Gk Ingle

Integrated management of neonatal and childhood illness: An overview

Annually over 10 million children in low- and middle-income countries die before they reach their fifth birthday. Seven in ten under-five deaths in such countries are from illnesses such as diarrheal dehydration acute respiratory infections measles malaria and malnutrition. All these five conditions can either be treated or prevented Despite this more than 25000 under-five children die from these illnesses each day. Factors that contribute to illness are poor living conditions like lack of safe water supply poor hygiene overcrowding; inability of parents to recognize danger signs; and delay in seeking appropriate treatment. The problem is compounded by the poor quality of care provided at the health facilities. Projections based on 1996 analysis in the Global Burden of Disease indicate that these conditions will continue to make major contributions to childhood mortality through the year 2020 unless significant greater efforts are made to control them. (excerpt)

Medical students' perception on eye donation in Delhi

Corneal transplantation remains a major treatment option for restoring sight among those suffering from corneal blindness. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate numbers of corneas collected. Medical students can be involved in the motivation of patients and relatives to pledge their eyes and to do grief counseling for donating eyes. The aim of the study was to assess the perception and willingness of 180 first-year medical students towards eye donation in Delhi. They were administered a pretested semi-structured questionnaire on eye donation. Data were analyzed using Epi-Info software package 6.04 version. The majority (99.4%) of students knew that eyes can be donated after death but only 41.1% knew that the ideal time of donation was within six hours of death. Most participants (87.2%) were willing to donate eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.5% of students. Perceived reasons for not pledging eyes by the people were: lack of awareness (32.7%), objection by family members (27.7%), unsuitability to donate because of health problem (17.7%) and the unacceptable idea to separate the eye from the body (15.5%). Mass media such as television, newspapers, magazines and posters were important sources of information on eye donation. Perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community.

Awareness and Perception about Tuberculosis in the General Population of Delhi

The present study was conducted to assess awareness and perception regarding tuberculosis among the general population of Delhi. A total of 1,008 adults, selected by multistage stratified systematic sampling, were interviewed using a pre-tested proforma. The majority had heard about tuberculosis (99.1%) and most (89.2%) perceived it to be an infectious disease. The correct mode of transmission i.e. airborne (coughing / sneezing) was known to 71.8% study subjects. The majority (90.1%) knew cough as a symptom. Nearly all (98.2%) perceived Tuberculosis to be a preventable disease, citing the treatment of patients as the main-stay of preventing spread of the disease. However, responses like separation of utensils or hospitalisation of the patient to prevent the spread of the disease indicate persistence of stigma and discrimination in a small proportion of the population. There is a need to widen the scope and intensify the information and education being provided to the population based on gaps identified. Asia Pac J Public Health 2007; 19(2): 10-15.

Cardiovascular risk behavior among students of a Medical College in Delhi

Background: Life style related behavioural risk factors are mainly implicated for increased burden of cardio- vascular diseases. Research related to these risk behaviours especially among medical students is essential, considering their role as future physicians and role models in public health intervention programmes. Objective: To evaluate the burden of cardiovascular risk behaviours among students of a medical college of Delhi, India. Materials and Methods: A cross sectional study was carried out among undergraduate medical students of a medical college in Delhi. Self administered questionnaire was used to collect information on identification data and risk behaviours in relation to cardiovascular diseases. Binary logistic regression analysis was done to calculate adjusted odds ratio to assess association between risk behaviours and covariates. Results: The minimum recommendation of taking at least five servings per day of fruits and vegetables was complied only by 12% of students. Consumption of carbonated soft drinks either once or more on daily basis was present in 23.7% students and 32.0% reported frequent consumption of fast foods in past week. Consumption of alcohol was present in 28.8% students but only small proportion of students (7%) was current tobacco users. Large proportions of students (42.6%) were either not carrying out or were involved in only occasional physical activity in past week. Conclusions: Unhealthy behavioural practises are present and may progress as student advance through medical college. Developing strategies targeting at these risk behaviours and determining factors is necessary to promote healthy life style among medical students.

Low back pain and associated risk factors among undergraduate students of a medical college in Delhi

CONTEXT Low back pain (LBP) is the most common orthopedic problem worldwide and is known to affect both younger and older adults. The stressful and time consuming curriculum of medical students predisposes them to this problem. Few statistics are available on prevalence rates of LBP among medical students in India. This study assesses the prevalence and risk factors of LBP in students of a medical college in Delhi. METHODS A cross-sectional study was carried out in a medical college in Delhi. The study subjects (n = 160; 100% participation) were selected via stratified random sampling from all undergraduate medical students (aged 17-25 years). A validated questionnaire was used to collect the data. RESULTS The overall prevalence of LBP among the students over the past one year was 47.5% (n = 76) with a prevalence of 32.5% at the time of data collection. Prevalence among males and females was 45.3% and 50%, respectively. Significant associations were found between LBP in the past year and coffee drinking (Regular = 57%, Occasional = 38.9%, Never = 65.2%, χ2 = 7.24, P= 0.02), body posture (Normal = 32.6%, Abnormal = 75%, χ2 = 18.97, P < 0.001), place of study (Study table = 33.8%, Bed = 58.6, Both = 61.5% χ2 = 10.51, P = 0.01), family history of LBP (Present = 75%, Absent = 38.3%, χ2 = 16.17, P < 0.001) and carrying backpacks (Regular = 50%, Occasional = 33%, Never = 0%, χ2 = 16.17, P < 0.001). The mean scores of depression (2.7 vs. 1.6), anxiety (3.5 vs 1.9), and monotonous work (3.9 vs. 1.8) were found to be significantly higher in group with LBP than in the non-LBP group. However, no association with LBP was seen for weight lifting, watching television/working on computers, driving, wearing heels, or body mass index. DISCUSSION The high prevalence of LBP among medical students and its association with poor study habits, lifestyle habits, and psychological factors highlight a need for life skills training, education, counseling, and restructuring of the medical curriculum.

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.

Knowledge of general public and health professionals about tetanus immunization

Objective : To study the awareness among general public and health care providers about tetanus immunization in relation to injuries, and their knowledge about tetanus immunization schedules in children, pregnant females and adults.Methods : It was a cross-sectional study done at a perfect health mela and all the government allopathic health agencies in Delhi.Results : The knowledge of tetanus immunization was poor among general public as well as health care providers. A substantial proportion of them indicated tetanus injection after every injury, which was unwarranted. The knowledge of tetanus immunization schedule for adults was poor among all categories of respondents, though it was comparatively better for pregnant females, but only 75% of doctors and 51.1 % of nursing personnel correctly knew the immunization schedule against tetanus in children.Conclusion : There is a need to upgrade the level of knowledge among health care providers so as to ensure that schedules of tetanus are followed properly and unnecessary repeated immunizations are avoided and the same knowledge is passed on to the general public also.

Expenditure audit of women with breast cancer in a tertiary care hospital of Delhi.

BACKGROUND Breast cancer is associated with substantial medical and economic burden. This study assisted the expenditure incurred by the subjects on diagnosis and treatment till the period of follow-up. MATERIALS AND METHODS This is a prospective study; a case series of patients studied at the time of diagnosis and followed after 6 months. The study was conducted at one of Hospitals in India, from January 2006 to December 2007. One hundred and seventy-two women with new primary breast cancer were included in the study. During the study period 69 subjects were lost to follow-up. The comparative analysis was done for 103 subjects. Cost implications of breast cancer include direct medical costs and indirect costs. Questionnaire for the data collection was used. Descriptive statistics and correlation analysis were used. RESULTS The median total direct and indirect expenditure was Rs. 12,100 (US

Prevalence of Dog Bites in Rural and Urban Slums of Delhi: A Community-based Study.

1 = Rs 50) with the range of Rs. 0-54000. The largest component of total direct medical costs was in stage I (median Rs. 6530), total indirect costs (median Rs. 7500), and median total cost was Rs. 17,600. The total expenditures (median Rs. 13,100) were the highest in younger age group (<40). The median direct expenditure was higher in the subjects who visited private setup before coming to Hospital (Rs. 8250) than those who came directly (Rs. 4500). CONCLUSIONS Cost of treatment for breast cancer depends on many factors, including the stages of the cancer, the womans age, perhaps the costs of treatment, private hospital and insurance.