Mongjam Meghachandra Singh

Risk factors with breast cancer among women in Delhi.

BACKGROUND The incidence of breast cancer is on the rise in India, breast cancer is the second most common malignancy in Indian women. AIM The aim of this study was to find out the association of various risk factors with breast cancer among women in Delhi. SETTINGS AND DESIGN This was a case-control study in Lok Nayak Hospital, Delhi. METHODS AND MATERIAL 332 women were studied. Subjects were women with breast cancer (N = 115) and age matched Control subjects (N-217) without breast cancer, attending Lok Nayak Hospital during 2006. Subjects were interviewed using a pretested questionnaire. The risk factors studied were: age, parity, socioeconomic status, marital status, breast feeding, menarche, menopause, family history. STATISTICAL ANALYSIS Data was expressed in proportion. RESULTS AND CONCLUSIONS Age of the patient ranged from 25 to 80 years. In this study, 69 (60%) cases and 127 (58.5%) controls were illiterate, the mean duration sum of total breast feeding for all children was 6.58 years in cases and 7.4 years in controls (OR = 1.91; 95% CI, 1.17 - 3.13) (P P P< 0.05). There was a significant difference between breast cancer cases and controls in relation to place of residence, occupation, marital status, body mass index and breast feeding.

Maternal health-care utilization among women in an urban slum in Delhi

Maternal mortality and morbidity continue to be high despite the existence of national programs for improving maternal and child health in India. This could be related to several factors an important one being non-utilization or under-utilization of maternal health-care services especially amongst the rural poor and urban slum population due to either lack of awareness or access to health-care services. Understanding of the knowledge and practices of the community regarding maternity care during pregnancy delivery and postnatal period is required for program implementation. Therefore the present study was carried out to evaluate the sociodemographic correlates and barriers of maternal healthcare utilization amongst married women aged 15-45 years living in a slum in Delhi. (excerpt)

Prevalence of Bacterial Vaginosis in a Community Setting and Role of the Pap Smear in Its Detection

OBJECTIVE To study the revalence of bacterial vaginosis (BV) in symptomatic and asymptomatic women in a community setting, to assess the validiy of the Pap smear in the detection of BV and to determine the sensitivity and specificity of clinical criteria for the diagnosis of BV. STUDY DESIGN Gram staining was performed on vaginal secretions collected from 301 women to determine the prevalence of BV. Each smear was assigned a score on the basis of the bacterial morphotypes identified. The bacterial pattern was also studied on 270 adequate, Pap-stained cervical smears and compared with the gold standard, the morphotypes on gram stain, to derive the validity of the Pap smear in diagnosing BV. Also each clinical criterion defined for diagnosis of BV was independently evaluated to determine their sensitivity and specificity. RESULTS The overall prevalence of BV was 41.5% in the study subjects using Amsels and Nugents criteria. The Pap smear was 78.3% sensitive and 86.9% specific in detection of BV. Among the clinical criteria, the presence of clue cells on wet mounts was both highly sensitive (76.7%) and specific (92.4%) for diagnosing BV, while a positive whiff test had a specificity of 86.9% with sensitivity of 33.9%. Vaginal pH > 4.5 was sensitive (88.3%) but less specific (58.6%). The presence of a thin, homogeneous discharge clinging to vaginal mucosa had low sensitivity (56.3%) and specificity (48.9%). In this study, BV was prevalent in both symptomatic and asymptomatic women. The routine Pap smear was able to detect BV in the majority of women. Its utility can be greater in asymptomatic women, in whom this infection may go undetected otherwise, resulting in future complications related to reproductive health. Among Amsels clinical criteria, the most sensitive and specific was the presence of clue cells in wet mounts. They can be detected easily by laboratory staff with little training in primary health care seting

Recurrent floods and prevalence of diarrhea among under five children: observations from Bahraich district, Uttar Pradesh, India

Background : Diarrhea is an important problem among the under-five children in India. Objective : The paper examines long-term impacts of recurrent floods on diarrhea among under-five children in Uttar Pradesh, India. Design : A two stage stratified cluster survey was conducted in flood affected (exposed) and non-flood affected areas (unexposed). Results : The long-term impact of the floods was not clearly marked in the overall prevalence of diarrhea with the exposed group having prevalence of 55.1% as against 56.2% in the unexposed group of children under five. Economic condition of the household is associated with the prevalence of diarrhea in both exposed and unexposed strata. Anemia was found to be a significant risk factor for diarrhea among children in both the flood exposed and non-flood exposed populations. The recurrent floods did not have any significant effect on the prevalence of diarrhea in relation to gender, religion, caste, and household size. Conclusions : The study indicates that the long-term impacts of floods are very differently manifested than the immediate impacts.

Dengue serotype-specific seroprevalence among 5- to 10-year-old children in India: a community-based cross-sectional study

BACKGROUND Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243). METHODS A convenience sample of 2609 healthy children aged 5-10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire. RESULTS Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7-61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype. CONCLUSIONS The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India.

Socio-demographic co-relates of psychiatric disorders

Objective: To find out the magnitude of probable psychopathology in children and study association of psychopathology with demographic, developmental and social factors.Methods: Childhood Psychopathology Measurement Schedule (CPMS) was used to measure the magnitude of probable psychopathology in 620 children from an urban slum of Miraj (Maharashtra). A second schedule recorded demographic, developmental and social factors.Results: CPMS score >10 was observed in 102 children (16.5%). It was significantly higher in children aged 7–10 years, in males, belonging to lower socioeconomic status, large families, being first born, having low birth weight (LBW); body mass index (BMI) less than 18.5. Low maternal education and alcohol abuse in father also had significant association with CPMS score >10.Conclusion: Findings suggest a need to educate the community about psychological implications of LBW, large family size and overcrowding in children. Improving maternal education and controlling alcoholism could help in reducing childhood psychopathology.

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 and correlates of tobacco smoking, awareness of hazards, and quitting behavior among persons aged 30 years or above in a resettlement colony of Delhi, India.

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.

Prevalence of reproductive morbidity amongst males in an urban slum of north India

Aim: To assess the prevalence and correlates of current smoking, awareness of hazards, and quitting behavior among smokers 30 years and above. Materials and Methods: Study design: Cross-sectional; Setting: Gokulpuri, a resettlement colony in East Delhi, India; Sample size: 911, persons aged 30 years and above using systematic random sampling; Study tools: Semi-structured questionnaire. Results: Prevalence of current smoking was found to be 24.6% (95% CI 21.90 - 27.49). Majority 198 (88.4%) of current smokers smoked bidi exclusively, and on an average 13.5 bidi/cigarette were smoked per day. Multivariate analysis showed the factors associated with current smoking as male sex, advancing age, illiteracy, skilled occupation, low socio-economic status, and low BMI (P < 0.001). 64.2% were aware of the hazards of smoking. 63 (21.9%) had quit smoking in the past, majority due to the health problems. Low educational status was associated with poor hazard awareness and quitting behavior. Conclusion: Smoking is a significant problem among poor and illiterate males, shows an increasing trend with an advancing age and is directly associated with skilled occupation and low BMI. There are significant gaps in knowledge regarding hazards of smoking.

Awareness About Anti-Smoking Related Laws and Legislation Among General Population in Slums of Delhi, India

Studies assessing the prevalence of reproductive morbidity among males in India have chiefly focused on prevalence of Reproductive Tract Infections/Sexually Transmitted Infections (RTIs/STIs) among males attending Sexually Transmitted Disease clinics blood donors and other selected population groups with only few focused on the magnitude and the type of reproductive morbidity amongst Indian males at community level. The objective was to estimate prevalence of reproductive morbidity including (RTIs/STIs) among males in the age group of 20-50 years residing in an urban slum of Delhi. Out of 268 males in the targeted age group selected by systematic random sampling residing in an urban sum of Delhi 260 males were subjected to clinical examination and laboratory investigations for diagnosis of reproductive morbidity. Laboratory investigations were done for diagnosis of Hepatitis B and C Syphilis Gonorrhoea Non gonococcal urethritis and urinary tract infection. A total of 90 (33.6%) of 268 study subjects reported one or more perceived symptoms of reproductive tract / sexual morbidity in last six months. Overall reproductive morbidity based on clinical and laboratory diagnosis was present in 76 (29.2%) study subjects and of this sexually acquired morbidity accounted for 21.2% cases. Hepatitis B was most common (10.3%) reproductive morbidity followed by Urinary Tract Infection (5.0%) scabies (3.5%) and congenital anomalies (3.5%). High prevalence of reproductive morbidity (29.2%) amongst males in an urban slum highlights the need for more studies in different settings. There is a need for developing interventions in terms of early diagnosis and treatment and prevention. (authors)