Indian Journal of Community Health
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Female gender disadvantage and its impact on Psychological morbidity: A cross- sectional study among married Indian rural women of child bearing age
Get PDFBackground-Male preference is deeply entrenched in the society. Gender disadvantage predisposes to limited education, employment opportunities and healthcare. Aims and objectives: To assess the Gender disadvantage in rural married females and its impact on their psychological morbidity. Methodology: Analytical Cross sectional study was conducted in a randomly selected village of a rural health block. All the eligible women were interviewed using Door Knock Procedure. Psychological morbidity was assessed using 20 items Self Rating Questionnaire (SRQ-20). Statistical Analysis: Data was analysed using SPSS ver 20.0. Tests of significance applied were Chi square test and ANOVA. P value of <0.05 was considered to be statistically significant. Results: Prevalence of Female gender disadvantage was 59.89%. Parental male predisposition and socioeconomic status were found to be statistically associated (p<0.05). The women’s own preference for a male child was strongly predicted by their own gender disadvantage from the parents. Statistically significant difference in psychological morbidity was found amongst women who had both parental male predisposition and lack of empowerment in comparison to those who did not have these (p=0.00). Conclusion: Psychological morbidity due to gender disadvantage is a cause of concern. Social awareness and strongly enforced laws like PC-PNDT can reduce these preferences
A retrospective analytical study of treatment outcomes among multi drug resistant tuberculosis patients
Get PDFBackground: India is amongst one of the high multidrug resistant tuberculosis (MDR-TB) burden countries globally with a huge contribution given by the state of Uttar Pradesh. Programmatic Management of Drug Resistant Tuberculosis, initiated in 2007 has taken over the disorganized and unsupervised treatment practice in India. However, regular scrutiny is required which points out both its success and failure. Aim & Objective: This study was conducted to evaluate final treatment outcomes among MDR-TB patients on standard Category IV regimen Settings and Design: Retrospective analysis was done using secondary data from medical records of all patients. Methods and Material: Data of all MDR-TB patients registered under RNTCP at King George’s Medical University, Lucknow from 2013 to 2016 was collected. Demographic details along with pre-defined treatment outcomes were recorded (cured, treatment completed, death, treatment failure, treatment default and transfer to higher centre). Statistical analysis used: Descriptive statistics using numbers and percentage. Results: The records of 3580 MDR tuberculosis patients registered at drug resistant tuberculosis centre in King George’s Medical University from January 2013 to December 2016 were included which consisted of 67%males and 33%female. Mean age of presentation was 31.17 years (95% CI 30.75-31.59). Mean weight of patients was 40.16 kg (95% CI 39.89-40.43). Year wise distribution of registered cases from 2013 to 2016 was 611, 799, 984 and 1186 patients respectively. Amongst 3580 patients, 30.39% were declared cured, 25.50% completed treatment, 21.39% died, 0.84% showed treatment failure, 12.54% were defaulters, 2.35% were transferred out to higher centre, 6.5% were shifted to regimen for Extensive drug resistant (EDR) TB, 0.16% patients needed to stop treatment due to ADR and 0.33% patient were still on treatment. Conclusion: The treatment success rate of MDR?TB patients is still low. Measures to improve treatment adherence as in National tuberculosis elimination programme (NTEP) attempts to further improve the success rate
Mapping of pathways of care, assessment of delays and gap analysis in provision of care following road traffic injury among patients in selected tertiary hospitals in urban Karnataka, South India
Get PDFBackground: Evidence-based public health advocates decision making based on best available scientific evidence, hence it is important to gather evidence of current scenario of trauma care. Aim & Objective: To determine pathways of care and delays among Road Traffic Injury patients and assess gaps in resources. Settings and Design: This cross-sectional study was conducted in selected tertiary care hospitals in Mangaluru taluk, Karnataka. Methods and Material: Participants were administered validated proformas on prehospital and hospital care. WHO trauma care checklist was used for capacity assessment and gap analysis. Statistical analysis used: Time intervals are expressed as measures of central tendency and dispersion. Descriptive analysis is given as percentages and proportions. Results: Median pre-hospital time was 30 minutes. Overall, 67.5% of the patients reached within golden hour. Majority (64.1%) were directly transported to current hospital. All patients received first aid, but only 0.8% received it at the RTI site. First aid was mostly administered by doctors (68.7%) or nursing staff (31.1%) and none by bystander. Insurance coverage was 32.8% and 87.9% incurred out of pocket expenditures. Scores were low in GP level hospital. Conclusions: Although transport was within the golden hour, pre-hospital care was poor. Out of pocket expenditures were high
A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city
Get PDFBackground: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without
Assessment of relationship between Hemoglobin and BMI levels in female college students and influence of diet and physical activity on these parameters
Get PDFAnaemia and nutritional status through Body Mass Index (BMI) are two key indicators in National Family Health Survey of India. The objective of the study is to determine the correlation between Hemoglobin (Hb) and BMI values and to understand the effect of diet and physical activity on these two parameters amongst college girl students. A questionnaire covering food habits and physical activity of 200 female students (18-22 years age) was used for data analysis along with Hb and BMI values of the same subjects. No significant association was found between Hb and BMI values, but a significant association was found between physical activity and BMI. Diet consumption which included leafy and other vegetarian diet, eggs and meat has shown significant contribution for high Hb levels. The present study strongly provides evidence based conclusion for the relationship between diet, nutrition and Hb levels as well physical activity and BMI. A multiple regression model was developed to estimate Hb levels based on their food habits
The Impact of COVID-19 Pandemic on the Developing Nations: Emerging Mental Health Challenges and Interventions
Get PDFThe world is facing an unprecedented challenge of the 21st century in the form of COVID-19 outbreak. People across the culture, race, ethnicity, socio-economic background are being affected by the rippling effects of this pandemic. The aim of this narrative review is to briefly describe the impact of the pandemic on mental health, the vicious cycle of social issues and psychological health caused and aggravated by the Covid-19 pandemic. We also aim to highlight certain interventions to overcome the mental health challenges posed by the pandemic. For this purpose, a thorough search of all databases was done to gather articles relevant to the objective of this narrative review. Keywords were used in combination and separately to identify the articles on the various psychosocial issues caused by the pandemic. Published articles in various databases like Scopus, Web of Science, Pubmed etc., related to psychosocial effects due to COVID-19 were searched and summarized to justify and support the objective of this paper. The coming months will reveal the extent of damage this pandemic has caused to the socio-economic and health sectors across the globe. It is crucial to recognize the psychosocial impact of this pandemic and necessitate the measures to overcome them by mobilizing the resources we have at hand
Infoveillance of Mucormycosis in India: A Google™ Trends Based Study
Get PDFIndia reported highest incidence of Mucormycosis in the past and during the second wave of COVID-19. Google Trends is a potential tool for infoveillance of infectious disease like Mucormycosis. Relative Search Volume (RSV) for term Mucormycosis (+ Black fungus), diabetes, steroid, oxygen, D-dimer (+ferritin) had been extracted from Google Trends for three months (March to May 2021) and state-wise prevalence for Mucormycosis released by Ministry of Health and Family Welfare was used for the analysis. India reported highest RSV for Mucormycosis among the top five countries with COVID-19 cases. RSV peak for oxygen preceded the Mucormycosis spike. Correlation between state-wise prevalence of Mucormycosis and their corresponding RSV was not significant. While a positive correlation was observed between Mucormycosis, diabetes and steroid, it was not statistically significant. Infoveillance using Google trends can serve as a proxy marker for the public health needs and priorities much before actual field surveys
The genesis of the second wave and the probable way forward for India
Get PDFAn unprecedented pandemic affecting 210 countries emerged in the watershed year of 2020 and involved India as well (1). We mined the number of daily cases of three equal periods of importance during the evolution of the pandemic in India, namely 1) initial lockdown (March-April 2020), 2) early days of unlocking (June-July 2020), and 3) second wave (March April 2021). Notice the March 2020 series in [Figure 1] and country-wise cases in [Figure 2], and we can observe that India was able to sustain itself against the first wave of the SARS Coronavirus-2 in a much better way compared to other developed countries. Social lockdown and other preventive strategies paid off even in the face of criticisms regarding lack of preparedness and economic slowdown due to strict enforcement of harsh measures. Soon, there were demands of decentralized control measures with more testing and local containment measures than the centrally dictated regimen. Lockdown was suggested for only local clusters with high positivity rather than a general clampdown (2). The June-July series in [Figure 1] represents the increasing numbers of cases resulting from suspicions, fear-mongering, and resultant relaxation in social restrictions as part of the phase-wise unlocking across the country
Molecular markers of Chloroquine resistance in India and Southeast Asia: A narrative review
No full textMalaria is a major global public health problem mainly in the tropics and subtropics. Malaria control and elimination strategies mainly rely on efficacious antimalarial drugs. At present the major hurdle faced by malaria control programs is the drug resistance to antimalarials. Molecular surveillance using genetic markers associated with resistance provides a valuable tool for detecting and tracking resistance as well as providing an in-depth understanding of the development and spread of resistance. Despite numerous published literatures there are limited review articles on molecular markers of drug resistance. Hence a review was planned. An exhaustive literature search was performed on PUBMED using “malaria”, “resistance”, “molecular”, “antimalarial”, “Chloroquine”, “Pfcrt”, “Pfmdr”, “Pvcrt”, “Pvmdr”as key words. Data pertaining to India and Southeast Asia were included. This review showed the widespread presence of molecular markers of drug resistance in Plasmodium falciparum and development of resistance in Plasmodium vivax over the years in Southeast Asia and India. This can have implications on malaria elimination and treatment guidelines in this region
Depression and its Association with Housing conditions and Family among Pregnant Women of Rural Varanasi
Get PDFBackground: Depressive disorders were the second leading cause of years lost due to disability in 2010 after low back pain and leading cause of disability adjusted life years (WHO 2010). Gestational depression may lead to low birth weight, premature births etc. Housing and family are important aspects of one daily life which if are unsatisfactory can increase stress level of its members. Aims & Objectives: The aim of this study is to see the relationship of housing and family with depression among pregnant women. Material & Methods: This is a community based cross sectional study of 220 pregnant women in 10 randomly selected villages of Chiraigaon, Varanasi, Uttar Pradesh during one year period; using predesigned, pretested and semi structured interview schedule for assessing housing and family conditions. Results: Depression was found to be more in women living in kutcha house, nuclear family and illiterate husband, husband as head of family and belonging to lower socio-economic status. Increasing number of female child also increases depression. Conclusion: Housing structure, education of husband, socio-economic status and number of daughters should be assessed in every pregnant woman as these affect depressive state of pregnant women which can adversely affect the outcome of pregnancy