bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatiotemporal mapping of dengue cases in Sleman district, Indonesia year 2014-2017
Authors: Sulistyawati Sulistyawati , Sukesi Tri Wahyuni , Mulasari Surahma Asti
Published: February 2019

Background: Dengue is a significant public health problem in the mostly tropical country such as Indonesia. Even though many efforts have been established in Indonesia, in fact, dengue remains drawing attention from the health sector. Geographic Information System (GIS) is a powerful tool to support dengue surveillance on understanding the dengue pattern with the goal to give input for the decision maker. Accordingly, there is a need to providing the presence and the dynamic of dengue case particularly in Sleman district to establish evidence on building dengue control strategy.Methods: A descriptive study using GIS was performed to provide a spatial-temporal mapping of dengue case. Secondary data which sourced from Sleman district health office was collected for period 2014-2017. This data was grounded into subdistrict level. Quantum GIS and Microsoft Excel were used to analyse the data.Results: During 2014-2017 dengue spreads over the Sleman district. In 2016, found the increased of subdistrict with high dengue case. The high dengue case found in sub-district with an urban characteristic.Conclusions: Mapping of dengue using GIS is helpful to understanding the disease presence and dynamic disease over time.
Urban health extension service utilization and associated factors in the community of Gullele sub-city administration, Addis Ababa, Ethiopia
Authors: Girmay Aderajew Mekonnen , Evans Martin R. , Gari Sirak Robele , Gebremariam Azage Gebreyohannes , Reta Mulumebet Tadesse
Published: February 2019

Background: In Addis Ababa, the capital of Ethiopia, the urban health extension program was started in 2009. Its approach is based on the assumption that access to and quality of primary health care in urban communities can be improved through transfer of health knowledge and skills to households. The study was conducted to assess the status of urban health extension service utilization and associated factors.Methods: A community based cross–sectional study was conducted to collect data from 628 participants. Sample size was determined by using a single population proportion formula. Binary logistic regression was used for data analysis.Results: The proportion of community utilization of the urban health extension program was found to be 86%. Respondents’ odds of utilizing urban health extension services among those who participated in the planning of urban health extension program activities were 2.8 (AOR=2.8; 95% CI: 1.43-3.70) times the odds of those who did not participate. The household respondents who utilized toilet with hand washing facilities had odds of utilizing urban health extension services that are higher by 2.62 (AOR=2.62 with 95% CI: 1.70-9.77) compared to those not utilizing toilet with hand washing facilities.Conclusions: The study provided important information regarding to the status of community utilization of urban health extension services. Respondents who utilized toilet with hand washing facilities were higher among the respondents who utilized and implemented the urban health extension packages. Respondents who participated in the planning of urban health extension program activities were those who significantly utilized and implemented the urban health extension program.
The pattern of off-label and unlicensed drug use in adult and pediatric patients in the Kingdom of Saudi Arabia: multicenter retrospective study
Authors: Sheblaq Nagham , Albahooth Zainab , Alfawzan Fatmah , Alanazi Khalid , Alshouli Sawsan , Alghalbi Amal , Alshnaiber Sameera , Alkurdi Moyasar , Almudaiheem Hajer , Almutairi Sattam , Alkuzaee Mohammed , Alanazi Anoud , Alshareef Abeer , Alotibi Nawaf , Almurshadi Samia , Alotaibi Mohammed , Aljohani Fatimah , Almutairi Lama , ElBagoury Marwan , Elagouz Ahmed M. , Hussein Omar M. , Najjar Amal
Published: February 2019

Background: Screening approved medications to identify therapeutics for drug repurposing is an effective tactic, and a deep research into off label drug use (OLDU) is required. Unfortunately, OLDU has not been extensively studied in Middle East. Our study aimed to evaluate the extent of OLDU in Saudi Arabia.Methods: Retrospective study carried out during 12 month period at six tertiary hospitals in Saudi Arabia. Each prescription was evaluated as unlicensed or OLDU based on the product information or based on Food and drug Administration (FDA) approval.Results: A total of 288 prescriptions were analyzed, where the reasons for off-label prescribing were OLDU by indication (94.42%), OLDU by different age group (2.09%), and other reasons represented (3.48%). Adults/geriatrics (≥18 years) received (89.05%) of the orders, and children (1-11 years) received (7.78%) of the orders. Both adolescents (12-18 years) and neonates (1-29 days) received (1.42%) of the orders per each category, while infants (1 month-1 year) received (0.36%) of the orders. The therapeutic classes most often prescribed were antidepressants (21.88%), antidiabetics (17.71%), and atypical antipsychotics (10.06%).Conclusions: Off-label prescribing was found in most adults/geriatrics suffering from depression, and diabetes mellitus. The most common reason for off-label prescription was off-label by indication. The results call for the need to conduct more studies with larger sample size, do more investigations on the OLDU in the whole kingdom, and develop policy for OLDU across hospitals.
A cross sectional study on self-medication practices among a selected rural community of Hooghly district, West Bengal
Authors: Taklikar Chandrashekhar S. , Dobe Madhumita
Published: February 2019

Background: Medicines are often used incorrectly; around 50% of all medicines are prescribed, dispensed or sold inappropriately, while 50% of patients fail to take their medicines appropriately (WHO 2002). Self-medication is an important concern worldwide and WHO has laid emphasis on correctly investigating and controlling it. Self-medication practices have dramatically increased in the last few decades, especially in developing countries like India. Therefore, the present study was planned to assess the prevalence of self-medication for during acute illness episodes and factors associated among a rural community.Methods: The cross sectional study was conducted from February to March, 2017 in Anandnagar village, Singur block. All the 900 households in village were included in the study. Data regarding pattern of self-medication were collected by using pretested structured schedule from head of the family or next available adult member. Data were analysed by using Microsoft Excel 2016.Results: Amongst 900 household’s data could be collected from 864 households. Majority respondents were housewives in age group 40-60 years and primary educated. 50.7% respondents reported having acute illness among family members in past 3 months, 48.5% amongst them reported using self-medication. Cough (56.6%), fever (20.3%) and pain (11.2%) were the conditions for which self-medication was used. Nearby medicine shop was the source of self-medication among 59.3% respondents. 2.3% reported using old prescriptions.Conclusions:Half of the communities having acute illness were using self-medication. Uncontrolled use of medicines needs to be addressed as it brings potential health hazards, drug resistance and misuse.
A cross sectional study on the prevalence and risk factors of fall among the elderly in an urban slum in Chennai
Authors: Senthil Kumar R. , Ravindran Kamali
Published: February 2019

Background: Falls are an important cause of morbidity and mortality in elderly people. Falls lead to multiple medical and psychological problems in the elderly. Aim was to study the prevalence of falls among the elderly and to find the associated risk factors for falls among the elderly living in an urban slum in Chennai.Methods: A cross sectional study was conducted among elderly population over 60 years and above, in an urban slum area. About 150 elderly were selected using simple random sampling method, using the voters list as the sampling frame. A pretested questionnaire was administered to collect information about falls. In statistical analysis univariate and multivariate logistic regression was employed using SPSS version 22.Results: Of the 150 elderly persons studied, prevalence of falls rate is 35.3% (95% CI 28.13 to 43.26). Of them 64.1% had one episode of fall and 35.8% had recurrent falls. The prevalence of fall among persons with comorbidities like hypertension or diabetes was 39.3% and 36.1% respectively .The rate of fall among those using a walking stick was 58.3%, having tremors was 15% and having abnormal gait was 40%. The risk factors found to be significantly associated in univariate analysis were gender and presence of tremors (p<0.05). In multivariate analysis none of the factors showed statistical significance.Conclusions: Falls are very common among elderly. It is utmost important to prevent the falls by making necessary environmental modifications and following healthy lifestyle.
Adherence of patients towards drugs and injections prescribed in a private medical institution in Chennai
Authors: Suganthi S. , Mallika S. V.
Published: February 2019

Background: The irrational use of drugs has become a potential health hazard in the modern days of medicine. Adherence to medication influences treatment outcome. Patient perceptions and education on medications are important determinants for a good adherence to prescribed drugs. Hence the present study intends to assess the knowledge and attitude of patients towards medications.Methods: A cross sectional study was conducted in urban health training centre of a private medical college in Chennai from January 2017 to February 2017. Taking the prevalence of injection preference as 63% and a non-response rate of 10% the required sample size arrived as 125. After obtaining, written informed consent from the participants data was collected using a pretested semi structured questionnaire statistical analysis was done using statistical software SPSS version 21.Results: Out of 125 participants 66.4% were females and the mean age of the study population was 43 years. 78.4% of the participants consult a doctor for medical advice, 58.4% of the patient demanded for injection. Knowledge of patients towards medications was good among highly educated participants which was statistically significant with a P value of 0.02.Conclusions: The knowledge and attitude towards medication was poor in the present study which in turn led to poor adherence. Directing health education towards people would bring significant behavior changes and also policy makers should emphasize on the rational use of drugs by the patients.
Evaluation of professional stress in IT professionals
Authors: Karthikeyan Arasu S. , Dhivakar R. , Cibi Chakravarthi J. , Kausik M. , Arun Kumar M.
Published: February 2019

Background: Stress has become common among the working people in this era. This may lead to further dire psychological consequences such as anxiety, depression etc. India being the information technology (IT) hub with lakhs involved as IT Professionals, there is a need to assess prevalence of professional stress. Not many studies have been conducted regarding this research topic in urban areas. Hence, this study has been exclusively done in Coimbatore which is an urban area in which IT is still developing. Aim of the study was to assess the stress levels of IT professionals in a software company in urban Coimbatore, Tamil Nadu.Methods: Cross–Sectional Study based on a validated questionnaire based on professional life stress scale (PLSS).Results: Out of the 105 employees interviewed 68% were in mild degree of stress. The remaining 32% had moderate degree of stress and none of the participants had high degree of stress.Conclusions: India being a leading sector in IT, its development largely depends on its employees’ physical and mental health. Occupational stress (job stress/work stress) need to be kept harnessed and minimized to provide conducive work environment in the organization.
A comparative study on women empowerment in urban and rural setting in Tamil Nadu
Authors: Saravanakumar P. , Elizabeth Varakumari J.
Published: February 2019

Background: Women empowerment is vital for decision making on nutrition, health-seeking, family planning and economic issues for the family as a whole. In reality, there is prevalence of unequal gender norms among the women in India in urban and rural area. The objective of the study was to compare the empowerment of women in urban and rural setting in Tamil Nadu.Methods: A cross-sectional study was conducted in Nandivaram (RHTC) and Shenoy Nagar (UHTC) attached to Government Kilpauk Medical College among 200 married women of age 15-49 years with a semi-structured questionnaire during June 2018. Data was entered and analyzed in SPSS 16. Chi Square test and logistic regression was used for statistical analysis.Results: Mean age in rural group was 26.74±6.45 years and 30.4±7.35 in urban. Illiterates were 27% in rural and 14% in urban. About 67% were homemakers in rural vs. 43% in urban. About 33% were BPL in rural vs. 21% in urban. Decision making regarding household decisions, about73% in rural vs. 87% urban had participated. In health seeking behavior, 77 % in rural had no say while only 45% in urban. For Family planning, 33% in rural vs. 74% in urban had decision making which were statistically significant. Only 33% contributed to family income in rural vs. 47% in urban.Conclusions: Women empowerment is better in urban setting than rural setting. There is a strong need to create awareness and training in rural setting for better productive life.
A study on knowledge and practice of breastfeeding in the field study area of a medical college in Haldia, West Bengal, India
Authors: Majumder Ronjoy , Samsuzzaman M.
Published: February 2019

Background: Breast milk contains all the nutrients an infant needs in the first six months of life. After 6 months of exclusive breastfeeding (EBF), WHO recommends infants should receive complementary foods. Only less than half of infants in India initiate breastfeeding within an hour and just about half are exclusively breastfed until 6 months. We conducted this study on various knowledge and practices for successful exclusive breast feeding.Methods: A cross sectional study was conducted with pretested and prestructured questionnaire on mothers of children in age group of 6 moths to 5 years.Results: Only 18 (21.7%) are working, 10 (12%) are illiterate and 7 (8.4%) are graduate. All of the mothers have heard about EBF. Mothers with correct knowledge of colostrums feeding being beneficial for baby (0.006), prelacteal feeding being harmful to baby (0.0003), knowledge of continuing EBF when baby is sick (0.00002), education (0.00015), when to start complementary feeding(0.001), institutional delivery (0.00002), when latching explained by nurses (0.0116), those who practiced burping (0.017), were significant for EBF for 6 months. Only 42 (50.6%) of mothers fed colostrum to their babies.Conclusions: In this study it was seen that mothers with knowledge for different aspects of breast feeding had more chance of successful EBF. Female literacy was found out to be a strong indicator for successful EBF and also a indicator for colostrum feeding in future pregnancy. Special attention to be given to raise awareness of family members, specially mother in law so that complementary feeding can be started at 6 months.
Prevalence of problematic online gaming among undergraduate medical students and its relation to well-being, self-esteem and depressive mood in Goa, India
Authors: U. Bicholkar Abhishek , Dias Amit , Mascarenhas Von
Published: February 2019

Background: Online video games are one of the most popular recreational activities irrespective of age, gender and culture. Gaming disorder has been recently included in the 11th Revision of the international classification of diseases (ICD-11). Thus online video game addiction among people is a serious mental health issue and unfortunately, research on this addiction is still in its infancy. Thus the present study examines the prevalence of problematic online gaming among undergraduate medical students and its association with demographic variables, and health-related measures like well-being, self-esteem and depressive mood.Methods: The present cross-sectional study was conducted among the undergraduate students of Goa medical college using online survey method. Problematic online gaming was assessed using the problematic online gaming questionnaire short form (POGQ-SF). Additionally, well-being was assessed using the satisfaction with life scale (SWLS), self-esteem was assessed using Rosenberg’s self- esteem scale (RSES) and depressive mood was assessed using the patient health questionnaire (PHQ-9).Results: According to POGQ-SF, 8% of the study participants showed problematic online gaming. It was significantly associated with sex of the study participants, frequency of online gaming, duration of internet use per day and duration of a gaming session.Conclusions: Playing online games is a widespread activity among undergraduate medical students and a substantial proportion of these students exhibit addictive behaviours with regards to online gaming. Further research in terms of longitudinal studies involving larger samples of general population is needed to throw light on causal relationship between problematic online gaming and related factors.
A study on the awareness and practice of modern and traditional methods for treatment of jaundice in an urban slum of Jorhat town, Assam
Authors: Dev Anoop , Hazarika Medhi Anuradha
Published: February 2019

Background: Jaundice is a term use for the condition in which yellow colouration of the skin and the sclera occurs and is caused by a raised level of bilirubin. There are a number of herbal medicines or self-remedy medications widely in use among the people especially in the rural areas and suburbs. Various study showed that people have also switched over to modern methods of treatment. The purpose of the study is to assess the awareness of people towards Jaundice and the methods of treatment they preferred and practiced.Methods: The study was a community based cross-sectional study which was conducted amongst the people of an urban slum of Jorhat district of Assam, over a period of three months. A sample of 156 study participants of age group (21-60) was taken. Data were collected using a pre-designed and pre-tested proforma. MS excel and SPSS version-23were used to analyze the data.Results: Majority (88.4%) of the study participants were aware of Jaundice while amongst them (89.6%) respondents were in the age group of (21-30) years. (56.5%) study subjects were aware of traditional methods of treatment whereas only (5.1%) were aware of modern methods. However (36.9%) were aware of both traditional and modern methods. (74.6%) preferred as well as practiced traditional methods of treatment .Majority of respondents 56 (54.4%) had influence of society for practicing traditional methods for treatment of Jaundice followed by belief 32 (31.1%).Conclusions: Behaviour Change Communication (BCC) and Information Education Communication (IEC) activities regarding Jaundice should be promoted.
Referral pattern of patients coming to Mandya Institute of Medical Sciences, Mandya
Authors: Vinay M. , Bharath J. , Harish B. R.
Published: February 2019

Background: In the act of medical practice, referral is the transfer of a patient’s care from one physician or clinician to another. Appropriate referral is an integral part of a complete quality health care management. At present, patients can visit any level of health care irrespective of severity of their health condition and most of the burden of these patients is on tertiary centers. This study was done to describe the Referral Pattern of Patients Coming to Mandya Institute of Medical Sciences, Mandya.Methods: It was a cross sectional study conducted from October 2017 to November 2017 with sample size of 400, p=50%. Sampling technique used was convenient sampling and data was collected by interview using the semistructured questionnaire.Results: Among the study population 197 (49.3%) were males and 203 (50.7%) were females, 392 (82.3%) had BPL card. Mean distance travelled by them to MIMS was 17.7±14.8 km. Medicine department n=80 (20%) followed by ophthalmology department n=64 (16%) were the most frequently visited departments. Mean distance to the nearest health center from their place of residence was 3.2%±2.9 km. 148 (37.0%) visited the health center near their place of residence before coming to MIMS and 253 (63.0%) did not visit.Conclusions: Most of the patients visited tertiary healthcare center (MIMS) without visiting health center near to them, though the distance is more and availability of specialists and low cost of treatment were the main reasons for visiting MIMS.
Patient knowledge survey in a multi-speciality hospital
Authors: Yeswanth Raja Bandaru , Angelo Simon Manithottiyle , Jayakumar K. T. , Sarvesh Sabarathinam
Published: February 2019

Background: The objective was to study the knowledge level and awareness among patients those attending a multi-speciality about their diseases and medications.Methods: A semi-constructed interview was done on 110 adult patients in the General Medicine Department, SRM Medical College, Hospital and Research Center, Kattankulathur, Kanchipuram.Results: Out of 110 patients. Were 58% was found to be male and 42% was found to be female. The patients' age group ranged from 12-84 years about 29% patients had no education, 30% of the patients were unaware of their diagnosis, 30% were unaware of the causes of their disease, 60% were unaware of the number of medications they were on, 68% did not know the names of their prescribed medication, 70% patients were non-smokers, 90.91% of the patients were aware that smoking was bad for health, 89% of the patients had received enough information from the doctors/nurses regarding their illness and treatment, but 38% of the patients were incapable of understanding their test results.Conclusions: Majority of the patients were aware of their diseases and the number of medications in spite of two third being illiterate. Thirty-two per cent did not know the causes of their illness and could not name their medications. Patients received little information from the health carers regarding their illness, Interpretation of investigations and aims of treatment. This study indicates that education is one of the main factors which are associated with a well understanding of the disease and medication.
Assessment of compliance to the COTPA 2003 legislation in tertiary healthcare institutes of Shimla: a smoke free city in India
Authors: Thakur Anita , Chaudhary Ankit , Chauhan Tripti , Gupta Anmol , Mahajan Anjali , Barwal Vijay , Chamotra Shaina , Chauhan Nidhi
Published: February 2019

Background: Tobacco smoking is a pandemic affecting populations and contributing to global morbidity and mortality. It is well known that the second hand smoke is equally hazardous like first hand smoke. Cigarette and other tobacco products act 2003 is an effort put forth by Government of India in order to curb this menace and protect people from ill effects of second hand smoke.Methods: The present study was conducted to assess the compliance to smoke free act in tertiary healthcare institutes in Shimla city, Himachal Pradesh. A total of 57 public places and 8 shops in five Tertiary healthcare institutes were evaluated for various provisions of the act. Compliance to different sections of the act was assessed using a structured observational checklist.Results: Signage indicating ban on smoking was seen at 71.9% places. Active smoking was absent at 77.2% places. About 25% shops around the institutes were found selling tobacco products. Signage displaying ban on sale within 100 m of educational institution and sale to minors was not observed at any shop. Tobacco product vendor was seen around 80% of educational buildings. Tobacco free institution signage was seen at 60% of educational premises.Conclusions: The study highlights that the level of compliance did not meet the standards laid down for a smoke free city. Timely and periodic assessment of the compliance must be conducted by the administrative authorities of the institutes for ensuring the adherence and strict implementation of the provisions of the act.
Evaluation of coverage, compliance of mass drug administration and assessment of awareness about lymphatic filariasis in Tikamgarh district of Madhya Pradesh: a cross sectional study
Authors: Panika Ram Kumar , Sahu Rupesh
Published: February 2019

Background: Lymphatic filariasis is the second leading cause of disability worldwide accounting for more than 5 million disability adjusted life years annually. It has been a major public health problem in India which leads to irreversible chronic manifestations which are responsible for considerable economic loss and severe physical disability to the affected individuals. Mass drug administration (MDA) means administration of diethylcarbamazine and albendazole tablets to all people (excluding children <2 years, pregnant women, seriously ill persons) in endemic areas once in a year. The objective of the study was to assess coverage, compliance of MDA and awareness about lymphatic filariasis in Tikamgarh district of Madhya Pradesh.Methods: Cross-sectional study was conducted and total 120 households were surveyed in four randomly selected clusters of Tikamgarh district of Madhya Pradesh.Results: Out of total 743 persons 678 (91.25%) persons were eligible for MDA. Coverage rate was 86.57% and compliance rate was 74.27%. The main reason for non-compliance was not having the concerned disease (55.78%) followed by fear of side effect (22.31%). Only 40.83% among the surveyed families were aware about MDA and only 45.83% respondents had heard about lymphatic filariasis.Conclusions: There is coverage and compliance gap and awareness about the lymphatic filariasis and MDA program is limited. Drug compliance need to be improved and awareness need to be raised. MDA program should not be confined to tablet distribution only and due importance should be given to compliance rate.
A study assessing patient satisfaction in otolaryngology OPD of a district medical college of West Bengal
Authors: Yasmin Shamima , Panja Tanmay Kanti , Baur Baijayanti
Published: February 2019

Background: Patient satisfaction is perhaps is a proxy indicator to measure the success of a hospital. The aim of this study was to evaluate the level of patient satisfaction among patients attending Otorhinolaryngology outpatient department (OPD) of a tertiary care teaching hospital in a district.Methods: Cross-sectional observational study among 230 patients attending Otorhinolaryngology outpatient department (OPD) of a tertiary care teaching hospital in a district using a modified validated Bengali questionnaire. Analysis of results was done by percentage and proportion.Results: Overall satisfaction was above 60% for only 42.6% of patients. Major dissatisfaction was with the registration system. 50.4% were dissatisfied for waiting at the queue of registration counter to get OPD ticket. Other causes of dissatisfaction were infrastructure e.g. non-availability of adequate seating arrangement (39.6%), fans (58.7%), non-availability of drinking water (71.7%). 78.3% were dissatisfied for the available washroom facilities. However 92% were satisfied by attention paid by doctors.Conclusions: The present study was an attempt to assess the level of satisfaction of the patients. It highlights maintaining privacy during history taking examination and improving infrastructure like drinking water and washroom facilities, improving registration system to decrease waiting time can improve patient satisfaction which can be easily done with help of stakeholders.
Knowledge, attittude and practice among mothers of under five children on immunization
Authors: Lamiya K. K. , Mundodan Jesha Mohammedali , Haveri Sheela P.
Published: February 2019

Background: Many parents have poor understanding of vaccine preventable diseases (VPD) and many believe in false propagations about the contents, side effects and effectiveness of vaccines. Lack of good knowledge and positive attitude about childhood immunization was believed to be the root cause for resurgence of VPDs. Aim of the study was to assess the knowledge, attitude and practice regarding childhood immunization among mothers of under five children.Methods: A cross sectional study was done among mothers with at least one child in the under-five age group residing in the rural field practice area of a teaching institution. Assuming 61% mothers have good knowledge (Mangalore study) the sample size was calculated to be 235 with 20% error and 1.5 design effect. Data was collected with the help of pretested semi structured questionnaire by interviewing 15 eligible mothers from each of 16 wards. Descriptive analysis was done.Results: The average age of the participants was 27.30±5.42 years with many of them educated up to 10th grade (40.3%) and most being housewife (74.5%). Knowledge of mothers regarding the diseases that can be prevented by immunization was fairly good. But the knowledge regarding individual vaccines, their dosages and schedule were found to be low. Majority of mothers had good attitude about immunization. Immunization coverage of the locality was relatively good (87.7%). Significant relation was established between attitude and practice. Sick at the time of vaccination was the most common cause of being partially immunised (68.96%).Conclusions: Intensify the awareness classes for mothers and religious leaders on immunisation.
Level of stress perception and its predictors among school going Bengali late adolescents in a rural block of Eastern India
Authors: Pramanik Rama , Saha Rajib , Saha Indrajit
Published: February 2019

Background: As adolescents are in transit from childhood to adulthood, they are vulnerable to stress and related complications. Measuring stress and its influencing factors is a prerequisite for developing strategy for this age-group. Objective of the study was to assess the level of perceived stress among school going late adolescents and to find out its predictors.Methods: This cross-sectional analytical epidemiological study was conducted among the school going Bengali late adolescents (15-17 years) of a rural block of West Bengal, India within July 2017 to December 2017. Finally, 102 students of class IX and XI were selected via two stage simple random sampling method. Data were collected by interview using pre-designed, pre-tested, semi structured questionnaire including 10 points Cohen’s perceived stress scale (PSS-10). Independent ‘t’ test, ANOVA, Mann Whitney U and Kruskal Wallis H test were utilized to establish the association between independent variables and PSS score. Independent variables found to be associated (p≤0.05) were considered in multiple linear regression to identify the predictors of stress.Results: Mean perceived stress score of participants were 16.8±3.7 (mean±2 SD) out of 40 (highest PSS score) with minimum and maximum score 8 and 26, respectively. In multiple linear regression, de-motivating comment, sibling pattern and love affair were found as predictors of stress perception among Bengali late adolescents. These factors collectively explained 15.6% variations of PSS score and individually contributed 3.8%, 5.6% and 6.2%, respectively.Conclusions: Stress can be alleviated by arranging motivational programme, counselling, and life skill education.
Organization and workflow management of central sterile supply department of a tertiary care hospital of Haryana
Authors: Singh Srishti , Verma Ramesh , Jangra Anuj , Kumar Raj , Sharma Nitika , Singh Srijan
Published: February 2019

Background: Nosocomial infection cause significant health issues and economic loss to the patients as well as the health care facilities. To combat hospital acquired infections, hospitals need an effective method of disinfection and sterilization which can be taken care by the central sterile supply department (CSSD). The objective of establishing a CSSD is to make reliably sterilized articles available at the required time and place. Aim and objectives were to study the organization and workflow management of CSSD of a tertiary care institution.Methods: This observational study was carried out from February 2018 to April 2018. An observation checklist was used for the purpose of study after obtaining permission from appropriate authorities.Results: CSSD of the institution is centrally located within the hospital premises and has 11 staff members. Linen, cotton, dressings, instruments and trays are sterilized in the CSSD. Sterilization is done by steam sterilization and gas sterilization with a total of seven autoclaves and two ETO machines. Physical, chemical and biological indicators are regularly used during the process of sterilization.Conclusions: CSSD of the institution is contributing its part towards reduction of nosocomial infections. Quality of standards for sterilization and disinfection is maintained.
A study on the weekly iron and folic acid supplementation in the government schools and anganwadi centres in urban field practicing area of a tertiary health care centre, Hyderabad, Telangana
Authors: Vemuri Jyothi Lakshmi Naga , Kandikonda Sri Harsha , Laxmi S. Bhavana , Rao R. L. Lakshman
Published: February 2019

Background: Anemia is a major public health problem especially in adolescent age group because of its intergenerational impact. The Ministry of Health and Family Welfare, India launched the weekly iron and folic acid supplementation programme for adolescent girls and boys. The objectives of the study were to study the awareness of the weekly iron and folic acid supplementation in preventing anemia in the study subjects; to assess the implementation of the weekly iron and folic acid supplementation in government schools and anganwadi centres.Methods: A cross-sectional study was carried out in the 4 government schools and 11 anganwadi centres of the urban field practising area of a tertiary health care centre, Osmania Medical College, Hyderabad. All the students who were present at the time of study, the teachers and anganwadi workers, who gave consent were included. The study was carried out for a period of 3 months (August to October, 2018) using a pretested schedule.Results: A total of 313 students, 21 teachers and 10 anganwadi workers had participated in the study. Among school students, only 15% had awareness of anemia. Girls had better knowledge than boys (p<0.05). The benefits of iron folic acid tablets were known to 17% students and 67% teachers. Most commonly side effects were nausea, vomiting and stomach pain. Irregular supply of tablets and poor maintainence of records was seen.Conclusions: The supply and distribution of tablets was found to be not in accordance with the guidelines of the programme.There is need of regular orientation to the teachers and anganwadi workers and nutrition education meetings for behaviour change communication to the parents.
A cross-sectional study on BMI and eating habits among students in a medical college in Kerala
Authors: Amruth M. , Kumar Akshath
Published: February 2019

Background: Obesity and overweight is increasing nowadays among the medical students. Erratic eating habits and other lifestyle related risk factors are mainly implicated for this increasing burden, and research related to these risk factors is essential, considering their role as future physicians and role models in public health intervention programs. The present study was conducted to estimate the BMI values of medical students and to compare obesity among male and female students with their socio-demographic factors, eating habits and lifestyle.Methods: A cross-sectional study was conducted among medical students in a medical college in Kerala during 1st May 2018 to 30th July 2018. A total of 573 students out of 600 participated in the study. Using a structured questionnaire data was collected. BMI was calculated for 483 medical students with age group of 20 years and above including 173 males and 310 females. SPSS version 17 was used for statistical analysis.Results: Using WHO BMI classification 18.2% were overweight and 2.1% were obese. Using Asia- Pacific BMI classification 18.2% were overweight and 20.3% were obese. Male students were more obese than females. Skipping breakfast, eating full stomach, not knowing balanced nutrition, eating fatty foods and snacks, eating more under stress and drinking soft drinks were common unhealthy eating habits among obese students.Conclusions: Obesity and overweight is very prevalent among medical students. Improving their knowledge regarding balanced nutrition, regular eating habits, proper stress management and adoption of healthy lifestyle will result in proper body weight and prevent obesity complications.
Urinary tract Infection among type 2 diabetic patients admitted in a multispecialty hospital in South Chennai, Tamil Nadu
Authors: Vignesh P. S. , Gopinath T. T. , Sriram D. K.
Published: February 2019

Background: Diabetes mellitus (DM) is a chronic and potentially disabling disease which is reaching an epidemic proportion in many parts of the world. UTI is a common infection observed in diabetic patients. The objectives of this study was to determine the prevalence of UTI among hospitalized type 2 diabetic patients, the frequent bacteria responsible for UTI and most susceptible antibiotics among the diabetic patients.Methods: A hospital-based study involving type 2 diabetes patients admitted with diagnosis of UTI between 2017- 2018 (July - June). The study was a cross sectional study and was approved by the Ethics Committee of the hospital. Patients fitting study inclusion and exclusion criteria took part in the study with informed written consent obtained. A validated pilot-tested questionnaire was used as a tool for data collection.Results: Total of 126 subjects were identified. Prevalence of UTI was around 25% higher in women with type 2 diabetes than in men. UTI was found to be significantly associated with age, creatinine (p<0.05) and Escherichia coli was the commonly isolated micro-organism. The gram negative pathogens were highly sensitive to cefoperazone-sulbactum and amikacin was found to be the most sensitive antibiotic for both gram positive and gram negative pathogens.Conclusions: UTIs are frequent in diabetic patients. Improved glycemic control in diabetics may help in controlling the UTIs. Accurate screening for UTI in diabetic patients is also critical to enable the appropriate treatment and avoiding related complications.
Micro-health insurance in dentistry: the road less travelled
Authors: Hakeem Naz-E-Farha , Eshwar Shruthi , Srivastava B. K. , Jain Vipin
Published: February 2019

Oral health is indeed a challenge for the urban poor. Majority of the patients spend from their pocket, which aggravates their financial condition. It is paramount for the government and the healthcare industry to adopt a value-based approach to redress the oral health lapses for the underserved population. Micro health insurance (MHI) can have a game changing effect on the oral healthcare space too, if concerned stakeholders build the right partner network. Aim of the study was to discuss the principal features, basic structure, and functioning of a few MHI schemes, and presents a hypothetical model of MHI which can be implemented in dentistry. Literature search was conducted in two main databases, pubmed and cochrane, using key phrases such as “community based health insurance,” “micro health insurance,” micro or community based health insurance,” and “health insurance and financial protection”. Articles published in last ten years with full texts were considered. 23 schemes were eligible for the systematic review. Our analysis shows that MHI, in the majority of cases, contributes to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, household borrowings and poverty. However, the studies did not affirm oral health benefits. The importance of oral healthcare in India is superficial. Focus on oral healthcare can be achieved only if the impending cost due to out of pocket payments can be supplanted with a more affordable and dynamic payment model. With MHI extended to oral healthcare, India can certainly achieve its SDG goal. It’s time to look beyond.
Knowledge, attitude and practice of gutkha chewing among youth in Hiroli village of Kalaburagi district
Authors: Deshmukh Sunil , Ghooli Shreeshail , Kurle Ravi S.
Published: February 2019

Background: Gutkha is a preparation of crushed tobacco, lime, catechu, areca nut and flavouring agent. Gutkha chewing may lead to various diseases like cancer of oral cavity, gingival diseases, addiction, submucosal fibrosis and overall poor health of an individual. The use of gutkha in youths is highly prevalent due to a lack of awareness and education and has misconceptions, particularly in rural areas like chewing tobacco products aids in digestion, acts as germ-killer, mood enhancement and tension relief.Methods: The study was undertaken to know the knowledge, attitude and practice among gutkha chewers of Hiroli village in Kalaburagi district, Karnataka, India. The study sample comprised a total of 479 participants.Results: The result of the study showed that the prevalence of smokeless tobacco consumption is high in rural population (49.2%). And most of the participants (51%) agreed that gutkha chewing is injurious to health, but the knowledge of gutkha causing oral and throat cancer was limited (40.6% and 36.4% respectively).Conclusions: The result indicated to increase awareness programs on associated health risks that focus on improving the knowledge, attitude and practice of gutkha chewing.
A KAP study on snakebite and its management among medical interns in a tertiary care medical college and hospital in Trivandrum district, Kerala
Authors: Kumar Amritesh , Gopakumar Soumya , Sathyan Sruthy , Singh S. Blessed , Bhasy Beena Idicheriya
Published: February 2019

Background: Snake bite is considered as one of the most significant health related problems throughout the world. According to the WHO, a snake bite is an important medical problem. It has been a neglected extrinsic injury in tropical and sub-tropical developing countries including India. It has been estimated that every year there are almost 83,000 snake bites and 11,000 deaths due to snake bites in India. The Goal of this study is to access knowledge, attitude and practice (KAP) among interns so as to find out gaps in academics and bridge them. Findings of this study will benefit community at large.Methods: An institutional based cross sectional study was conducted for the entire batch of interns in a tertiary care center in Trivandrum, Kerala, South India during June–September 2018. A non-probability sampling was done. Data was collected by self-administered questionnaire.Results: Among 100 students 48% had a score equal to and above 8 which was taken as good level of knowledge and 52% had poor level of knowledge. Attitude towards management of snake bite was 100% among study subjects. Only 35% of students had median score above 4 as good level of practice and remaining 65% had poor level of practice.Conclusions: Respondents have adequate knowledge on snake bites. They discarded various prevailing myths in society. Although study showed adequate attitude towards management, that was not reflected in practice. This gap can be overcome by teaching in simulated environment, so as to make them competent enough for managing snake bites.
A glance on public private partnership: an opportunity for developing nations to achieve universal health coverage
Authors: Titoria Reena , Mohandas Anu
Published: February 2019

The government of India has joined hands with the rest of the world aiming at universal health coverage (UHC) and has set the target for 2022. The huge population, the difficult land terrain, unequal distribution of health care system, socio-economic and cultural factors are posing serious challenges. Public private partnership (PPP) even though not exactly a novel concept, some innovations can tackle these challenges to an extent and give us a smooth track towards UHC. In the past, PPP models were utilized to some extent for development and refurbishment of health infrastructure. But expanding the partnership between the two sectors to human resource, service delivery and financial management with supervision and monitoring by the government may bring out the needed significant difference.
Recurrent ominous spinal mass
Authors: Gollwitzer Maria , Hasenauer Wolfgang , Grimmer Anja , Gruber Andreas
Published: February 2019

Hypertrophic pachymeningitis is a very rare form of diffuse inflammatory dural fibrosis. It is typically encountered intracranially rather than spinally and can have a progressive and recurrent course as encountered in our patient. The aetiology of this disorder is multifactorial. While acute management of hypertrophic pachymeningitis consists of immediate decompression in conjunction with steroid medication and treatment of the underlying disease, the management of chronic and recurrent disease is controversially debated in the current literature. A previously healthy 49-year-old woman presented with progressive back pain and acute onset of incomplete paraplegia. Spinal MRI showed a large ventral semicircular mass with intense contrast enhancement from Th3-8. Acute patient management consisted of immediate decompression and debulking the space-occupying lesion in conjunction with antibiotic and steroid therapy. Histopathologic examination of the surgical specimens revealed a chronic inflammatory process. The patient fortunately recovered from the severe paraparesis and upon discharged, spinal MRI disclosed a further regressing residual spinal mass. Over time, our patient suffered two times a relapse and was finally treated with Methotrexate and low-dose steroids. Under this medication she has made a nearly complete neurological recovery. This case report highlights a rare disease with challenging management, which should be considered diagnostically in patients with intraspinal space-occupying lesions. In our experience combination of Methotrexate and low-dose steroids might be an effective and safe treatment.
A rare morphological and immunophenotypic presentation of adult B-cell acute lymphoblastic leukemia with blasts in the monocytic zone on CD45 side scatter
Authors: Bhat Shuaeb , Hussain Saleem
Published: February 2019

We present a case of B-acute lymphoblastic leukemia in an elderly patient who presented with severe weakness and pancytopenia. The patient was a 75 year old Female whose blasts had an unusual morphology in form of coarse azurophilic granules and cytoplasmic blebs and on flow cytometry the blasts were present in the bright CD45 zone with a high side scatter. Bone marrow aspirate sample was subjected to multicolour flow cytometry using Beckman Coulter Navios® which is an 8 colour flow cytometer.  Flow cytometric analysis of the bone marrow aspirate showed blasts in the monocytic zone with a precursor B cell immunophenotype. Complete blood counts showed pancytopenia with peripheral blood film not showing any blasts. Bone marrow aspirate smears showed 20% blasts with coarse azurophilic granules and cytoplasmic blebs. The position of the blasts in this case which were in monocytic zone giving them a bright expression of CD45 and a high side scatter on the CD45 side scatter. This is not the usual position for blasts in B- acute lymphoblastic leukemia as these blasts are less complex. A bright expression of CD45 by blasts in B- acute lymphoblastic leukemia is known to be associated with a poor prognosis but the clinical significance of blasts being bright CD45 with a high side scatter is a very rare occurrence and more number of cases with a similar presentation are required to determine a prognostic significance.