Naveen Ramesh

Reproductive tract infections among women in a peri-urban under privileged area in Bangalore, India: Knowledge, prevalence, and treatment seeking behavior

Introduction: Globally, reproductive tract infections (RTIs) are a major cause of acute and chronic illness with severe consequences. Women are at a greater risk than men and are less likely to seek treatment because of the associated stigma. Objectives: To assess the knowledge and estimate the prevalence of RTIs, and treatment seeking behavior regarding RTI. Materials and Methods: A community-based cross-sectional study was done in a peri-urban underprivileged area, in Bangalore where all ever-married women in the reproductive age group were interviewed using a pre-structured and pre-tested schedule by female medical doctors in the privacy of their homes. Results and Discussion: Of the 179 women who participated in the study, 47.5% were in the age group of 25 to 34 years with the mean age being 29.84 years (±7.92). The mean knowledge score was found to be 3.78 (±2.3) and the maximum score was found to be 10, which indicated poor knowledge regarding RTIs which was similar to other studies done elsewhere. The prevalence of RTI was found to be 26.8%, while the period prevalence of RTI for the last 1 year was 39.1%, and 60% of these women sought some form of treatment. Other studies have reported prevalence ranging from 21.9% to 92% in India. The age-specific prevalence was highest in the 15 to 19 years age group (30%), with most common symptom being white discharge per vagina (43.7%). Conclusions: Knowledge regarding RTI was poor while the prevalence of RTI was high (26.8%) and the treatment-seeking behavior was inadequate.

Prevalence, pattern, and factors associated with work-related musculoskeletal disorders among pluckers in a tea plantation in Tamil Nadu, India

Context: Musculoskeletal pain is common among tea leaf pluckers and is attributed to the load they carry, long working hours, the terrain, and insufficient job rotations. As a result of this, their health and work capacity are affected. Aims: To assess the prevalence, patterns, and factors associated with work-related musculoskeletal disorders (WRMDs) among pluckers in a tea plantation in Annamalai, Tamil Nadu, India. Settings and Design: This cross-sectional study surveyed 195 pluckers selected by simple random sampling aged between 18 years and 60 years. Materials and Methods: The interview schedule had four parts––sociodemographic detail, Standard Nordic Scale, numeric and facial pain rating tool, and a tool to assess factors associated with WRMDs. Statistical Analysis Used: Statistical Package for the Social Sciences (SPSS) version 16. Results: Prevalence of musculoskeletal pain in the last 12 months and the last 7 days was 83.6% and 78.5%, respectively. The most common site for last 1 year was shoulder (59%) and for last 7 days was the lower back (52.8%). Independent t-test revealed that the mean age of those with pain was 6.59 year more and mean years of employment was 1.38 years more among the workers with pain compared to workers without pain. Increasing morbidities among workers was also significantly associated with an increase in WRMDs on Chi-square test. Conclusions: The prevalence of musculoskeletal pain was high among tea pluckers and the most common site during the last 12 months and the last 7 days was the shoulder and lower back respectively was mild in character. Increase in age and duration of employment was associated with WRMDs.

Shift work disorder and related health problems among nurses working in a tertiary care hospital, Bangalore, South India

Introduction: Shift Work Disorder (SWD) is a sleep disorder characterized by sleepiness and insomnia, which can be attributed to the person′s work schedule. Awareness of the mechanisms behind shift work related health problems could be essential to schedule the shift work, employment routines, clinical treatment, and selection of employees. Objective: To assess the prevalence of SWD and to identify related health problems among nurses in a tertiary care hospital in Bangalore. Materials and Methods: We conducted a descriptive cross-sectional study in a tertiary care hospital in Bangalore between May and September 2014. Based on simple random sampling, 130 nurses were selected for the study. After obtaining written informed consent from the participants, structured interview schedule using Standard Shift Work Index and Bergen Shift Work Sleep Questionnaire (BSWSQ) was administered. Results: The mean age of the 130 nurses was 27.4 ± 2.64 years. The prevalence of SWD was found to be 43.07%. Headache, back pain, gastritis, and menstrual disorders were the most common complaints, which are found in 78 (60.0%), 75 (57.6%), 42 (32.3%), and 39 (30.0%) cases, respectively. Anxiety and depression was found in 23 (17.6%) and 31 (23.8%) individuals, respectively. We also found a significant association of SWD with increasing age, more number of nights worked in a year, and longer duration of working hours. According to the BSWSQ, 70 (53.8%) nurses were found to have sleep problems. Conclusion: A high prevalence of SWD symptoms calls for a focus on the antecedents of work related sleep problems and appropriate intervention, such as behavioral changes, clockwise rotating shifts, and treatment.

Knowledge, attitudes, and poultry-handling practices of poultry workers in relation to avian influenza in India

Avian influenza (AI) is a viral disease of domestic and wild birds. The recent pandemics caused by highly pathogenic AIA (H5N1) in domestic poultry is currently rated phase 3 by the World Health Organization on the pandemicalert scale. Materials and Methods: A pretested and semistructured survey instrument was administered to both live bird market and poultry farm workers in two most populous cities in Karnataka in South India to collect data on demographics, knowledge, attitude, and practices among them. Results: The mean age was similar among both population groups (31.5 years). There was a higher level of biosecurity practices adopted in poultry farms compared with those adopted in live bird market. Knowledge regarding AI was acceptable but poorly correlated with actual biosecurity practices. Discussion: Live bird market and poultry farm workers have been identified as the weakest link in the prevention and control of the spread of AI in the two most populous cities studied in Karnataka. Conclusion: Risk reduction models of behavior change targeting these groups are important toward the control and prevention of AI spread.

Depression, anxiety and stress levels in industrial workers: A pilot study in Bangalore, India

Background: Mental health disorders affect around 500 million people worldwide. In India, around 10-12% of people are affected by a mental disorder either due to stress, depression, anxiety, or any other cause. Mental health of workers affects the productivity of the workplace, with estimates putting these losses to be over 100 million dollars annually. Aims: The study aims to measure depression, anxiety, and stress levels of workers in an industry and to investigate if it has any effect on productivity of the firm. Materials and Methods: The study utilized a cross-sectional design and was conducted among workmen of the firm. A sociodemographic based questionnaire and a mental health screening tool -Depression Anxiety Stress Scale (DASS)-21 were used for the same. A total of 90 completed questionnaires were analyzed for the study. The data was analyzed for central tendencies as well as for any associations and correlations. Results: The study showed that none of the workers had a positive score for depression. It also showed that around 36% of the workers had a positive score for anxiety and 18% of the workers had a positive score for stress on DASS-21 scale. The odds ratio between stress and number of leaves taken by a worker in the last 3 months suggested a dose-response relationship, but was statistically insignificant. Conclusion: The study found a prevalence rate of around 18-36% for anxiety and stress amongst the workers at the factory. Large-scale studies will help understand the effect mental health status has on the Indian workplace.

Weekly dose of Iron-Folate Supplementation with Vitamin-C in the workplace can prevent anaemia in women employees.

Objective: To assess if a weekly dose of iron and folic acid along with vitamin C, in the workplace would reduce the prevalence of anaemia. Methodology: A multi-pronged intervention was carried out to reduce the prevalence of anaemia among workers of 7 apparel manufacturing factories using a regime consisting of a supervised single dose of albendazole (400mg) followed by a weekly dose of dried ferrous sulphate (150mg), folic acid (0.5mg) and vitamin C (100mg). Workers were provided information on the causes of anaemia and its prevention. The total duration of the intervention was 16 weeks. Haemoglobin levels of a randomly selected sample of workers were tested before and after the intervention using a computerized non-cyan-meth-haemoglobin method. Results: Of the 10810 workers who were enrolled a sample of 515 workers was randomly selected for the blood investigations. At the end of the intervention (18 weeks after the first blood sample was collected) only 361 out of the 515 who had been enrolled a little more than 16 weeks earlier still remained in the factories and among women 279 out of 385 enrolled were still working in the factories. In the 385 unmatched samples the number of anaemic women had reduced from 141 before the intervention to 79 after - mean haemoglobin increasing from 12.2 to 13.0 (p < 0.001) and in the 279 paired samples prevalence of anaemia had reduced from 105 to 58 - mean haemoglobin increasing from 12.1 to 13.0 (p < 0.001). Conclusions: Our results demonstrated that in resource poor regions, where prevalence of anaemia is high, the workplace may be considered an ideal location to give a weekly supervised dose of iron, folic acid and vitamin C to effectively tackle the problem and probably improve worker efficiency.

Quality of life among patients with arthritis seeking outpatient care at a government secondary health care centre, Anekal taluk

Arthritis means inflammation of the joints. Arthritis can be caused due a variety of local and systemic illnesses, the most common among them being osteoarthritis and rheumatoid arthritis. Arthritis can affect men, women and children. Arthritis is an important problem which has been reported worldwide. Worldwide estimates are that 9.6% of men and 18% of women aged over 60 years have symptomatic osteoarthritis. A large majority (80%) of those with osteoarthritis will have limitations in movement and 25% cannot perform their major daily activities of life. In India it was found that 28.7% adults suffer from osteoarthritis of knee.

Quality of life and probable psychological distress among male workers at a construction site, Kolar district, Karnataka, India

Introduction: The construction industry, which mainly consists of migrant labouers is one of the largest employers in the unorganized sector in India. These workers work in poor conditions and are often vulnerable to exploitation. These workers also do not have health care benefits and often these factors lead to poor quality of life (QOL) and psychological distress. Objectives: To assess the QOL, probable psychological distress and associated factors among male construction workers. Materials and Methods: A cross-sectional study was conducted between September 2013 and November 2013 among 404 male workers. These construction workers were enrolled by consecutive sampling at a construction area in Kolar district, Kaarnataka, India. The study tools used were World Health Organization (WHO) QOL-BREF and 12-Item General Health Questionnaire (GHQ-12) to assess QOL and probable psychological distress, respectively. The transformed scores in WHO QOL-BREF in all four domains ranged 0-100. The four domain scores are scaled in a positive direction with higher scores indicating a higher QOL. Associations were done using statistical tests such as Chi-square, correlation, regression, independent samples t-test, and analysis of variance (ANOVA). Results: A total of 404 male workers with a mean age of 25.6 ± 7.3 years were studied. Mean scores of various domains of QOL were 68.5 ± 13.7 (physical), 59.9 ± 13.5 (psychological), 64.3 ± 16.4 (social), and 44.1 ± 12.8 (environmental). On the self- rating scale, 59 (14.6%) workers were rated as having poor QOL. The prevalence of probable psychological distress was 27.5%. Factors such as increasing age, being currently married, and low educational status were found to be significantly associated (P < 0.05) with poor QOL and psychological distress. There was a significant negative correlation (P < 0.05) between QOL and psychological distress and a positive correlation between income and QOL. Conclusion: The QOL in the environmental domain, which mainly deals with living conditions, health, and recreational facilities was found to be poor and there was a high prevalence of probable psychological distress among workers. This indicates a need for improving workplace amenities, and access to health and recreational facilities.

Estimation of work capacity and work ability among plantation workers in South India

Background: Work capacity is the ability to perform real physical work, and work ability is a result of interaction of worker to his or her work that is how good a worker is at present, in near future, and how able is he or she to do his or her work with respect to work demands and health and mental resources. Objective: To assess the work capacity and work ability and to study the factors associated with work capacity and work ability of workers at a tea plantation in South India. Materials and Methods: A cross-sectional study was conducted at a tea plantation in Annamalai, South India, from March to May 2015. Data were collected using a structured interview schedule comprising of three parts as follows: sociodemographic data, work ability questionnaire, and work capacity assessment. Results: Of the 199 subjects participated in the study, majority [90 (45.3%)] were in the age group of 46-55 years, and 128 (64.3%) were females. Of the 199 workers, 12.6% had poor aerobic capacity (by Harvard Step test), 88.4% had an endurance of more than 1 h, 70.9% had better work productivity and energetic efficiency, and the voluntary activity workers spent most time on household chores. Of the 199 workers assessed, only 9.6% had good work ability. There is negative correlation between work ability and body mass index (BMI). Conclusion: Our study found 12.6% workers with poor aerobic capacity and 9.6% of workers with good work ability. Periodic health examinations and other screening procedures should be made as routine in workplace to improve work ability and capacity.

Staff working in ancillary departments at a tertiary care hospital in Bengaluru, Karnataka, India: How healthy are they?

Background: Ancillary health services are those supplemental services other than room, board, and medical/nursing services provided to hospital patients in the course of care. Ancillary department staff forms an integral part in the smooth functioning of a hospital. There is a need to focus on the health of these individuals to ensure their well-being and in turn, productivity at the workplace. Objective: To study the morbidity profile of the staff working at ancillary departments of a tertiary care hospital in Bengaluru, Karnataka, India. Materials and Methods: We conducted our study in a 1,200-bedded tertiary care hospital in Bengaluru, Karnataka, India. Annual medical checkup (AMC) for all the staff working at the ancillary departments has been started in recent years and is provided free of cost and during working hours. A total of 150 employees from ancillary departments underwent AMC in the year 2013. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0. Spearman′s correlation and Chi-square test were used. Results: Of the 150 employees, the majority was male (72%); the mean age was 38 ± 11 years. The most common morbidities were diabetes mellitus (11%), hypertension (10.6%), musculoskeletal disorders (9.3%), surgical problems (8.6%, hemorrhoids, varicose veins), and dental caries (6.6%). On stool microscopy, 12% of the dietary workers showed ova/cyst. There was a significant positive correlation between age and the number of chronic morbidities (P < 0.01). Conclusion: Lifestyle disorders such as diabetes mellitus and hypertension were the major morbidities among the staff in the ancillary departments of the hospital. We ensured regular follow-up, adherence to medication, and lifestyle modifications in terms of diet and exercise.