bluuebunny/crossref_metadata_2025 huggingface dataset:
Massive hepatomegaly in a neonate: an unusual cause
Authors: Khurana Ritika , Aggarwal Anju , Dabas Aashima , Gupta Natasha
Published: December 2016

A female neonate presented with progressive abdominal distension. Liver was palpable, 11 cm below costal margin and a spleen of 10 cm. USG abdomen revealed massive hepatomegaly with multiple nodules in liver, kidney size and texture being normal. Contrast enhanced CT scan of the abdomen was suggestive of enlarged multinodular liver with splenomegaly. Liver biopsy revealed replacement of liver architecture by small rounded cells, which were positive for synaptophysin and S100 stains suggestive of neuroblastoma. A repeat abdominal radiological evaluation revealed a small 2 x 1 cm mass in left suprarenal area. Neuroblastoma stage 4S presenting as hepatomegaly is rare.
Gingival enlargement in 10 years old: a case report
Authors: Attar Nilofar B. , Gaikwad Rajesh P. , Jugade Shraddha C. , Banodkar Akshaya B. , Sethna Gulnar D.
Published: December 2016

Generalized gingival enlargement in children interferes with the eruption of teeth. It may lead to difficulty in mastication and phonetics. Very few cases of generalized gingival enlargement associated with eruption of teeth in as young as 10 year old child had been reported in literature. The pathphysiology for occurrence of gingival enlargement with eruption of teeth is not clearly established. Generalized gingival enlargement was present in a 10 year old girl since the eruption of permanent teeth. The gingival biopsy was done followed by full mouth gingivectomy of maxillary and mandibular arch. The histopathological picture showed hyperplastic tissue. The treatment of gingival enlargement at early stage leads to exposure of teeth. The treatment resulted in improvement in mastication and establishing the aesthetic smile of the 10 year old child. This case represents systematic evaluation of gingival enlargement followed by gingival biopsy and gingivectomy. The management of gingival enlargement in children is challenging and requires systematic follow-up.
Klippel Trenaunay Syndrome: a rare case report in a neonate
Authors: Kumar Krishnappa Santosh , Kumar Nanjappa Mohan
Published: December 2016

Klippel Trenaunay Syndrome (KTS) is a cutaneous vascular malformation in combination with bone and soft tissue overgrowth, with or without lymphatic malformation. Symptoms appear by birth and approximately 90% of the cases are diagnosed by the age of 12 years. Prompt diagnosis at the earliest and conservative management with regular follow up is crucial in prognosis of KTS.
MRI imaging in afebrile pediatric epilepsy: experience sharing
Authors: Ahluwalia Vandana V. , Sharma Neelmani , Chauhan Ankita , Narayan Shamrendra , Saharan Prerna Singh , Agarwal Dipti
Published: December 2016

In this article, we emphasize the usefulness and cost-effectiveness of non-contrast MRI as the primary imaging modality in the evaluation of non-febrile pediatric seizure, illustrate the MR spectrum of different structural lesions causing pediatric seizures, and finally describing the main MR imaging features of these disorders. Among 366 cases of pediatric epilepsy studied over a period of fifteen years the commonly detected structural malformations are mesial temporal sclerosis unilateral and bilateral, heterotopias, cortical dysplasia, neurocutaneous syndromes and few neoplasms. MRI showed hippocampal atrophy and increased signal intensity of the hippocampus on T2-weighted images in mesial temporal sclerosis, cortical thickness and sulcation are decreased in microcephaly, enlarged dysplastic cortex in hemimegalencephaly, and focal cortical dysplasia shows ipsilateral focal cortical thickening with radial hyperintense bands. MRI detects smooth brain in classic lissencephaly, the ectopic position of gray matter in heterotopias, and the nodular cortex with cobblestone cortex in congenital muscular dystrophy. MRI can detect polymicrogyria and the related syndromes, as well as schizencephaly types. In conclusion, MR imaging is essential to demonstrate the morphology, distribution, and extent of different disorders causing seizures in children as well as the associated anomalies and related syndromes to guide patient for further surgical treatment and counseling.
Evaluation of health information system in reproductive and child health program at primary health center level: a system analysis
Authors: L. N. Deepa , D. Gopinath
Published: December 2016

Background: Primary aim of health information system is, using it in decision-making. Not many systematic studies on actual status of health information system are available.  So this study was undertaken to evaluate the current status of Health Information System (HIS) at the primary level in relation to selective components of Reproductive and Child Health (RCH) Programme and to determine its utilization for identification of problem and decision making at that level.Methods:Cross sectional study done in Bangalore Urban District. HIS was analyzed for completeness, timeliness and utilization. Monthly reports of previous 3 months from PHCs were looked for completeness and timeliness.  Utilization of information was assessed by interviewing the medical officers of 4 PHCs for actions they intend to take for modifying the performance; prior to and also after providing them with analyzed information of the available data (customization of data). Both these were compared for differences and specificity of responses. For customization of the data, sub center reports were reviewed and few beneficiaries were interviewed.Results: 85% of the reporting formats were incompletely filled. It was observed an increase in number of medical officers giving more specific actions such as review in monthly meeting, ask explanation by specific sub-center health worker for not giving follow up care to improve the performance than the responses which were more general prior to receiving the customized data. It shows that MOs are not utilizing the available health information for identification of problem or to make decisions.Conclusions:This study showed that medical officers are signing the monthly reports prepared by health workers, without actually using the information at least to identify the problem as it was seen that coverage in one sub-centre was consistently low for all the three months but didn’t focus their actions towards that sub center.
Road traffic accidents with head injury: delay in treatment and socioeconomic and legal impact
Authors: Urfi . , Amir Ali , Khalil Salman , Hoda Mohd F.
Published: December 2016

Background: Road traffic accidents (RTAs) with the head injury warrants early treatment. The delay in receiving the specialized care adversely affects the outcome. Economic losses due to RTA with the Head Injury amount of Rs 550 crores (12.5 billion dollars), an amount that equals our defense budget. Insurance of vehicles and victims and compensation claims are related legal issues. The Objectives of the study were: 1. To analyze the delay in reaching the hospital following the Road Traffic Accident with Head Injury. 2. To study the pattern of pre-hospital treatment received. 3. To measure the socioeconomic and legal impact of Road Traffic Accident cases with Head Injury.Methods: A hospital based cross-sectional study was conducted in casualty and allied departments of Jawaharlal Nehru Medical College and Hospital, Aligarh. All cases of RTA with Head Injury admitted from August 2010 to July 2011 who were 15-45 years of age were included in the study using purposive sampling. Data was analyzed with SPSS 20.Results: A total of 463 patients were included in the study. Almost two-third of patients i.e. 315 (68.0%) were brought to hospital within 6 hours and the remaining 148 (32.0%) reached hospital after lapse of 6 or more hours. Of all patients who reached hospital before 6 hours, only 70 males and 10 females received some form of pre-hospital treatment. The mean expenditure during hospital stay was Rs.3663.71. About 51.6% of patients had to stay for 1-3 days in hospital following a head injury. As many as three-fourth of vehicles involved in accident were insured while just 14.3% of patients were insured. Only 5 (1.1%) out of the 463 patients applied for compensation till the time of interview.Conclusions: Reaching hospital early has direct bearing on final outcome of accidents. RTAs with Head Injury lead to variable out-of-pocket expenditure for patients and their attendants. Majority of victims do not have insurance, though insurance of vehicles is a common practice.
Prevalence and correlates of alcohol consumption in Northeast states, India (evidence from district levels household survey: 2012-13)
Authors: Yadav Jeetendra , Gautam Subhash , Singh Kh Jitenkumar
Published: December 2016

Background: Despite the increased awareness of adverse effects of alcohol consumption, India is a one of the countries with high prevalence of alcohol use. The third round of National Family Health Survey (2005-06) estimated that 32% men consume alcohol. Evidence suggests the magnitude of alcohol use is likely to be higher among Northeast who residing in adverse geographical settings.  The objective of the study was to analyzed prevalence and determinants of alcohol use in Northeast states, India.Methods: The study using data from the fourth round of District Level Household Survey (2012-13). The outcome variables included in the study was alcohol consumption. The study used bivariate and multivariate to determine the prevalence, differentials and determinants of alcohol consumption.Results: The result shows that alcohol consumption was significantly high among the young age group of 25-34 years. The prevalence of alcohol consumption was high among male as compared to female and alcohol consumption is slightly low among more educated person. Alcohol consumption was high in Meghalaya and Mizoram as compared to other Northeast states.Conclusions: We conclude by this study that, the prevalence of alcohol consumption in Northeast was very high and alarming. There are really an important health concerns and they need to be counselled about the ill effect of alcohol consumption. Establishment of de-addiction centers or strong referral to de-addiction centers among those consuming alcohol is a might be a novel step for well-being of Northeast people. Government specially, Doctors and media should play their roles and spread information regarding harmful effects of alcohol consumption.
The relationship between fried food consumption and physical activity with diabetes mellitus in Yogyakarta, Indonesia
Authors: Sudargo Toto , Pertiwi Shinta , Alexander Ruth Audy , Siswati Tri , Ernawati Yuli
Published: December 2016

Background: Diabetes mellitus (DM) is one of degenerative disease and the prevalence is increasing each year. WHO predicted that in 2025 the number of diabetes mellitus outpatients in the world can reach up to 300 milions people. Early detection is needed to prevent higher prevalence in type 2 DM. Moreover, nowadays people are tend to have sedentary lifestyle and bad food pattern. The Objective of this research aims to determine risk factors which related the evidence of type 2 DM.Methods:It was an observational study with cross sectional design. Subjects were 179 people of the study were staffs of Gadjah Mada University who did general check-up at Gadjah Mada Medical Center (GMC) health cencer on March and April 2014. Research variable included diabetic family history, ethnic, physical activity, habit of smoking history, obese, eating pattern, fried foods consumption and diabetes. Data of eating pattern and fried foods consumption are obtained by semi quantitative food frequency questionnaire (SQFFQ). Data about diabetic family history, ethnic, habit of smoking are obtained by interview. Data about physical activity is obtained by IPAQ questionnaire and data about obese an fasting blood glucose value are obtained by secondary data from GMC health center.  Data were analyzed using chi square.Results: There was significant association between diabetic family history, fried food’s consumption frequency and the incidence of type 2 diabetes mellitus (p<0.05). There was no significant association between ethnic, physical activity, habit of smoking, obese, eating pattern, fried food consumption (fried foods mass, fried foods energy and fried foods fat) (p>0.05).Conclusions:Risk factors related with type 2 DM evidence are diabetic family history and fried food’s consumption frequency.
Prevalence of hypertension and its risk factors among adults in urban field practice area NMC, Raichur, Karnataka, India
Authors: K. V. Chethana , T. Anusha , Mane Abhay , Prasad Vijaya Mahanth , Sunkad Vijay Mahantesh
Published: December 2016

Background: Hypertension is the commonest cardiovascular disorder, posting a major public health problem of the world and especially to population in socio-economic and epidemiological transition. It is one of the major and independent risk factors for non-communicable diseases like cerebrovascular disease, coronary heart diseases, and cardiac and renal failure. The recent WHO report states that considering the prevalence of any diseases, hypertension ranks fourth in the world. As it is hidden beneath an outwardly asymptomatic appearance, the disease does immense harm to the body in the form of ‘Target organ’ damage hence the WHO is named it the “silent killer”. The objectives were to estimate prevalence of hypertension among adults in urban population and to estimate the risk factors associated.Methods: A cross sectional, community based study over a period of one year from January 2013 - December 2013, in Urban field Practice area of Navodaya Medical College. Diagnostic criteria (based on JNC VII guidelines) includes SBP ≥140mmHg and/or DBP ≥90mmHg and persons already on anti-hypertensive treatment. Study Population includes people aged 18-65 years residing in the urban  field practice area of NMC. Systematic random sampling method is used. Statistical Analysis was done by Chi Square Test by using SPSS version 17.Results: The hypertension prevalence was 33.6%. The   prevalence   increased with age. Males have shown higher prevalence of HTN (49.4%) compared to females (23%).  Family history of hypertension was present in 36.9% of hypertensives. Majority were taking >6 grams salt per day. Prevalence of hypertension was more in past smokers (82.4%) followed by current smokers (51.5%) when compared to non-smokers (27.6%). 45.4% of hypertensives had stress.Conclusions: Prevalence of hypertension among adults in urban field practice area is 33.6%.There is significant association of hypertension with age, smoking tobacco, high salt intake, stress.
Does glycaemic status influence quality of life of type II diabetes patients: an exploratory study in Mysuru, Karnataka, India
Authors: B. B. Savitha Rani , N. C. Ashok , Kulkarni Praveen , M. Renuka
Published: December 2016

Background: Type II diabetes is a major public health problem in India. The epidemiological shift of the disease towards younger and middle aged individuals has resulted in longer duration of life with diabetes among the patients. Diabetes being a lifestyle disease, requiring robust behavioural and social adjustments influences the quality of life of an individual to a largest extent.Methods: A cross-sectional study conducted among 200 type II diabetic patients attending JSS Hospital, Mysuru for a period of one year. Information regarding socio-demographic characteristics like gender, education, occupation was collected in a pretested   proforma by interview technique. Assessment of Quality of life was done using the WHO BREF questionnaire. Glycemic status of subjects was assessed using glycosylated haemoglobin (HbA1C) levels. The Data entry and Statistical analysis were done using Microsoft Excel and SPSS 22version. Descriptive statistics like mean and standard deviation of QOL calculated and analysed with Sociodemographic variables, inferential statistics like Chi-square and Man-Whitney U test was done.Results: Among 200 study participants majority, 53.5% belonged to age group of 41-60 years, 57.5% were males, 67.5% belonged to lower socio economic class according to BG Prasad classification, 85% were married, 51% were Obese, 44.5% were having family history of diabetes, 48% were having Hypertension, 68.5% were on oral hypoglycemic, 10.5% were on Insulin, 20.5% were on both oral hypoglycaemic and Insulin. Overall Quality of Life was poor in 114 (57%), 114 (57%) had Poor Physical QoL score, 109 (54.5%) had poor psychological QoL score, 108 (54%) had poor social QoL score and 113 (56.5%) had poor environmental QoL score and 87 (43.5%). Median score of overall score of QoL was less in uncontrolled diabetes when compared to controlled diabetes status, this difference was statistically significance (P value- 0.04).Conclusions: Patients with type 2 diabetes have a substantially lower quality of life. QOL was poorer in subjects with uncontrolled glycemic status compared those with good diabetic control.
Magnitude of behavioural risk factors for cardiovascular diseases among college going young adults (18-25 years) in Mysuru, Karnataka, India
Authors: Nair Lakshmi Malavika , B. Madhu , K. M. Srinath , Gopinath Anup , Yadav Kavita
Published: December 2016

Background: Sedentary lifestyle and unhealthy diet patterns increase the risk of cardiovascular disease (CVD). Estimating the magnitude of behavioural risk factors is vital for planners and policy makers to formulate appropriate and locally suitable interventions.  The objective of this study was to estimate the magnitude and pattern of behavioural risk factors for cardiovascular diseases among college students (medical, dental, pharmacy, engineering and arts and science colleges) in Mysuru.Methods:A cross sectional study was carried out among students of medical, dental, pharmacy, engineering and arts and science colleges in Mysuru using snow-balling technique. Based on CDC-BRFSS (Behavioral Risk Factor Surveillance System) and Cardiovascular Risk Assessment Questionnaire developed by Metagenics, New Zealand, a  self-administered questionnaire was developed according to the local cultural and food practices , which was used to collect information on dietary pattern, exercise pattern, tobacco and alcohol consumption. Statistical analysis was performed using SPSS software (version 22) and P value of <0.05 was considered as significant.Results: In the study, 45.8% of 970 study participants lead a sedentary lifestyle and 13.1% exercise in the gym regularly. Majority of students from Arts and Science College lead a sedentary lifestyle. Dietary pattern assessment revealed that 71% of the students consumed fried food frequently (highest among medical students - 82.4%). Medical and dental students also consumed the maximum amount of sweets i.e. 60.9% and 67.1% respectively. Non-vegetarian food was frequently consumed by 30% of medical and dental students.47% of the current smokers were MBBS students. 37.8% of the students who consumed alcohol admitted to binge drinking.Conclusions:Unhealthy behavioural risk factors for CVDs are higher among medical students, despite the fact that they know most about the detrimental effects of these practices. Developing strategies targeting these behavioural risk factors to improve the health status of college students play a crucial role in protecting the youth from cardiovascular diseases in future.
Determinants of treatment adherence among the patients receiving treatment in the ART centre of a tertiary hospital in Kolkata, West Bengal, India
Authors: Biswas Atanu , Mandal Asok Kumar
Published: December 2016

Background: WHO recommended adherence of 95% or more to antiretroviral therapy for better outcome in terms of general well-being and decreased chance of drug resistance. This study was conducted with the objective of describing the factors associated with adherence pattern to ongoing ART regimens in adults with HIV/AIDS in R. G. Kar Medical College and Hospital (RGKMCH), a tertiary hospital in Kolkata, West Bengal, India.Methods: An observational, descriptive cross-sectional study was conducted on the adults receiving treatment at the ART centre of R. G. Kar Medical College, Kolkata. Patients above 15 years of age, who received at least one year of treatment before the day of the interview, comprise the study population. Sample size was 279. We tried to find out any association between adherence level and factors like socio-demographic profile, treatment profile, lifestyle pattern etc. applying bivariate analysis, Chi square test, multiple logistic regressions. Data were analyzed using IBM SPSS (version 20).Results: Different factors like employment status, monthly income, language of communication, addiction, following advice on food and water intake, side effects from ART were found to be statistically associated with level of adherence among the subjects.Conclusions: Emphasis should be given on thorough counseling of the people with HIV/AIDS so as to motivate them to take medication as advised and to maintain adequate adherence level of therapy improving their general well-being.
Catastrophic household expenditure on health in an urban slum: a cross-sectional survey
Authors: Nagendra Kanchana , Belur Mangala , C. Nandini , Krishna Anirudh
Published: December 2016

Background: The World Health Report 2000 identified financial protection against the costs of ill health as a fundamental objective of health systems. Out-of-pocket expenditure accounts for an average increase in poverty by 2.9 percent for urban India. Therefore, this study aims at evaluating the out-of-pocket health expenditures as well as assessing the predictors of catastrophic health costs care in urban slums.  The objectives was to find the prevalence of catastrophic household expenditures on health and to assess the determinants and illnesses commonly associated with catastrophic household expenditure on health.Methods:The study was conducted in a notified urban slum of Shivamogga district which was selected randomly and all the households were included in the study. Data was collected after informed consent using pre-tested semi-structured questionnaire and analyzed in SPSS vs18.Results: Out of 197 households, 94 (47.7%) households experienced catastrophic health expenditure in past one month. Most common conditions associated with catastrophic expenditure were respiratory infections (cough, cold and fever; p-0.034), arthritis (p-0.001), hypertension (p<0.01) and diabetes (p-0.015).Conclusions:We conclude that almost half of the community incurred catastrophic health expenses. Findings have important policy implications and can be used to ensure higher degree of financial protection against the economic impact of illnesses.
A comparative study of anthropometric measurements of children attending urban and rural anganwadi centres of a coastal district in Karnataka, India
Authors: N. Navya , Udayakiran Nalam
Published: December 2016

Background: Malnutrition is defined as a pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients. Weight for age, height for age and weight for height are usually used to describe the nutritional status of children. The present study was done to compare the anthropometric measurements of children attending urban and rural anganwadi centres.Methods: A cross sectional study was carried out in children aged three to six years attending 34 anganwadi centres of a coastal district of Karnataka. Anthropometric measurements like height, weight and mid arm circumference was measured using standard methods. Malnutrition was assessed based on WHO z scores. Statistical analysis used: Data was expressed in Percentages and frequencies. Comparison of anthropometric measurements were done using chi square analysis.Results: 25.5% of the children attending urban anganwadis were underweight, 10% severely underweight, 15.5% stunted, 2.5% severely stunted, 24% wasted and 8.5% severely wasted. 18.5% of children attending rural anganwadis were underweight, 6.8% severely underweight, 11.8% stunted, 3.2% severely stunted, 15.2% wasted and 4.5% were severely wasted. The prevalence of wasting was significantly higher (p=0.006) in children attending urban anganwadi centres compared to rural centres.Conclusions: Urban anganwadis had a higher prevalence of underweight, stunting and wasting. Underweight and stunting was higher in females compared to males whereas wasting was found almost equally in both the genders.
A study of adolescent health problems in a rural school in Thiruvanthapuram district, Kerala, India
Authors: P. Nazeema Beevi , L. Manju , Bindhu Anil
Published: December 2016

Background: Adolescence is a period of transition from childhood to adulthood. As adolescents are less vulnerable to diseases than the children, health problems specific to this group is given less importance. Their emotional problems are little noticed by the parents.Methods:A cross sectional study was conducted in a rural government higher secondary school, Kilimanoor during November 2013. 10th and 11th class students (110 girls and 107 boys) were interviewed with the help of a pretested questionnaire.Results: A total of 217 students in the age group of 15-17 years were studied. Obesity was found in 2.8% of students. 45.6% falls under normal category and the rest 51.6% were in the underweight category. Hypertension was observed only in males i.e. 4.2%. 24.4% were in the pre hypertensive group. Systolic BP is correlated with BMI (r = 0.270, p-value <0.001). The prevalence of hypertension and pre hypertension in males are 8.4% and 30.8% respectively, whereas none of the females are hypertensive and 18.2% are in pre hypertensive group. Among the 106 girls, the prevalence of premenstrual symptoms is 83%. Among the 107 boys it was found that 13.0% students smoked cigarettes and 15.8% had consumed alcohol at this age. 11.2% students reported that they have both these habits.Conclusions:This study brought out the problems of malnutrition both under nutrition and over nutrition so also the prevalence of hypertension and pre hypertension among adolescents which are going to be serious health problems in future.
Study of prevalence of diabetes mellitus in the rural areas of Hubballi, Karnataka, India
Authors: Jahagirdar Shubhashri S. , Bant Dattatraya D. , Bathija Geeta V.
Published: December 2016

Background: India is largely a rural nation. The prevalence of diabetes in the rural areas is increasing. The prevalence data is mainly available for urban areas and insufficient data is available for rural areas.  Aims and objectives: To estimate the prevalence of diabetes mellitus in rural areas of Hubli taluk, Karnataka, India and also to assess the risk factors associated.Methods: One village was selected randomly in the taluk. Information was gathered on demographics, personal history, past history, family history of diabetes mellitus and hypertension, life style practices and other parameters pertinent to the study objectives. Blood pressure was recorded and anthropometric data was collected. FBS was recorded and WHO criteria was used for diagnosis.   Results: 15.6% are known diabetic and 84.4% were non diabetic. According to IDRS risk scores, 6.4% subjects belonged to low risk category, 34.9% belonged to medium risk category and 58.7% belonged to high risk category. 11% of people were under weight, 40.4% were normal, 22% were overweight, 22.9% were pre obese and 3.7% are obese. 77.1% of people have normal FBS values, 8.3% had impaired glucose tolerance and 14.7% had impaired fasting glucose. There was significant difference in the mean FBS values (p=0.0001) and mean IDRS risk score (p=0.031) of Normal subjects, Pre-diabetics and Diabetics on ANOVA test.Conclusions: The total prevalence of Diabetes in the study was 22%. There was significant relationship between the family history of Diabetes among diabetics and non-diabetics (p=0.036).
Co-morbidities and addictions affecting treatment outcome in new smear positive cases in Amritsar city, Punjab, India
Authors: Nagpal Manisha , Devgun Priyanka , Chawla Naresh
Published: December 2016

Background: Although the current approach to TB control focuses on case detection and treatment, recent studies suggest that this strategy might not be sufficient to achieve this goal and it may also be necessary to reduce risk factors that contribute to the occurrence of tuberculosis infection and/or disease. Such risk factors may act at one of several steps in the natural history of the disease. The life time risk of breaking down to disease among those infected with TB is 10–15%, which gets increased to 10% per year amongst those co-infected with HIV. Other determinants such as diabetes mellitus, smoking tobacco products, alcohol abuse and malnutrition also increase the risk of progression from infection to TB disease.Methods: The study was conducted on new smear positive patients registered under Directly observed treatment, short course (DOTS) in two Treatment Units (TUs) present in Amritsar city. The patients were enquired about their socio-demographic profile, family history, occupational history and associated co-morbidities and addictions. Data management and analysis was done by using Microsoft excel and SPSS version 17.00.  Results: Out of 250 patients, 149 (59.6%) were males and 101(40.4%) were females. Male preponderance, with male to female ratio of 1.5:1 was seen. Out of the total 250 cases, 7.2% of the cases had associated diabetes mellitus, 1.2 % had hypertension and only 1 case was of asthma. While enquiring for addictions, it was observed that 28.8% of the cases were alcoholic, 17.2% were smokers, 8% had the habit of tobacco chewing and 6% were drug abusers. Favourable outcome was significantly higher in non-addicted cases while presence of co-morbidities was found to have no effect on the treatment outcome.Conclusions: In the present study, it was observed that favourable outcome was significantly associated with the absence of addictions. So, it is concluded that prevention of tuberculosis should include effective screening especially among high risk groups in order to ensure early detection and aggressive treatment.
A cross sectional study on association between overweight and obesity in adolescent population
Authors: Gorantla Anand Krishna , Kumar Murari Pradeep
Published: December 2016

Background: The rate of malnutrition in India remains high, increase in overweight and obesity have been observed in some areas undergoing rapid economic and epidemiologic transition. The aim was conducted to study association between obesity and overweight in adolescent population.Methods: A total of 1258 students (males-644; females-614) with an age group 10-19 years were selected from the higher secondary schools and junior colleges in the urban area of Tirupati.Results: The family history of obesity was reported by 54.7% of adolescents. The prevalence of overweight & obesity among males was found to be slightly higher in male adolescents 14.6% than in female adolescents 13.5%. Prevalence of overweight and obesity combined decreased with increase in the degree of physical activity from 12.7% in mild category to 10.0% in vigorous category and the differences are also found to be statistically significant in the present study.Conclusions: The present study recommended that the health education destined to inculcate healthy life style practices should be provided at an early age group to reduce the incidence of overweight and obesity in adolescent population.
Knowledge, beliefs and practices about breast cancer and its self-examination procedure among urban and rural women of district Gurdaspur, Punjab, India: a cross sectional study
Authors: Sehrawat Jagmahender Singh , Garima . , Mor Suman
Published: December 2016

Background: The entire world is at the risk of various dreadful diseases and cancer is one of them. Most of the victims seek medical interventions at advanced stage of breast cancer due to lack of awareness about its risk factors, symptoms, early detection methods and treatment. Present study was conducted to assess the knowledge levels, beliefs and the practices about breast cancer among both rural and urban women of Gurdaspur (Punjab) in an attempt to spread awareness and remove the fear of an unwarranted trauma among target population.Methods: Data was generated by interviewing 300 Gurdaspur (Punjab) women (20-40 years) through a pre-structured questionnaire designed to collect information about their knowledge of breast cancer, its causative factors, screening methods, treatments and beliefs.Results: Mean age of the participants was 41±5 years. More than 80% women had heard about breast cancer from family members or friends. About 70% women had knowledge about symptoms of this traumatic disease and more than half of them had heard about the practice of breast self-examination, though only 8.9% urban and 5.2% rural women had ever practiced it. Awareness of breast cancer was found significantly associated with age, marital status, educational level and socioeconomic status of the woman.Conclusions: Participants had a very limited knowledge about symptoms, screening procedure, risk factors, treatment of breast cancer etc. Some public health intervention and evaluation programs are urgently required to educate women about early detection and treatment strategies of breast cancer to reduce mortality from this disease.
Utilization of antenatal services in urban slums of Jorhat municipality, Assam, India and the socio - demographic factors affecting it
Authors: Rahman Syeda Jesmin , Medhi Anuradha Hazarika
Published: December 2016

Background: Antenatal service is an important strategy for improvement of maternal and child health, reduction of maternal mortality and neonatal death. But mere presence of this service is not enough. Utilization of the antenatal service is the most important aspect and there are many socio demographic factors that influence the women for its utilization. The objective of the study is to assess the utilization of antenatal services in the urban slums of Jorhat municipality, Assam and the socio - demographic factors affecting it.Methods: A community based cross-sectional study was done among women of the slum areas who had at least a child less than one year by using a pre structured and predesigned questionnaire.  Results: Adequate utilization of antenatal service was 19% while inadequate utilization was 66%. 74.2% of women had at least one dose of TT and 87.2 % consumed Iron and Folic Acid tablets for four months or more. Women who were high school and above had either adequate (13.2%) or inadequate utilization (81.1%) and only 5.7% of them did not have any antenatal service at all as compared to 37.5% among illiterates. Religion, caste, age of the women, parity did not have much role in its utilization. Among women from the joint families who did not have any antenatal service was only 4.8% as compared to 19.2% of women from nuclear families.  Conclusions: Majority of women had inadequate utilization of antenatal service in the slum areas and education played a very important role. Key words: Utilization, antenatal services, slum area.
Fertility and socio-economic determinants: evidence from co-integration and multivariate Granger casualty tests
Authors: Kengnal Prakash , Bullappa Asha
Published: December 2016

Background: The empirical work on fertility determinants widely discusses the role of socio-economic factors like female labour force participation rate, urban population and per capita gross national income in determining fertility rates. The India’s high fertility rate began to decline gradually after late 1950s and continued to fall since then. India achieved almost 31 per cent decline in fertility rate from 1990 to 2012. The objective was to examine the relationship between fertility rate, urbanization, female labour force participation rate and per capita gross national income for India.Methods: This study covers the sample period from 1990-2012. Moreover, the direction of causality between fertility rate, urbanization, female labour force participation rate and per capita gross national income in India using Granger Causality test within the Vector Error-Correction Model (VECM) are examined.Results: As a summary of the empirical results, we found that fertility rate, urbanization, female labour force participation rate and per capita gross national income in India are co-integrated and there is unidirectional Granger Causality between the four variables in long and short-run.Conclusions: The growth in urban population, female labour force participation rate and per capita gross national income are responsible for the decrease in fertility rate in India.
Utilization pattern of health services for non-communicable diseases in an urban slum: a study of Turbhe stores slum in Navi Mumbai, Maharashtra, India
Authors: Deshmukh Sona , Kalaskar Shrikant K. , Kadam Suhas B. , Mote Balu , Paslawar Srilatha K. , Adhav Ambadas S. , Thakare Bharat S. , Muthuvel Thirumugam
Published: December 2016

Background: The growing burden of non-communicable diseases among the urban poor in the absence of affordable health care services is a big public health challenge in India. In this context, the present paper explores the utilization pattern of health services to deal with two specific non-communicable diseases (NCD) namely hypertension and diabetes.Methods: The study was conducted in Turbhe Stores in Navi Mumbai, a slum of 5014 households.  An initial listing of the households revealed that there was at least one person suffering from either hypertension, diabetes or both in 254 households. By systematic random sampling, 84 respondents suffering from diabetes and/or hypertension from last one year were selected from these 254 households. Data was collected by structured interview schedule.Results: Three fourths of the respondents had utilised health service for their problem. About 95% sought medical care from private providers and almost all sought approached allopathic practitioner. Only half of respondents went for regular monthly follow up and almost 75 percent were found self-medication of old prescriptions for their treatment. Poor follow up and non-regular utilization of health services was mainly influenced by the individual perception of not giving importance of regular treatment and lack of attention due to asymptomatic nature of disease, followed by financial constraints.Conclusions: Self-awareness about the disease and importance of regular treatment & follow up is found lacking in the community. Health care services were regularly utilized for these silent diseases by those who can afford it. Factors like ability to afford costly treatment, high satisfaction level from the treatment sought and proximity of health care provider were found strongly associated with higher utilization.
Default rate and its awareness in management of tuberculosis in Chittoor district population, Andhra Pradesh, India
Authors: Bineni Chandrasekahr , Gorantla Anand Krishna , Reddy K. Ashok Kumar
Published: December 2016

Background: Default rate is the most essential feature of the DOTS strategy itself and also especially relevant in view of increased prevalence of drug resistance tuberculosis.  The aim of the present study was conducted to give awareness on default rate in management of tuberculosis.Methods: A total of 229 patients with smear positive tuberculosis cases of both category-I and category-II from DOTS centre in tuberculosis, S.V.R.R. Government General Hospital, Tirupati, A.P, India were enrolled and registered for the present study. Consent was taken from the patients to give awareness on default rate role in management of Tuberculosis in Chittoor district population.Results: Higher default rate is found among those employed 12.4% compared to those unemployed 4.3% and the difference is also found to be statistically significant. The defaulter rate has been found to be higher in those with 3 + sputum grading 12.4% followed by 1 + grading 7.9%.Conclusions: Default rate in the present study is high which points out that even with DOTS therapy, there can be significant default rate. So it is recommended that DOTS providers are periodically supervised and explained on the need to ensure full compliance and minimize the rate.
A cross-sectional epidemiological study of prevalence of work stress among resident doctors of a metropolitan tertiary care hospital
Authors: Deshpande Swati , Dhoundiyal Anurag , Shrestha Dipika , Davuluri Praveen
Published: December 2016

Background: To assess the prevalence of work stress , to compare of the prevalance of stress among resident doctors working in clinical and non/para-clinical departments, to determine the factors leading  to stress among resident doctors.Methods: after getting approval from Institutional ethics committee all the resident doctors of the hospital were contacted during a period of data collection of one year. Data was collected using standard questionnaire. Detailed descriptive statistical analysis was done.  Results: The mean age of the participants in the study was 26.8 years with maximum age being 39 years and minimum being 24 yrs. Among 454 study subjects nearly 34.8% were female and 64.2% were male i.e. 158 & 296 respectively. Among 454 resident doctors 188 from 1st , 139 from 2nd & 127 were from 3rd year of residency with percentage contribution of 41.4, 30.6 & 28.0 respectively, 39.4% of resident doctors are suffering from some degree of stress. While 16.1% suffered from mild degree of stress 7.9% suffered from moderate degree of stress, the percent of resident doctors suffering from severe and extremely severe degree of stress was 15.2 & 0.2 respectively. The prevalence of stress among clinical is much more (29.2%) as compared to non/para-clinical (13.9%), stress was more with increasing duration of working hours.Conclusions: It was found that the prevalence of stress among resident doctors was much more as compared to general population. The prevalence was directly correlated to factors like duration of working hours, gender and department.
Perception of current medical practitioners about undergraduate community medicine training, implications for future undergraduate curriculum: a cross sectional study
Authors: Reddy Murali Mohan , Panakkal Anisha Mohan , S. Loganathan , Venkatappaiah Jagannath
Published: December 2016

Background: Assessing the perceptions of medical practitioners regarding undergraduate community medicine training, its utility in their practice may provide vital inputs necessary for curriculum reforms. This study has been conducted to address this vital gap in the knowledge.Methods: Cross sectional study for 6 month period conducted among 213 medical practitioners from Chennai, by convenient sampling. Pre tested structured self - administered questionnaire used to collect data using email and manually.Results: Mean age of participants was 37(±12). Seventy (33%) MBBS graduates. Clinical, Pre & Para-clinical and super specialties constituted 72 (33%), 62 (29%) and 10 (5%) of participants respectively. Majority 164 (77%) participants felt disproportionate amount of time is allotted to the subject in under-graduation. To make it more relevant to practice, 150 (70%) suggested that there should be practical application of research methodology, 94 (44%) suggested more field work and 90 (42%) people suggested training in family medicine practice. Regarding application of community medicine principles in   practice, 122 (57%) said they routinely assess and address social determinants, 192 (90%) regularly advise patients on preventive aspects, 61 (29%) displayed good knowledge about public health issues.Conclusions: Need to revamp the undergraduate community medicine curriculum to make it more relevant. Practical application of research to be given priority in curriculum as essential foundation for evidence based medical practice. Intense, skill based training in clinic social case management suggested.
Epidemiological study of road traffic accident cases admitted in government tertiary hospital: a study from Punjab, India
Authors: Mahajan Sanjeev , Gupta Arti , Coonar Param Pal Singh
Published: December 2016

Background: Among all types of injuries road traffic injuries constitute a major public health problem. They lead to not only deaths but many more cases of morbidity and disability. People from all economic groups are affected but poor are affected the worst because they suffer from double brunt of injuries and also the economic loss; sometimes pushing them below the poverty line. The present study was conducted to study the epidemiological variables involved in road traffic accidents.Methods: 500 road traffic accident victims admitted in emergency department of Rajindra Hospital, a tertiary institute;  attached to Government Medical College, Patiala (Punjab) were studied from July 2002 to February 2003. In this descriptive study pretested proforma was used to know the various epidemiological factors related to road traffic accident victims. The demographic variables, category of road users, details of injured pedestrians and types of vehicles involved in road traffic accidents were studied.Results: The road traffic accident victims mainly include the young males, especially 21-30 years (31.4%), married (70.6%), and men (86.8%) mainly literate (66.6%), from rural areas of Punjab. Maximum accidents occurred during night time (8pm- 4am) and major involvement was of two wheelers (63.4%). Mainly drivers were affected in the road crashes (46.6%) followed by pedestrians (21.4%).Conclusions: young male drivers are affected the most, mainly involving two wheelers. There should be regular and continuous on-going traffic safety and awareness programs covering all the media especially directed towards education of drivers, pedestrians and young population; mainly focusing on  the schools and colleges youth.
A study on health morbidities among under five children in relation to birth weight in urban health centre field practice area at tertiary care centre, Bidar, Karnataka, India
Authors: Havale Naveenkumar G. , Bedre Rahul C. , Kesari Pallavi M. , Swamy Ratikanth
Published: December 2016

Background: Low birth weight (LBW) i. e. birth weight <2500 grams is a major public health problem in many developing countries. About 30% of babies born in India are LBW. Birth weight of an infant is the single most important determinant of its chance of survival, healthy growth and development. This study is to correlate the health of under five children in relation to birth weight.Methods: Community based cross sectional study carried in urban health centre field practice area of Bidar Institute of Medical Sciences Bidar. 250 under five children were surveyed and findings were recorded.  Results: Among the 250 under five children surveyed 68 were LBW children and 182 were normal birth weight children.164 children were having acute respiratory tract infection (ARI), 121 were underweight, 21 were having vitamin A deficiency, 145 were anaemic, 25 were having diarrhoea and 130 were having fever.Conclusions: underweight, Vitamin A deficiency, diarrhoea and fever were significantly associated with LBW babies compared to babies with normal birth weight.