bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary malignant melanoma of the uterine cervix treated with radical surgery and adjuvant chemo-radiation using temozolomide and cisplatin: a case report
Authors: Doke Goter , Tsering Shyam , Nobin Hage , Gara Dacto
Published: July 2019

Primary malignant melanoma of the uterine cervix is a rare neoplasm and the overall prognosis of patients with this disease is very poor. Herein, authors report a case of 45-year-old woman who presented with vaginal bleeding for one months and examination showed an exophytic, 6 cm polypoid blackish-pigmented tumor on the cervix involving vaginal fornix. She underwent abdominal radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy and further received adjuvant concurrent chemo-radiation with cisplatin (CDDP) and temozolamide but died 7 months after surgery.
Rare case of ruptured uterus in previously normal delivered patient due to hydatid cystic disease in pregnant uterus
Authors: Bargaje Ganesh Mahadeo , Ghumare Jitendra Pundlik
Published: July 2019

Hydatid cystic disease is parasitic disease caused by Echinococcus granulosus. Dogs and carnivors like fox are definitive hosts harbouring warms in intestine. Eggs passed in stools eaten by intermediate hosts and larvae encyst in liver, lungs and other organs. Humans are accidental hosts. Incidence of hydatid cystic disease in genital organs is low around 0.5%. Hydatid cyst most often found in liver - 60%, lungs - 30% accounting approximately 90% of the disease. Incidence of hydatid disease in pregnancy is very rare ranging from 1/20000 to 1/30000. 22 years old G2P1L1 with 39weeks gestation age (GA) with intrauterine fetal death (IUFD) with query ruptured uterus, extra uterine pregnancy, transverse lie with severe anaemia referred from Jalgaon civil hospital for further management.
A case report on IgA nephropathy in pregnancy
Authors: Anand Nupur , Gokhale A. V. , Agarwal Shonali
Published: July 2019

IgA Nephropathy is a primary glomerular disease leading cause of primary glomerulonephritis and one of the important  leading cause of secondary hypertension. Pregnancy causes complex pathological changes in patients with IgA nephropathy affecting the renal function leading to secondary hypertension which in turn affects the prognosis of these patients. The association between chronic kidney disease and increased risk of adverse maternal and fetal outcomes which includes pre-eclampsia, accelerated decline in renal function, intrauterine growth retardation, preterm delivery and fetal death, is well recognised. Management of patients with IgA Nephropathy in pregnancy is challenging and thus authors are discussing here a case with successful outcome. Our patient was a known case of IgA Nephropathy and landed up with complications during pregnancy which was manged successfully.
Postpartum atypical haemolytic uremic syndrome: a rare clinical entity
Authors: Sablok Aanchal , Gupta Taru , Gupta Sangeeta , Duggal R. K. , Tiwari Amrita
Published: July 2019

P-aHUS has incidence of 1 in 25000 pregnancies. It’s characterized by microangiopathic haemolytic anemia, thrombocytopenia and renal failure. Mrs X, 26 year old lady, G2 P1L1 with 39 weeks POG came to emergency of a tertiary care hospital. She underwent LSCS in view of previous caesarean section not willing for trial of labour. Antenatal, intrapartum and immediate post operative period were uneventful. However, she became anuric 36 hours post operatively. Laboratory investigations suggested hemolysis. Complement system evaluation showed decreased complement levels. Diagnosis of p-aHUS was made by taking multidisciplinary approach and renal biopsy. Patient received 4 sessions of plasmapheresis and symptomatic treatment. Gradually her urine output increased and she was discharged with the baby on post operative day 19. Diagnosis of p-aHUS is tricky owing to similar clinical features with many other pregnancy associated conditions. Timely management and diagnosis are imperative to save the mother’s life.
Large cervical fibroid: a rare case report
Authors: N. Sunanda
Published: July 2019

Although leiomyomas are the most common pelvic tumors presenting in the reproductive age group, cervical fibroids are rare accounting for 2% of all uterine fibroids. We report a case of 40 year old lady presenting with a firm, non-tender mass of 22-24 weeks size pregnant uterus with restricted mobility. Laparotomy showed a large mass arising from the anterior lip of cervix, with a small uterus pushed posteriorly. Enucleation followed by total abdominal hysterectomy was done. Large cervical fibroids are rare, presenting with surgical difficulties. Careful dissection by expert hands is needed in the management of such cases.
A rare case of dicephalous dibrachius dipus conjoined twins:case report
Authors: Davile Medha , Gaikwad Mrunal
Published: July 2019

Conjoined twin is a rare complication seen in 1% of monochorionic monoamniotic twins and associated with severe morbidity and mortality. We are reporting a case of 30 years old second gravida referred to our tertiary care center at 35 weeks of gestation with ultra-sonographic diagnosis of dicephalus conjoined twin and further confirmed after caesarean delivery.
A rare case of craniopagus parasiticus delivered vaginally at a district hospital
Authors: Chhabra Komal Kuldeepsingh
Published: July 2019

Craniopagus Parasiticus is a very rare type of parasitic twinning. It has an incidence of only 4-6/10,00,000 births. Most of the babies with Craniopagus Parasiticus are still born with only few cases which survived after postpartum surgical separation. In Craniopagus Parasiticus the head of one of the twins is parasitic and protrudes from the head of the normal twin with an undeveloped or underdeveloped body. The skulls of the twins are fused but the body of one of the twins is not developed. The developed twin is known as the auto site while the undeveloped twin is the parasite. Age of the mother or certain nutritional factors have been implicated in the etiology of this type of twinning. This is a rare case report of a female baby with a parasitic craniopagus delivered vaginally at this district hospital. The patient was a fourth gravida 28 year old. There was antenatal polyhydramnios. The patient delivered preterm a still born female baby with a parasitic co-twin. In this case the heads of the twins were fused in temporal and parietal areas while the body of the parasitic twin was completely undeveloped. It was a morphologically female baby with rudimentary labia. The causes of Craniopagus Parasiticus are still not known. Scientists and researchers are continuing work to determine these and also to improve the prognosis and chances of post-surgical survival of these twins. Till present day however there have been only limited number of studies on Craniopagus Parasiticus owing to the rarity of the cases.
Retrospective review of maternal deaths and maternal near misses due to major obstetric haemorrhage at a tertiary care centre in India
Authors: Agrawal Swati , Singh Anuradha , Biswas Ratna , Singh Abha
Published: July 2019

Background: Maternal near miss (MNM) is now widely accepted as a better indicator of maternal health than maternal death and reflects the quality of obstetric care in a particular institution.Methods: This is a retrospective study conducted at Lady Hardinge Medical College and Smt. Sucheta Kriplani  Hospital over a period of 12 months (April 2016-March 2017), of  all cases of maternal death and near miss maternal deaths due to major obstetric haemorrhage(MOH).Results: During the period reviewed, there were 13,083 deliveries, 12,958 live births and 37 maternal deaths. There were 30 cases of near miss maternal deaths and 2 maternal mortalities due to MOH. The mortality index was 6.25%. Severe maternal outcome ratio (SMOR) was  2.46.Among the near miss cases (n=30), morbidly adherent placenta was the cause in 26.6% of cases(n=8), postpartum hemorrhage in 23% of cases(n=7); rupture uterus in 13% cases(n=4); massive abruption in 13% of cases(n=4) and placenta praevia with antepartum haemorrhage in 3% of cases(n=1). Early obstetric haemorrhage due to ruptured ectopic pregnancy and incomplete abortion resulted in MNM in 16% (n=5) and 3.3% (n=1) cases respectively.It was observed that in 40% (n=12) of MNM cases (8 cases of morbidly adherent placenta plus 4 cases of rupture uterus), previous cesarean section was the single most important causative factor  for the morbidity of the patient.Conclusions: Reduction in cesarean section rates is imperative to reduce morbidity and mortality associated with MOH.
Knowledge and personal hygiene practice among food handlers in public university campus of Bangladesh
Authors: Al Mamun A. H. M. Shamim , Hsan Kamrul , Sarwar Md. Shanjid , Siddique Md. Ruhul Furkan
Published: July 2019

Background: Millions of people are suffering from food borne illness and it has become a growing public health concern in the world. To reduce the burden of food borne illness, food handlers must have accurate knowledge of food safety. The objective of the study was to assess the knowledge and level of personal hygiene practice among food handlers of Jahangirnagar University.Methods: It was a descriptive cross sectional study, done among the food handlers in Jahangirngar University Campus, Dhaka, Bangladesh from May 2016 to September 2016. Data were collected from 119 food handlers by using face to face interview using a pre-tested questionnaire. Statistical Package for Social Sciences (SPSS 22.0) software was used for data analysis.Results: Study found that 65.55% of the food handlers did not have adequate knowledge regarding personal hygiene. The study also found that 71.4% of the food handlers had poor hygiene practice. The study revealed that age, education and sleeping place and knowledge regarding personal hygiene were significantly associated with the respondent’s personal hygiene practice.Conclusions: The study shows that knowledge and its practice among the food handlers is very poor. Implementation of training and awareness program on personal hygiene are required to improve their knowledge and personal hygiene practice.
Infant feeding practices among parturient women in rural communities of Anambra State, Nigeria
Authors: Obiora Oluchukwu Loveth , Ezenduka Pauline O. , Umeonwuka Chuka Ifeanyi
Published: July 2019

Background: Infant feeding is an integral part of the reproductive process with important implications for the health of mothers and their babies. However, various practices exist in different communities. It is therefore pertinent to know the infant feeding practices among rural dwellers, as well as the factors that influence them.Methods: This study was a cross sectional survey. A total of 372 volunteering parturient women were recruited using a multi-stage stratified sampling technique. Ethical approval and respondents’ informed consent was obtained. A self-developed and validated questionnaire was used to collect data. Descriptive and inferential statistics was used to analyse data.Results: Findings revealed that majority (84.4%) of the respondents were aware of exclusive breastfeeding (EBF), but only about half (50.5%) ever practiced exclusive breastfeeding. Also, a significant percentage of the respondents introduced complimentary feeding to the baby immediately after birth while 29.3% of participants reported drinking palm wine which is mainly alcoholic to stimulate breast milk secretion. Occupation of parturient women was associated with the practice of EBF (p=0.002).Conclusions: Almost half of our studied parturient women do not engage in EBF. There is need for health care workers to strategically educate parturient women and their significant others on the numerous benefits of exclusive breast feeding.
The dilemma of delayed presentation in breast cancer: a perspective from the Radiology department of a developing country of Asia
Authors: Gul Palwasha , Gul Pari , Jogezai Shama , Gul Khanda , Parveen Tanzila
Published: July 2019

Background: In Asia, Pakistan has the highest incidence of breast cancer with 1 in 8 women will develop breast cancer at some stage of their life. Delays in presentation and diagnosis are major determinants of breast cancer survival, but these have not been comprehensively investigated in Pakistan.Methods: A cross-sectional study was done from June 2017 till October 2018 at Radiology department of Bolan medical complex hospital in Quetta, Pakistan. Patients with breast cancer above the age of 18 and below 70 years were interviewed who were diagnosed with breast cancer. The time interval between self-detection and deciding to seek care was defined as delayed if the woman presented to a health care professional three months or more after detecting an abnormalityResults: A total of 86 breast cancer patients fulfilling the criteria were included in the study. Of these, 34% presented to physician within 3 months of appearance of symptoms, 68% patients presented with a delayed of more than 3 months. Presentation delay was due to financial issues which were seen in 30 patients. 18 patients (20.9%) showed delayed to due difficulty in reaching hospitals, 16 patients (18%) stated delay due to prior use of alternative therapies. Embarrassment and spiritual belief constituted 4.6% cases. 51% and 36% presented with stage III and IV disease out of which majority belonged to poor socio-economic status.Conclusions: The findings suggest that majority of the patients with breast cancer presented late and this has significant effect on their disease prognosis. Most cases of breast cancer presented in advanced stage probably due to poor economic status, difficulty in reaching hospital, illiteracy and negligence by patient or family.
A cross-sectional study on obesity and menstrual abnormalities among women of reproductive age in urban field practice area of Kempegowda Institute of Medical Sciences, Bangalore
Authors: Srikanth Jayanthi , Kumari Nitu , Rajanna Pushpa
Published: July 2019

Background: Obesity is on the rise among Indian women; increasing from 12.6% (NFHS-3) to 20.7% (NFHS-4). This leads to dysregulation of several groups of hormones and has deleterious effect on the reproductive system. Extra adipocytes are sources of extra estrogen that can cause menstrual disorders such as oligomenorrhoea, polymenorrhoea, menorrhagia and metrorrhagia. Counselling women about weight reduction will help in improving their reproductive health and quality of life. Thus, the present study was done to assess obesity among women and to describe the menstrual abnormalities among them; simultaneously, the perception of obesity among these women was also assessed.Methods: A cross-sectional study was conducted by doing house to house survey among 250 women of reproductive age residing in the urban field practice area of KIMS, Bangalore for a period of 3 months from June to August 2018. Details about socio-demographic factors, presence of any menstrual abnormalities and perception of obesity were collected using questionnaire by house to house survey. Anthropometric measurements were done and BMI was calculated. Data was entered in MS excel and analysed using appropriate statistical tests.Results: The study included 250 subjects; among whom 59.2% were obese. The common menstrual problems reported were dysmenorrhea (52.8%), oligomenorrhea (20.4%), hypomenorrhea (14.1%), menorrhagia (13.6%) and polymenorrhea (1.6%). Menstrual problems affected daily activities in 50.7% subjects. The difference between perception of their body image and their actual weight was found to be statistically significant.Conclusions: Obesity is an important health issue among women and most of them had menstrual abnormalities.
Analysis of environmental impact on emotional health of people visiting temples of Vrindavan, India: a qualitative survey
Authors: Shoor Purva , Bhatt Bhumika
Published: July 2019

Background: In this century, blind faith in unhealthy environments is dwindling and more focus on environmental impact on a truly spiritual and emotionally uplifting experience is regarded as most important to contemporary visitors to sacred places. The main objective is to describe the emotional state of people visiting temples of Vrindavan and to describe the viewpoints on environmental factors affecting their emotional health.Methods: Type of study: a qualitative survey, study population: visitors to temples of Vrindavan. Method of sampling: purposive sampling, sample size: 67 people, study tool: pre-tested, semi-structured questionnaire for interview, data was analyzed using Microsoft Excel spreadsheet, and tabulated.Results: 82.09% of people interviewed were of the age 18-50 years. Among the visitors all were Indians, and one NRI. Majority interviewed were males. 6 people visiting temple 1 reported feeling annoyed, disturbed and insecure during visit. There were relatively positive responses regarding environmental factors due to religious constraints. Many people reported good conduct of pujaris (temple priests) in all the three temples with quite a few bad comments like professional seekers and greedy. Long queues and no comfort was disliked for all the three temples, however some people expressed no problem with it.Conclusions: Pilgrims do not critically analyze environmental aspects managed by authorities. They felt spiritual and emotionally aroused and preferred not to comment on not so comfortable experiences. We cannot neglect the rising exceptions to the usual herd of visitors who are on the rise.
A cross-sectional study on malnutrition in elderly using mini nutrition assessment scores in an urban slum
Authors: Sonawane Sharon Samson , Varghese Varsha Anna , Moses John Paul Jetpole
Published: July 2019

Background: The global demographic shift presents new challenges regarding health of elderly. Nutrition in elderly affects their immunity and functional ability. Most cases of malnutrition in elderly go under-reported. Hence, this study was conducted to study malnutrition in elderly using MNA score with the aim to find out the prevalence of malnutrition in elderly and study its associated factors in an urban slum in the field practice area of parent medical college.Methods: Study was conducted in 120 elderly (>60 years) study participants. A pre-tested semi-structured questionnaire consisting of information on lifestyle, somatic, functional, social factors and Mini Nutrition Assessment (MNA)questionnaire was administered to assess the nutritional status of the elderly. Descriptive statistical measures like percentage, mean, standard deviations and inferential statistical measure like chi square were calculated.Results: Among 120 elderly study participants, 83 (69.17%) were females, 37 (30.83%) were male and their mean age was 67.21 (±6.27) years. 40 (33.33%) had malnutrition, 65 (54.17%) were at risk of malnutrition and 15 (12.5%) had satisfactory nutrition. Medication use, socio-economic status and marital status showed significant association with malnutrition in elderly.Conclusions: The high prevalence of malnutrition and risk of malnutrition in elderly necessitates appropriate preventive and corrective measures like detailed evaluation, regular follow-up and dietary interventions to be undertaken to deal with malnutrition in elderly.
Mortality pattern in a tertiary care teaching hospital in North Karnataka, India
Authors: Shankar Gowri , Kalburgi Eshwar B.
Published: July 2019

Background: India is undergoing rapid epidemiological transition due to economic and social change. The pattern of mortality is a key indicator of the long term health effects. Mortality data indicates the health of the population under study. Hence this study was done to know the socio demographic profile and mortality pattern of all deaths in a tertiary care teaching hospital in North Karnataka, India.Methods: A one year retrospective study of all deaths in Hangal Sri Kumareshwar Hospital and Research Center, Navanagar, Bagalkot, Karnataka State, India was done of the year 2017, after ethical clearance and Institutional Review Board. The case records of all deaths from Medical Record Department were analyzed for socio demographic profile and mortality pattern. The deaths had been classified according to International Classification of Diseases-10th revision. Data was analyzed using percentages and chi-square test.Results: Out of 357 deaths in the year 2017, 214 (59.94%) were males and 143 (40.06%) were females. Maximum deaths were between 15 to 60 years of age contributing to 43.14% of the total followed by deaths in more than 60 years of age (35.29%). Non-communicable diseases contributed to 70.03% of the total deaths.Conclusions: Non communicable diseases are on the rise in the urban and rural communities of the study area. Preventive care is the need of the hour and it can be achieved through health education and screening of the high risk population.
Survey of compliance with the cigarettes and other tobacco products act, 2003 at schools in Mangalore, Dakshina Kannada district, Karnataka
Authors: Mathias Jennifer , Jena Pratap Kumar , Shah Sanjeev Kumar , Sah Jay Prakash , Gautam Koshish Raj , Upadhayay Abinash
Published: July 2019

Background: Tobacco use is a major problem of public health significance as the tobacco smoking causes a wide range of diseases and adverse health impacts that affect nearly every organ of the body. The COTPA, 2003 i.e., the Indian smoke-free legislation “Prohibition of smoking in Public places” which forbids smoking in public places, including educational institutions. The main objective of this study is to assess the compliance of Section 4 and Section 6(b) of cigarettes and other tobacco products act (COTPA), 2003 in schools, to observe compliance of smoking ban at public places, to observe compliance of display of signboards at prominent places, to observe for direct and indirect evidence of smoking and other tobacco products used in school buildings and premises, to study the availability of tobacco products within 100 yards of school premises.Methods: A cross sectional survey in 100 schools in Dakshina Kannada district using compliance guide developed by partners of Bloomberg School of Public health to reduce tobacco use.Results: In 100 schools, 55 were rural area and 45 from urban area, further division shows government/semi-government schools were 44 and Private schools were 56. Section 4 for the presence of signboard, there is an association between the Management wise schools and presence of signboards (p=0.001), for section 6(b) of COTPA, there is an association between this Section and type of management (p=0.004).Conclusions: The schools depending upon the location show varied compliance towards the law. The Section 6(b) shows better compliance than Section 4.This study will help to address the implementation issues of COTPA.
Formal education about hygienic aural care and the relationship between aural hygiene awareness and practices: a cross-sectional study from a super-speciality hospital in West Bengal, India
Authors: Samaddar Saikat , Chakraborty Arup , Samaddar Sangita Bhattacharya , Lahiri Arista , Bandyopadhyay Saumendra Nath
Published: July 2019

Background: The result of poor ear care and hygiene behaviours are often encountered in otology practice. There is also lack of any proper guideline of hygienic ear care behaviours. The present study aims to assess the awareness and practice of hygienic ear care behaviours of the community, in the light of the guidelines as per WHO Primary Ear and Hearing Care Training Resources-Basic level.Methods: A cross-sectional descriptive study was conducted at Baruipur Sub-Divisional Hospital serving semi urban population of South 24 Parganas, West Bengal, India. Patients and parents (in case of children below the age of six years) were interviewed. Maintaining the inclusion and exclusion criteria after obtaining informed consent 480 participants were included in the study who responded to a validated self-reported semi structured questionnaire.Results: The mean age was 32.44 (±18.95) years. Around 51.3% were male, 81.25% were professionals. Majority belonged to nuclear family (52.083%) and Islam (53.333%). Around 88.958% of the population had practice of ear care behaviour which was poor. Joint family had an odds of 2.86 (p value=0.002) and Islam by religion had an odds of 1.99 (p value=0.044) for a higher level of awareness. Educated group had an odds of 4.07 (p<0.001) for higher awareness. Aware group had an odds of 19.95 (p<0.001) in favour of having hygienic ear care practices.Conclusions: The study demonstrated lack of formal education regarding ear hygiene at the community level. Dearth in formal knowledge leading to poor practices is compounded with several socio-cultural issues.
Awareness, attitude, participation and use of technology in birth preparedness and complication readiness among husbands of women availing obstetric care at a rural maternity hospital in South Karnataka
Authors: Kalliath Jacob Davies , Johnson Avita R. , Pinto Priya , James Nidhi , Sebastian Victoria
Published: July 2019

Background: Birth preparedness and complication readiness (BPCR) is an evidence-based strategy to reduce maternal mortality. Husbands have an important role to play in birth preparedness. There is paucity of data regarding husband’s participation and the use of technology in BPCR. The objective is to assess awareness, attitudes and the use of mass media and technology in BPCR among husbands of women availing obstetric care at a rural maternity hospital.Methods: A cross-sectional study was conducted in a rural maternity hospital in Ramanagara district, Karnataka. Husbands of women of more than 28 weeks of gestation, or postnatal mothers up to 6 weeks after delivery were included in the study.Results: Of the 133 participants, only 37.6% of the husbands had adequate awareness of BPCR, 62.4% had adequate participation in BPCR. Husbands’ participation was highest in saving money for delivery (75.9%), and lowest for arranging a blood donor (27.8%). Commonest source of information regarding BPCR was mobile phone (30.8%). Husbands awareness of BPCR was associate with reading MCP card OR=5.36 (2.47-11.63), seeing BPCR- related posters in hospital OR=6.59 (1.32-33.13) and using mobile phone for accessing BPCR-related information OR=2.28 (1.07-4.85). Husbands participation in BPCR was associated with awareness of BPCR OR=3.72 (1.65-8.41) and accompanying wife for antenatal visits OR=2.84 (2.25-3.59). Only one third of husbands felt it necessary to accompany their wife for antenatal visits or delivery.Conclusions: The MCP card and mobile phone technology may be further tapped to improve husband’s awareness and participation in BPCR, besides encouraging men to accompany their wife for antenatal visits.
Prevalence of aflatoxin contamination in groundnuts in Pune city
Authors: Deshmukh Manasi Shailesh , Vaidya Varsha Mahesh
Published: July 2019

Background: Aflatoxin contamination in groundnuts is caused by the fungi Aspergillus flavus and Aspergillus parasiticus. In this study, the prevalence of aflatoxin B1 in groundnuts has been assessed. Aflatoxins are highly carcinogenic, mutagenic and teratogenic. They are known to cause hepatocellular toxicity. The aim of the study is to estimate prevalence of aflatoxin contamination in groundnuts sold in the city of Pune and to assess the awareness about aflatoxin contamination amongst shopkeepers of selected shops/vendors.Methods: Sampling of groundnuts was conducted in 17 out of 144 administrative wards of Pune city. Hundred samples weighing 250g each were purchased from the randomly selected stores and transported in black polythene bags to The State Public Health Laboratory, Pune. Thin layer chromatography (TLC) was used by the laboratory to determine levels of aflatoxin B1. A pre-structured questionnaire was used for assessment of knowledge of aflatoxin contamination amongst vendors.Results: Out of 100 samples, four samples were contaminated with aflatoxin. However the maximum contamination was 0.6 parts per billion, which is well within the permissible limit of 30 parts per billion. Awareness of aflatoxin contamination amongst vendors was six percent. Ninety four percent of vendors were unaware of the concept of aflatoxin contamination.Conclusions: It is necessary to educate vendors, suppliers and handlers about the health hazards caused by this toxic fungus for the benefit of the average consumer.
Active detection of tuberculosis: tackling the problem head on in the remote area of Andaman and Nicobar Islands
Authors: Burma Samarendra Prasanna , Jahnavi Gunda , Lal Pappachen , Thatkar Pandurang V.
Published: July 2019

Background: Community based active case finding for tuberculosis (TB) is an essential step in the fight forward for eliminating TB. One of the steps in targeting TB intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. Active case finding (ACF) targeting the entire population by house to house survey was done in Nicobar district of these islands.Methods: A community-based, cross-sectional, descriptive study was conducted with the trained mobile teams from 17.07.2017 to 31.07.2017 in the Nicobar District. The algorithm of the case detection included screening patients by symptoms, then by sputum microscopy for confirmation. X-ray was done in patients who were symptomatic but sputum negative. If both smear and chest X-ray results were negative but still symptomatic, then cartridge-based nucleic acid amplification test (CBNAAT) was done.Results: A total population of 18526 was mapped of which 14784 (79.8) could be screened. A total of 209 people were identified by the mobile teams with symptoms who were examined by sputum microscopy. Among them 7 cases were identified to be sputum smear positive, 2 X-ray positive and 2 were diagnosed by CBNAAT.Conclusions: This study shows that the active case finding method is feasible and acceptable by the community. The results obtained are encouraging for the implementation of ACF through mobile team activity in all these islands in order to meet the target of WHO’s End TB Strategy.
Nutritional status of children under five year of age: a cross sectional study in rural area of Jhalawar, Rajasthan
Authors: Jain Manish , Bhati Jagdish Singh , Jain Mayank , Kumar Vinod , Garg Kapil , Gupta Pankaj Kumar
Published: July 2019

Background: Adequate nutrition is essential in early childhood to ensure healthy growth and development, proper organ functions and a strong immunity. Accurate assessment of nutritional status of children is a requisite in appropriate planning and effective implementation of nutrition interventions. The objective of this study is to assess nutritional status of children under five year of age in rural area and to identify the socio-demographic factors associated with under nutrition.Methods: A cross sectional study was conducted among children aged six months to five years in rural area of Jhalawar, Rajasthan. Nutritional status of the children was assessed by measurement of mid upper arm circumference and information like birth order of children, birth weight and number of siblings was collected using a pre-coded and semi structured questionnaire.Results: Moderate under-nutrition was present in 16.8% children. Under-nutrition was present among 9.9% male and 24.2% female children. 38.1% children with birth weight less than 2.5 kg were under-nourished. Proportion of under-nutrition was 27.7% among children with number of siblings more than 2 while it was only 11.1% among those with 2 or less number of siblings.Conclusions: Gender, number of siblings and birth weight of children were significantly associated with nutrition status of children.
Rapid screening for behavioral risk factors in adolescents in North India
Authors: Banga Poonam , Singh Tarundeep , Kumar Rajesh
Published: July 2019

Background: Habits get established during the transitional age of adolescence making it important to conduct surveillance to detect high risk behaviours at an early age. Feasibility of such a surveillance system was tested for monitoring the risk factors in schools.Methods: A cross sectional survey was conducted in randomly selected schools of Chandigarh in India, by enrolling 226 students of class V to XII. A pretested structured questionnaire on dietary pattern, physical activity, tobacco and alcohol consumption, drug abuse, mental health, sexual behaviour etc., was administered after ensuring privacy and confidentiality.Results: A total of 226 students with a mean age of 14years (range 10 to 19years) participated in the study. The prevalence of tobacco use was 8%, alcohol consumption was 3%, and drug abuse was 4%. About 47% were involved in a physical fight. Around 7% students were overweight. About 50% of the students skipped breakfast during previous week, and 6% had no intake of fruits and vegetables in last one month. Only 53% reported consistent use of seat belts.Conclusions: Several behavioral risk factors were prevalent among school children in Chandigarh. Behaviour surveillance to monitor trends should be conducted at regular intervals.
Practices of contraception among rural people in Nellore district, Andhra Pradesh: a cross-sectional study
Authors: Gollapalli Pavan Kumar , Conjeevaram Jyothi , Veluri Chandrasekhar
Published: July 2019

Background: As per the census 2011, the provisional population of India is about population of 1.21 billion. It is now estimated that by 2030, India will most likely overtake China to become the most populous country on the earth. India was the first country in the world to officially launch a national family planning programme (NFPP) in 1952 to reduce birth rate and to stabilize the population at a level consistent with the requirement of national economy.  Protecting the young couple from unwanted fertility and educating them to adopt their desired family through informed choice, are among the prerequisites to achieve a TFR of 2.1. To study the prevalence of contraceptive methods among rural population and to study the reasons for not using family planning methods among eligible couples.Methods: A community based cross-sectional study was done among 600 married women in reproductive age, in the three randomly selected Primary health centre areas, one each from the three revenue divisions of Nellore, dated from June 2011 to May 2012.Results: The contraception prevalence rate was 56.3% among whom 91.4% adopted permanent family planning methods.Conclusions: The contraceptive prevalence rate in the study subjects was 56% which was lower than that reported in NFHS-III (67%). Majority of the women opted for permanent sterilization when compared to spacing methods.
Knowledge, attitude and practice study on bio-medical waste management among interns in a tertiary care hospital in Kancheepuram, Tamil Nadu
Authors: P. Mohan Kumar
Published: July 2019

Background: All the wastes which are generated by the hospital are collectively called as health care waste. The medical interns exposed to various health hazards while working in the hospital during their training period. The study was done with the aim to assess the knowledge and awareness regarding various aspects of biomedical waste management amongst interns in a tertiary care hospital, Kancheepuram, Tamil Nadu.Methods: This was a descriptive cross sectional study carried out among 94 interns who had cleared the final MBBS exams and 81 interns who participated in the study after giving informed consent. A pretested, self-administered questionnaire on knowledge and awareness of bio-medical waste management policy and practice were given to the interns. Statistical analysis was done using Microsoft Excel.Results: Around 63% interns knew the correct definition of biomedical waste. 24.6% interns were aware that authorization is required for biomedical waste management by Central Pollution Control board. Only 22.2% of the interns had undergone the training programme and 64.1% were keen to attend training program for biomedical waste management. 88.8% knew about sources of generation of BMW and 96% had knowledge of bio-hazard symbol. 72.5% had knowledge of segregation of waste but none had knowledge of correct colour coding. 91.3% said that record maintenance was essential for biomedical waste management. 96.2% agreed that BMW is teamwork.Conclusions: It is hour of need for rigorous training, IEC program for all the medical interns to make them aware of the various health hazards associated with biomedical waste products.
A cross sectional study to assess the infrastructure and logistics available at Anganwadi centres in a rural area
Authors: Khan Anas Ahmad , Imtiaz Danish
Published: July 2019

Background: ICDS is running from about last four decades in our Country sponsored by Central Government. For achievements of ICDS objectives Anganwadi Centres need to be well equipped in infrastructure and logistics as they are the main source of services provided under ICDS. To find out available infrastructure and logistics at Anganwadi Centers (AWCs), to study the bio-social profiles of Anganwadi Worker (AWWs) and to assess the factors affecting the organizing ‘matriya samiti’ meeting by AWWs at AWCs.Methods: A cross sectional observational study conducted in a rural area of district Bareilly in 22 Anganwadi Centres selected by multi-stage sampling technique. Selected Anganwadi Centres were visited and selected Anganwadi workers and beneficiaries were interviewed.Results: Majority of AWCs were having pucca type of construction but only 18% were having toilet facility. 60% of AWCs were having regular supply of supplementary nutrition, 72% of AWCs do not have any cooking utensils, around 55% were having growth charts, only 32% were having complete non formal pre-school education kit, less than 40% were having complete medicine kit and only 13% were having referral slips.Conclusions: Most of the AWCs were not having adequate infrastructure and logistics as requires.
A study on awareness of cervical cancer and human papilloma virus vaccine among the women’s degree college students in Nandyal
Authors: Kumari Ganesam Krishna , Pasha Mohammed Mushtaq , Fatima Afasar
Published: July 2019

Background: In India cervical cancer is the second most common cause of cancer mortality in women after carcinoma breast. Human papilloma virus (HPV) is the principal causative agent for cervical cancer. FDA approved 2 vaccines for primary prevention, and is available in India, but is not part of National Immunization Programme. Due to societal, religious and ethical issues associated with the vaccination of adolescent girls in India together with lack of awareness about HPV and HPV vaccines, no successful HPV immunization program has been employed in India. To study the awareness of Degree college students on cervical cancer and HPV vaccine.Methods: This cross sectional study was conducted at SPY REDDY Women’s Degree College, Nandyal from 16th December 2018 to 15th February 2019. The participants were 327 Degree students of first to final year. Students who were not present during the study were excluded from the study. The data was collected using a semi structured questionnaire. The data was analysed by using spss version 24 and the results expressed as proportions.Results: The mean age of participants was 19.53±1.26 years. 89% of the students were unmarried and 11% were married. 46.4% of the students were aware of cervical cancer. Poor genital hygiene (11.2%), smoking and alcohol (5.8%), multiple sex partners (4.3%), sex at an early age (3.4%), long term OCP usage (2.5%) were considered as risk factors for cervical cancer by the students. 18.4% of the students had knowledge about HPV virus. Among the students who knew about cervical cancer, 22.3% of the students responded as vaginal bleeding after menopause is a symptom of cervical cancer, 8.1% responded as bleeding during or after sex, 3.4% as pain during sex, 1.6% as severe low backache. Only 1% knows about Pap smear. Only 12% know about the vaccine. Only 4% correctly knew the vaccine eligibility. None of the students were HPV vaccinated.Conclusions: The level of awareness of students about cervical cancer and HPV vaccine is far below for effective vaccination and prevention of carcinoma cervix. More effective awareness programmes are needed to screen early for cervical cancer and vaccinate & prevent the high mortality from carcinoma cervix.
Adherence to anti-retroviral therapy and factors influencing it among HIV/AIDS adult patients in Agra: a cross-sectional study
Authors: Meena Sunil Kumar , Negi Rudresh , Chaudhary Shailendra Singh , Misra Sunil Kumar
Published: July 2019

Background: HIV/AIDS remains a significant global public health problem. With approximately 56% HIV patients in India receiving treatment, adherence to drugs is a crucial element for successful management. Sustainable development goals, National Strategic plan for HIV/AIDS and STI (2017-24) and 90-90-90 target pushing towards ending of AIDS epidemic require adequate adherence and this research estimates the adherence, associated factors and reasons for non-compliance.Methods: This analytical cross sectional study was undertaken on 160 HIV patients from an ART Centre. A pre-structured, pilot tested, face validated questionnaire was used and data collected by face to face interviews, through random selection of participants from outpatient department register. Data was analysed using Epi Info software and chi squared test applied.Results: Of the 160 study subjects, 86.8% remained adherent to the treatment with forgetfulness (71.4%) being the most common cause for non-adherence. Statistically significant treatment adherence was observed to be associated with socio-economic status (p=0.021) and period elapsed since diagnosis (p=0.041).Conclusions: Improving adherence to drug therapy through intensive counselling, streamlined drug supply and increased family participation would go a long way in reducing the menace of HIV.
Utilization of Rajiv Aarogyasri Health Scheme by rural policyholders of Chittoor district in Andhra Pradesh
Authors: Mannuru Manjuram
Published: July 2019

Background: Rajiv Aarogyasri has covered 86.53% of the families across the state. Majority of its people are living in rural areas. Hence, our study will explore gaps in accessibility of urban centric health services by rural policyholder’s under the scheme. To find out the current status of Aarogyasri coverage, awareness, utilization and experiences of rural policyholders in Chittoor district of Andhra Pradesh during the year 2014-15.Methods: This is a cross-sectional quantitative study and a total of 200 households were surveyed by using multi-stage random sampling technique to obtain primary data, and for background & discussion secondary data was reviewed. SPSS software was used for data analysisResults: In the past one year, 6.77% of the families have received benefits under the scheme. Amongst the ones who have utilized RAS services, 2/3rd of the families were protected from catastrophic illnesses and the mean average of 91.70% of the total costs was covered by RAS. Another 19.21% of the families were in need of healthcare but did not utilize the services due to lack of RAS card, lack of awareness, non-listed therapies, procedural difficulty, non-availability of caretaker, loss of wage and low quality of services.Conclusions: Overall, 66.66% of the beneficiaries expressed their satisfaction, 16.66% opinionated fair while 16.66% were dissatisfied with the RAS services. Beneficiaries experienced shortage of supportive services in Government hospitals under the scheme. Further, IEC activities, alternatives for excluded conditions, strengthening of public facilities will improve the utilization of RAS and reduce the OOPE.
Prevalence, pattern and predictors of domestic violence against women in Delhi: a community based study
Authors: Sharma Kamlesh Kumari , Vatsa Manju , Kalaivani Mani , Bhardwaj Daya Nand
Published: July 2019

Background: Domestic violence against women has serious health consequences for women. Prior research indicates its pervasive nature, albeit with wide variations in its prevalence across different settings. We examined the prevalence, pattern and predictors of domestic violence against women.  Methods: Our community based, cross sectional, mixed methods study included 827 ever married women aged up to 60 years, from Delhi (India), selected through cluster sampling followed by systematic random sampling.  Data were collected during 2010 to 2011 using structured questionnaires and in-depth interview guide. Statistical analysis was carried out using Stata 11.0 (College Station, Texas, USA) and thematic analysis for qualitative data obtained on in-depth interviews.Results: The life time prevalence of psychological, physical and sexual violence was 43.4%, 27.2 % and 26.4 % respectively; and when measured over past 12 months it was 37.6%, 19.3% and 20.3% respectively. ‘Any form of violence’ emerged as a sizeable category with a lifetime prevalence of 43.4%, and 37.8% in past one year. In most instances, the acts of violence were continuing and were perpetrated by husband. Violence was significantly higher among women having low neighborhood support (OR: 2.71, 95% CI: (1.39, 5.27), negative dowry effect (OR: 19.93, 95% CI: (10.36, 38.35) and alcoholic husband (OR: 2.12, 95% CI: (1.46, 3.09), whereas family support was protective against violence (OR: 0.31, 95% CI: (0.20, 0.49).Conclusions: The prevalence of domestic violence in Delhi is considerably high. There is need to use multipronged approach including effective and sustainable public health interventions to address the violence.
A comparative study on health seeking behaviour of parents towards their child’s illness in rural and urban field practice area of a medical college
Authors: Burra Kalyan Chakravarthy , Dimmala Chandrashekhar Varaprasadrao
Published: July 2019

Background: The attitude of parents towards their children’s health and illness is an important factor with regards to child’s overall development. In most developing countries, the health of the children is strongly dependent on parental healthcare behavior. This current study mainly looks into these aspects.Methods: A community based cross sectional study involving urban and rural area field practice areas of a medical college in the study period of November 2016-January 2017 with a sample size of 100 families each having children in urban and rural areas have been fixed purposively. House to house survey done by simple random method using pretested semi structured interview schedules.Results: Around 55% of rural parents took treatment from RMP (quacks) with 55% of urban counterparts opting for wait and watch method. Only 8% of respondents from both areas too their children to a pediatrician. About 12% of urban area went to government hospital and none from rural utilized government hospital facilities.Conclusions: Large proportions of respondents did not seek appropriate medical care for childhood illnesses.