Jitesh P Mehta

Various factors related to development of category I tuberculosis and its relationship with outcome in urban area of Jamnagar

Background: India has highest number of tuberculosis (TB) cases in terms of absolute number of cases that occur each year. TB is a social disease and described barometer of social welfare.[1] Every year one-fourth of the global incident TB cases occur in India. Objective: This study is done to know various social and demographic factors and its impact on treatment outcome of Category I TB patients in an urban area of Jamnagar. Materials and Methods: A longitudinal study was carried out enrolling all Category I TB patients under directly observed treatment, short-course treatment during the period from July 2014 to December 2014 (2-quarter), in the urban area of Jamnagar. After necessary exclusion total 199 patients were visited personally, interviewed and followed up to completion of treatment. At the end of completion of treatment, final outcome was noted. Results: Out of total 199 patients, the patients between 16 and 45 years age group were 59.30%, male was 69.35%, literates was 78.39%, and laborers were 36.18%; overall treatment success was 81.91%. Among total 118 new sputum positive patients, success rate was 78.81%. And relationship between type of TB and treatment outcome was found statistically significant (P = 0.008). Among total 68 patients in age group of more than 45 years success rate was 72.06%. And relationship between age and treatment outcome was found statistically significant (P = 0.016). Patients belong to lower class (Class IV and V) were 48.24% and relationship between social class and treatment outcome was found statistically significant (P = 0.008). Out of 72 (36.18%) laborer patients, successful treatment outcome was found in 69.44% of patients. Relationship between occupation and treatment outcome was found statistically significant (P = 0.008). Relationship with overcrowding and ve ntilation condition with successful treatment outcome was also found statistically significant (P = 0.01 and P = 0.02, respectively). Conclusions: The findings of this study suggest that mostly affected people were lower socioeconomic class, with higher unsuccessful treatment outcome. Variable such as occupation, overcrowding, and poor ventilation also associated with unsuccessful treatment outcome. Improvement in quality of life is necessary for better outcome. Future program or research should focus on improvement of quality of life by addressing such social and demographic issues for better outcome.

A study on transfusion transmitted infections (TTIs), transfusion-related complications, and quality of life among the beta-thalassemia major patients in Jamnagar district -

Background: Thalassemia is considered the most common genetic disorder worldwide. The condition affects economical and psychosocial quality of life of whole family broadly. It is a serious public health issue throughout Indian subcontinent and southeast Asia. Objective: (1) To study the prevalence of transfusion transmitted infections (TTIs) in patients of beta-thalassemia major who are on transfusion therapy, (2) to assess the complications of iron overload and complications owing to chelation therapy, and (3) to study psychosocial and economic burden on patients’ family. Materials and Methods: This cross-sectional study was conducted in Thalassemia ward of Pediatric Department from December 2010 to December 2011. All the patients of beta thalassemia major on blood transfusion therapy were included in the study. Preformed, pretested questionnaire was used to interview the patients and their caretakers. Data entry and analysis were done using Microsoft Excel 2007 and SPSS software, version 17. Result: Prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) was 3.95%, 2.25%, and 2.25%, respectively. Six in every 10 patients ever have experienced from blood transfusion reactions. Almost 40% patients had left the studies owing to illness or they have not gone to school ever. Conclusion: Even after introduction of sensitive screening test, prevalence of TTIs is more in patients than general population. Quality of life is affected economically and psychosocially.

Assessment of utilization of child health services (under RCH program) and incorrect practices related to perinatal events in Jamnagar district, Gujarat, India -

Background: India contributes to 25% of the over 6.9 million under-five deaths occurring worldwide every year with nearly half of them in neonatal period .This study is related indirectly with the causes of U5MR (e.g. Neonatal sepsis, prematurity-LBW) through focusing on service utilization related to perinatal events & incorrect practices of essential Newborn care (e.g. initiation of breast feeding and exclusive breastfeeding). Objectives: (1) Assess utilization of child health services related to perinatal events (2) Assess incorrect practices related to perinatal events (3) Assess effect of demographic variables on service utilization and association of these variables with practices. Methods: A cross-sectional study of 400 children (12 to 59 months) was done using multistage sampling technique in Jamnagar district. 120 children were selected from urban and 280 from rural areas as urban: rural ratio is 3:7 in India. Results: 93.55% children having umbilical infection. Birth weights were taken in majority of children (95.75%), 15.83% of those weighed were having low birth weight (LBW). Application on umbilical cord after birth was seen in 10.25% & prelacteal feed in about 1/3 rd children. Breastfeeding immediately or within 4 hours after birth was seen in 3/4 th , exclusive breastfeeding in 2/3 rd children. Conclusions: Children having umbilical infection were treated indicating better utilization of curative services. Taking of birth weights in majority of children indicating good functioning of healthcare professionals but some of those weighed were having low birth weight (LBW) indicating underutilization of preventive-antenatal services indirectly affecting child health. Incorrect practices like application on umbilical cord after birth and prelacteal feed were seen in children. Recommended practices like breastfeeding immediately or within 4 hours after birth, exclusive breastfeeding were seen in children. Colostrum giving was more prevalent and low birth weight was less prevalent in rural areas compared to urban areas which indicated better health care utilization in rural areas.

A Study on Breastfeeding and Weaning practices by Mothers enrolled in Anganwadi centres in Urban Settings of Jamnagar

Breast feeding and weaning practices have significant effects on both mother and children. It improves the nutritional status of children and thus reduces both morbidity and mortality. This study was carried out to as- sess the existing breast feeding and weaning practices of mothers having children between the age of 6-24 months. Aim was to assess breastfeeding and weaning practices by mothers and to study the influences of various socio-demographic factors on these practices. Total 250 mother-baby pairs were studied from seven anganwadi during October 2012 to December 2012. A total of 201(80.4%) were initiated breastfeeding to their child within 1 hour after delivery, 37(14.8%) women giving prelacteal feed, practices of exclusive breastfeeding seen in 165(66%) women, 131(52.4%) women started weaning timely, at the age of 6 months of child.