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   2013| October-December  | Volume 38 | Issue 4  
    Online since October 21, 2013

 
 
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VIEW POINT
Increasing fruit and vegetable consumption: Challenges and opportunities
Sandeep Sachdeva, Tilak R Sachdev, Ruchi Sachdeva
October-December 2013, 38(4):192-197
DOI:10.4103/0970-0218.120146  PMID:24302818
  10,319 552 2
CME
Burden of corneal blindness in India
Noopur Gupta, Radhika Tandon, Sanjeev K Gupta, V Sreenivas, Praveen Vashist
October-December 2013, 38(4):198-206
DOI:10.4103/0970-0218.120153  PMID:24302819
  10,175 636 1
EDITORIAL
Conjugate pneumococcal vaccines: Need and choice in India
Akash Malik, DK Taneja
October-December 2013, 38(4):189-191
DOI:10.4103/0970-0218.120140  PMID:24302817
  9,274 551 -
ORIGINAL ARTICLES
Study of Rogi Kalyan samitis in strengthening health systems under national rural health mission, district Pune, Maharashtra
Neha Adsul, Manoj Kar
October-December 2013, 38(4):223-228
DOI:10.4103/0970-0218.120157  PMID:24302823
Background: With objective of health systems strengthening, as visualized under National Rural Health Mission (NRHM); one key strategic intervention is up-gradation of health service delivery facilities so as to provide sustainable quality care with accountability and people's participation, which required the development of a proper management structure called Rogi Kalyan Samitis (RKS). It is the State's attempt to make health everyone's business by de-mystifying health-care delivery at district and sub-district levels with reference to facility based health-care delivery by encouraging citizen's participation in management bodies. Objective: The study was an attempt to define 'functional Health Systems' with a focus on strategic issues concerning RKS operations. Materials and Methods: A mixed-method, multi-site, collective case study approach was adopted. In-depth interviews of key-stakeholders were conducted. Qualitative data were analyzed thematically and coded inductively. Results: RKS is yet to bring out quality component to the health services being provided through facilities. This can be attributed to structural and managerial weakness in the system; however, certainly NRHM has been consistent in creating a road-map for benefitting local community and their participation through RKS. Conclusion: The progress of the RKS can further be enhanced by giving due priority to critical areas. Furthermore, the results emphasize an urgent need for devising strategies and actions to overcome significant systemic constraints as highlighted in the present study.
  3,223 438 1
A study to assess the emotional disorders with special reference to stress of medical students of Agartala government medical college and Govinda ballabh pant hospital
Taranga Reang, Himadri Bhattacharjya
October-December 2013, 38(4):207-211
DOI:10.4103/0970-0218.120154  PMID:24302820
Background: Stress is very common psychological phenomena where medical students faced in day to day activities. Epidemiological studies have asserted that about 70-80% of the diseases may be related to stress. Research related to this stress especially among medical students is essential, considering their learning, role and responsibilities as a future physician and health intervention programs. Objectives: To estimate the prevalence of stress and identify stressors among medical students. Materials and Methods: A Cross-sectional study was carried out among undergraduate medical students and self administered GHQ-12 and stressor questionnaire were used to collect information regarding stress. Binary logistic regression analysis was performed to calculate odds ratio (OR). Results: Prevalence of stress was 94.52% and more common among females. 33.56% students felt constantly under strain and 25.34% had loss of sleep over worry. Majority of the students of all semesters had stress (P > 0.05) and stressors viz. 'competition for marks' (P = 0.005), 'frequent examination' (P = 0.001), 'difficulty in finding time for recreation' (P = 0.014) and 'being away from home' (P = 0.027) were predominantly experienced by the 1 st year medical students. Multiple logistic regression analysis revealed the causal effect of main parameter on the GHQ caseness and students who found difficulties in following teaching language among the caseness had 81.59% higher chance of developing stress (OR = 8.159, CI = 1.228-54.213). Conclusion: The stress experience was more common due to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life.
  2,819 608 -
Community based maternal and child health nutrition project, Uttar Pradesh: An innovative strategy focusing on "At risk" families
Sheila C Vir
October-December 2013, 38(4):234-239
DOI:10.4103/0970-0218.120159  PMID:24302825
Research Question: Use of community based volunteers, frequently reaching and counseling a selected group of prioritized families, can make a substantial difference in improving maternal and child care practices and in reducing child undernutrition. Setting: Program Rural Uttar Pradesh, India. Study Design : A comparison of baseline and endline surveys following 4 years of community based project intervention Participants: "At risk" undernutrition families comprising mothers of under twos, newlyweds, and severely undernourished children below 6 years. Intervention: Mapping and counseling of "at risk" families. Measuring impact on maternal-child care practices, underweight status. Results: Trained community mobilizers identified and counseled selected "at risk" families. Following 4 years of implementation in 907 villages of 8 blocks of four districts, significant improvement was noted in practices of early initiation of breastfeeding, feeding colostrum, timely introduction of complementary feeding, and washing the hands after defecation. Percentage of mothers exclusively breastfeeding at 6 months was only 2.1% with 78% receiving prelacteal feeds. A small increase in normal and mild malnutrition and a significant reduction of 43% in severe malnutrition was noted. Conclusion: Frequently counseling by accredited social health activists by focusing on selected defined "at risk" families of under twos and those with severe malnourished children could result in increasing acceptability of correct child health, feeding, and care practices and in contributing to improving nutritional status scenario.
  2,855 533 -
A study on the role of mobile phone communication in tuberculosis DOTS treatment
R Elangovan, S Arulchelvan
October-December 2013, 38(4):229-233
DOI:10.4103/0970-0218.120158  PMID:24302824
Background: Every year, a lot of Tuberculosis (TB) patients undergo Directly Observed Treatment Short-course (DOTS) in Salem city, one of the high TB districts in South India. Mobile phone usage among these patients and health workers is common. Mobile phone communication has a great potential in TB treatment. Objectives: To analyze the mobile phone usage and its effectiveness in TB DOTS treatment. Materials and Methods: A cross-sectional survey with 150 TB patients was followed by a focus group discussion with treatment supervisors, DOTS providers, and health workers. Results: Majority of patients use mobile phones to make calls to health workers to clarify their doubts on side effects, food, and symptoms of the disease. TB treatment supervisors effectively use mobile phones to counsel patients to adhere to the treatment regimen. Patients see mobile phones as a useful communication tool in TB treatment though they prefer direct interpersonal communication with health workers. Though the mobile ownership is 68% among the TB patients, many of them are not able to send text messages or read messages in English. Conclusion: Mobile phone possession and usage is high among the patients. Patients need to be trained to use mobile phone features such as alarm, voice mail, and interactive voice response. Incentives like free talk time and short message service (SMS) will encourage patients to communicate frequently with health workers, thereby, increasing the chances of better adherence to DOTS. SMS could be made available in the regional languages.
  2,922 441 2
Health seeking behavior in Karnataka: Does micro-health insurance matter?
S Savitha, KB Kiran
October-December 2013, 38(4):217-222
DOI:10.4103/0970-0218.120156  PMID:24302822
Background: Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. Objectives: This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. Materials and Methods: The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. Results: Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. Conclusion : Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective.
  2,898 413 -
Effect of prenatal exposure to kitchen fuel on birth weight
Yugantara Ramesh Kadam, Anugya Mimansa, Pragati Vishnu Chavan, Alka Dilip Gore
October-December 2013, 38(4):212-216
DOI:10.4103/0970-0218.120155  PMID:24302821
Background: Maternal exposure to kitchen fuel smoke may lead to impaired fetal growth. Objective: To study the effect of exposure to various kitchen fuels on birth weight. Methodology : Study type: Retrospective analytical. Study setting: Hospital based. Study Subjects: Mothers and their newborns. Inclusion Criteria: Mothers registered in first trimester with minimum 3 visits, non-anemic, full-term, and singleton delivery. Exclusion Criteria: History of Pregnancy Induced Hypertension (PIH), Diabetes Mellitus (DM), tobacco chewers or mishri users. Sample size: 328 mothers and their new-borne. Study period: Six months. Study tools: Chi-square, Z-test, ANOVA, and binary logistic regression. Results: Effect of confounders on birth weight was tested and found to be non-significant. Mean ± SD of birth weight was 2.669 ± 0.442 in Liquid Petroleium Gas (LPG) users (n = 178), 2.465 ± 0.465 in wood users (n = 94), 2.557 ± 0.603 in LPG + wood users (n = 27) and 2.617 ± 0.470 in kerosene users (n = 29). Infants born to wood users had lowest birth weight and averagely 204 g lighter than LPG users (F = 4.056, P < 0.01). Percentage of newborns with low birth weight (LBW) in wood users was 44.68% which was significantly higher than in LPG users (24.16%), LPG + wood users (40.74%) and in kerosene users (34.48%) (Chi-square = 12.926, P < 0.01). As duration of exposure to wood fuel increases there is significant decline in birth weight (F = 3.825, P < 0.05). By using logistic regression type of fuel is only best predictor. Conclusion: Cooking with wood fuel is a significant risk-factor for LBW, which is modifiable.
  2,692 385 1
LETTERS TO EDITOR
Factors associated with attitudes of rural women toward cervical cancer screening
Smita Asthana, Satyanarayana Labani
October-December 2013, 38(4):246-248
DOI:10.4103/0970-0218.120163  PMID:24302829
  2,130 292 1
SHORT COMMUNICATION
Investigation of a cholera outbreak in a tea garden of Sivasagar district of Assam
Bhupendra Narayan Mahanta, Tulika Goswami Mahanta, Rochan Sinha, Abhijit Dutta, D Payeng, Q Jawed
October-December 2013, 38(4):240-243
DOI:10.4103/0970-0218.120160  PMID:24302826
Background: In late May 2012, Bagjan division of Borbam tea estate, of Sivasagar district of Assam was affected by an outbreak of acute watery diarrhea, subsequently confirmed as Vibrio cholerae O1. Objectives: Our objective is to investigate and control the acute diarrheal disease outbreak in Sivasagar district of Assam. Materials and Methods: A physician-epidemiologist-led team did rapid outbreak investigation to confirm the outbreak and instituted treatment and control measures. Quantitative data collection was done using standard schedule and qualitative data by using key informant interview schedule. Results: Spot mapping of cases was done along the garden residential lines. About 120 suspected cases were line listed; with 1:1.23 male: female ratio. Ages ranged from 3 to 70 years (median - 40.5 years). Attack rate was 4.79% with one death; case fatality rate was 0.83%. Open air defecation was practiced by 94.6%. Rectal swabs were positive for V. cholerae O1 (Ogawa). All the piped water samples were class IV unsatisfactory for domestic use. Conclusions: There is a need to improve water and sanitation facility in the tea garden lines along with implementation of a strengthened disease surveillance system through integrated disease surveillance project covering all tea estates.
  2,170 223 -
LETTERS TO EDITOR
Increase in hemoglobin among the mothers at different levels of hemoglobin
Neha Sareen, Ajeet Singh Bhadoria, Umesh Kapil
October-December 2013, 38(4):249-249
DOI:10.4103/0970-0218.120164  PMID:24302830
  1,157 166 -
Reply to: Dilemmas in immunization?
Ali J Abedi
October-December 2013, 38(4):245-245
DOI:10.4103/0970-0218.120162  PMID:24302828
  1,165 155 -
Breastfeeding week celebrations in rural Puducherry
Murugan Venkatesan, Amol R Dongre
October-December 2013, 38(4):244-244
DOI:10.4103/0970-0218.120161  PMID:24302827
  972 152 -
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  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007