bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of antiinflammatory therapy in patients with severe asthma and cold air-provoked bronchial hyperresponsiveness
Authors: Pirogov A. B. , Prikhod’ko A. G. , Gassan D. A. , Mal’tseva T. A. , Kolosov V. P. , Perel’man Yu. M.
Published: December 2018

The aim of this study was to assess effects of antiinflammatory therapy with leukotriene receptor antagonists (LTA) and/or combination of an inhaled corticosteroid (ICS) and a long-acting β2-agonist (LABA) on the clinical course and airway inflammatory patterns in patients with severe asthma and cold air-provoked bronchial hyperresponsiveness. Methods. Asthma symptoms, lung function, and spontaneous sputum cytology were assessed at baseline and after 24 weeks of the therapy. Subgroup analysis was performed for patients with sputum eosinophils < 61% and sputum neutrophils < 61%. Eosinophilic patients were treated with fluticasone propionate/salmeterol, neutrophilic patients with treated with fluticasone propionate/salmeterol plus montelukast during 24 weeks. The control of the disease was assessed using Asthma Control Test (ACT). Results. After 24-wk treatment, eosinophilic patients improves asthma control from 10.9 ± 0.5 to 19.6 ± 1.3 according to ACT questionnaire (р < 0.001), FEV1 improved from 45.9 ± 3.7% pred. to 79.2 ± 2.2% pred. (р < 0.001). Sputum eosinophil number decreased from 27.9 ± 2.1% to 7.1 ± 1.9% (р < 0.001); sputum neutrophil number decreased from 21.1 ± 2.1% to 8.7 ± 2.3% (р < 0.001). In neutrophilic patients, ACT score improved from 8.9 ± 0.6 to 15.9 ± 1.2 (р < 0.001), FEV1 improved from 42.9 ± 2.6% pred. to 72.3 ± 2.5% pred. (р < 0.001). Sputum neutrophil number decreased from 76.8 ± 3.7 to 52.2 ± 4.3 % (р < 0.001); Sputum eosinophil number decreased from 8.1 ± 0.7% to 6.2 ± 0.4% (р < 0.05). After 24 weeks of the treatment, partial control of asthma (ACT 20 -24) was achieved in 63% and 29% of patients in eosinophilic and neutrophilic groups, respectively (χ2 = 1.81; р > 0.05) after treatment. Conclusion. Adding montelukast to the combined therapy with fluticasone propionate/salmeterol in patients with severe asthma, cold air-provoked bronchial hyperresponsiveness and increased sputum neutrophils did not resulted in better control of the disease. The analysis of airway inflammatory pattern could be used as an additional marker to predict treatment efficiency.
Broad spectrum antibiotic use among in-patients at a hospital in Nairobi, Kenya
Authors: Mariita Kizito M. , Chirima Harriet A. , Maina Carol K.
Published: December 2018

Background: Antimicrobial resistance is an increasingly serious threat to global public health. While the use of antibiotics is an important contributing factor, there are gaps regarding this in our region. This study aimed to describe the use of nine broad spectrum antibiotics among in-patients of The Nairobi Hospital (TNH) so as to identify opportunities for quality improvement.Methods: This was a retrospective review of the use of meropenem, ertapenem, imipenem, cefepime, piperacillin, gentamicin, amikacin, vancomycin and teicoplanin among in-patients of TNH from 1st January 2018 to 31st March 2018. Demographic and clinical data of all in-patients who were prescribed these antibiotics during the study period were retrieved from patient files.Results: There were 301 study participants with a median age (range) of 30years (1day-74years), of whom 161 (53.5%) were male. More than half of the participants were admitted for less than one week and had at least one co-morbidity. Meropenem was the most commonly prescribed study antibiotic 123 (40.9%) followed by amikacin 89 (29.6%). Respiratory tract infections 125 (41.5%) were the predominant indications. Meropenem had the longest mean duration of administration, 6.5days while the aminoglycosides were administered for a relatively shorter duration of about 4.8days. Cultures were done on 187 (62.1%) patients though it is only samples of 45 patients that grew an organism, E. coli and Klebsiella sp being the most frequently isolated organisms.Conclusions: There’s a need to strongly intensify implementation of restriction strategies for Meropenem use and introduction of education programs on antimicrobial stewardship targeting all prescribers.
Anti-inflammatory and ulcerogenic activities of thiazolidine-4-ones in rats
Authors: N. Shiva Murthy , V. Srinivas , M. Shanthi
Published: December 2018

Background: NSAIDS are associated with side effects and research should continue for developing safer drugs. This study aims to evaluate newer thiazolidine-4-ones for their anti-inflammatory and ulcerogenic activities in wister rats.Methods: Five groups of wister rats, 6 in each were used.  Anti-inflammatory and ulcerogenic activities of diclofenac (30mg/kg), nimesulide (50mg/kg), thia-1 (50mg/kg) and thia-2 (50mg/kg) are compared with control group (4% Gum Acacia). Carrageenin-induced paw edema, formaline induced acute peritonitis and cotton pellet-induced granulomatous tissue formation models were used for evaluating anti-inflammatory activity. After removing cotton pellets with granuloma on 8th day gastric ulcerogenicity was assessed by using macroscopic and microscopic scoring of ulcers.Results: Diclofenac, nimesulide and thia 2 reduced both paw edema and peritoneal exudate volume significantly (p <0.01). Wet weight of cotton pellets reduced significantly (p <0.01) by diclofenac, nimesulide and thia 2. Diclofenac (p <0.01) and thia 2 (p <0.05) reduced dry weight of cotton pellets significantly. nimesulide and thia-1 reduced it by 19.14% and 2.68% respectively and was considered statistically not significant (p>0.05). Nimesulide, thia-1 and thia-2 did not increase gastric ulcer score significantly (p >0.05). Diclofenac increased ulcer score significantly (p <0.01).Conclusions: Thia-2 demonstrated significant anti-inflammatory activity in acute and chronic models. In addition to inhibition of cyclooxygenase pathway, PPAR agonistic activity may be involved in its anti-inflammatory activity.  No significant ulcerogenicity was observed on comparing with nimesulide and control. Further in-vitro and in-vivo studies are recommended to confirm the results of this study.
Assessment of medication adherence among patients with chronic diseases: a descriptive cross-sectional study
Authors: Mir Shakeel Ahmad , Muzamil Furqanah , Bhat Mehraj UD Din , Amin Abid , Shakeel Danish
Published: December 2018

Background: Adherence is a key factor associated with effectiveness of all pharmacological therapies. Medication non-adherence is a significant barrier to achieve positive health outcomes especially for patients suffering from chronic diseases. Improving medication adherence is a public health priority and could reduce economic and health burdens. The aim of the present study was to assess medication adherence to some common chronic ailments.Methods: Pre-validated questionnaires were distributed among 300 patients suffering from chronic illnesses, by simple randomization out of which 240 patients returned completely filled questionnaires. The analysis was done by manual calculators, VassarStats, and SPSS V20. Results were calculated using univariate linear regression, with each patient’s adherence score as the dependent variable and each predictor as the independent variable. Results are expressed in frequencies and percentages.Results: In this study, 46.66% patients were males and 53.33% females. The mean age was 56.69 years ranging from 24 to 90 years.65.00% patients were uneducated.40.00% were taking one drug, 53.33% two to four drugs and 6.66% more than four drugs. 63.33% had low medication adherence, 35.00% medium and only 1.66% had high adherence. Compared to 14.28% men, 43.75% women were moderately adherent to medications. 41.02% uneducated patients had medium adherence as compared to 14.28% educated patients. 92.30% young patients had low adherence as compared to 53.25% in adults. 44.79% of patients receiving a single drug had medium adherence as compared to 25.00% in those receiving multiple drugs. Linear regression analysis demonstrated that the level of medication adherence was associated with patient gender, age, educational level, and number of prescribed drugs.Conclusions: There are many challenges in understanding the reasons for non-adherence. In this study medication adherence in chronic diseases was found suboptimal and associated with patient`s socio-demographic characteristics. Patient-tailored interventions are required to achieve sufficient adherence to therapeutic drug regimens.
Preclinical evaluation of antidepressant activity of aqueous extract of Piper betle leaves in Swiss albino mice
Authors: Krishna Uttara , Nayak Roopa P. , R. Chaitra S.
Published: December 2018

Background: There is a growing demand for alternative medicines derived from indigenous plants having natural antioxidants and neuroprotective actions for the treatment of many behavioural disorders such as anxiety and depression. This study was designed to screen antidepressant activity of aqueous extract of Piper betle L. leaf (betel leaf) in Swiss albino mice.Methods: Swiss albino mice of both sexes weighing 25-30grams were used in the present study. Piper betle leaves aqueous extract (PBAE) was administered to the animals at a dose of 100, 200mg/kg body weight orally for 14 days. On the 14th day, after 1 hour of PBAE administration, experiments on force swim test (FST) and tail suspension (TST) were carried out for studying the level of depression. In FST and TST, time of immobility was noted for a period of 5 minutes.Results: Data was analyzed by one-way ANOVA followed by Tukey Kramer’s multiple comparison test at P = 0.05. The results were represented as Mean±SE. PBAE at a dose of 100mg/kg has shown significant antidepressant activity, as evidenced by decrease in the immobility time in both the screening tests of depression.Conclusions: Present results demonstrated that PBAE possess potent antidepressant property. The exact mechanism(s) related to the active compound(s) in Piper betle leaf extract have to be elucidated in future studies.
Adverse drug reactions associated with first line anti-tubercular drugs, their prevalence and causality assessment in patients on Directly Observed Treatment Short-course (DOTS) in a tertiary care hospital
Authors: Nazir Tauseef , Farhat Sameena , Adil Mohd , Asraf Zuryat
Published: December 2018

Background: Treatment of tuberculosis involves giving multiple drugs to the patient which is done to prevent development of resistance besides targeting all bacterial sub-populations. The objective of the present study was to find out the adverse drug reactions (ADRs) of the first line anti-tubercular drugs and to calculate prevalence and causality of these drugs.Methods: The study was conducted by the Department of Pharmacology, Government Medical College, Srinagar in association with the department of Chest medicine. All patients of tuberculosis on directly observed treatment-short course (DOTS) of either sex or age group were enrolled. An assessment of the causality and allocation of ADRs was done using Naranjo’s monitoring scale and WHO-UMC scale.Results: A total of 57 ADRs with 13 different types were observed in 164 patients, with an overall prevalence of about 34.7%. Thirty seven (64.9%) ADRs were categorized as having a ‘probable’ causal relationship while 17 (29.8%) was categorized as ‘possible’ as per the Naranjo’s scale. As per the WHO-UMC monitoring scale fifty two (91.2%) were categorized as ‘possible’ while three (5.3%) were categorized as ‘certain’.Conclusions: Occurrence of ADRs generally results in non-adherance. Timely detection of ADRs through an effective pharmacovigilance programme is the need of hour. The establishment of an active pharmacovigilance centre which was set up in our institution has paved the way to improve the quality of patient care by ensuring safer use of drugs and has helped us to identify and report the various ADR’s encountered.
Oseltamivir induced sinus bradycardia: an area of potential concern
Authors: Shah Karan B. , Shah Bhavesh S. , Malhotra Supriya D. , Patel Pankaj R.
Published: December 2018

Oseltamivir was approved for the prevention and treatment of influenza in 1999 by the USFDA (US Food and Drug Administration). The use of Oseltamivir is increasing rapidly all over the world, especially after the 2009 “Swine Flu” pandemic. Less data is published as far as the cardiovascular side effects of Oseltamivir are concerned, but it could be associated with some serious cardiovascular side effects. This study presented a case series of 5 cases suspected to be suffering from seasonal influenza H1N1 (“Swine Flu”), who developed sinus bradycardia while they were on Oseltamivir therapy.
Schoolbag weight limit: should there be a cut off?
Authors: Bhat Srikanth S. , S. Vinay Kumar , Dhanwadkar Sharanabasappa S. , N. B. Ashwini Kumari
Published: December 2018

Background: School children are at a development age and it is important that they do not carry excessive loads. Heavy school bags can change the body posture and the musculoskeletal system must react appropriately in order to compensate for this stress. There is still no consensus about a guideline for weight of school bags. The objective of the present study was to asses the bag weight in school going children, Compare the bag weight with the whole-body weight of children, Percentage of bag weight to whole body weight at different age groups.Methods: 727 children (413 males and 314 girls) were examined from different schools in Davangere. Descriptive analyses and measures of central tendency were performed on the demographic data to describe the sample.Results: Overall 21.7% of children carry a bag which is >25% of their body weight, 46.5% children are carrying a bag >20% of their body weight and 74.7% of children carry a bag of >15% of their body weight. 40.9% children between 8-10 years carry bag of >25% and 39.8% of them between 11 -13 years carry bag of >20% and this is statistically significant (p = 0.000).Conclusions: The weight of schoolbags of school children were higher than the internationally acceptable standards in majority of school children. The school authorities and ministry of health should further evaluate and take the necessary steps to rectify the situation. Early intervention and good regulation can prevent long term complication.
Meconium aspiration syndrome: clinical profile, risk factors and outcome in central India
Authors: Kamble Milind B. , Jain Poonam
Published: December 2018

Background: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disease affecting some neonates born through meconium-stained amniotic fluid (MSAF). MSAF complicates delivery in approximately 8% to 25% of live births, of which nearly 5% of the neonates born through MSAF develop MAS. The present study was undertaken to find out the prevalence of MSAF and MAS and to study the etiology, risk factors, clinical profile and outcome of MAS.Methods: By purposive sampling technique, all newborns, fulfilling the inclusion criteria during one year of study period were enrolled in this hospital based cross-sectional observational study. Risk factors and clinical profile were compared between those who died and survived.Results: Out of 8765 deliveries in hospital 1220 neonates were born with MSAF of which 94 neonates had MAS. Thereby, incidence of MSAF was 13.9% and incidence of MAS out of MSAF was 7.7 %. Of the 94 neonates who had MAS 13.82% died. Almost 3/4th of the MAS neonates were term and AGA. MAS were more common in primigravida mother (68%) and LSCS deliveries (53.2%). Of the total MAS 54.2% had thick meconium in whom mortality was 92.3%. The mortality in MAS cases was significant in low 5-minute APGAR score and non-vigorous baby.Conclusions: Since MSAF is associated with higher morbidity and mortality, if the knowledge of risk factors is known to health care personnel then timely referral or intervention can help in decreasing MAS and its complications.
Quality of life in children with thalassemia major following up at a tertiary care center in India (GOTQoL)
Authors: Ankush Ankush , Dias Amit , Silveira M. P. , Talwadker Yash , Souza Joachim Piedade
Published: December 2018

Background: This study aims to measure the quality of life (QoL) scores in children with thalassemia major following up at a tertiary care center for routine blood transfusion in comparison to healthy children.Methods: A case control study design was adopted, wherein on the QoL of 36 children with thalassemia in the age group 5 to 18 following up for blood transfusion at Goa Medical College, was measured using PedsQL™ 4.0. This was compared to the QoL in age and gender matched healthy children from a government school. A higher score on a subscale indicates better quality of life on this instrument.Results: The children with thalassemia had lower mean scores on physical (67.85 vs 84.24; P <0.001), social (78.34 vs 87.95; P=0.002) and school (62.64 vs 79.48; P <0.001) functioning subscales compared to the healthy children. They also had lower mean psychosocial summary score (73.32 vs 82.01; P=0.003) and total health summary score (71.95 vs 82.57; P <0.001). The physical functioning subscale had significantly higher score among the children who were on chelation and also among the ones whose parents reported as being informed about the condition.Conclusions: The children with thalassemia have poor QoL in physical, social and school functioning domains. Improvement in QoL requires consolidated efforts on part of doctors, parents, school authorities and policy makers. These patients should be provided with low cost-effective chelation therapy. The parents need to be counselled about this disease by the treating team.
Comparison of clinical and biochemical profile of obese and nonobese children
Authors: C. Patil Lingaraja Gowda , S Srinivas
Published: December 2018

Background: We compared clinical and biochemical parameters of obese children aged 6 to 18 years with normal controls visiting to outpatient department in a tertiary care hospital. It was a prospective case control study.Methods: Obese children with Body Mass Index > 2 standard deviation according to WHO chart were included. Endocrinological and syndromic obese children were excluded.  We described risk factors for obesity and compared clinical and biochemical parameters between cases and controls. Student’s t test, Chi-square test and ANOVA (analysis of variance) were used for statistical analysis.Results: We noted higher prevalence of intake of junk food and sedentary lifestyle in obese group. Anthropometric parameters including BMI, skin fold thickness and abdominal circumference were higher in obese children compared to control group. Both systolic and diastolic blood pressures were high in obese children compared to control group. We observed higher prevalence of insulin resistance and dyslipidaemia among obese children.Conclusions: This study reemphasises that junk foods and sedentary lifestyle are important risk factors for obesity. Always screen for glucose intolerance, hypertension, insulin resistance and dyslipidaemia in obese children.
Clinico-laboratory profile of dengue fever in children
Authors: Wani Gowhar , Imran Ayesha
Published: December 2018

Background: Dengue is rising globally. It presents with varied clinical manifestations. This study was done to describe the salient clinical as well as laboratory findings of serologically confirmed cases of dengue fever.Methods: This was a prospective study conducted at Government Multispeciality Hospital-16 Chandigarh from July 2017 to December 2017. All children below 17 years of age that had clinical features of dengue and who were antigen or antibody positive were included in this study.Results: Age group most commonly affected was 5-10 years with maximum number of dengue cases with warning signs(72.94%). Fever was present in all cases followed by headache(89.41%) and myalgia(78.82%). Thrombocytopenia was the commonest hematological abnormality(97.6%).Conclusions: Dengue presents with varied clinical features. Community awareness, early diagnosis and management and vector control measures needs to be strengthened in order to reduce the increasing number of dengue case.
Risk factors of pediatric urinary tract infections: an epidemiologic study
Authors: Esteghamati Maryam , Mousavi Seyedeh Elaheh , Alizadeh Shervin Haj
Published: December 2018

Background: Urinary tract infection (UTI) is the second most prevalent pediatric infection, and if it is not recognized and treated properly, it can cause severe irreversible complications such as renal failure and hypertension. In this research, some of the risk factors of UTIs were compared in children with urinary tract infections.Methods: This is a cross-sectional study, with the urinary tract infection as the dependent variable and gender, circumcision status, history of urinary catheterization, family history, history of renal stone, hypercalciuria, constipation history, reflux, neurogenic bladder, phimosis, posterior urethral valves (PUV), ureteropelvic junction obstruction (UPJO), and ureterovesical junction obstruction (UVJO) as the independent variables. A total of 405 children were studied in this research. The data was collected using questionnaires, checklists, and examinations. Data analysis was also carried out using descriptive and analytical statistics method in SPSS.Results: This research revealed the prevalence of urinary tract infection among children with several risk factors, and the common factors were positive family history, history of urinary catheterization, constipation, and other non-anatomical disorders (history of renal stone and hypercalciuria. The most common risk factors regardless of gender and age were non-anatomic disorders that were observed in 147 cases (43.7%) (p-value<0.001). Among the non-anatomical factors, constipation was the most common factor observed in 66 cases (16.3%). A higher rate of urinary infection was observed in the uncircumcised male patients than the circumcised patients, and there was a significant relationship between circumcision and UTI.Conclusions: In this study, urinary tract infection staged a significant relationship with gender, circumcision status, urinary catheterization history, family history, renal stone history, hypercalciuria, history of constipation, reflux, neurogenic bladder, phimosis, PUV, UPJO, and UVJO.
Typhoid fever with multiorgan involvement: pulmonary, hepatic and renal complications with dyselectrolytemia
Authors: Verma Manish , Jat Jaisingh , Agarwal Khushboo
Published: December 2018

Typhoid fever is an important health problem in developing countries like India, especially among young children. It may involve a number of systems and may present with various complications specially if untreated. We report a rare case of typhoid fever with multiple complications in 4 years young female who presented with fever, toxemia, bronchopneumonia, icteric hepatitis and also developed AKI, hyponatremia. Enteric fever with its complications has been reported previously but mostly reported with surgical complications, pulmonary complication, Myocarditis, hepatitis, hepatitis with renal failure etc but this seems to be unique case as presented with multiorgan involvement e.g. bronchopneumonia, icteric hepatitis, AKI and dyselectrolytemia. Previously reported cases were usually adolescents while this case is just 4 years young child. Despite multiple complications, patient responded well to treatment of enteric fever and discharged successfully.
Femoral hypoplasia-unusual facies syndrome: a rare clinical entity
Authors: Lichade Vinaya , Wade Poonam , Gandhi Prachi , Saxena Shruti , Malik Sushma
Published: December 2018

Femoral hypoplasia-unusual facies syndrome (FH-UFS) is a disorder with multisystem involvement comprising predominantly of craniofacial dysmorphism with bilateral hypoplastic femurs. The exact etiology of this disorder is unknown, however maternal infections, drug and radiation exposure, oligohydramnios has been implicated. In affected children born to non-diabetic mothers, a genetic contribution is suspected; however, no chromosomal or gene mutations have been identified so far. The syndrome closely resembles with caudal dysplasia or syringomyelia which occur due to insufficient mesoderm in the caudal part of the embryo leading to lumbosacral defects, renal agenesis, and dysplastic lower limbs, however they lack craniofacial dysmorphism. The pathogenesis of FH-UFS involves poor development of subtrochanteric portion of the femoral cartilage. This results in shortening of proximal femur. Maternal diabetes justifies the teratogenic effect of hyperglycemia and ketones on fetus leading to dysmorphic features in fetus. Here, we are reporting a female neonate with characteristic phenotypic features of FH-UFS. She had cleft lip and palate, low set ears, retrognathia and micrognathia, dolichocephaly with bilateral femoral hypoplasia with talipes deformity of both feet. Karyotype was normal (46XX). Renal and cranial ultrasounds were normal. The 2D Echo revealed small 0.3mm PDA.
Comparative study of rise of vitamin D in hypovitaminosis D babies after two different dosage recommendations
Authors: Shrivastava Bijal , Aryan Rashi , Tiwari Abhinav , Tiwari Lekha , Pravallika Nimmkayala
Published: December 2018

Background: There are currently two different guidelines for treatment of Vitamin D deficiency in infants, one is that of American Academy of Pediatrics and the other being Clinical Practice Guidelines of the Endocrine Society. This study was done to compare the two guidelines for treatment of Vitamin D deficiency in infants.Methods: A hospital based, longitudinal interventional study was conducted for 2 years and 115 babies having vitamin d deficiency (Vitamin D less than or equal to 20ng/dl) were divided into group A and group B. Group A babies were treated as per American Academy of Pediatrics Guidelines whereas Group Cases were treated as per International Endocrine Society guidelines. All babies were followed up after 3-4 months when repeat Vitamin D levels were checked and then compared.Results: In present study, Vitamin D level had increased by 0.6 times in Group A whereas it had increased by 1.3 times in group B and it was significant.Conclusions: Study results were in favour of the guidelines recommended by the International Endocrine Society.
Knowledge and attitude towards consanguineous marriage among educated adults in Riyadh
Authors: Mahboub Samira M. , Alsaqabi Alanoud A. , Allwimi Noura A. , Aleissa Dana N. , Al-Mubarak Basmah A.
Published: December 2018

Background: In Saudi Arabia there is still a high prevalence of consanguineous marriage in spite of increased educational level. This may be attributed to the fact that this practice is more influenced by attitude towards this type of marriage rather than educational level. The Aim of this study was to determine knowledge and attitude towards consanguineous marriages among educated Saudi adults.Methods: A cross sectional study was conducted using an online questionnaire. A total of 680 educated Saudi adults living in Riyadh were asked about their socio-demographic characteristics, their knowledge and attitude towards consanguineous marriage.Results: Most of participants had poor knowledge and negative attitude (53.31% and 57.21% respectively). One third of participants had no idea about the possibility that consanguineous couples may have diseased offspring more than non-consanguineous couples. Those who had significantly higher attitude score towards consanguineous marriage were older age group, males, those who are married to their relatives, people who have frequent family history of consanguineous marriage and participants with parental consanguinity. Attitude towards consanguineous marriage can be predicted by age and knowledge.Conclusions: Changing the attitude can be done by changing level of knowledge. So, educational programs are recommended and should be directed to groups with higher attitude score.
Sexual behaviour among rural women in Ondo state, Nigeria: do cultural and gender norms matter?
Authors: Imo Chukwuechefulam K. , Olusanya Oyewole O. , Oluwatuase Ifeoluwa E.
Published: December 2018

Background: The issues of sexual behaviour that increase risk of a negative outcome among women have been debated. This paper explored the influence of cultural and gender norms on sexual behaviour among rural childbearing married women in Akoko, Ondo State, Nigeria.Methods: The study utilized exploratory study design and purposively recruited 394 and 30 childbearing married women for quantitative and qualitative studies, respectively through which data were generated. The analyses were carried out with Stata software (version 13.0) for quantitative data using descriptive and chi-square statistics, while thematic content analysis was used for qualitative data.Results: About two-third of the respondents did not use contraceptive methods, which was a significant predictor of unplanned pregnancies among the women at p<0.05. Alluding to cultural preference of children and male roles in sexual behaviours, the qualitative data revealed that desire for large family sizes by partners, cultural norms, men’s superiority on sexual matters and partners’ disapproval of contraceptive usage predict women’s inability to negotiate sex with partners.Conclusions: Therefore, risk reduction strategies aimed at enlightening childbearing married women on their imperative positions in sexual relationships within marriages should be initiated to facilitate the achievement of sustainable development goals should be intensified.
A field survey on provision of health care service in a community clinic of Bangladesh: a case study of Raicho community clinic
Authors: Barman Sowrav , Nayeem Muhammad Abu
Published: December 2018

Background: Community clinics have been restarted in 2009 by government of Bangladesh through a project called “Revitalization of Community Health Care Initiatives in Bangladesh” (RCHCIB) to enhance provision of healthcare services at community level. We have conducted a survey on provision of health care service to recognize the availability and extent of health services provided in a community clinic of Bangladesh.Methods: 25 respondents who usually receive primary health care service from Raicho community clinic situated in Comilla district of Bangladesh were included in the survey.Results: The highest number of respondents was male (52%) and the majority of them were literate (96%).36% of study population were included in no income group, whereas 20% belong to rich population group. 32% people presented with fever (32%) followed by weakness (24%) in the community clinic. 32% respondents went to community clinic for him/her and that was the highest. The highest number of people were referred to private clinic (32%). 70% respondents think that women are receiving maternal service in the clinic. 88% respondents have participated in EPI vaccination program. 80% respondents use contraceptive method and majority used contraceptive pill. 68% people received sufficient medicine, whereas 32% respondents did not receive medication from the clinic. 75% respondents think that during working hours CHCP and HA are available in the clinic. 48% population mentioned corruption is the most possible responsible factor for heath service inequalities at grass-root level.Conclusions: Although standards are lacking in providing services, community clinics have opened a new era in health service of Bangladesh.
Diabetes related distress in adults with type 2 diabetes mellitus: a community-based study
Authors: Symon Allbright K. , Vargese Saritha Susan , Mathew Elsheba , K. R. Akshay , Abraham Jacob
Published: December 2018

Background: Living with diabetes can be difficult, since it can affect the patient physically as well as psychologically. Patients with diabetes face psychological issues which may be part of the spectrum of disease experience, distinct from depression, which hinder glycaemic control. The objective of the study was to determine the prevalence of diabetes related distress, and its association with socio-demographic characteristics, in adults with type 2 diabetes.Methods: A community based cross sectional study was conducted among 250 individuals of 30-60 years, with type 2 diabetes.Results: The prevalence of diabetes related distress in the study population was 13.3%; among the sub scales highest reported was regimen related distress 21.6%, followed by physician related 17.2%, emotional burden 16.4%, and inter personal distress 14.8%. Diabetes related distress was found to have significant statistical association with occupational class. In occupational class, distress was higher among unemployed while least in unskilled workers. It was higher among older (above 50 years) participants, males, members of joint family, unmarried and those with more years of education though there was no significant difference.Conclusions: The prevalence of diabetes related distress (13.2%) especially regimen and physician related, underscores need for better clinician involvement paying appropriate attention to systematic diabetes self-care and management education, and timely diagnosis of distress for positive clinical outcome.
A study on prevalence of overweight and obesity amongst school children of Bangalore
Authors: Kumar D. A. Sunil , M. Rohith , Philip Greeva
Published: December 2018

Background: As such, obesity and overweight have both been described as anomalous accumulation of excessive body fat which may be harmful to health. Obesity is one of the most prominent problems imminent among all societies, particularly in developing countries. Often these conditions lead to complications such as hypertension, diabetes, cardiovascular diseases and if not treated timely, death. The objective of the study was to assess the prevalence of overweight and obesity amongst school children of Bangalore and to study the association of age and gender with overweight and obesity amongst school children of Bangalore.Methods: School based cross sectional study was conducted at B.G.S International school, from August to December 2017. Students aged 6 to 16, who were present during the survey, were included in the study.Results: Overall, the prevalence of overweight and obesity among the students were 7.09% and 4.08%. The prevalence of overweight and obesity amongst boys were 3.19% and 2.04%. The prevalence of overweight and obesity amongst girls were 3.90% and 2.04%.Conclusions: Integrating physical activity and nutrition education in school curriculum at all levels will play a great part in decreasing the prevalence of obesity and overweight.
A cross sectional study on assessment of epidemiological factors associated with open field defecation in a tribal community
Authors: Chakkarwar Priyanka , Kinge Amol
Published: December 2018

Background: Almost 2.5 billion people don’t have the access to clean toilet globally. In 2011 sanitation coverage globally was 64%. While open defecation is declining across the globe, 15% (one billion) of the global population still defecate outdoors. OFD practices are associated with transmission of variety of infectious diseases. This study was conducted to understand the nature of defecation practices with respect to hygiene in a tribal community.Methods: It was a cross sectional study conducted among patients attending out-patient department of a rural health training center from a nearby tribal area, Thane district, Maharashtra which is a field practice area of rural health training centre of Seth GSMC and KEM Hospital, Mumbai.Results: Majority of the subjects practiced open field defecation (67%), followed by 18% subjects used household latrines and 15% used community based latrines. Majority of the study participants practiced open field defecation in agriculture fields (81%), while 44% preferred nearby water source as a site for defecation.Conclusions: The sanitary condition in the study area was poor. Rural areas with better literacy seems to have lower open field defecation prevalence and higher percentages of sanitary latrine usage.
A study on KAP regarding environment and global warming in senior secondary school students in Kochi, Kerala
Authors: Kumar Amritesh , Jacob Arun , Paul Nimitha , P. S. Rakesh
Published: December 2018

Background: Global warming is a phenomenon of an increase in the earth’s temperature. It leads to an environmental, as well as social loss, which has shown an upward trend since the industrial revolution. Greenhouse gases have been showing catastrophic consequences as well. This study aims to assess the knowledge, attitude and practice among students on the environment so as to discover the gaps and take steps to curb them.Methods: A cross sectional study was conducted among 10th grade high school students. Purposive sampling was done. A pre-tested, semi-structured and self- administered questionnaire was used to collect data. The data was analyzed using SPSS V2.0.Results: In this study, 48% of the students were boys and the remaining 52% were girls. A majority of the students were Hindu and belonged to the age group 15-16 years. A hundred percent of the students showed concern regarding the degrading environment. 85% agreed to fact that it can be restored by cumulative efforts. Everyone regarded the sun as the ultimate source of energy. The attitude on protecting the environment was high among the majority of the students. 50% of the students save electricity when not needed. 69% of the students had good knowledge, 65% had a good attitude and 53% had a poor level of practice concerning the environment.Conclusions: In light of the scarcity of adequate literature this study was able to identify gaps among students. Appropriate measures are needed to strengthen their knowledge and attitude and improve their practice.
Global age-specific denominator estimation for monitoring of health and nutrition SDGs and indicators based on population projections of the UN World population prospects, 2017 revision, for the year 2018
Authors: Raut Manoj Kumar
Published: December 2018

Background: The success of any program is measured by continuous monitoring through service statistics for a periodic oversight and through evaluation surveys to measure the relevance, effectiveness, efficiency and impact of activities in the light of specified objectives. Service statistics need a lot of indicators to be tracked on a regular basis. The service statistics provide us with numerators. To understand the numerators more meaningfully, we need to standardize them by using specific denominators. So, denominators have to be estimated, which can enable computation of indicators for monitoring purposes. Census and Large scale sample surveys provide proportions to calculate denominators for program monitoring purposes.Methods: This paper uses demographic techniques to estimate denominators for all the countries for which data from the world population prospects is available.Results: The denominators have been estimated for number of infants, children and women of reproductive age and elderly in the age group of 60+ years.Conclusions: The estimations of denominators at the sub-national levels becomes quite challenging due to the scarce availability of data to be used as proportions for different population groups. But, once, the methodology is improved with appropriate data, it could serve as a boon for annual program monitoring process at multiple data time points between two national surveys.
Danger signs of acute respiratory tract infections in under-five children: awareness among mothers in the urban slums of Hyderabad, its relation to treatment seeking behaviour
Authors: Challa Sairam , Krosuri Varsha
Published: December 2018

Background: Sustainable development goals (SDGs) proposes to all countries an aim to reduce under-five mortality to 25 per 1000 live births by 2030. Acute respiratory tract infections including pneumonia are the leading cause of death among the children less than five years in India. Identification of severe respiratory infections from non-severe forms necessitates that care-givers, especially mothers are aware of danger signs. An attempt is made to study the awareness of danger signs among the Mothers and see its relation to treatment seeking behaviour.Methods: Community based cross-sectional survey was conducted involving 344 mothers of under-five children living in the urban slums of Hyderabad.Results: The awareness of mothers about the danger signs of ARI is poor. Very few knew that fast breathing (11 percent), wheezing (4.7 percent), convulsions (1 percent), lethargy (1 percent) are major danger signs of ARI requiring urgent medical attention. A majority of mothers took the child with ARI to private hospital (42 percent) while few approached Govt. Hospital or dispensary (4.7 percent). Many mothers (77 percent) were aware that vaccination against diseases might protect the children against ARIs. The prevalence of acute respiratory infections among the children in the current study (59.3 percent) is much higher that previous studies elsewhere.Conclusions: A very high proportion (44 percent) of the mothers were ignorant of any danger sign of ARI. The significant association between awareness and positive health care seeking behaviours, like consulting allopathic doctor or govt. hospital or private hospital establishes the evidence that awareness levels are the prerequisite for the positive health care behaviour.
Knowledge and awareness of breastfeeding, weaning practices and newborn care in pregnant women in urban areas
Authors: Joshi Sumedha M. , Srivathsan Mayakalyani , Velankar Deepa H.
Published: December 2018

Background: Breastfeeding, proper weaning practices, and newborn care play a crucial role in the health of a child. The objective of the study is to determine the availability of information regarding breastfeeding, newborn care and immunization and to find out about the attitude of women towards newborn care practices.Methods: A cross-sectional observational study was conducted in a tertiary health care centre in an urban area in Navi Mumbai, on primigravidae in their third trimester of pregnancy. The data was collected by a questionnaire, results were analysed by EpiInfo7.Results: 93% women knew the benefits of breastfeeding, 92% knew of exclusive breastfeeding. 90% would initiate breastfeeding immediately after delivery, 83% would not give prelacteal feeds. 75% would practise skin-to-skin contact and 95% would practise rooming-in technique. 44% would delay bathing the newborn. 95% women received TT immunisation. All agreed to vaccinate their child. 19% believed traditional practices like applying kajal to eyes, prelacteal feeds etc. to be hazardous.Conclusions: The knowledge pregnant women have about breastfeeding and newborn care is inadequate. There is a need for intervention measures such as behavior-change-communication and better health services, to equip mothers so they may provide optimal care to their babies.
Risk factor profile for non-communicable diseases: findings of a STEPS survey from urban settlement of Bangalore
Authors: . Abdussattar , Itrat Malik
Published: December 2018

Background: Increasing burden of non-communicable diseases (NCDs) across the globe is largely due to the rise in prevalence of various risk factors. These risk factors are measurable and largely modifiable. Quantifying the present levels of risk factors exposure in a community is helpful in predicting the future risk and driving the public health policy for prevention and control of NCDs. Keeping this in mind, present study was planned to estimate the prevalence of NCDs risk factors in an urban settlement of Bangalore.Methods: A community based cross-sectional survey was done with 600 individuals aged 15-64 years in Hegganahalli locality of Bangalore city from April to October 2017. Systematic random sampling technique was applied to obtain the desired sample size. Information on NCD risk factors was collected by using STEPS questionnaire.Results: Tobacco and alcohol consumption was observed in 27.2% and 11.8% of respondents respectively. Low level of physical activity was recorded among 14.8% and inadequate consumption of fruit and vegetable was observed among all the respondents. Prevalence of general and central obesity in the study population was found to be 30.7% and 12.8% respectively. Hypertension was prevalent among 35.5% respondents.Conclusions: High prevalence of NCD risk factors was observed among the study population that needs to be addressed through a comprehensive approach with due emphasis on preventive care in order to make ‘healthy living’ a social norm.
A comparative study on vaccination default rates among children aged 9-24 months attending a static immunization clinic in urban and rural area of Bangalore
Authors: Srikanth Jayanthi , Kumar Pankaj , Upadhya Kavya G. , Rajanna Pushpa
Published: December 2018

Background: Immunization contributes significantly to the achievement of millennium development goal number 4 and is one of the eight elements of primary health care. Effective utilization of immunization services is associated with reduced infections in young children with immature immune system and improved child health outcome. The objectives of the study were to compare the default rates for vaccine doses in immunization schedule; to study the factors responsible for default; to describe the socio-demographic profile of study subjects.Methods: An observational study was conducted in the urban and rural Primary health centre on immunization days for 3 months. The study subjects were children aged (9-24) months attending immunization clinics. Their care givers were interviewed regarding socio-demographic profile and causes for default. Sample size calculated was 184 (92) each from urban and rural clinic).Results: Among 184 care givers interviewed, mean age of study subjects was 14.9±4.6 months in urban & 14.6±4.9 months in rural clinic. Default rates for vaccination were 5.4% (birth dose), 7.6% (6th wk.) both in urban & rural clinic. However, for further doses i.e., 10th week, 14th week, 9 months and 18 months the default rates were slightly higher in rural compared to urban clinic. Commonest reason for default was mother not aware that child had missed dose (urban 52.2% and rural 42.3%) followed by child being sick (urban 26.6% and rural 30.4%).Conclusions: The overall default rate was found to be very high which is a serious concern and need to be addressed in order to prevent eventual dropouts.
Women’s knowledge and practice regarding primary health care services in Garhwal region of Uttarakhand
Authors: Dixit Ruchita , Bandhani Aaradhana
Published: December 2018

Background: Primary health care (PHC) relies heavily on the contributions of women, particularly in the area of health education, it raises their self-esteem and empowers them to serve their communities in a number of ways: by improving women's health and the health of their families and by training women both as care givers and as health educators. Primary health care is the first level of contact of the individuals, the family and the community with the national health system bringing health care as close as possible to where the people live and work: It should be based on practical, scientifically sound and socially acceptable methods and technology. It should be made universally accessible to the individuals and the family in the community through their full participation. This study projected to evaluate the knowledge and practice of women regarding health care services and their source of information.Methods: Stratified multistage random sampling of the target population was done. In the first stage villages were selected by simple random sampling technique. In the second stage population for the study purpose was selected from the selected village again by simple random sampling technique.Results: In this present study knowledge regarding health care services were higher and found satisfactory, health functionaries were found to be more informative as compared to media and others sources of information.Conclusions: From the results found in this study it can be said that women’s knowledge regarding health care services was found satisfactory.