Gajendra Singh Meena

Knowledge, attitude, and level of physical activity among medical undergraduate students in Delhi.

INTRODUCTION Physical inactivity has been implicated as a major risk factor for cardiovascular diseases. The healthy lifestyle of medical students could facilitate the formation of healthy physicians who is more likely to give effective preventive counseling to their patients. Therefore, this study was undertaken to assess the knowledge, attitude, and pattern of the physical activity among the medical students. MATERIALS AND METHODS A cross-sectional study was conducted amongst 161 eligible sixth semester medical undergraduate students. A pretested questionnaire was used to collect the data. Anthropometric measurements were also taken. The data were fed and coded in Microsoft Excel 2007 and analyzed using SPSS 17.0 and Epi Info software of World Health Organization. RESULTS Knowledge regarding different types of exercise and anthropometric variables was fairly low among the study participants. Only 9.3% of the students were aware of the recommended level of the physical activity but nearly all (96.27%) were aware of the benefits of it. The attitude of the participants toward the physical activity was favorable, yet only one-third (32.3%) subjects adhered to recommended guidelines. Boys (39.8%) were found to be significantly more active than girls (20.6%) (P = 0.01). CONCLUSION The knowledge and practices regarding the physical activity was found to be low amongst the medical students. There is a need to provide an enabling environment for promoting the physical activity amongst them so that can inculcate the same in their patients.

Knowledge and Use of Personal Protective Measures Against Mosquito Borne Diseases in a Resettlement Colony of Delhi

Background: Mosquito borne diseases (MBDs) are major public health problem in India. State of Delhi is endemic for dengue and other MBDs. The increasing incidence of MBDs in Delhi in recent years warrants a pro-active approach for their prevention. Knowledge and use of personal protective measures (PPMs) presents an effective strategy for prevention and control of MBDs. Aim: The present study was conducted to assess the knowledge and use of PPMs against MBDs in an urban resettlement colony of Delhi. Subjects and Methods: It was a cross-sectional study carried out in a resettlement colony of Delhi. A total of 100 families were selected by systematic random sampling. Data was collected using semi-structured questionnaire and supplemented by spot survey by the investigator in the community. The results were analyzed in SPSS version 16.0 (Chicago Illinios, USA). Results: Out of the 100 respondents, 65% (65/100), 58%(58/100) and 13% (13/100) had heard about dengue, malaria and chikungunya, respectively. Nearly, one-fifth (20/100; 20%) of the participants reported incorrect breeding sites for mosquitoes. The knowledge regarding PPMs was very high (93/100; 93%) and about (90/100; 90%) families were actually using at least one of the PPMs. However, very few families were using them correctly (1/90; 1.1%) and adequately (5/90; 5.6%). The most common PPM being used by the study population was liquid vaporizers (54/90; 60%). Nearly one-third (29/90; 32.2%) of the participants reported side-effects due to PPMs with irritation to smell being the most common reported side-effect. On house visit, adult mosquitoes were seen in 67% (67/100) of the houses, while potential mosquito breeding sites were found in and around 56% (56/100) houses. Conclusions: There were crucial gaps in knowledge and practices of participants with regard to prevention and control of MBDs. Thus, there is a need to intensify efforts toward creating public knowledge and mobilizing community about correct use of preventive measures against MBDs.

Screening for abuse and mental health problems among illiterate runaway adolescents in an Indian metropolis

Objective To evaluate the prevalence of physical and sexual abuse, and their relation to mental health problems among the illiterate/semiliterate runaway adolescents in New Delhi, India. Design Cross sectional. Setting New Delhi, India. Patients Runaway adolescent boys (n=119) aged 11 to 18 years at an observation home. Methods Study subjects were screened for physical and sexual abuse using the Child Maltreatment History Self Report and Finkelhors sexual abuse scale. Mental health problems were identified using the Achenbachs Youth Self-Report scale. As the participants were illiterate or semiliterate with Hindi being their primary language, the screening tools were appropriately translated, read out to them and their responses recorded. Results A total of 72 (62%) boys experienced domestic violence, 70 (59%) had engaged in substance abuse and 103 (87%) boys had been employed as child labourers. Physical abuse was reported by 86 (72%) and sexual abuse by 42 (35%). Mental health problems were recognised in 83 (70%) boys, which included internalising syndromes (59%) and externalising syndromes (34%). Multivariate analysis demonstrated that physical abuse was an independent predictor of internalising syndromes (OR: 3.3; 95% CI 1.2 to 9.1; p<0.01), while substance abuse and sexual abuse were independent predictors of externalising syndromes. Conclusions Our study demonstrates that childhood abuse and mental health disorders are widely prevalent among the runaway adolescents evaluated at an observation home in New Delhi. Appropriate modification of the standardised self-report screening tools may allow the identification of mental health disorders in this vulnerable illiterate/semiliterate population.

Effect of Life Skills Training on Dietary Behavior of School Adolescents in Delhi A Nonrandomized Interventional Study

Skill-based education has been shown to reduce high-risk behavior among adolescents, but in India, life skills have often been looked at only from the reproductive health perspective. Therefore, the current study was undertaken to assess the effect of life skills training on dietary behavior of adolescents studying in grades 9 and 11 of 2 schools in Delhi. This was a nonrandomized interventional study with a control group. A self-administered questionnaire was used for assessment of dietary behavior at baseline, 15 days, and 3 months after the life skills training. Two life skills training sessions were imparted to the intervention group, focusing on the use of life skills in making healthy choices. Participants in the intervention group (n = 180) showed significant improvement in knowledge (P < .001), attitude (P = .007), and practices (P < .001) following the life skills training. To conclude, a skills-based approach does help improve the dietary behavior in adolescents.

Demand and Supply Side Factors Affecting Utilization of ImmunizationServices in an Urban Village Of Delhi

Even after introducing the Universal Immunization Program (UIP) three decades ago, India is still far from achieving the target 4 of Millennium Development Goals. The target is to reduce the under-five mortality by twothirds by 2015 end but India still hasn’t achieved that. Undoubtedly, raising the immunization coverage will contribute towards bringing down the mortality rate of children. This short commentary tries to throw light on the various demand and supply side factors that play a role in determining the immunization. The factors influencing immunization are education level of parents, socio-economic status, family structure, family size, immunization card, migrant population, healthcare delivery service quality, institutional deliveries, tetanus immunization of expectant mothers, contraception use, supply of vaccines and motivation of healthcare personals providing vaccination services.

Usage and Perceived Side Effects of Personal Protective Measures against Mosquitoes among Current Users in Delhi

Background. Mosquito-borne diseases constitute an important cause of morbidity and mortality. The use of personal protective measures (PPM) like mats, bednets, screening, repellents, liquid vaporizers, mosquito coils, and so forth has been advocated as an effective tool in control of mosquito-borne diseases, but data about the safety profile of personal protective measures is still scarce. Objective. To study the usage and side effects of personal protective measures against mosquitoes among current users in Delhi. Materials and Methods. A community-based cross-sectional study among 350 adult individuals selected by systematic sampling method. Data was collected using pretested semistructured questionnaire after taking written informed consent. Data was analysed using SPSS version 17. Chi-square/Fishers Exact test was used for qualitative variables to find association and P value <0.05 was considered significant. Results. Out of 350 families selected, 210 belonged to rural area and 140 to urban area. Personal protective measures were used by 219 (62.5%) subjects. Liquid vaporizer was the most preferred method (41.4%). Most common perceived side effect of personal protective measures was headache (7.7%). Other perceived side effects were cough (3.2%), sore throat (2.7%), allergy (1.3%), and eye irritation (0.9%) predominantly among coil users. Conclusion. There is a need to have a close watch for side effects of personal protective measures among users. Further research is also needed to develop safe and effective personal protective measures against mosquitoes.

Effect of life skills training on physical activity patterns amongst school adolescents in Delhi: a non-randomized interventional study.

Abstract Background: Effect of life skills on physical activity behavior of adolescents is little explored. Objective: To assess impact of life-skills training on the level of physical activity amongst adolescents. Methods: A nonrandomized interventional study with a control group. All students studying in Class IX and XI of two schools in Delhi were included. Data was collected at baseline, 15 days and 3 months after the life-skills training. Two life-skills training sessions were conducted for each standard following collection of baseline data. Results: There were 180 students in the intervention and 183 students in the control group. A significant increase was noted in the level of light-moderate, vigorous physical activity, and stretching and strengthening exercises (p<0.001) in an intervention group over the period of 3 months following the training. The number of students enrolled in physical education classes also increased. Conclusions: A skills-based approach helped to improve the level of physical activity amongst the school adolescents.

Study of coverage and determinants of vaccination in children aged 1 to 3 years in a rural population of Delhi

Introduction & Aim: Late preterm infants are defined as those born at 34-0/7 to 36-6/7 week’s gestational age. There is accumulation evidence of higher risks for health complications in these infants including serious morbidity and three fold higher mortality rate compared with term infants due to immaturity. Main causes of morbidity in newborn period are hyperbilirubinemia, poor feeding and infection. Hapatitis B vaccine induces high rate of immunization in infants but there are no study in late preterm infants. Therefore we conducted this study to evaluate the status of antibody formation for Hapatitis B in Korean late preterm infants. Methods: Late preterm infants admitted to Kyungpook National University Children’s Hospital were included. They were immunized with 0, 1 and 6 mo schedule with Hepatis B vaccine (Euvax B inj, LG Life Sciences, Korea). Blood were obtained at 9 corrected months to evaluate antibody titer for hepatitis B. Infant of HBs antigen positive mother was excluded. Results: Total of 178 infants (85 male and 93 female) were evaluated. Their birth weight was 2181.7+367.2 g. At 9 corrected months, all of them cached their weight, height and head circumferences (>10 percentile). 25 infant (14.0%) showed low anti-HBs antibody titer (<10 IU/L). In infant who had <10 IU/L anti-HBs antibody titer, mean was 698.2+237.1. Infants with low titer showed more antibiotics usage and maternal chorioamnionitis (P<0.05), lower 25-hydroxyvitamin D level at birth (P<0.01), higher ferritin level at birth and 9 corrected month (P<0.05). Conclusion: Late preterm infant showed poor immune response to regular hepatitis B immunization schedule, especially in the infants with maternal chorioamnionitis, antibiotics used low vitamin D and ferritin level.

Human Papilloma Virus Vaccine in Indian Settings: Need of the Hour

Cervical cancer is a major public health challenge accounting for a fifth of the global incidence and mortality. India has a population of 432.20 million women aged 15 years and above who are at risk of developing cervical cancer. The factors leading to high prevalence of cervical cancer in India are many. The high mortality due to the disease is mainly due to lack of awareness and absence of organized screening programs. India needs to take a leaf out of the book of 58 countries that have included Human Papilloma Virus (HPV) vaccine in their national immunization schedule so that the prevalence of this cancer can be brought down. Simultaneously, a need of organized screening programs throughout the country cannot be ignored.

PS 15-10 HYPERTENSION AND ITS CORRELATES AMONG POLICE PERSONNEL IN NATIONAL CAPITAL REGION (NCR), INDIA

Objective: To study the burden of hypertension and associated risk factors among police personnel in National Capital Region (NCR), India. Design and Method: A cross-sectional study was conducted among a random sample of 300 police personnel working at 15 police stations across the national capital region (NCR), India. A pre-tested (a = 0.638) questionnaire was applied to assess: morbidity profile, dietary habits, physical activity, salt intake, tobacco & alcohol intake, mental stress and obstructive sleep apnea (OSA) etc among the participants. Study questionnaire adopted various validated tools viz. WHO Steps instrument v.2.1, Goldbergs general health questionnaire and Berlin sleep apnea scale. New recruits (less than 5-year job), clerical and gazetted police staffs were excluded. Anthropometric and clinical examination conducted based on WHO NCD surveillance guide and hypertension classified according to JNC 7 criteria. Data were analyzed using Chi-squared and students T test along with variation and correlation analysis by SPSS-17 software. Results: The prevalence of hypertension was 92 (30.66 %) including 20 (6.66%) pre-diagnosed cases. Among new cases majority 58 (80.5%) were stage 1 hypertensives and of the total participants, nearly half 138 (46.0%) were found to be pre-hypertensives. Hypertensive status was significantly associated with male gender, age (> 40 yrs), job (> 25 yrs), overweight & obesity, tobacco & alcohol intake and high-risk OSA. Both systolic & diastolic BP were significantly higher among male gender and higher rank and was positively correlated with weight and waist circumference of the participants. Participants with high rank, poor education, morbidity, mental stress and inadequate physical activity and fruit & vegetable intake had a higher burden of hypertension. Conclusions: The present study suggests a very high burden of hypertension and risk factors among policemen reflecting poor lifestyle and job control. Measures should be implemented to halt cardiovascular disease progression preventing both physical and economic strain.