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  Citation statistics : Table of Contents
   2013| April-June  | Volume 38 | Issue 2  
    Online since May 23, 2013

 
 
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ORIGINAL ARTICLES
A study on risk factors of breast cancer among patients attending the tertiary care hospital, in Udupi district
Ramchandra Kamath, Kamaleshwar S Mahajan, Lena Ashok, TS Sanal
April-June 2013, 38(2):95-99
DOI:10.4103/0970-0218.112440  PMID:23878422
Background: Cancer has become one of the ten leading causes of death in India. Breast cancer is the most common diagnosed malignancy in India, it ranks second to cervical cancer. An increasing trend in incidence is reported from various registries of national cancer registry project and now India is a country with largest estimated number of breast cancer deaths worldwide. Aim: To study the factors associated with breast cancer. Objectives: To study the association between breast cancer and selected exposure variables and to identify risk factors for breast cancer. Materials and Methods: A hospital based Case control study was conducted at Shirdi Sai Baba Cancer Hospital and Research Center, Manipal, Udupi District. Results: Total 188 participants were included in the study, 94 cases and 94 controls. All the study participants were between 25 to 69 years of age group. The cases and controls were matched by ± 2 years age range. Non vegetarian diet was one of the important risk factors (OR 2.80, CI 1.15-6.81). More than 7 to 12 years of education (OR 4.84 CI 1.51-15.46) had 4.84 times risk of breast cancer as compared with illiterate women. Conclusion: The study suggests that non vegetarian diet is the important risk factor for Breast Cancer and the risk of Breast Cancer is more in educated women as compared with the illiterate women. Limitation: This is a Hospital based study so generalisability of the findings could be limited.
  20 10,384 941
Awareness about Human Papilloma Virus and its vaccine among medical students
Sumita Mehta, Shalini Rajaram, Geetika Goel, Neerja Goel
April-June 2013, 38(2):92-94
DOI:10.4103/0970-0218.112438  PMID:23878421
Background: Cancer of the uterine cervix is the most common malignancy amongst women in India. Identification of its pre-cancerous lesions and prevention by HPV vaccine may go a long way in decreasing the incidence. Aim: The aim was to study the awareness about the various aspects of the HPV infection and vaccine among medical students. Settings and Design: It was a cross-sectional study conducted in a tertiary care hospital of Delhi. Materials and Methods: 150 medical students aged between 18-25 years were requested to complete a 35 point questionnaire regarding cervical malignancy, HPV infection, HPV vaccine and the answers were then analyzed. Results: None of the students knew the correct incidence of cervical cancer in India and 18% of them did not know that the HPV vaccination prevents cervical cancer and 50% thought that vaccination induces false sense of security. Fifty percent were unaware of HPV infection and its association with other STD's and cervical cancer. The information regarding the mechanism of action, dosage, schedule and cost of the HPV vaccine was lacking in majority of them. The limitation of this study is that it does not reflect the knowledge or awareness of a layman or full-fledged medical doctor. Conclusions: To conclude gaps in knowledge regarding HPV infection and vaccination existed amongst the medical students and a more integrated teaching regarding HPV carcinogenesis, vaccination and cervical cancer needs to be introduced.
  16 3,297 515
CME
Adherence to antiretroviral therapy in India: A systematic review and meta-analysis
Rahul Mhaskar, Vaibhav Alandikar, Patricia Emmanuel, Benjamin Djulbegovic, Sangita Patel, Atul Patel, Eknath Naik, Shyam Mohapatra, Ambuj Kumar
April-June 2013, 38(2):74-82
DOI:10.4103/0970-0218.112435  PMID:23878418
Objective: To assess the adherence to antiretroviral therapy (ART) in the human immunodeficiency virus (HIV)-infected population in India. Design: Systematic review and meta-analysis. Materials and Methods: The Medline and Cochrane library database were searched. Any prospective or retrospective study enrolling a minimum of 10 subjects with a primary objective of assessing ART adherence in the HIV population in India was included. Data were extracted on adherence definition, adherence estimates, study design, study population characteristics, recall period and assessment method. For metaanalysis, the pooled proportion was calculated as a back-transform of the weighted mean of the transformed proportions (calculated according to the Freeman-Tukey variant of the arcsine square root) using the random effects model. Results: There were seven cross-sectional studies and one retrospective study enrolling 1666 participants. Publication bias was significant (P = 0.003). Pooled results showed an ART adherence rate of 70% (95% confidence interval: 59-81%, I 2 = 96.3%). Sensitivity analyses based on study design, adherence assessment method and study region did not influence adherence estimates. Fifty percent (4/8) of the studies reported cost of medication as the most common obstacle for ART adherence. Twenty-five percent (2/8) reported lack of access to medication as the reason for non-adherence and 12% (1/8) cited adverse events as the most prevalent reason for non-adherence. The overall methodological quality of the included studies was poor. Conclusion: Pooled results show that overall ART adherence in India is below the required levels to have an optimal treatment effect. The quality of studies is poor and cannot be used to guide policies to improve ART adherence.
  14 4,657 470
DHANWANTRI ORATION
Universal Health Coverage for India by 2022: A Utopia or Reality?
Zile Singh
April-June 2013, 38(2):70-73
DOI:10.4103/0970-0218.112430  PMID:23878417
It is the obligation of the state to provide free and universal access to quality health-care services to its citizens. India continues to be among the countries of the world that have a high burden of diseases. The various health program and policies in the past have not been able to achieve the desired goals and objectives. 65 th World Health Assembly in Geneva identified universal health coverage (UHC) as the key imperative for all countries to consolidate the public health advances. Accordingly, Planning Commission of India constituted a high level expert group (HLEG) on UHC in October 2010. HLEG submitted its report in Nov 2011 to Planning Commission on UHC for India by 2022. The recommendations for the provision of UHC pertain to the critical areas such as health financing, health infrastructure, health services norms, skilled human resources, access to medicines and vaccines, management and institutional reforms, and community participation. India faces enormous challenges to achieve UHC by 2022 such as high disease prevalence, issues of gender equality, unregulated and fragmented health-care delivery system, non-availability of adequate skilled human resource, vast social determinants of health, inadequate finances, lack of inter-sectoral co-ordination and various political pull and push of different forces, and interests. These challenges can be met by a paradigm shift in health policies and programs in favor of vulnerable population groups, restructuring of public health cadres, reorientation of undergraduate medical education, more emphasis on public health research, and extensive education campaigns. There are still areas of concern in fulfilling the objectives of achieving UHC by 2022 regarding financing model for health-care delivery, entitlement package, cost of health-care interventions and declining state budgets. However, the Government's commitment to provide adequate finances, recent bold social policy initiatives and enactments such as food security bill, enhanced participation by civil society in all health matters, major initiative by some states such as Tamil Nadu to improve health, water, and sanitation services are good enough reasons for hope that UHC can be achieved by 2022. However, in the absence of sustained financial support, strong political will and leadership, dedicated involvement of all stakeholders and community participation, attainment of UHC by 2022 will remain a Utopia.
  10 4,706 602
ORIGINAL ARTICLES
Impact of short term yoga intervention on mental well being of medical students posted in community medicine: A pilot study
Rahul Bansal, Monika Gupta, Bhaskar Agarwal, Sachin Sharma
April-June 2013, 38(2):105-108
DOI:10.4103/0970-0218.112445  PMID:23878424
Background: High level of stress, anxiety and depression is seen among medical students. Aims: To assess the impact of brief structured yoga intervention on mental well being of MBBS students. Materials and Methods: The participants consisted of 82 MBBS students of 3 rd semester in the age group of 18-23 years. The students were assessed at baseline and at the end of one month of specific yoga intervention by using General Health Questionnaire-28 (GHQ-28). Results: The students reported improvement in general and mental well being following the intervention and difference was found to be highly significant. Conclusion: A short term specific yoga intervention may be effective in improving general and mental well being in MBBS students. It is feasible and practical to include yoga practice in block postings of community medicine.
  7 3,997 401
Magnitude, types and sex differentials of aggressive behaviour among school children in a rural area of West Bengal
Debashis Dutt, Girish Kumar Pandey, Dipak Pal, Suprakas Hazra, Tushar Kanti Dey
April-June 2013, 38(2):109-113
DOI:10.4103/0970-0218.112447  PMID:23878425
Background: Aggression affects academic learning and emotional development, can damage school climate and if not controlled early and may precipitate extreme violence in the future. Objective s : (1) To determine the magnitude and types of aggressive behavior in school children. (2) To identify the influence of age and sex on aggressive behavior. Materials and Methods: A cross-sectional study was conducted in Anandanagar High School, Singur village, West Bengal. Participants were 161 boys and 177 girls of classes VII to IX. The students were asked to complete a self-administered questionnaire indicating the types of aggressive behavior by them in the previous month and to assess themselves with reference to statements indicating verbal/physical aggression. Results: Overall, 66.5% of the children were physically aggressive in the previous month: Boys 75.8%, girls 58.2% ( P = 0.001); 56.8% were verbally aggressive: Boys 55.2%, girls 61% ( P = 0.97). Verbal indirect passive aggression was more common among girls (55.3%) than among boys (22.3%) ( P = 0.000 [1.17E09 ]). Boys were more liable to physical aggression, viz. 60.2% of the boys would hit on provocation compared with only 9% of the girls ( P = 0.000 [6.6E -23 ]). Regarding attributes indicating verbal aggression, girls were more argumentative (63.8%) than boys (55.2%) ( P = 0.134) and disagreeing (41.8%) compared with boys (33.5%) ( P = 0.145). With increasing age/class, physical direct active aggression decreased while physical indirect passive and verbal indirect passive aggression increased. No classes had been taken on anger control/management by school the authorities. Conclusions: Aggressive behavior was common both among boys and girls. Life skills education/counseling/classroom management strategies are recommended.
  5 5,102 254
Road traffic accident: An emerging public health problem in Assam
Pranab Jyoti Bhuyan, Faruquddin Ahmed
April-June 2013, 38(2):100-104
DOI:10.4103/0970-0218.112441  PMID:23878423
Background: In the northern states, there is hardly any scientific study except road traffic accidents (RTAs) statistics obtained by the Ministry of Home whereas the main way of transportation is by road. There is the increasing load of motor vehicles on the already dilapidated roadways which has resulted in the increasing trend of RTAs in Assam. Objectives: To find out the prevalence, probable epidemiological factors and morbidity and mortality pattern due to RTAs in Dibrugarh district. Materials and Methods: Descriptive study was carried out in Dibrugarh district from September 1998 to August 1999 under the department of Community Medicine. The information was collected from Assam Medical College and Hospital and cross checked with the police report. A medical investigation including interview, clinical and radiological investigation was carried out; in case of fatality, post-mortem examination was examined in details. An on the spot investigation was carried out in accessible RTAs to collect the probable epidemiological factors. Results: RTAs affected mainly the people of productive age group which were predominantly male. Majority of the RTAs were single vehicle accidents and half of the victims were passengers. Accident rate was maximum in twilight and winter season demanding high morbidity and mortality. Head and neck, U.limb and L.limb were commonly involved. Conclusion: RTAs is a major public health problem in Assam which needs more scientific study.
  5 4,800 447
Hepatitis C virus infection in HIV positive attendees of Shiraz behavioral diseases consultation center in southern Iran
Mohammad Ali Davarpanah, Farnaz Khademolhosseini, Abdolreza Rajaeefard, Alireza Tavassoli, Seyed Kamalaldin Yazdanfar, Abbas Rezaianzadeh
April-June 2013, 38(2):86-91
DOI:10.4103/0970-0218.112437  PMID:23878420
Objective: To determine the prevalence of HCV co-infection and its correlation with demographic and risk factors among human immunodeficiency virus (HIV)-infected individuals attending Shiraz behavioral diseases consultation (SBDC) Center in southern Iran. Materials and Methods : In a cross-sectional study, 226 consecutive HIV-positive patients who referred to SBDC Center from April 2006 to March 2007 were interviewed face-to-face to record demographic data and risk factors of HIV transmission. A 10ml sample of venous blood was drawn from every subject and tested for HCV-antibodies by third generation enzyme linked immunosorbant (ELISA) and recombinant immunoblot assays (RIBA). All samples were also analyzed by qualitative reverse transcriptase polymerase chain reaction (RT-PCR) for detection of HCV-RNA. Results: The study population consisted of 214 men (94.7%) and 12 women (5.3%) with a mean age of 35.6 ± 7.9 years. The most prevalent risk factor was imprisonment (88.9%) followed by injecting drug use (79.2%). The prevalence of HCV infection was 88.5% by ELISA and 86.7% by RIBA, while HCV viremia was detected in 26.1% of the patients. HCV-antibody positivity was significantly associated with gender, age, marital status, occupation, injecting drug use, and history of imprisonment. It was inversely related to "having an infected or high risk sexual partner". In the logistic regression model, the predictors of HCV-positivity were injecting drug use (OR = 24.9, P = 0.004) and imprisonment (OR = 21.4, P < 0.001). Conclusions: Prevalence of HCV infection among HIV-positive individuals in our region is very high and there is a need for stricter preventive actions against transmission of HCV among this group of patients.
  4 2,481 172
VIEW POINT
Is myopia a public health problem in India?
Rohit Saxena, Praveen Vashist, Vimla Menon
April-June 2013, 38(2):83-85
DOI:10.4103/0970-0218.112436  PMID:23878419
Myopia, a form of refractive error is a leading cause of visual disability throughout the world. In India uncorrected refractive errors are the most common cause of visual impairment and second major cause of avoidable blindness. Due to this the public health and economic impact of myopia is enormous. Although school vision screening programme is very successful in many states, still a significant number of school going children remain unidentified and the unmet need for correcting refractive errors in children appears to be significant.
  3 4,568 283
SHORT COMMUNICATIONS
Comparative assessment of satisfaction among outpatient department patients visiting secondary and tertiary level government hospitals of a district in Delhi
Narinder K Saini, Samiksha Singh, Ganesh Parasuraman, OP Rajoura
April-June 2013, 38(2):114-117
DOI:10.4103/0970-0218.112449  PMID:23878426
  2 2,093 249
LETTERS TO EDITOR
Insulin resistance and cardio metabolic abnormalities among overweight south Indian children: Chennai slim and fit programme
Shabana Tharkar, Arutselvi Devarajan, Satyavani Kumpatla, Parthiban Muthukumaran, Vijay Viswanathan
April-June 2013, 38(2):121-122
DOI:10.4103/0970-0218.112452  PMID:23878428
  1 1,480 157
SHORT COMMUNICATIONS
Effect of maternity schemes on place of delivery in a tribal block of Gujarat
Pankaj P Shah, Dhiren K Modi, Shobha P Shah, Shrey A Desai
April-June 2013, 38(2):118-120
DOI:10.4103/0970-0218.112450  PMID:23878427
  1 1,598 226
BOOK REVIEW
Urbanizing cholera: The social determinants of its re-emergence
Anjali Chikersal
April-June 2013, 38(2):124-124
  - 1,006 126
EDITORIAL
Vaccines, social mobilization, or any other game changer: Polio eradication is an unfinished narrative
Sanjay Chaturvedi
April-June 2013, 38(2):67-69
DOI:10.4103/0970-0218.112429  PMID:23878416
  - 2,276 366
LETTERS TO EDITOR
Why children are taking up the job?
Hanmanta V Wadgave, Lata B Godale
April-June 2013, 38(2):122-123
DOI:10.4103/0970-0218.112453  PMID:23878429
  - 3,492 116
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007