Bijaya Nanda Naik

Overweight and obesity among elderly in an urban slum of Puducherry: A facility-based descriptive study

Background: Overweight and obesity are important addendum to the pool of risk factors for noncommunicable disease (NCD) among the elderly. Objectives: The objectives of this study were to find (1) the proportion of overweight and obesity and (2) the distribution of overweight and obesity based on sociodemographic characteristics and four major risk factors for NCDs (smoking, alcohol consumption, unhealthy diet, and physical inactivity) among the elderly attending the out-patient department/NCD clinic of a Urban Health and Training Centre (UHTC). Materials and Methods: This facility-based descriptive study was conducted among 181 elderly attending one UHTC, in Puducherry during June and July 2015. A pretested interview schedule was used to obtain information on sociodemographic details and history of NCD risk factors after obtaining verbal informed consent. Anthropometric measurements were taken as per standard procedures prescribed by the World Health Organization. Body mass index (BMI) was calculated and classified using BMI classification for the Asian population. Results: Among the elderly, 18% were overweight and 51% were obese. The proportion of obesity was more among females than males. Obesity was found to be decreasing with increase in age. Overweight and obesity were found to be significantly inversely related to chronic disease status. Overweight and obesity were proportionately more among elderly who were consuming alcohol and doing less physical activity than prescribes. However, the proportion of overweight/obees elderly with no tobacco use and not having unhealthy diet was found to be more than their counterpart. Conclusion: Overweight and obesity are important public health problems in the study population. Hence, interventions should be implemented targeting elderly as well as the adult to decrease the obesity and overweight among the elderly.

Assessment of quality of life in children with nephrotic syndrome at a teaching hospital in South India

This study was conducted to assess the quality of life (QOL) in children between 2 and 18 years of age with primary idiopathic nephrotic syndrome (NS) using Pediatric Quality of Life Inventory (PedsQL 4.0 Generic Core Scales). This cross-sectional comparative study was conducted at a tertiary care hospital in South India between December 2014 and February 2015. In this questionnaire-based study, 50 children with primary idiopathic NS and an equal number of age-matched controls with other chronic ailments were recruited. Their clinical and demographic details were recorded, and QOL was assessed using PedsQL 4.0 Generic Core Scales. The median (interquartile range) total QOL score in children with NS [65 (59-68.75)] was found to be higher compared to controls [62.19 (58.05-65.78)] (P = 0.012). Children with NS had significantly higher QOL scores in physical (P = 0.004), emotional (0.029), and social functioning (0.010) domains as compared to controls; however, the school performance was not different from controls. The QOL scores did not significantly differ between the various clinical pheno- types of NS. Demographic details such as age, gender, duration of illness, and steroid resistance did not significantly influence the total QOL scores among the nephrotic children. The present study shows that the overall QOL in children with NS was better than in children with other chronic illnesses. Further studies are needed to confirm these findings and explore the underlying cause of poor school performance.

Level of tobacco dependence among tobacco users in an urban slum of Puducherry: A pilot study

Context: Successful tobacco quit by the tobacco users can avoid millions of premature death. However, the physical dependence on tobacco use results in frequent relapse most commonly due to withdrawal symptoms. Aims: The aim of this study was to study the level of tobacco dependence among tobacco users in an urban slum of Puducherry. Materials and Methods: This facility-based descriptive pilot study was conducted among patients aged 15 years or above attending an urban health and training center in an urban slum of Puducherry. A total of 90 consecutive current tobacco users were included after obtaining verbal informed consent and interviewed using a pretested questionnaire. The information on tobacco dependence was collected using Fagerstrom Addiction Scale for smokers and smokeless tobacco users separately. Results: Of the 90 current tobacco users, 95% were daily tobacco users. Of the current tobacco users, 48.8%, 45.6%, and 5.6% were smokers, smokeless tobacco users, and dual users, respectively. Majority of the smokers (61%) and most of the smokeless tobacco users (41%) had medium dependence for tobacco use. However, physical dependence was much higher among smokeless tobacco users (41.3%) than smokers (20.4%). Conclusion: Proportionately high physical dependence on tobacco is a concern in the study population. Community-based interventions are required to curb the problem; however, study with representative sample should be carried out before that.

Speed detection device in preventing road traffic accidents: A realistic approach in India!

Dear Editor, Globally, about 1.25 million people die because of road traffic crashes every year. Although low‐ and middle‐income countries have only half of the total vehicles, they contribute nearly 90% of all crashes in the world.[1] In India, according to the Ministry of Road Transport and Highways (MoRTH), there was an increase in the total number of accidents, persons injured, severity of injuries, and deaths in 2015 as compared to 2014. In 2015, there were nearly 5 lakh accidents, 5 lakh injuries, and 1.5 lakh deaths in India. In 2015, Indian cities with more than 1 million populations together accounted for 22.1% of total accidents in India. The road accident‐related deaths among the cities were reported to be 14.9/100 accidents and varied from 2.6 (Mumbai) to 66 (Amritsar).

Prevalence of Domestic Poisoning in a Rural Area of Tamil Nadu

OBJECTIVE To find out the prevalence of domestic poisoning in a rural village of Tamil Nadu. Material and Method A community based cross-sectional study was conducted during the month of October, 2015 in a rural village of Tamil Nadu. Sociodemographic information and details of domestic poisoning were obtained from a sample of alternately selected 398 households (housing 1251 individuals) using a semi structured questionnaire. Results The three months period prevalence of domestic poisoning was found to be 11.9 per 1000 persons. Majority (61.5%, 8/13) of domestic poisoning cases were due to scorpion sting. Others were inhalation of pesticides while spraying (2/13), consumption of poisonous seeds (2/13) and a case of snake bite. Except one case of scorpion sting which occurred while the victim was sleeping, rest all cases of scorpion sting had occurred during performing household works like gardening, cleaning, lifting a brick etc. Conclusion Awareness should be generated among community members focusing on prevention of domestic poisoning. Specific activities like health education on adopting preventive measures while handling pesticide will prevent unintentional poisoning due to pesticides. Awareness should be spread on availability of mental health services and same should be offered to the family having mental health issues. Language: en

Attack rate and household secondary attack rate of acute conjunctivitis during an outbreak in South India: A community-based survey

Introduction: Knowledge on epidemiology of the disease in the contemporary world will help to develop appropriate strategies to curtail the transmission during an outbreak. This study was carried out during an outbreak of conjunctivitis in selected areas of Puducherry, South India, to assess the attack rate of conjunctivitis, identify factors associated with developing conjunctivitis and calculate household secondary attack rate (HSAR) of conjunctivitis and its correlates. Methodology: During December 2014, a community-based survey was conducted in a selected urban and rural area in Puducherry, South India. Simple random sampling was used to select primary sampling units and systematic sampling to select households. All individuals in the selected households were studied. A questionnaire was used to obtain data on sociodemographic characteristics, conjunctivitis during September-November, 2014, and number of household contacts who developed conjunctivitis within 7 days of index case. The attack rate and HSAR of conjunctivitis was expressed as percentage. Multivariate logistic regression was used to find factors independently associated with developing conjunctivitis and also 100% HSAR. Results: Of 3193 study participants from 772 households, 509 (15.9%, 95% confidence interval 14.7-17.2%) had an attack of conjunctivitis during the reference period. Of the 772 households, 218 (28.2%) had at least one case of conjunctivitis. Of 218 households, 33 (15.1%) households had 100% HSAR. Lower age, not being unemployed, low socioeconomic status, and residing in rural area were independently associated with developing conjunctivitis. Index case being male and living in a household with ≥5 members were independently associated with 100% HSAR. Conclusion: In the outbreak under study, more than one-fourth of households had at least one case of conjunctivitis and about one in every six individuals had an attack of conjunctivitis.

Understanding the perceived reasons and practices related to gender preferences in an urban population of Puducherry: an exploratory study

Background: Declining child sex ratio in India even after enactment of PCPNDT Act is a major concern from public health point of view. Objectives: 1) To find out the perceived reasons and preference for the gender of the prospective child 2) to find out practices related to ultrasound (USG) scanning during pregnancy and abortion and 3) to find out the child sex ratio in the selected urban field practice areas of JIPMER, Pondicherry. Methods: A community-based explorative study was conducted during the months of June and July 2013. A pre-tested semi-structured questionnaire was used to collect information on the socio-demographic details, sex preference for the prospective child, and practices related to USG scanning during pregnancy and abortion among 270 households in the study area of urban Puducherry. One Focus Group Discussion (FGD) was organized to explore and understand the qualitative aspect of gender preference in the study area. Results: Among the respondents who had not completed their families (67), majority (60%, 40/67) didn’t have any gender preference. Out of the rest 27, 16 respondents (60%) preferred their prospective child to be male. The common reasons for male preference were 1 st child being female, dowry and other financial reasons. Majority (62%) of the USG during pregnancy were done in private set up. Nearly three fourth of the abortions took place either in private set up or at home. Nearly 37 % of respondents felt that proportion of females was less in their area as compared to males. Nearly 6% (16/270) of the respondents were aware of existence of practice of sex determination and female foeticide in their area. The child sex ratio was found to be 1012 per 1000 males. Conclusions: Male preference in the backdrop of higher proportion of practice of abortion in the private set up, along with participants’ awareness of existence of sex determination practices points towards plausible female foeticide. There is a need to generate stronger evidence to confirm these suspected links.