Indian Journal of Community Health
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Non-Alcoholic Fatty Liver Disease and other Non-Communicable Diseases: Time for an Integrated Approach
Get PDFNon-Alcoholic fatty liver disease (NAFLD) is a broad term covering a spectrum of conditions ranging from hepatic steatosis, steatohepatitis and cirrhosis. NAFLD is highly prevalent across all regions of the world with its global prevalence of 25.2%(95%CI:22.1-28.7). It is commonly referred as the ‘hepatic manifestation’ of metabolic syndrome (MetS). Moreover, it is strongly associated with the individual components as well as MetS as a whole. NAFLD has been independently associated with other non-communicable diseases (NCDs) like chronic kidney disease (CKD), Polycystic ovary Syndrome (PCOS), Stroke and Cancers. This strong association of NCDs with NAFLD not only affects the prevalence but also the progression and management of the disease. Thus, this review aims at highlighting the association of NAFLD with other NCDs. A literature search was undertaken in the MEDLINE database using the necessary MeSH terms. The review concludes NAFLD is a systemic disease, not just confined to liver-specific morbidity and mortality, but also associated with numerous extra-hepatic manifestations, such as metabolic syndrome, cardiovascular diseases, chronic renal diseases, and malignancy. With co-existence of NAFLD with various NCDs it is expected to become the most overwhelming liver disease in the world in coming years. Hence, to reduce medical and economic impact associated with these comorbidities, it is recommended that all countries should estimate and predict the burden on comorbidities associated with NAFLD and galvanize its health resources in providing integrated therapeutic approaches for management of NAFLD and related comorbidities at an early stage
An assessment and correlation of emotional Intelligence and mental health of medical students
Get PDFIntroduction: Emotions like joy, anger, grief, jealousy, love, fear make our life worthwhile. Whatever we do, incites some emotion in us. If we are able to enjoy our emotions, without them having excessive control over us, then we can make ours as well as others’ lives better. Aim of the study was to assess and correlate emotional Intelligence with mental health. Methods: Type of study: Descriptive type of cross sectional study. Sampling: Simple random sampling. Study population: Under graduate students in a private medical college in western Uttar Pradesh. Study duration: 1/07/2019 to 1/09/2019. Sample size: 246. Results: The average emotional intelligence score was 26.82 with standard deviation of ±5.80. Average emotional intelligence among males was 27.04(±6.72) and was 26.63(±5.07) among females. Spearman Rank correlation coefficient “r” =0.789, showed highly positive correlation between ranks from both the score. (p=0.0000). Conclusions: The medical students showing higher scores of emotional intelligence are less likely to be mentally stressed
Impact of Supplementary Nutrition on Undernourished Children In An Urban Area Of Meerut- A Longitudinal Study
Get PDFBackground: Infants and pre-school are most susceptible to undernutrition. Integrated Child Development Services is the programme focussing undernourished children by providing them supplementary nutrition. Aim& Objective: To study prevalence of undernutrition in 0-6 year old children and to study factors associated with it. To study impact of supplementary nutrition on undernourished children. Settings and Design: A longitudinal study. Methods and Material: The present longitudinal study was conducted in randomly selected Anganwadis of urban Meerut. Children found to be suffering from under nutrition were followed up at interval of six months to see the impact of supplementary nutrition provided to them at the anganwadi centre. A detailed history of relevant underlying factors responsible for causation of under nutrition were taken from mothers of these children. Statistical analysis used: chi square test was used to find out association between risk factors and undernutrition. Risk factor found statistically significant were further analysed using step wise multiple logistic regression analysis. The impact of supplementary nutrition was assessed using paired t test. Results: Iron folic acid supplementation during pregnancy, exclusive breast feeding in children, immunization and time of initiating complementary feed were found statistically significant on both chi-square and multiple logistic regression analysis. No impact of supplementary nutrition was found on anthropometric measurements of children. Conclusions: The main focus for fighting undernutrition in children (0-6 years) should be on preventing risk factors associated with mothers in antenatal period and during child rearing practice
A study to Assess Anxiety, Stress and Depression among MBBS interns working in Covid care Isolation facility of a tertiary level Hospital: An Observational study
Get PDFIntroduction: The Emergence of new Delta strain of Corona virus has created havoc with all health care systems across the globe, there has been tremendous pressure due to shortage of health care workers forcing government to involve MBBS interns to overcome the shortage of health staff in Covid care. Aims & Objectives: To assess magnitude of anxiety, stress and depression among MBBS interns working in Covid Isolation facility of Government Medical College, Patiala. Material and methods: The Google form was created and the link to the online questionnaire was circulated through whatsapp group to the MBBS Interns working in Covid isolation facility during June to July 2021. The form included two instruments the Perceived Stress Scale-4 (PSS-4) and the Patient Health Questionnaire for Depression and Anxiety-4 (PHQ-4). Results: A total of 144 interns participated in the survey .Patient Health Questionnaires and Perceived Stress Scale-4 (PSS-4 ) scores of interns were 56% and 49% respectively. Anxiety and depression symptoms requiring further evaluation were seen in 19% of the Interns. Univariate analysis of PHQ-4 and PSS-4 shows statistically significant association with past history of psychiatric ailment .Conclusion: Careful monitoring of psychological and mental wellbeing of interns during the pandemic will go a long way in mitigating the worsening psychological wellbeing of budding doctors and interns
Evaluation of Mass Drug Administration to Eliminate Lymphatic Filariasis in Surguja and Surajpur District, Chhattisgarh
Get PDFBackground: Mass Drug Administration of a single dose of DEC was launched on June 5, 2004 by the Government of India. MDA coverage increased gradually from 72.42% in 2004 to 88.96% in 2014. However, compliance has remained relatively low in most of the endemic areas as in 9 endemic Districts in State of Chhattisgarh. In Chhattisgarh State, Lymphatic Filariasis affected 14,818 people in the year 2011 and 13921 in the year 2013 with demonstrated manifestation. Objectives: To assess the coverage and compliance along with factors affecting compliance regarding MDA implementation in Surguja and Surajpur District of Chhattisgarh. Methods: A cross-sectional descriptive study was conducted from July-September 2021 in two district of Chhattisgarh. The division of segments and selection of the households was done based on the WHO criteria of coverage evaluation survey field guide in which from 30 villages, 450 households were covered. Result: The overall coverage rate was 95.55% in Surguja and 89.16% in Surajpur District. The overall compliance was 89.3% with Coverage-Compliance gap of 4.12. The Effective Coverage Rate was 89.3% in 2243 eligible population of Surguja and Surajpur District. Coverage and Compliance was found more in females as compared to males but was found to be statistically not significant. Coverage and Compliance was found more in Surguja district as compared to Surajpur district. Conclusion: Training programme for drug distributors should emphasize more on how to address the fear of side effects among beneficiaries and other reasons of low compliance for the benefit of the MDA programme
Indian Diabetes Risk Score (IDRS) as a strong predictor of diabetes mellitus: A cross sectional study among urban population of Jhalawar, Rajasthan
Get PDFIntroduction: The patients with Type 2 diabetes Mellitus may often remain asymptomatic for a longer period of time. The Indian Diabetes Risk Score (IDRS), a simple screening tool for prediction of undiagnosed diabetes. Objective: Validation of IDRS with standard test for type 2 diabetes among urban population of Jhalawar, Rajasthan. Material and Methods: A Community based Cross-sectional study was carried out in urban field practice area of Department of Community Medicine, Jhalawar Medical College, Jhalawar, Rajasthan. The study was conducted using a two-stage sampling design. A predesigned, pretested proforma and Indian Diabetes Risk Score (IDRS) sheet was used to collect data from the study participants. The IDRS is based on four parameters: age, family history of diabetes, waist circumference and physical inactivity. Data was collected using the World Health Organization stepwise approach to surveillance (STEPS). Results: Among 450 participants, 12.7% participants were in low risk, 59.1% were in moderate risk and 28.2% were in high risk of developing diabetes according to IDRS score. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes with sensitivity 92.3% and specificity 82.6%. Positive Predictive value and Negative Predictive value were 47.3% and 98.5% respectively. Conclusion: Association of IDRS was found significant with diabetes. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes. IDRS is found valid screening tool for early detection of Diabetes
Impact of Training on Awareness of COVID-19 among The Health Care Workers in A Tertiary Care Hospital of Dehradun
Get PDFBackground: Novel Corona virus infection (Covid-19) was declared global pandemic by WHO infecting more than 118,000 cases in 114 countries and the number of deaths counting to 4291. WHO recommends the only strategy to limit the spread of Corona virus is only by prevention itself. Aim and Objective: To assess the awareness among Health Care Workers on covid-19 infection. To compare the level of knowledge among the study participants and To assess the impact of training about the knowledge on covid-19 control. Material and methods: The study was conducted by the Research team of Community Medicine Department, SGRRIM&HS, Dehradun between 1st October to 31st December 2020. Self-administered, pre-tested questionnaire was used to assess the knowledge and awareness among health care workers. Data collected and analysed using SPSS software for different parameters. Result: A total of 421 health care workers participated in the present study. Majority of the study participants were female with 346 (82.2%) while 75 (17.8%) of them were male. Independent t-test was used to compare pre and post test values with Socio-demographic profile, designation, and work place of the respondents. Conclusion: Improvement in the knowledge and awareness among health care workers was observed post training
Determinants of Health-Related Quality of Life among Post-Partum Women Residing in a Resettlement Colony of East Delhi.
Get PDFAbstract: The postpartum period marks a transition phase in the life of the mother as well as the whole family. Health Related Quality of Life (HRQoL) is an important aspect for not only mother’s physical and psychological health. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a sample size of 330 post-partum women and the data was collected in the 6th week of post-partum period using the MOS SF-36 (Medical Outcomes Study Short Form 36 Health Survey) for health related quality of life. Among the study subjects, 34.2% had the birth order two and they showed the best mean HRQoL score. The mean score was low for the study subjects with complications in the antepartum, intrapartum and postpartum period (52.9 ± 18.4) as well as in foetal complications where the intrapartum period complications had the worst mean HRQoL score. Healthcare workers of the study area visited 91.5% of the subjects during the post-partum period and had better HRQoL mean score. Also, 22.4% subjects had history of mistreatment and abuse with decline in the mean HRQoL scores. Across the study subjects, 54.4% had financial hardships faced by their family members which had poor HRQoL mean scores. This study uncovered various horizons of health related quality of life for assessment of women in the post-partum period which emphasised the modifications and considerations to include quality as one of the determinant and indicator of health
Impact of Celebrity Suicides on mental health of vulnerable population
Get PDFSuicide is culminating into a grave public health concern. Approximately 800,000 people worldwide commit suicide annually, with 3/4th owing to low- middle-income countries.(1) In 2016, the suicide rate in India was 16.5, exceeding the global average of 10.5/1,00,000.(1) Suicide is the deliberate ending of one\u27s own life(2) and primarily done due to persistent sense of despair, depression, drug misuse, and various personal and financial stress factors. One such trigger is suicide by an eminent figure, also known as werthering effect, modelling effect, or copycat suicide. This phenomenon commonly affects the adolescent and younger adults. In India, the 15-29 age group were found most vulnerable.(1) Nearly 5% of consecutive suicides occur after a celebrity death primarily among young, female, and unemployed without being prompted by adverse life circumstances.(3) Given the global gravity of suicide and India\u27s contribution to it, it is critical to identify the psychopathology and risk factors behind it
Predictors of Practice of breast self-examination among women in District Ambala (Haryana)
Get PDFBackground: Breast cancer is the most common cancer among women and its early detection is critical to improve survival. Breast self-examination is a cheap, basic and non-intellectual method to detect breast cancer. Aims and objectives: 1To determine the knowledge, attitude and practices regarding breast self-examination2. To explain the various factors which affect the practice of BSE Material and Methods: The present study was carried out among 300 women residing in rural and urban areas of district Ambala using a self-designed pretested semi-structured questionnaire. Results: In this study 127 (42.3%) of the participants had heard of BSE and 107 (35.7%) of the participants knew how to perform BSE. Overall, 47.7%, 30.3%, and 22% of the study participants had poor (<50%), medium (50–75%), and good knowledge (>75) on BSE, respectively. Educational qualification, knowing the three positions to perform BSE, knowing how often should BSE be done, taught how to do BSE, BSE is a useful tool to detect breast cancer were seen to be significantly associated with practice of BSE. Conclusion: This study elucidates that the knowledge as well as practice of BSE was significantly low in the population. This study provides insights into the various factors which affect the practice of BSE