bluuebunny/crossref_metadata_2025 huggingface dataset:
High dose, short course prednisolone for acute idiopathic thrombocytopenic purpura (ITP) in children
Authors: Jayaraman Aparna , Das Sarthak , Biswal Niranjan , G. Dillikumar C. , Bade Bhavna Ashok
Published: August 2017

Background: Immune thrombocytopenia (ITP) is a relatively benign and self-limiting condition. Though its dramatic presentation with skin or mucosal bleeds could be worrisome, the incidence of serious bleeding like intracranial hemorrhage (ICH) is relatively low (<1%) occurs at a very low count of <20,000 /mm3. The aim of the study was to compare a high dose, short course prednisolone with conventional Prednisolone therapy in the treatment of acute ITP of childhood.Methods: 20 cases and 18 retrospective controls with acute ITP were enrolled. The study group received 5mg/kg/day of oral prednisolone for four days. All the controls had received 2mg/kg/day of oral prednisolone for 14 days, tapered and stopped over the third week.Results: The study group was found to have significant decrease in clinical bleeding, (p=0.02), and significant increase in platelet count by day 3 of treatment (p=0.03) but no significant difference in platelet counts on day 7 of treatment (p=0.07) when compared with the control group.Conclusions: We conclude that the high dose short course oral prednisolone is significantly better than the conventional regimen in reducing clinically significant bleeding and raising the platelet count to safe levels within first 72 hours of therapy.
Infant feeding practices and risk of occurrence of diarrheal and respiratory infections in infancy-a hospital based study
Authors: Sharma Rakesh , Sood Arvind , Niar Priyanka
Published: August 2017

Background: Breastfeeding is the most cost-effective intervention for protecting children against various childhood morbidities. Suboptimal breastfeeding has been linked with numerous adverse child health outcomes including increased incidence of diarrheal disease and pneumonia.Methods: A sample of 360 infants was surveyed during the period of one year (2013-2014). The socio-demographic characteristics and feeding modes were collected from the parents of the children during the interview.Results: A total of 228 (63.3%) were suffering from acute gastroenteritis and 132 (37.7%) were suffering from pneumonia. The risk of diarrhea and pneumonia was higher and statistically significant in partially breastfed and non- exclusive breast fed as compared to exclusive breast fed. Infants who were bottle fed had higher risk of morbidity. Infants who were breast fed for longer duration (more than 4 months) has lesser risk of morbidity as compare to counterparts who were fed for lesser duration.Conclusions: These results indicate that promoting exclusive breastfeeding will play an important role in reducing the risk of infantile diarrhoea and pneumonia. This observation is important given the growing concern of the modern society wherein breastfeeding is on the decline.
Study of clinical and radiological profile of children with neurocysticercosis
Authors: Pandit Manjunath Suresh , Sharma Jagadish Narayan , Choudary Anita , Vijay Priti
Published: August 2017

Background: To study the clinical and radiological profile of children with Neurocysticercosis Hospital based, Observational study conducted in SPMCHI, Jaipur from June 2015 to June 2016.Methods: 50 children diagnosed of neurocysticercosis based on clinical features and findings on magnetic resonance imaging with contrast were enrolled while excluding the other common causes of granuloma.Results: A total of 50 children completed this study. Mean age of the presentation was 8.68±2.133 (5 to 16) years, with an M: F of 0.92:1. Overall patients presented with generalized seizure in 76%, focal in 16%, headache±vomiting in 6%, focal neurodeficit in 2% and combination of symptoms in 60.5% cases. MRI brain showed a solitary lesion in 45 (90%) and multiple in 5 (10 %). At presentation lesions were vesicular in 46 %, nodular calcified in 16 %, granular nodular in 10 %, colloidal vesicular in 6% and mixed in 6%. One child presented with a starry sky appearance.Conclusions: Neurocysticercosis usually affects young persons, youngest age of presentation 5 years, was found more common among vegetarians. Most common clinical manifestation is seizures. Single lesion is more common than multiple lesions, commonly presenting in vesicular stage. NCC should be considered first in the differential diagnosis of new-onset seizure among the children of developing countries, where taeniasis is endemic.
Knowledge on rotavirus and pneumococcal vaccines among mothers of under five children
Authors: Muppidathi Subbiah , Boj Jenitha , Deivanayagam Saminathan
Published: August 2017

Background: Childhood vaccines are one of the great triumphs of modern medicine. They are undoubtedly the most cost-effective healthcare interventions. Knowledge, attitude, and practices regarding the vaccines administered under the National Immunization Programme have been studied in different settings; however, studies regarding Rota virus and Pneumococcal vaccines in India are scarce. The Objective of the study was to assess the mothers’ knowledge on Rota virus and Pneumococcal vaccines and to identify the reasons for non-administration of these vaccines.Methods: This study is a cross-sectional study conducted in pediatric immunization clinic of Chennai Medical College Hospital and Research Centre from February to April 2017. About 380 parents were interviewed with a preformed structured questionnaire.Results: Of 380 respondents, 130 (34.2%) mothers were aware about Rotavirus vaccine and 148 (39%) about Pneumococcal vaccine. Awareness for these vaccines was seen high among middle and upper socio-economic group mothers. Among the mothers who were aware about these vaccines, the major source of information was doctors followed by health workers and media. Of 380 respondents only 66 (17%) mothers had administered Rotavirus vaccine and 75 (19.7%) had administered Pneumococcal vaccine. The reason for not administering these vaccines was lack of awareness. 274 (87.2%) mothers were not aware about Rotavirus vaccine and 261 (85.6%) mothers were not aware about pneumococcal vaccine.Conclusions: Present study found that most of the mothers were not aware about these live saving vaccines and they need to be educated about these vaccines through health workers or intense campaigning by using mass media.
Serum vitamin D concentration in acute lower respiratory tract infection in infants: a case control study from Northern India
Authors: Ahmed Parvez , Bhat Javeed Iqbal , Chaman Shilakha , Ahangar Ambreen Ali
Published: August 2017

Background: Vitamin D insufficiency is believed to be the most common nutritional deficiency and one of the most undiagnosed medical conditions in this region. People across the world are becoming increasingly aware of the role played by vitamin D in health and disease, especially its role in immunity and its anti-infective role. The present study was conducted to study the relationship between serum vitamin D levels and severity of respiratory tract infections. To study the relation between serum vitamin D levels and severity of acute respiratory tract infections.Methods: 1-year prospective study from September 2014 to August 2015. Children from 1 month to 1 year of age participated in the study. Serum Vitamin D levels were measured in case group suffering from severe acute lower respiratory tract infections (ALRTI) and in a control group. The primary outcome variable was difference in serum vitamin D levels between case group and control group.Results: The median (IQR) age of cases and controls was 5.0 (4.75) months and 4.0 (4.0) months, respectively. There were no significant differences in baseline demographic and anthropometric parameters between the 2 groups.  The median vitamin D level in a case group was significantly lower compared with matched controls (p <0.05).Conclusions: Vitamin D deficiency is an important independent risk factor for childhood pneumonia. We found a severe vitamin D deficiency of our infants suffering from severe acute lower respiratory tract infections. The deficiency was more prevalent in exclusive breast feed infants.
Association of congenital heart diseases with extracardiac anomalies
Authors: Dewangan Mithlesh
Published: August 2017

Background: Congenital heart diseases are one of the main causes of death among the congenital malformations. An extracardiac malformation further increases the risk of morbidity and mortality to these patients, in addition to risks of surgical correction. So here comes the importance of extracardiac malformation.Methods:This prospective observational study was conducted at Neonatology Section, Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. The study was conducted over a period of 2 years (from January 2015 to December 2016). Newborns with congenital heart disease were examined for extracardiac defects.Results: This hospital based cross-sectional study found that there were 121 cases of congenital heart diseases among 11030 live births making an incidence of 1.09% Out of these 73.5% were acyanotic heart diseases and 26.5% were cyanotic heart disease. Extracardiac anomalies were found in 38 (31.5%) cases.Conclusions:Association of Congenital heart disease with extracardiac anomalies is well known. Syndromes are most commonly associated.
Outcome of neonatal ventilation: a prospective and cross-sectional study in tertiary care centre
Authors: Sharma Ravi , Baheti Swapnil
Published: August 2017

Background: Neonatal mortality accounts for nearly two thirds of infant mortality and half of under 5 mortalities in India. It is possible to increase neonatal survival and improve the quality of life only through prompt and adequate management of critically ill newborn. Mechanical ventilation has become a must to enhance neonatal survival and is an essential component of neonatal intensive care.Methods: Hospital based prospective, cross-sectional study from 1st July 2012 to 30th June 2013. All NICU admitted neonate requiring mechanical ventilation were included. It was a descriptive, cross-sectional study of a prospective data.Results: Indication of mechanical ventilation: Out of 72 neonates studied, majority of preterm were ventilated for RDS - 34 (89.5%) and majority of Full term were ventilated for MAS - 16 (100%) followed by HIE - 8 (88.89%). Out of 38 RDS cases, 30 (79%) were ventilated till 4-7 days duration and 3 (7.9%) required ventilation for >10 days. Out of 16 MAS cases, 10 (62.5%) were ventilated for 4-7 days duration and none required prolonged ventilation. Duration of ventilation is not statistically associated with indication of mechanical ventilation with p=0.301.Conclusions: Mechanical and Pulmonary complications of mechanical ventilation are not statistically significant for outcome of mechanical ventilation but it increases length of NICU stay. Hypotension on ventilator, requirement of more than 3 ionotropes were associated with high mortality.
Cardiac changes in asphyxiated neonates-need for early detection to improve long-term outcome
Authors: Lakshmanan Raja , Verma Yogendra Singh
Published: August 2017

Background: Cardiac changes are common in Perinatal asphyxia. Detecting them early will help in specific management and good long-term outcome. Cardiac monitoring is recommended in every resuscitation as per NRP 7. Objective of present study was to evaluate myocardial dysfunction in neonates having Hypoxic Ischemic Encephalopathy by clinical, electrocardiographic and echocardiographic examination. Methods: Observational analytical study of 79 neonates who suffered from asphyxia as per selection criteria were done at medical college hospital. Myocardial dysfunction was evaluated by clinical features assessed on first 2 days and electrocardiographic and echocardiographic examination was done after 24 hours. Data were collected and analysed by SPSS 21 software.Results: Respiratory distress was found in 67.08% of the subjects. Prolonged capillary refill time was found in 39.24% of the subjects. Mean QTc (ms) interval was prolonged in non-survivors (496.6±20.8) when compared with survivors (418.2±33.7) (p - 0.000). T wave changes were present in non-survivors (94.7%) when compared to survivors (41.7%) (LR- 19.558). ST wave changes were present in non-survivors (73.7 %) compared with survivors (10%) (LR- 28.483). Mean Ejection Fraction (%) was shortened in non-survivors (53.79±7.53) compared with survivors (71.48±10.28) (p-0.000). Significant tricuspid regurgitation (78.94%) was present among non-survivors compared to survivors (10%) (LR- 17.859). Evidences of significant pulmonary artery hypertension were found in most of the (78.94%) non-survivors compared to survivors (10%) (LR-22.4). Similarly, severe grades of asphyxia had significantly high findings of increased CRT, reduced EF, LVES, ST and T wave changes etc.Conclusions: Cardiac changes in severe asphyxia are high and can be identified early by clinical, electroctrocardiographic and echocardiographic examination.
Prevalence and risk factors of obesity among higher secondary school students in urban and rural schools of North Kerala
Authors: K. V. Urmila , Krishnan K. Divya , Sudakaran . , Nambiar Muralikrishnan
Published: August 2017

Background: Childhood overweight and obesity have become an important public health problem. Life style approach is required, and requires political and social commitment in addition to medical management. We investigated the prevalence of obesity and the association with risk factors relating to physical activities, in higher secondary school children of government and private schools.Methods: In 2015, we surveyed higher secondary students in North Kerala both in government and private sector schools. We measured height, weight and plotted Body mass Index on CDC (Child Developement Centre) charts. Factors affecting obesity like physical and sedentary activities (using Bharathy et al questionnaire) and school-based risk factors were also studied.Results: Multivariate logistic regression was done to evaluate the significance of these risk factors for overweight and obesity. On the basis of measurements taken in 496 higher secondary school students, the estimated provincial prevalence of overweight was found to be 7%, obesity 3% and malnutrition 18%. Children who studied in private school was found to have increased risk of overweight p=0.02 with odds ratio (OR of 2.97 95% confidence interval CI 1.27-6.97), whereas those who went to school by walking were at decreased risk (OR 2.78, 95% CI 1.16-6.65). Students involved in house hold chores for 4hours or more a week were associated with a decreased risk of overweight (OR 3.96, 95% CI 1.42-11.07) and those with less activity were at increased risk for obesity (OR 6.61, 95% CI 1.91-22.84).Conclusions: Home and schools provide important opportunities for public health initiatives for reducing childhood overweight and obesity. Children in private schools coming from higher socio-economic background are being less physically active and has thus susceptible to obesity and its consequences.
Seroprevalance of hepatitis-c infection in multi-transfused thalassemic children: study from a West Indian tertiary care center
Authors: Agrawal Sheesham , Sulaniya Pawan Kumar , Garg Kapil , Choudhary Ramesh , Sulaniya Chandrakanta
Published: August 2017

Background: To study the prevalence of hepatitis-C virus infection in multi-transfused thalassemic children and to correlate these patients with age, number of transfusion, serum ferritin levels and transaminases levels.Methods: This study was conducted in the Department of Pediatrics of a Teaching Institute of Rajasthan. It was a hospital based cross sectional study, conducted over a period of 12 months (April 2016- March 2017). Blood sample for Ant-HCV antibody detection was taken at time of follow-up visit in the subspeciality clinic. These samples were processed in central laboratory for hep-C antibody, serum ferritin and transaminases levels. Anti-HCV antibody detection was done by BI-DOT machine. HCV RNA PCR was done to access viral load in all positive cases.Results: A total of 300 patients were enrolled in the study. There were 219 (73%) males and 81 (27%) females. The mean age of the study group was 7.59±3.6 years (range 1.5-18years). At the time of our study 277 (92.4%) cases were on one or the other chelating agent whereas 23 (7.6%) cases were not taking any kind of chelation therapy. Out of 300 patients, 72(24%) cases tested positive for anti HCV antibody. Out of 72 patients only 36(12%) patients had detectable viral load in RNA PCR.  Mean age of the HCV positive cases (9.58±3.28) years was higher as compared to HCV negative cases (6.98±3.54). Maximum HCV positivity 20/38 (52.6%) was seen in 12-18 year age group; followed by 33/76 (43.4%) in 9-12yr age group. Significant association was observed between advancing age and prevalence of hepatitis C in thalassemia major patients (p=0.002). The number of blood transfusions received by anti-HCV positive children (Avg. Transfusion 185±98.40 ml/kg/year) was significantly higher than that by anti-HCV negative patients (Avg. Transfusion 102.8±71.20) (p value<0.001). Maximum HCV positive cases 33 (45.83%) had total transfusions >200 in a year followed by 15 (20.83%) cases with 151-200 transfusions (p<0.001).Conclusions: Despite ELISA screening of blood donors, our study demonstrated high (24%) prevalence of transfusion transmitted hepatitis-C virus in thalassemic children which increases with increasing number of transfusions, it also correlates with rising serum ferritin level and SGPT level.
Pediatric acute myeloid leukemia with t(8;21) variant: what is the value on clinical outcome?
Authors: Abreu Juliana C. , Fontes Raissa M. , Matos Jesamar C. , Jorge Fátima G. , Lima Diego S.
Published: August 2017

Acute myeloid leukemia (AML) is characterized by clonal expansion of undifferentiated myeloid precursors that results in the bone marrow (BM) failure. Some cytogenetic alterations can be used to predict the prognosis of the disease. AML with t(8;21), presenting RUNX1/RUNX1T1 gene fusion, is associated to favorable prognosis and it is one of most prevalent structural abnormalities in pediatric AML. Variants of t(8;21) has been described, though the prognostic value of these changes remains controversial, especially in pediatric patients. Thereby, we report a pediatric patient with AML with RUNX1/RUNX1T1 fusion presenting the variant t(1;21;8). The diagnosis was confirmed by myelogram, immunophenotyping, cytogenetics and molecular biology. After the diagnosis, the patient was subjected to chemotherapy and submitted to related allogeneic BM transplant. Until this date, the patient has no clinical complaints, predicting a favorable outcome. The register of variants and its proper follow up contributes to a better understanding of the mechanisms involved in these rearrangements and provides information that may be relevant for an appropriate classification and risk stratification of these patients.
Prevalence and associate factors of low birth weight in North Indian babies: a rural based study
Authors: Kumar Manoj , Verma Ramesh , Khanna Pardeep , Bhalla Kapil , Kumar Raj , Dhaka Rohit , Chayal Vinod
Published: August 2017

Background: LBW is universally used as an indicator of health status and is an important subject of national concern and a focus of health policy. LBW is the strongest determinant of infant morbidity and mortality in India. Regional estimates of LBW include 28% in south Asia, 13% in sub-Saharan Africa and 9% in Latin America. Among regions, South Asia has the highest incidence of LBW; with one in four newborns has LBW. In 2011, Indian Statistical Institute reported nearly 20% of new born have LBW in India. DLHS-4 (2012-2013) in Haryana found that the prevalence of LBW was as 12.7%. The aims and objectives of study were to know the prevalence and its associated factors of low birth weight in rural area of Haryana.Methods: The beri block (Jhajjar) which is rural field practice of department of Community Medicine Pt B D Sharma PGIMS Rohtak (Haryana) India, has one CHC Dighal having 20 sub-centers. 10 sub-centers were selected by simple random sampling from these 20 sub-centres and 800 study subjects were enrolled from June 2015 to May 2016 from selected subcentres.Results: In present study, prevalence of LBW was 17%. The study found that sex of baby, type of family, socioeconomic status, educational status of mother, occupation of mother, anemia and intake of IFA had significantly impacted on LBW in India.Conclusions: Prevalence of LBW is decreased by health and nutrition education, iron and folic acid supplementation, effective management of complication.
Assessment of biomedical waste management of a multispeciality hospital in the light of new BMW rules 2016: what has changed from the past?
Authors: Hiremath Ravishekar N. , Basandra Sumeena , Kunte Renuka , Ghodke Sandhya , Edwards Tarana Sarah , Yadav Jyoti , Yadav Arun K. , Patil Shailaja
Published: August 2017

Background: The hierarchies of Bio-Medical Waste (BMW) is largely based on the concept of the “3Rs”, namely reduces, reuse and recycle, and broadly relates to the sustainable practice of resources. The objectives of the study were to assess the Bio-Medical Waste (BMW) Management operating system in a multispecialty hospital and discuss the situation in terms of newly introduced BMW Rules 2016.Methods: A hospital based cross-sectional study was carried out by collecting data by means of independent surveys involving on-ground operating system of BMW management across different wards, outpatient departments, emergency departments, intensive care units and laboratories in the hospital.Results: The hospital was following Bio Medical Waste (Management and Handling) Draft rules, 2011 in the management of BMW. All the wastes were categorized into 8 categories as per 2011 draft rules. Efficient waste segregation, collection, storage, transport and waste treatment were followed as per norms with regular training of all health care workers under the close supervision and monitoring by dedicated BMW management committee. The hospital was registered for BMW management and renewal was being carried out every three years.Conclusions: It can be concluded that the hospital had an efficient and a well-organized BMW management system in place that was even conforming to the latest BMW Management Rules 2016 to some extent. Moreover, the hospital could upgrade the techniques of BMW management as per the newly introduced latest guidelines. As far as the categorization of BMW is concerned, it has to be changed accordingly to the new rules. Needless to say, a regular training and monitoring of BMW Management at all hospitals is the need of the hour and has a long way to go for environmental and human health.
A study to assess the pulmonary functions in a cement ware house workers near railway station, Nishatpura, Bhopal
Authors: Rathore Bhavishya , Neelkanth Namita , Toppo Manju
Published: August 2017

Background: It is unfortunate enough that cement industry workers despite of so many awareness campaigns, unable to seek protection against dust of cement and thus bound to face respiratory problems. In developing countries no legitimate bindings regarding protection of such workers though cement industry is one of the largest industries. Methods: Non probability sampling done in which cases taken from cement workers and control taken from nearby residents matched for age gender and smoking status of participants. Results: When studied for the restrictive and obstructive respiratory problems it was found 2.82 times and 4.71 times higher in cases respectively. When cases studied for duration of working against disease developed, it was found that 61.81% developed obstructive pulmonary disorder and proportion increased from 23.63% to 30.80 as the work span increased from 0-5 years to 5-15 years respectively. When it has been observed for restrictive pulmonary disorder, it has been increased from 3.6% to 5.4%. Conclusions: It has been observed that workers have either obstructive pulmonary dysfunction or normal pulmonary functions and on increasing the duration, number of workers with restrictive pulmonary function increases proportionately.
Prospective, longitudinal, cohort study for assessment of vascular ageing among adults of urban and rural area of Central India: research protocol
Authors: Bhagat Vijay , Baviskar Shubhangi , Mudey Abhay B. , Goyal Ramachandra
Published: August 2017

Background: Considering the complex interaction of risk factors in causation of CVD; assessment of vascular ageing among the high risk group through non-interventional statistical models was useful in controlling CVD. While, many CVD risk assessment models were especially designed for application in the specific population or region such as SCORE scales for Europeans, ASSIGN scores for people of Scotland. The Framingham Risk Score were modified, validated and used in several countries. Though Indians have significantly higher predilection for CVD, no indigenous scores were developed or validated to assess the CV risk. The objective of the study were to determine vascular age of the study participants using Framingham risk prediction model, to assess its relationship with development of cardiovascular disease and to develop, validate and compare cardiovascular risk prediction model based on the follow up observations of the study participants.Methods: Community based cohort study will be conducted in large urban and rural population aged 31-60 years of age those who have no evidence of CVD. The study population will be followed up for three years and will be assessed for development of CVD. The vascular age will be determined using Framingham Risk Scores. Based on the risk factors associated with occurrence of CVD during the study period, the risk prediction model will be designed and tested for validity and accuracy. Results: The newly developed CVD risk prediction will be more accurate in assessment of CV risk among the study subjects. Conclusions: The newly developed and validated CV risk prediction model specific for Indians may be one of the first prospective CV risk assessment cohort study.
Evaluation of different phenotypic methods for the detection of methicillin resistant Staphylococcus aureus and antimicrobial susceptibility pattern of MRSA
Authors: Sharma Sheetal , Srivastava Preeti , Kulshrestha Anjali , Abbas Ameer
Published: August 2017

Background: Rapid and accurate detection of methicillin resistant Staphylococcus aureus (MRSA) is an important role of clinical microbiology laboratories to avoid treatment failure. The aim of this study was to compare conventional methods against the cefoxitin disc diffusion method to determine the best phenotypic method. Methods: Study was carried out in the Department of Microbiology, National Institute of Medical Sciences & Research, Jaipur (India), between July 2016 – December 2016. The methods included were Oxacillin E-test MIC, Oxacillin screen agar, Oxacillin disk diffusion, Cefoxitin disk diffusion and CHROMagar- MRSA methods. Antimicrobial susceptibility performed as per CLSI guidelines.Results: Out of 142 isolates of S. aureus, fifty three (37.32%) strains of MRSA were isolated from clinical specimen. E-MIC test was selected as gold standard method. The sensitivity and specificity of Oxacillin screen agar and CHROMagar-MRSA were same 98.07% and 97.80%, respectively. The sensitivity and specificity of oxacillin disk diffusion were 94.23% and 98.89%. Fifty three strains of S. aureus were MRSA by cefoxitin disk diffusion method and Oxacillin Ezy MIC test. The sensitivity and specificity of cefoxitin disk diffusion method and Oxacillin Ezy MIC method was 100% and 100% respectively. All isolates including MRSA were susceptible to Vancomycin and Linezolid. Conclusions: All phenotypic methods had high sensitivity and specificity for detection of MRSA. However, cefoxitin disk diffusion method in comparison to other methods had higher sensitivity and specificity.
KAP study of bio-medical waste management among health care workers in Delhi
Authors: Soyam Gajanan C. , Hiwarkar Prabhakar A. , Kawalkar Umesh G. , Soyam Vishal C. , Gupta Vimal K.
Published: August 2017

Background: Bio-medical waste management is vital issue not only to hospitals, but also to the environment, law enforcement agency, media and to the general public.The objectives of the study were to find out level of knowledge, attitude and practices of health care workers (HCWs) about bio-medical waste management in a rural hospital of Delhi. Methods: A cross sectional study was carried out in rural hospital, Delhi on 155 HCWs. Pre-designed, pretested, structured questionnaire were administered on 155 HCWs of hospital. Data collected and analyzed by using SPSS-17. Results: Total of 155 HCWs were selected. Majority of HCWs were in the age group of 30.3 years±5.6 (mean age±SD) Almost half (54.2%) of study population comprised of female. Most of them were nursing staff. Mean years of experience in service was 4.8±3.7 (mean age±SD). Majority HCWs in this study took education up to senior secondary and they possess respective professional qualification. Statistically significant numbers of HCWs vaccinated with HBV vaccine and received training of bio-medical waste management (p<0.05). Almost all (97.4%) HCWs aware of bio-medical waste management rules and have very positive attitude. Practice of HCWs regarding bio-medical waste management was relatively poor. Conclusions: Nursing staff have not only best knowledge and attitude but also good practices among all HCWs. Additional training have been required to Paramedics and group-D workers.
An epidemiological study to assess prevalence and behavior related to substance abuse among urban Bikaner population Rajasthan
Authors: Qureshi Asif Ahmed , Acharya Rekha , Sharma Gaurav , Sethia Renu , Shekhawat Kirti , Kawatra Abhishek
Published: August 2017

Background: Substance abuse exists in the world since time immortal; it has become a serious global problem in recent times. Methods: This was a cross sectional community based study performed from March 2016 to August 2016 among resident of UHTC Mukta Prasad dispensary (urban health and training center) attached to Sardar Patel Medical College, Bikaner. Results: Overall prevalence was 25.14%. Majority of people were using only tobacco (67.07%) while 20.12% people were consuming tobacco and alcohol both, only alcohol was used by 10.98% people and rest (1.83%) were having other types of substances like Doda-post etc. Conclusions: Almost 1/4th of study population was abusing one or the other substance. Most commonly abused substances were tobacco and tobacco+alcohol.
Maternal determinants of low birth weight in a rural block of Haryana: a community based study
Authors: Verma Ramesh , Kumar Manoj , Bhalla Kapil , Kumar Raj , Dhaka Rohit , Chayal Vinod
Published: August 2017

Background: If a pregnant woman is taken care of as advised, she will give birth to a child who does not have any diseases- a healthy, physically strong, radiant and well-nourished baby. Low-birth-weight (LBW) is universally used as an indicator of health status and is an important subject of national concern and a focus of health policy. In 2013, more than 20 million newborns, an estimated 16% of all babies born globally that year, had LBW. DLHS-4 (2012-2013) Haryana reported the prevalence of LBW as 13.6% in rural area (below 2.5 kg). The aim of study was to identify the maternal determinants of low birth weight in a rural block of Haryana.Methods: The CHC Dighal (Jhajjar) has 20 sub-centers, out of these sub-centers, 10 sub-centers were selected by simple random sampling. The 800 study subjects were enrolled over a period of one year (June 2015 to May 2016).Results: In present study, 136 (17%) newborn had low birth weight. The odds of LBW delivered were 1.76 times higher for female babies as compared to male babies. Mothers who were educated up to primary level had 3.768 times higher odds.Conclusions: The study conclude that sex of baby, caste, type of family, socioeconomic status identified as independent predictor of LBW. Health functionaries should focus on preventing incidence of preterm deliveries, anemia, diabetes etc.
Unmet need for contraception among married women of reproductive age in rural Maharashtra
Authors: Tapare V. S. , Parande Malangori A. , Borle Pradip S.
Published: August 2017

Background: The concept of “unmet need” for contraceptive points to the gap between women’s reproductive intention and their contraceptive behavior. About 12.8% of currently married women in India have an unmet need for contraception. The present descriptive cross-sectional survey was initiated to address the research questions regarding unmet need for contraception among married women of reproductive age group in rural Maharashtra.Methods: 400 married women of reproductive age living in rural area of Sangli district of Maharashtra state interviewed. The survey based on women’s response to survey questions regarding family information, fertility profile and attitude and practice of contraceptive use. Expanded formulation used for surveys to assess the size and characteristics of unmet need group, dividing it into distinct subgroups and to explore the reasons for unmet need using in-depth qualitative research. Data analyzed with absolute number and percentage of women having unmet need which is useful to set priorities in program for effective fertility control. The data was tabulated and analyzed using MS Excel.Results: Total unmet need for contraception was found 27.50% women, which comprises need for ‘spacing’ in 12.25% women, need for ‘limiting birth’ in 13.25% women and need for ‘appropriate contraception’ in 2.0% women among 400 married women of reproductive age. Most unmet need among younger women is for spacing birth (67.18%) while in older women above age 30 year; most unmet need (68.18%) is for limiting birth. The education of women does not affect significantly the unmet need for spacing and limiting birth. After first child the unmet need for spacing decreases with each additional child. On the contrary unmet need for limiting birth increases with each additional child after first child and it was maximum (96.55%) among women having 3 or more children.Conclusions: The study group expresses multiple reasons for the unmet need. Many of the reasons are not directly related to contraception. Most women with unmet need desire to use contraception in future favours spacing methods. People should have access to good quality information and services. Health education and motivation is needed to overcome these causes.
Source of previous anti-TB treatment for re-treatment TB cases registered under Revised National Tuberculosis Control Program in Pondicherry
Authors: Niranjjan R. , Sahu Swaroop Kumar , Roy Gautam , Vijaya Vani S. Arul
Published: August 2017

Background: Re-treatment TB cases are still a big challenge to National TB control programme. The objectives of the study were among retreatment TB cases, to study the source of previous anti-TB treatment, to find the time delays in initiating re-treatment and to find the risk factors for initiating retreatment under Revised National Tuberculosis Control Program (RNTCP) in Pondicherry.Methods: It was a cross sectional study. Source, date of completion or interruption of recent previous anti-TB treatment, missed doses, DM status; smoking and alcohol intake in the past TB treatment were collected using pretested structured questionnaire and available records. Data was entered in EpiData software version 3.1 and analysed using SPSS v20.Results: Of 241 re-treatment TB patients, the proportion of relapse, TAD, failure and others were 52%, 24%, 12.4% and 11.6 respectively. About 90% [95% CI (85.6-93.2)] had received their recent previous anti-TB treatment from RNTCP sources. In multivariate analysis, Age >24 years, below secondary level of education and relapse cases have independently associated with RNTCP source of previous TB treatment. The median time interval of re-registration for relapse, TAD, failure and others were 334, 211, 140 and 53 days respectively. This difference between groups are statistically significant (p<0.0001). Almost one out of four retreatment TB patient was known diabetic. More than half of retreatment TB patients had consumed alcohol during their recent previous TB treatment.Conclusions: The public-private partnership is better in Pondicherry as only 10% of re-treatment TB cases were previously treated from Non-RNTCP sources. There is a scope for reducing the time between declaration of failure and initiation of re-treatment TB regimen. Screening and appropriate counselling of all registered TB patients for smoking and alcohol intake may be necessary.
Assessment of knowledge, attitude and perception among mothers towards immunization in a tertiary care teaching hospital
Authors: Md. Sarfaraz , A. Athira , Thotamsetty Lakshmi Mani Deepa , Ravilla Sree Anoohya , Nadikudi Naresh , Doddayya H.
Published: August 2017

Background: The knowledge, attitude and perception (KAP) of parents is an important factor for better immunization coverage. Previous studies showed misconceptions on parent’s knowledge towards childhood immunization. This study aimed at promoting the childhood immunization by providing information and knowledge to mothers regarding immunization.Methods: A prospective interventional study was conducted on 103 mothers for a period of six months in a tertiary care teaching hospital, Karnataka. The study was divided into Pre-intervention and post-intervention phases and was performed using a KAP questionnaire.Results: 103 mothers were enrolled in the study, of which 77 (74.75%) mothers were uneducated which was the main reason for lack of knowledge on immunization. Most of the mothers in pre-intervention phase got score in the range of 2-4 and in post-intervention phase they got score in the range of 10-12. A significant difference was observed in the Pre and Post-intervention scores which indicated that level of knowledge among mothers was improved after counseling session. Chi-square test was used to analyse the pre and post- intervention scores and was found to be significant (p<0.01). Out of 103 mothers who had attended counseling session on immunization 80 (77.66%) children were immunized, 23 (22.66%) were partially immunized and no one was unimmunized.Conclusions:It was therefore suggested that proper health education and health promotion interventions be taken as measures to improve knowledge, attitude and perception of mothers towards immunization as a disease prevention tool.
Knowledge and attitude regarding organ donation and transplantation among medical students of a medical college in South India
Authors: Alex Prince , Kiran K. G. , Baisil Sharon , Badiger Sanjeev
Published: August 2017

Background: The shortage of organ donors is the key rate-limiting factor for organ transplantation in India. Many strategies have been proposed. One of the strategy is by improving awareness of organ donation and transplantation in the population. This study seeks to assess the knowledge and attitude of the medical students toward organ donation and transplantation. The objective of the study was to assess the knowledge and attitude regarding organ donation and transplantation among medical students.Methods: A cross-sectional study was conducted among 510 undergraduate medical students of K.S Hegde Medical Academy. A tool with 30 questions was designed and administered to the students, in order to assess their knowledge and attitude regarding organ donation and transplantation. Data collected was analysed using SPSS software.Results: The mean age of the students was (20.21±1.32). When compared to boys, girls reported higher mean scores in knowledge (9.22±1.11); and attitude (7.32±0.81). The first year students had higher scores for their knowledge (9.46±1.28) compared to other years. The third year students showed a higher mean attitude score (1.61±1.07) (p=0.02). Hindus scored significantly higher mean knowledge, and attitude as compared to Christians and Muslims (p=0.03). There was a positive correlation between mean knowledge, and attitude of students regarding organ donation and transplantation.Conclusions: There was adequate knowledge in students but their attitude was poor. The study throws light on their inadequacies of knowledge and attitude of medical students, necessitating the inclusion of the topic in their curriculum.
Elderly depression: unnoticed public health problem in India- a study on prevalence of depression and its associated factors among people above 60 years in a semi urban area in Chennai
Authors: Mohan Yogesh , Jain Timsi , Krishna S. , Rajkumar A. , Bonigi Sathvika
Published: August 2017

Background: Worldwide proportion of elderly population is expected to double from current 12% to 22% by 2050. This growth in elderly population inevitably leads to increase in age related diseases such as depression and serious constrains on quality of life among them. As depression frequently manifest with somatic symptoms like tension, headache and heaviness, etc., most of the elderly persons visit non psychiatry outpatient services seeking relief for their symptoms.Methods: A cross sectional study was done in the field practice area of Saveetha Medical College and Hospital. Geriatric depression scale (GDS) short form was used to measure the level of depression in geriatric population. Structured questionnaire was used in order to assess their physical health, socio-demographic data and social support. Elderly mobility scale was used to measure the level of physical dependency. Proportion and chi-square were used for analysis.Results: Prevalence of depression was found to be 76%. Among depressed elderly 47% had mild depression, 28% had moderate depression and 25% were suffering from severe depression. Severity of depression was also found to be significantly more among those who had lost their life partner and those who were physically dependent on others.Conclusions: Prevalence of depression in the elderly was found to be high moreover none of the elderly were diagnosed to be depressed. Steps like screening for depression among elderly should be undertaken to diagnose the cases of depression, they should be treated and also be given proper counseling sessions to reduce their levels of depression.
A study on the prevalence and awareness of hypertension among women in the reproductive age group and the factors contributing to it in a rural area of Jorhat district, Assam
Authors: Singh Namrata , Rahman Syeda Jesmin
Published: August 2017

Background: Hypertension has been identified as one of the major causes of morbidity and mortality in both developed and developing nations. Prevalence is seen to be increasing in the rural areas, especially among the females in the reproductive age group. The prevalence of hypertension is found to be high in Assam, while the awareness is quite low thus necessitating a study in this regard.Methods: A total of 400 women in the reproductive age group were selected from Bagchung block, Jorhat by Simple Random Sampling. They were interviewed and their blood pressure was measured along with some anthropometric variables. Classification of hypertension was done as per the US Seventh Joint National Committee (JNC 7) report on the prevention, evaluation and treatment of high BP.Results: A total of 23.5% prevalence of hypertension was found among the study subjects. 44.5% of the total was in the pre hypertensive stage. 77% of them had heard of hypertension while only 20% were aware of its side effects. Extra salt intake, family history and underlying medical conditions were the major risk factors.Conclusions: Knowledge, awareness on hypertension in women in this part of the district is poor and the prevalence is high and their life style practices are grossly contributing to it. Therefore, efforts should be geared towards improving the levels of awareness of the women regarding hypertension and the risk factors.
Clinical profiling of sickle cell disease patients with respect to pulmonary hypertension
Authors: Gosavi Rajesh V. , Jain Shilpa
Published: August 2017

Background: Sickle cell disease (SCD) is the commonest heritable hematologic abnormality affecting humans. Pulmonary hypertension is documented in patients of SCD by both non-invasive methods and catheterization, with incidence reported to be as high as 20%-63%. However, pulmonary hypertension has not been studied as complication of patients of sickle cell disease in India.

Methods: A total of 94 (54 SS and 40 AS) more than 12 years old cases diagnosed to have sickle cell disease by hemoglobin electrophoresis were recruited. All the participants were assessed with complete history, general and systemic examination, hematological and biochemical tests, X-ray chest, ECG, pulmonary function tests and 2D echocardiography and Doppler studies. Cases were observed in 2 groups: SS cases and AS cases. Sixty four age/sex matched healthy close relatives of the cases with ‘AA’ Hb electrophoresis pattern were the controls.  

Results: Five SS cases were detected to have pulmonary hypertension. Pulmonary hypertension was not detected in any AS case or control. Pulmonary hypertension was more common in females (3/23, 13%) than males (2/26, 7.7%). The mean age of the SS cases with PH (32±5.15) was found to be significantly higher than that of the SS cases without PH (24.2±6.21) (p<0.01).

Conclusions: The incidence of PH was low in this study, as compared to western studies. This may be since most of the cases of SCD being in remote areas having no access to health care facilities. 
Goûts et imaginaires cosmopolites des jeunes Français
Authors: Cicchelli Vincenzo , Octobre Sylvie
Published: August 2017

En France, les jeunes sont les acteurs majeurs de la globalisation de la culture, à la fois parce qu’ils sont très engagés dans les consommations culturelles, mais également parce qu’ils sont issus des générations les plus multiculturelles dans leur composition, et les plus socialisées aux injonctions de mobilité (voyageuse, estudiantine, professionnelle...). La recherche « Le cosmopolitisme esthétique chez les jeunes » se penche sur le rôle de la consommation esthético-culturelle – à travers les séries, les films, les lectures, les musiques, les jeux vidéo, les usages des réseaux sociaux, etc.- dans l’émergence d’un rapport au monde de nature cosmopolite et dans la formation d’un goût du monde.
The Validity of Self-Report Measures in Assessing Historical Knowledge: The Case of Canada’s Residential Schools
Authors: Boese Greg D. B. , Neufeld Katelin H. S. , Starzyk Katherine B.
Published: August 2017

The Truth and Reconciliation Commission of Canada (TRC) strives to increase public education regarding residential schools. A baseline measure of the public’s residential school knowledge could be useful to evaluate the progress of the TRC. The National Benchmark Survey, Urban Aboriginal Peoples Study, and Canadian Public Opinion on Aboriginal Peoples Report are three existing surveys that provide such a baseline, though each use only self-report measures. We measured residential school knowledge of 2,250 non-Indigenous Canadian undergraduate students through self-report (subjective) and multiple-choice (objective) measures. Analyses revealed a statistically significant correlation between self-reported and objective knowledge of residential schools.