bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative efficacious study between preoperative pregabalin and gabapentin on postoperative pain in abdominal hysterectomy: an institutional experience
Authors: K. B. Gayathri , V. Prem Swaroop , G. Sajana , Uday . , P. R. K. Bhargav
Published: November 2017

Background: Pain is a consistent and predominant complaint following surgical intervention including abdominal open hysterectomy. A multimodal approach has been suggested to improve postoperative analgesia and to reduce opioid related side effects. In this context we conducted a comparative study on efficacy between gabapentin and pregabalin on postoperative pain relief.Methods: In this prospective randomised study, 60 patients were divided in to two arms group G and group P. 900 mg of gabapentin and 300 mg of pregabalin were administered orally one hour before spinal anaesthesia to respective groups. Hemodynamic parameters such as heart rate, mean arterial pressure, respiratory rate was monitored pre, per and postoperatively. Also, the need for first analgesic dose and visual analog pain score were documented in all subjects of both groups. Statistical analysis with SPSS 16.0 performed.Results: There was significant fall in mean arterial pressure in group G than group P patients. Further the fall in mean pulse rate was more in group G compared to group P throughout pre, per and post-operative phases. In terms of mean postoperative time required for first dose of analgesic drug, pregabalin and gabapentin was required after 7 and 5 hours respectively. There was a statistically significant change in Visual Analogue Scale, showing pregabalin as better drug than gabapentin in post operative pain control with score 5 and 7 respectively.Conclusions: Pre-emptive analgesia with pregabalin appears to be superior to gabapentin as a part of multimodal perioperative pain management in abdominal hysterectomy.
Correlation of ultrasonography, hysterosalpingography and hystero-laparoscopy findings in cases of infertility
Authors: Shaikh Falahunisa S.
Published: November 2017

Background: Infertility is a condition which has medical as well as social impact on the state of the couple. Approximately 10-15% couples are infertile. A wide arena of tests is available for the diagnosis of the causes of infertility. The aim of present study is to correlate the findings of ultrasonography, hysterosalpingography and hysterolaparoscopy in infertility.Methods: It is a prospective study done over 2 years at INHS Asvini hospital, Mumbai. Infertile women underwent ultrasonography, hysterosalpingography and hystero-laparoscopy. Data was assessed using SPSS 17 software.Results: Of 105 patients, on ultrasonography, 22.9% had Polycystic ovaries (PCO), 2.9% had ovarian cyst, 4.8% had fibroid, 4.8% had endometrioma, 3.8% had adnexal mass, 3.8% had polyp. On hysterosalpingography, 18 (17.1%) had left and 20 (19%) had right tubal block, 11 (10.47%) had B/L tubal block, 6 (5.7%) had septate uterus, 6 (5.7%) had hydrosalpinx. On laparoscopy, 12 (11.4%) had PCO, 4 (3.8%) had ovarian cyst, 12 (11.4%) had fibroid, 7 (6.7%) had endometrioma, 19 (18.1%) had left and 18 (17.1%) had right tubal block, 12 (11.42%) had B/L tubal block, 4 (3.8%) had hydrosalpinx. On hysteroscopy, 7 (6.7%) had septate uterus, no polyp seen.On laparoscopy, 21 (20%) had endometriosis, 1 (1.9%) had bicornuate uterus.Conclusions: On comparing the results it was observed that hysterolaparoscopy gives definitive diagnosis and should be considered gold standard, though other modalities of investigation should be considered complimentary and not competing with it, as they are noninvasive.
Comparison of diagnostic value of visual inspection with Lugol’s iodine to conventional Paps smear in detection of colposcopic biopsy proved CIN: a tertiary care experience
Authors: Bajaj Manisha , Ahmad Shamshad , Trivedi Shubha S.
Published: November 2017

Background: An organized cytological screening (Pap smear) is the mainstay for cervical cancer prevention and control programme. Financial and logistic burden of operating such a program is considerable. This has prompted the evaluation of alternative feasible techniques. It appeared from the earlier studies that visual inspection with lugol’s iodine (VILI) could be a potential alternative to cervical cytology. VILI is a low cost, easy to apply and highly sensitive technique. It gives result immediately thus allows doctors to “see and treat” at first visit. Objective of present study was to evaluate the performance of visual inspection with lugol’s iodine and its comparison with cytology in cervical cancer screening.  Methods: 400 non-pregnant reproductive age women were subjected to Paps and VILI in this prospective study done in a tertiary-care centre in Delhi. Reference standard used for all was colposcopy and colposcopic-directed biopsy (when required).Results: Of 400 Pap smears done 11.75% were normal, 77.5% inflammatory, 5.5% had ASCUS, 0.25% ASC-H, 0.5% AGUS, 2% LSIL, 1.5% HSIL and invasive cancer in 0.5%. With LSIL and above smears as significant, the sensitivity and specificity of Paps were 50% and 97.66% respectively. VILI was positive in 12.8% of cases. Sensitivity and specificity of VILI was 85.5% and 89.9% respectively. Overall accuracy of VILI in detecting pre-invasive lesion was 89.7% while with pap smear it was 96%.Conclusions: Accuracy of VILI and Pap smear in detecting pre-invasive cervical lesion was comparable. At tertiary-care centers VILI can be used effectively to screen the patients with significant lesions. Patients can be directly subjected to further treatment at the earliest thus reducing loss to follow-up.
IUFD incidence, causes and complications: a retrospective study done at a tertiary care centre in greater Noida, India
Authors: Jamal Shehla , Agarwal Shelly
Published: November 2017

Background: Demise of a fetus is not only a cause of distress to the parents but also leaves the obstetrician with little choice. Managing such a pregnancy and counselling of the patient becomes a difficult task for us. Early assessment and timely intervention are the key approaches for reducing the incidence of still births globally. By such a strategy, peripartum complications can also be reduced. The current study was undertaken with an aim to assess the incidence of IUFD, causes and peripartum complications associated, in order to formulate a management protocol at our centre.Methods: This is a retrospective study done over a period extending from September 2014 to October 2015. IUFD was taken as absent fetal heart sounds beyond 20 weeks gestation which was confirmed by sonography. Maternal and fetal records were analysed for studying demographic profile, obstetric details including present and past complications, along with evaluation of fetal parameters.Results: Total number of deliveries over this period was 995 and cases of IUFD reported were 56. Hence calculated proportion was 5.62%. Majority of the cases were unbooked (66%) and presented to obstetric casualty. Maximum cases were found in primi gravida patients, i.e., 35.7% and most of the cases were identified at a gestational age of 20-24 weeks, 32.1%. Hypertensive disorders of pregnancy, 41% and Anaemia, 25% were found to be the leading maternal causes at our centre. Whereas congenital anomalies 23.2% and Antepartum haemorrhage 30.3% were the commonest causes in fetal and placental factors studied. Prolonged labor was observed in 33.9% and Atonic PPH was present in 21.4% patients. ARF was present in 3.5% and DIC was also found in 3.5% of the cases. However, no explainable cause could be found in 12.5% of the patients.Conclusions: Barring the unexplained fetal losses, most of the causes that were ascertained in present study were avoidable. This highlights the importance of our need to understand the avoidable causes of IUFD and to enforce the need of adequate antenatal care so as to timely identify the risk factors. In addition, the necessity of pre-conceptional counselling in order to avoid complications and recurrence must also be emphasized.
A study of lipid parameters among GDM and non GDM pregnant women: a hospital based study
Authors: K. R. Bharathi , S. Vijayalakshmi , R. P. Shrunga
Published: November 2017

Background: Altered maternal lipid metabolism is common in pregnancy. In women with GDM physiological changes in insulin and lipid levels are exaggerated during pregnancy, leading to significant alterations in lipid levels compared to normal pregnancy. Assessment of raise in certain lipid parameters in pregnant women with GDM and non GDM.Methods: A hospital based case control study done in the Department of OBG AIMS Bellur, Mandya, Karnataka, with sample size of 100 pregnant women. 50 cases of GDM (confirmed by OGCT) and 50 controls (non GDM cases) pregnant women were taken during 1 year study period from June 2015 to June 2016. Mean age of presentation of women was 20-25 yrs. Ethical committee clearance was taken and consent from control and cases was taken. Fasting lipid profile was sent. Parameters obtained were analyzed using student t test for statistical significance.Results: There was no statistical difference in age and parity between control and case group. Triglyceride (cases- 286.4±77.60 mg/dl) (controls-166±26mg/dl), total cholesterol (cases-256.5±41.7 mg/dl) (controls -202.5±20.18mg/dl), VLDL (cases-53.4±13.2 mg/dl) (controls-46.6±13.1mg/dl) showed statistically significant values (p value<0.001). HDL and LDL values did not show any statistical significance (p value >0.5) among GDM and non GDM group. Lipid profile was performed predominately in women in II trimester.Conclusions: Serum triglyceride, total cholesterol and VLDL level are significantly higher among woman with GDM compared to non GDM pregnant women, where in the lipid profile can be used as predictor for gestational diabetes mellitus in future which needs further research.
A study of maternal and perinatal outcome in cases of HELLP and partial HELLP syndrome
Authors: Durugkar Kanchan
Published: November 2017

Background: The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. The objective of the present prospective study is to study on incidence, diagnosis, and variable presentations of HELLP syndrome in preeclampsia to analyse the severity and complications, as it is associated with maternal, perinatal morbidity and mortality. HELLP syndrome is difficult to diagnose when it presents with atypical clinical features.Methods: In the prospective study of 300 admitted cases with more than 20 weeks of gestation, were having preeclampsia. The selected cases were analyzed clinically with relevant history, clinical data and detailed laboratory investigations made for better analyses of complications and outcome in HELLP syndrome.Results: Under further clinical diagnosis of 300 cases of preeclampsia, 34 cases (11.33%) were of HELLP Syndrome and 44 (14.66%) cases were of partial HELLP syndrome. The present study shows 2.9% maternal mortality in HELLP and 4.5% in partial HELLP syndrome. Perinatal mortality was 17.6% with HELLP and 25% with partial HELLP.Conclusions: The diagnosis of HELLP syndrome has been made as a severe variant and complication of severe preeclampsia and eclampsia. It needs early diagnosis, timely intervention to arrest further progress and complications like multi organ dysfunction, renal failure, DIC, abruption etc and to improve maternal and perinatal outcome.
Clinical study of Misgav Ladach technique of caesarean section
Authors: Gadappa Shrinivas N. , Dixit Pratibha V. , Sharma Deepika , Gavit Yogita
Published: November 2017

Background: In the last decades caesarean section rates increased in many countries becoming the most performed intraperitoneal surgical procedure. The operative technique performed is made chiefly on the basis of the individual experience and preference of operators, the characteristics of patients, timing and urgency of intervention. Present study was undertaken to assess the benefits of the Misgav Ladach caesarean section technique in tertiary care hospital and evaluate the operative parameters like efficacy, safety, duration of surgery, blood loss, need for suture material, post-operative morbidity.Methods: Prospective surgical interventional study conducted in department of obstetrics and gynecology in tertiary care institute.Results: The duration of surgery, blood loss and post-operative complications were significantly less in the Misgav Ladach technique of LSCS.Conclusions: The choice of the Caesarean section technique is strictly linked to the individual experience and confidence of the surgical team. Misgav-Ladach technique proved to be associated to less complications, moreover, since its shorter operating time; it is to prefer in all that cases a prompt operation is required.
Comparative evaluation of abdominal hysterectomy by ligasure and conventional method
Authors: Singh Harjinder , Jindal Monika , Gupta Monika , Goraya S. P. S. , Behal Manisha , . Tanjeet
Published: November 2017

Background: Hysterectomy is the 2nd most common surgical procedure performed in women and is associated with various complications like any other major surgical procedure. The objectives and aims of this study was to compare the effects of ligasure and conventional clamping and suturing in abdominal hysterectomy.Methods: A randomized controlled trial was performed by randomizing the patients in 2 groups - ligasure (A) and conventional hysterectomy (B). Operative time, no. of sutures, blood loss, hospital stay and cost factor to patient were studied as its main outcomes. A total of 100 patients were studied.Results: 66% of patients in group A had duration of surgery that was less than an hour in spite of associated co-morbidities. More no (76%) of patients in Group A had significantly less blood loss (<50 ml) as compared to 60% of patients in Group B. Only one suture was used in 80% of patients in Group A while in group B all of the patients required more than one suture from stumps to vault. There by reducing the cost of surgery.Conclusion: Apparently ligasure group seems to have less time for surgery and less blood loss and more intraoperative and postoperative complications, but to prove one ligasure group superior or inferior over conventional method we need to have more studies. But yes, Ligasure group reduces the cost of surgery to patient by reducing suture consumption as compared to conventional group.
Clinical presentation and prevalence of uterine fibroids: a 3-year study in 3-decade rural South Indian women
Authors: Munusamy Mohanambal M. , Sheelaa Wills G. , Lakshmi Vijaya P.
Published: November 2017

Background: Uterine fibroids are benign tumors arising from smooth muscle cells of myometrium. This study was conducted in rural women belonging to poor socio-economic class and primary school dropouts to find out clinical presentation, prevalence of uterine fibroids, their knowledge about health services and to develop modalities to improve awareness and early reporting to prevent morbidity and improve quality of life.Methods: Women ranging from 26-55 years age attending Gynecology OPD of SSSMCRI for abdominopelvic mass, pain, menstrual abnormalities over a period of 3 years were registered for the study. Socio-demographic profile, detailed menstrual history, reason for attending hospital and previous treatment taken prior to the hospital visit were recorded. Women with pregnancy with fibroids and fibroids detected by ultra-sonogram less than 12 weeks were excluded from the study. Clinical, local and ultra-sonographic examination was done for the morphology of the fibroids. Comparison was done with histological picture for accuracy in clinical and sonographic diagnosis.Results: 362 women who presented with uterine fibroids, menorrhagia or with abdomino pelvic mass were registered for this study. Of 136 patients who had uterine fibroids 66% had menorrhagia with severe anemia, 23% needed blood transfusion, 17 were nulliparous women. Menorrhagia was the commonest menstrual pattern seen in 58.8% women. Asymptomatic fibroids with huge abdomino pelvic mass was seen in 46 women (33%). The size was 12-28 weeks. The mean age was 46 years. Abdominal hysterectomy was done in 88 women, and 3 in-situ hysterectomies (91 cases) (67%), polypectomy in 16 and myomectomy in 22 nulliparous women. Laparotomy for torsion sub-serous fibroids was done in 7.Conclusions: Further research is needed to find out biological factors causing fibroids including diet, stress, environmental and racial influences. Routine screening, early detection, increase awareness by early reporting to the hospital will reduces morbidity and improves quality of life socioeconomically.
Novel use of balloon tamponade saves a patient with uterine inversion in severe shock
Authors: Yadav Sumitra , Malhotra Anjali
Published: November 2017

A patient with G1P0 status 38 weeks pregnancy with pain with no high risk delivered at PHC, Hatod, Madhya Pradesh (India). She delivered a male baby by spontaneous vaginal delivery of 3.1 kg. All of sudden after 2nd stage of labour, her 3rd stage of labour was eventful. Placenta did not come out spontaneously so controlled cord traction was given by the ANM over the PHC. She was given intramuscular oxytocin 5 IU. She did the traction with proper care but inspite of that while doing so placenta got separated but there was complete uterine inversion. ANM herself tried to reposit the uterus but could not do so. So ANM immediately referred her from PHC to MYH, Indore, Madhya Pradesh (India).
Spontaneous rupture of an unscarred uterus during pregnancy: an interesting case report
Authors: K. Durga
Published: November 2017

Uterine rupture in pregnancy is very rare and potentially catastrophic for both mother and foetus. The most common cause of uterine rupture is giving away of previous caesarean uterine scar. Spontaneous rupture of an unscarred uterus during pregnancy is a rare occurrence. We hereby present a rare case of a spontaneous complete uterine rupture in a non-labouring unscarred uterus of a 33-year-old nulliparous woman at 35 weeks of gestation. She presented with lower abdomen pain and decreased foetal movements at Institute of Obstetrics and Gynaecology, Chennai. Even before getting into labour, patient suddenly collapsed, and emergency laparotomy was proceeded in view of suspicious concealed abruption. There was frank hemoperitoneum along with a dead baby in the abdominal cavity. There was rupture of uterine fundus extending from one cornual end to the other and closure of uterine rent proceeded. Spontaneous rupture of uterus occurs when there is an upper segment uterine scar. She had a past history of eventful uterine curettage which was the risk factor for uterine rupture.
Suicidal attempt by woman in labor
Authors: Bangal Vidyadhar B. , Mandade Krishna , Verma Priyanka , Amrale Prachi , Aher Kunal , K. Bhavsar Dhruval
Published: November 2017

Suicidal ideation during delivery is extremely rare. Very few cases have been reported in the literature. Unwanted pregnancies, pre-existent mental disorders, substance abuse or addictions, marital dis-harmony, fetal demise or stillbirths have been documented as associated factors in reported cases of suicidal attempts by women in labour. Women tried taking overdose of sedative pills or have attempted hanging, drowning or jumping from hospital terrace. Lack of prenatal education, suboptimum use of labour analgesia, ill-treatment by health professional and relatives have been the contributory factors for suicidal ideation during pregnancy and labour. We report a rare case of attempted suicide by woman in active labour. She tried to cut the forearm and wrists with the help of razor blade used for preparation of part in preparation room attached to the labour room. The situation was recognized early by vigilant nurse on duty. The woman was resuscitated, treated, and counselled by psychiatrist before discharge from the hospital.
Conquering mount diabetes: the highest peak in India
Authors: Panchagnula Neha Bharadwaj
Published: November 2017

The term diabetes has come into colloquial usage over time. As the day passes by, we have more people being diagnosed and more people facing complications. How the silent killer is creeping its way into the world is a known thing. Are all our task forces ready to face the end result?  Though we have enough research and supportive facilities, the provider-consumer distance in a developing country like India is a transparent issue. Bolstering the team dynamics and a well-structured team approach right from the primary care provider’s level, might offer us a solution for all that we are facing today.
Sleep problems: an emerging public health issue.
Authors: H. S. Siddalingaiah
Published: November 2017

Sleep is one of the most significant yet neglected topic by health professionals as well as general public. Sleep has profound implications for physical, mental and psychological wellbeing of an individual. Modern socio-economic and lifestyle factors have resulted in sudden increase of the prevalence of sleep disorders over last few decades. Sleep disorders are resulting in significant economic losses for nations and are becoming a public health burden. High quality research studies have helped to better understand the determinants of sleep problems. Also the understanding of the nature and the control mechanisms of sleep have helped in devising screening, preventive and early-intervention modalities which need to be utilized widely by clinical and public health professionals. Advocating and educating about optimal sleep quantity, quality and sleep hygiene at occupational, institutional and various high risk group settings should be done by public health professionals through regulation on work hours, work shift patterns, and behaviour modification measures.
Comparing the risk factors of coronary artery diseases in patients with stenotic and ectatic lesions
Authors: Zamani Bijan , Babapour Behzad , Amani Firouz , Ghasemian Mohsen
Published: November 2017

Background: Coronary artery ectatic usually have relation with hyperlipidemia, systemic hypertension and male gender and its diagnosis done by angiography. Due to lack of proved risk factors for incidence of coronary artery ectatic lesions and also its important. The aim of this study was to compare the risk factors of coronary artery in patients with ectatic and stenotic lesions. Methods: This is a descriptive and analytical study that has been done on 300 patients hospitalized in Ardabil city hospital. Patients were enrolled according to the criteria and undergone to angiography. According to result of angiography, patients who have ectatic lesions as the first group and patients whose lesions were stenotic were named as the second group. Information obtained from patients entered in the checklist and analyzed by statistical methods in SPSS.16. Results: 22% of patients with ectatic lesions and 78% with stenotic lesions in patients with ectatic lesions. The mean age was 58.7 years and 74.2% were male and in patients with lesions stenotic the mean age was 60.7 years and 54.3% were male. Based on angiography results, in patients with ectatic lesions 42.4% have engaged in a carotid and 44.4% were two clashes coronary arteries in group stenotic. 34.7% of patients have history of previous mi, 32.9% history of coronary artery disease, 54.7% history of smoking, 56% had diabetes mellitus and 56% had hypertension. History of previous MI (p=0.028), smoking (p=0.04) and diabetes mellitus (p=0.001) and history of coronary artery disease are effective risk factors in two groups. Conclusions: The results showed that previous history of myocardial infarction, smoking and DM have significant relation with type of lesions.
Role of health awareness among malaria control workers in their occupational health and safety practices
Authors: Elamin Bushara Mohamed Osman
Published: November 2017

Background: The study conducted at Khartoum North, Khartoum state, Sudan to determine the role of health awareness among malaria control workers in their occupational health and safety. All workers (80) were selected for the study. Methods: This was a quasi-experimental study concentrating on the role of awareness among Malaria control program workers who were using insecticides in their occupational health and safety practices, where questionnaire, interviews, intervention program used. Results: The study clarified that there is a high significant change in practices among malaria control workers concerning the use of personal protective equipment from 68% to 86% after intervention, also there was a significant change in practices among malaria control workers concerning the using always of personal protective equipment’s from 75% to 86% after intervention. Conclusions: The study concluded that the hazard of insecticides to the Malaria control workers occupational health is high, because of their limited awareness about the risks resulted from it, health awareness interventions can tackle this problem.
An efficient method to conduct large population survey in a low resource setting: Tamil Nadu tobacco survey
Authors: E. Vidhubala , S. Divyraj Prabhakar , C. Sundaramoorthy , E. Hemanth Raj , Shewade Hemant Deepak , Lal Pranay
Published: November 2017

Background: Resource allocation for tobacco surveillance in low-income settings like India is a challenge. The current study describes an efficient method to conduct a large population-based tobacco survey in an Indian state. Methods: Tamil Nadu Tobacco Survey (TNTS) was conducted in Tamil Nadu, the sixth most populous state in India, between March and November, 2015. About 100,000 subjects aged 15 years and above, representing both urban and rural populations within 32 districts, were included. The Global Adult Tobacco Survey (GATS) questionnaire was modified and translated into the local language (Tamil) to develop the survey questionnaire, which was pre-tested in 1,690 participants in three districts in November 2014. The survey was conducted through research collaboration between 31 educational institutions and three NGOs. Once collected, data were double-entered using an open access tool (Epidata). Results: The quality and the accuracy of the data was ensured at every level and the data was double entered to minimise the entry error. Among a total number of 32,945 participating households, 111,363 eligible individuals were identified, of which 99,825 individuals completed the survey. The overall Household Response Rate (HRR) was 91.23% (range within districts: 72-99%). The overall Individual Response Rate was 89.24% (range within districts: 73-99%). The unweighted population almost equally represented the weighted population in the selected demographic variables such as age, gender, and type of residence. Conclusions: TNTS was conducted in an efficient manner utilizing local resources, without compromising on quality. This method can be replicated in any setting with the low or limited resource.
A study to assess the knowledge regarding practices of menstrual hygiene and RTI among high and higher secondary school girls: an educational interventional study
Authors: Neelkanth Namita , Singh Daneshwar , Bhatia Padma
Published: November 2017

Background: Menstruation still a taboo subject to whisper and so, more difficult to discuss the hygiene, practices, perception and myth associated with it. The very ancient socio -cultural restrictions still play a major role in plenty of reproductive tract infections left undiagnosed. Thus resulting in the potential loss of economy in terms of GDP, medical costs, and status of health. The objectives of the study were to assess the awareness, source of information and problems regarding menstrual hygiene at pre-questionnaire stage and to compare the assessment of awareness at post questionnaire stage after educational intervention provided among the study group; to find out the mean age of menarche among the study group; to find out the knowledge regarding symptoms of reproductive tract infections among the study group; to inculcate safe hygienic practices during menstruation so as to percolate the same during reproductive episodes e.g. termination of pregnancy or uterine bleeding etc. Methods: Convenient sampling with Semi-structured questionnaire method. A girls’ government school chosen for the study with 197 girls including class standard 9th, 10th, 11th and 12th. After the session of pre questionnaire, all girls were included in the study who were present on the day. Results: On statistical analysis, mean age of menarche among girls is 13.5 years. Data regarding awareness level found statistically significant after the completion of study. Conclusions: Satisfactory improvement in hygiene level found post intervention. It could be implied on massive level in all the schools in country. In conformity with, Indian government also came up with the programme of provision of free sanitary pads in government schools.
Knowledge and attitude of married men towards vasectomy in an urban slum of Navi Mumbai
Authors: Nair Ganesh R. , Wadke Rishikesh , Relwani Nisha , Mahadik Virendra , Anjenaya Seema
Published: November 2017

Background: India’s total fertility rate has been 2.2 in 2016, which is not far from replacement levels of 2.1. Tubectomy has been able to achieve this to a good extent, however vasectomy which is a far safer and effective method, isn’t still popular amongst men due to gender bias in our country. This study intends to understand the reasons for gap in the demand for vasectomy. The objective was to assess knowledge and attitude of married men towards vasectomy. Methods: A descriptive cross sectional study was carried out amongst 121 married men selected by simple random sampling, in the age group of 21 to 50 years and who hadn’t undergone vasectomy. A pretested structured questionnaire was used to assess knowledge. Respondents’ attitude was measured on 4 point Likert’s scale. Data was analysed using SPSS software version 21. Results: 70.2% men were aware of vasectomy. Main sources of information were mass media (42.35%), family and friends (29.41%) and doctors (24.7%). 47.1% of respondents felt that men should not undergo vasectomy. The main reasons given for disapproval were “women are best suited for sterilization procedure” (68.42%), “Vasectomy can make men impotent”(14.03%), “Leads to general weakness and blood loss” (13.03%), “Can’t do heavy work” (11.5%) and “Fear of surgery”(5.7%). Only 16.5% men agreed that vasectomy is better than tubectomy. Conclusions: In our country there is a clear gender bias towards tubectomy as men are reluctant to undergo vasectomy. Thus there is an urgent need to intensify the behavioural change communication approach which will enable to improve knowledge and change men’s attitude towards vasectomy.
A socio-demographic study on prevalence of undernutrition among pre-school children, under Rural Health Center, Santhiram Medical College, Nandyal, Andhra Pradesh
Authors: Mushtaq Pasha M. A. , Fatima Afsar , Veeresappa D. K. , Prasad Raja Vikram
Published: November 2017

Background: Life of every human starts with infancy, childhood into adult life. During this process, childhood happen to be the most vulnerable phase associated with nutritional deficiency affecting the growth leading to morbidity and mortality. Malnutrition in pre-school children is considered most important indicator of the nutritional and health status of the country which is given top priority in National Family Health Survey- 4 (NFHS-4). Pre-school children in India have higher percentage of undernourished children and are 100th place among 119 malnourished countries in the world. The aims of the study were to assess the nutritional status of children aged 3-6 yrs in rural area attending Anganwadi centers under Rural Health Center, SRMC, Nandyal and to identify the factors associated with the nutritional status of pre-school children.Methods: Cross sectional study, area under Rural Health Center, Santhiram Medical College, A.P. Sample size for study is 161, calculated using Epi info-7 calculator. Study was carried during June 2017- July 2017 for a period of two months among 3-6 yrs children attending AWC under RHC, SRMC, Nandyal. Samples selected were based on using multistage random sampling technique. All the children were subjected to measure for body weight and their ages were recorded using Gomez classification based on weight for age. All the mothers were interviewed using pre tested questionnaire. The data compiled in excel sheet and later was analyzed using SPSS-22 version.Results: Total number of children between 3-6 yrs included in the study is 161. Female children (57.8%) outnumbered male children (42.2%) in the study. Undernourished children according to Gomez classification were falling in second degree with 77 (47.8%), followed by first degree 63 (39.1%). The age, mothers’ education and B G Prasad socio economic class-4 and class-5 with Under Nutrition were showing significant correlation showing p value less than 0.05. Conclusions: Mothers’ education and BG Prasad socio economic class is showing more influence on second degree and first degree under nutrition based on Gomez classification.
Gutkha ban in Chennai, India: is there any impact?
Authors: K. Deepak , M. Angeline , E. Vidhubala , C. Sundarmoorthy , Basumallik Barsha
Published: November 2017

Background: Gutkha is banned under Food Safety Act, India, effective from May, 2013 in Tamil Nadu. The current study is to find out the impact of Gutka ban on sale and consumption in Chennai city. Methods: Shop keepers (n=90) selling Gutkha and tobacco users (90) were chosen using stratified simple random sampling method from 15 zones of Chennai. Three different types of shops (platform/permanent/petty) were identified and a structured questionnaire was used. The questions included for shopkeepers were awareness about Gutkha ban, supply mode, sale and price difference and questions for users included motivation to quit, reduction in use, availability and price difference. Results: No shop had open display of Gutkha and all the shopkeepers and users were aware of the ban. Shopkeepers either bought Gutkha from the whole sale market (58.9%) or the agent (41.1%). Raid was conducted at 81% of the shops. There was a significant reduction in the sale after the ban (p<0.05). Users did not find it difficult to procure as it was easily available; however, price has increased up to 300%. Users felt guilty (18.9%) and fearful (23.3%) when using banned products. Users were motivated to quit (22.4%), made attempts to quit (58.9%) and felt the need for professional support to quit (38.9%). Significant difference was observed in the number of sachets used before and after ban (p<0.05) by the users. Conclusions: The ban did not have any impact on the availability of Gutkha, however it had a little impact on users. Stringent enforcement is crucial to achieve the purpose.
A study to assess common morbidity pattern of an urban population of Tripura
Authors: Datta Anjan , Nag Kaushik , Karmakar Nabarun , Datta Srabani
Published: November 2017

Background: To plan for effective health measures, knowledge regarding morbidity profile of local area is very important. Preventive health strategies cannot be made without an idea about the disease burden and changing trend of diseases of the locality. Keeping this background in mind the present study was conducted. The objective of the study was to assess the common morbidity pattern of people living in an urban area of Tripura.Methods: A community based cross-sectional study was conducted among people living in the filed practice area of Urban Health Training Centre, Dukli under Department of Community Medicine, Tripura Medical College & DR. BRAM Teaching Hospital, Hapania for a period of one year. Five hundred fourty participants were selected using simple random sampling technique and data was collected using a pre-designed pretested questionnaire and analyzed using SPSS version 20.0 software. Results: Majority (50.93%) of the study participants were females and belonged to 19-59 years age group (32.78%). The commonest type of morbidity was found to be acute respiratory infections (31.10%), followed by musculo-skeletal disorders (17.78%), with non-communicable diseases like diabetes mellitus, hypertension, obesity etc. catering 13.70% of all morbidities. Majority of the participants were having single morbidity (55.74%) than those having comorbidities. Conclusions: There is dual burden of communicable as well a non-communicable diseases in our study population. Future studies for risk factors assessment are required to plan for effective preventive strategies locally.
Rural-urban disparities in prevalence of anemia among adolescent girls in India
Authors: Yadav Jeetendra , Yadav Ashish K. , Srinadh Ranganadham
Published: November 2017

Background: Anaemia continues to be a major public health problem at all ages worldwide. Today, every fifth person in India is an adolescent (Census, 2011). Anaemia effects adolescent girls critically by decreasing their capacity to do physical work, affects their growth as a result they are not well prepared for upcoming pregnancy and motherhood challenge. NFHS-3 reports indicated wide rural-urban disparity in prevalence of anaemia. The present study aims to explore rural-urban disparity in prevalence of anaemia and to study the factor associated with anaemia among adolescent girls in India. Methods: District levels household survey (DLHS-4, 2012-13) was used for the present study. The outcome variables included in the study was anaemia. Bivariate analyses including chi square tests were applied to determine the prevalence of anaemia and logistic regression models to understand the determinants of anaemia. The whole analysis was performed using STATA version 13.0 to take into account the survey design (i.e. sampling weights with clustering and strata), QGIS, and R CRAN. Results: The prevalence of anaemia was observed high in urban (65.3%) as compared to rural (57.3%). However, the prevalence of severe anaemia was high in rural area as compared to urban area. The mean hemoglobin level of the study population was 10.4±2.22. Prevalence of anaemia varies across key selected individual, household and community characteristics of adolescent girls. Finding of multivariate logistic regression analysis indicated that anemia has a strong relation with age, education, family size, religion, caste, economic status, sanitation facility and place of residence of adolescents. Conclusions: This study concludes that the prevalence of anaemia is a significant problem of adolescent girls in India. The study also proved that anemia is significantly associated with age, education, income strata and place of residence.
Socio demographic determinants of health care seeking behaviour among tuberculosis patients admitted in the isolation ward of tertiary care hospital: a health belief model
Authors: Yamini K. , Rao B. T. , Valleswary K.
Published: November 2017

Background: Health care seeking behavior explains that people differ in their willingness to seek help from  health  care services. It is difficult to identify which determinants are most influential in the decision to utilize health care. The health belief model proposes that a person's health-related behaviour depends on the person's perception in critical areas. The aims and objectives of the study was planned to determine the socio demographic factors of sputum positive tuberculosis patients and to assess the health care seeking behaviour of patients by health belief model.Methods: Cross sectional descriptive study was conducted on sputum positive tuberculosis patients above 15 years in Tuberculosis wards of Rajiv Gandhi Institute of Medical Sciences, Ongole from April to September 2014. Results: Mean age group of the 100 participants was 48.89±5.93 years, 92% were males and 49.5% were labourers. Accessibility of the health care services was good in 95% of the cases, diagnostic tests and ATT treatment were accepting in good way by 71% of cases. In first contact, 36% of the cases contacted rural RMPs and 39% of the patients visited private practitioners. Symptoms of the tuberculosis were recognized by 20% of the patients and only 22% of them were perceived about the signs and symptoms. Significant association observed between the recognition of severity of symptoms and awareness on threat of tuberculosis among Tuberculosis patients (p<0.5). Conclusions: Heath education can be done by using the results of health belief model to increase awareness on perception, susceptibility, threat and understanding about the tuberculosis, there by patient’s intake of the drugs will be increased so that we can prevent chances of transmission of the disease.
Hypertension and QOL among rural elderly
Authors: Satyanarayana Pradeep Tarikere , Chikkegowda Lokesh Kabbalu
Published: November 2017

Background: Aging is a natural phenomenon and quality of life among elderly gets compromised. The biggest killers among old age are heart disease and stroke and greatest cause of morbidity are sensory abilities, Diabetes and depression. The life of elderly gets compromised when they start facing problems to fulfil basic requirements such as social relations; personal care, nutrition and accommodation added to old age health problems.Methods: It was a community based cross sectional study from June to September 2017 and study duration was for 3 months. Sample size calculated was 201 and was rounded off to 230. Snowball sampling technique was used. Data regarding socio-demographic profile and morbidity status was collected using semi structured questionnaire. QOL was assessed using WHO QOL OLD Questionnaire after informed consent. All those aged above 60 years were included in the study and those who are chronically sick and beds ridden were excluded from the study. Data were entered in Microsoft excel and analyzed using SPSS v22. Level of significance was defined with p value less than 0.05. Mean and standard deviation were calculated and to compare between various group Independent t test applied.Results: Among 231 study participants, 122 (48.8%) belonged to 60-65 years age group, 126 (54.5%) were females, 130 (56.3%) were illiterates and 119 (51.6%) were completely dependent financially on family members, 97 (41.9%) were Hypertensive. Statistically significant difference was found in AUT domain where non-hypertensives had higher scores. Male hypertensives comparatively had better scores; literate hypertensives had better scores compared to illiterate hypertensives in SAB, AUT, PPF, INT domains.Conclusions: Hypertension affects the quality of life and age, marital status, education also has some effect on the QOL in elderly stressing the importance of addressing the issues in regular clinics.
Prevalence and determinants of external injuries among industrial workers in an urban area of Kancheepuram district, Tamil Nadu
Authors: C. Sashidharan , P. Mohan Kumar , S. Gopalakrishnan
Published: November 2017

Background: Workers engaged in industries and construction sites faced several problems and often work in substandard conditions, getting exposed to various hazards in the work place without appropriate safety training. Injuries among workers are an important health issue in industries. This study was planned to assess the prevalence of external injuries among industrial workers in an industrial area and to identify the association between socio-demographic risk factors and external injuries among the industrial workers.Methods: This community based cross-sectional descriptive study was carried out in an urban area of Kancheepuram District. A sample size of 302 was calculated based on a previous study result and Probability Proportional to Size sampling was used to select the required number of workers from the four sites identified. A structured questionnaire was used for data collection. Data analyzed by using SPSS version 21. Descriptive and Analytical Statistical calculations were done.Results: This study shows that 44.3% workers were affected by some form of external injuries during their working time. Skin Injuries like abrasions and lacerations [43%], contusion [26%], cut injuries [16%], foreign body in the eyes [12%] and falling from a height [10%] were common. There was strong statistically significant association with the occurrence of external injuries in the work place with the habits of smoking and tobacco use, alcohol drinking and the nature of work among the study group.Conclusions: The study shows high prevalence of external injuries among the workers. They need to be properly trained in safety mechanisms and procedures to follow in work places and also wearing proper personal protective devises during the working hours to prevent such injuries.
Prevalence of depression and factors associated with it in geriatric population in rural area of Vadodara, Gujarat
Authors: Jadav Pranay , Patel Maharshi V.
Published: November 2017

Background: Geriatric depression is becoming a global public health problem causing considerable morbidity and disability. This problem is also increasing in India but still not sufficient work has been done on depression in many parts of India. This study aimed to find out prevalence of and factors associated with depression in elderly population in Vadodara, Gujarat.Methods: A community based cross sectional study was performed among 176 participants of more than 60 years of age. Simple random sampling was done to select talukas, villages and participants. Depression was screened by Geriatric Depression Scale-15 (GDS 15). Person with score more than 5 was considered as depressed. Descriptive and bivariate analysis was conducted with the help of SPSS version 11.5 for windows.Results: The overall prevalence of depression in old age was 34.1% but in female it was higher (64.7%) than male (14.81%). Bivariate analysis revealed that gender (OR=10.64, 95% CI: 5.093 – 21.82), p<0.001), lower education (OR=4.167, 95% CI: 1.991 – 8.719, p<0.001) and cognitive impairment (MMSE score) (OR=121.333, 95% CI: 37.384 – 393.79, p<0.001) were independently associated with depression.Conclusions: Gender, lower education and cognitive impairment are some of the factors associated with depression in older population.