 34(2):87-88
DOI:10.4103/0970-0218.51223  PMID:19966950
  2,038 380 1
Awareness about birth registration in a resettlement colony of Delhi
Megha Gupta, Harsh Mahajan, P Lal
April-June 2009, 34(2):162-163
DOI:10.4103/0970-0218.51218  PMID:19966967
  2,028 195 -
XDR tuberculosis: A looming threat
Vishal Sharma, Sourabh Aggarwal
April-June 2009, 34(2):166-166
DOI:10.4103/0970-0218.51215  PMID:19966970
  1,643 346 -
Knowledge and attitudes of medical students and interns with regard to female feticide
Anita Nath, Nandini Sharma, Gopal K Ingle
April-June 2009, 34(2):164-165
DOI:10.4103/0970-0218.51217  PMID:19966969
  1,662 266 1
HIV/AIDS and forces
Neerja Jindal, Usha Arora
April-June 2009, 34(2):164-164
DOI:10.4103/0970-0218.51216  PMID:19966968
  1,380 174 2
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007