Parveen Singh

Health care providers knowledge, attitudes and perceived barriers towards emergency contraception in a sub-Himalayan state of India

The first national study of the incidence of abortion and unintended pregnancy in India, has estimated that in the year 2015, a total of 15.6 million abortions were performed. It thus translated to an abortion rate of 47 per 1,000 women in the age group of 15-49 years. In about 81% of these cases, medical methods of abortion were the most commonly preferred method. The data further deciphered that the incidence of unintended pregnancy in India was about half of the total pregnancies (a total of 48.1 million pregnancies in 2015). Estimates showed that unintended pregnancy rate in India was 70 per 1,000 women aged 15-49 in the year 2015. The unsafe medical abortions that account for 8-20% of all maternal deaths occur as a consequence of unintended pregnancy. The use of Emergency Contraceptives (EC) worldwide has played a significant role in preventing unintended pregnancies and abortions and this is owing to its potential to reduce maternal mortality and morbidity caused by unsafe abortion.

Epilepsy: what do Indian public living in Jammu know?

Background: Epilepsy, a neurological disorder, still remains one of the most stigmatising disease. Myths, beliefs and negative attitudes associated with the disease have been ascribed to the low levels of awareness and knowledge among the public. The present study aimed to assess the knowledge, attitudes and practices of the public regarding epilepsy visiting a tertiary care hospital in Jammu city of Jammu and Kashmir, India. Methods: This cross-sectional study was conducted over a period of three months among adult persons (aged 18 years and above) visiting OPD in a tertiary care teaching hospital in Jammu city, J&K, India. A 29-item questionnaire was pilot tested and then distributed to 410 adults during the survey period and 30 of them were excluded as they had never heard about epilepsy. Results: About 92.6% of the surveyed respondents had heard about epilepsy with mass media and family/ friends as the major sources of knowledge. 59.7% knew a person suffering from epilepsy and 30.7% had actually witnessed an attack of seizure. Only one-fourth of the respondents knew the disease to be a neurological disorder. More than half of the respondents would object to their children being associated with epileptic person in the school but surprisingly 63% would accept to work/become a friend with epileptic person. About 41% respondents would take patient in seizure to hospital while 43.5% would put a shoe on his nose. Conclusions: The public knowledge was found to be reasonably good, but attitudes were found to be of mixed type while practices were also not up to the desired levels. Need is for persistent and effective information campaigns to change public attitudes towards person with epilepsy.

Hand hygiene: knowledge, attitude and practices among mothers of under 5 children attending a tertiary care hospital in North India

Background: Hand hygiene remains the most cost effective strategy in prevention of health care associated infections as it may limit or completely stop the transmission of microorganisms. Poor hand hygiene practices especially of the mothers of under five children are likely to pose a major threat to the health of their children. The present study aimed to assess the knowledge attitude and practices of under-five mothers visiting an outpatient department in a tertiary teaching care hospital in North India. Methods: This cross-sectional study was conducted among 330 mothers who were attending with their under five children in paediatrics OPD of Government Medical College Jammu. A self-administered questionnaire which was pilot tested was administered to the consenting mothers. The questionnaire consisted of socio demographic information followed by knowledge attitudes and practices of the respondents about hand washing. Results: Knowledge about spread of disease was excellent among the respondents. Other knowledge parameters like responsibility of mother to ensure proper hand washing among children and long nails can spread bacteria were better among the urban mothers (p<0.05). Similarly attitudes of the urban mothers were found to be more favourable especially about towel sharing and teaching children about proper hand washing (p<0.05). Practices like usage of soap and water after defecation were found to be excellent among both the urban and rural respondents. However higher proportion of urban females reminded their children about hand washing before and after eating (p<0.05). Conclusions: The study results reveal a better knowledge attitude and practices among urban mothers in comparison to their rural counterparts. This necessitates community awareness generation regarding hand hygiene more so in rural mothers so that many communicable diseases which could be transmitted by improper hand hygiene are taken care of.

Assessing the functional disability of rural elderly population from North-West India using activity of daily living scale: A cross-sectional survey

Background: Aging is associated with both physical impairment and functional disability. One of the areas of concerns is a derangement in the activities of daily living (ADL) where the elderly people are unable to perform their basic personal care tasks. The present study was planned with the aim to evaluate functional impairment among rural elderly using ADL scale. Materials and Methods: The study was conducted as a cross-sectional population-based survey using multistage randomized sampling technique from August 2015 to October 2015 in Miran Sahib Health Zone of R S Pura health block in Jammu District in North-West India. The study involved 418 elderly individuals above 60 years of age. Results: A higher proportion of elderly (378/418; 90.43%) were classified as functionally independent. Among the study participants 9.54% (40/418) were found to have some had some impairment. Among the elderly impaired individuals, 5.26% (22/418) were moderately impaired while 2.64% (11/418) were severely impaired. However, importantly only a small proportion (7/418; 1.67%) of elderly individuals was completely dependent on others. Conclusion: The total impairment prevalence reported among the geriatrics in the current study was 9.5%. With the increase in the geriatric population expected in near future, this number will be significant. Policies with a clear focus on geriatric health-care need to be developed to reduce the dependency among elderly.

PC-PNDT act: perspectives of medical undergraduates in a Sub-Himalayan state

Background: Sex selective abortions have grossly distorted the child sex ratio in India. Role of medical technology in declining sex ratio at birth cannot be undermined. To combat this social evil, PC-PNDT (Pre-conception Prenatal Diagnostic Test) was promulgated in 2003 by Government of India. Enhancing the knowledge of medical fraternity with focus on undergraduate students can imbibe an enduring commitment towards this predicament Methods: The present cross-sectional study was conducted in Government Medical College of Jammu. Students of 1 year MBBS of Batch 2016-2017 were administered the pre-designed and pretested questionnaire. Information was collected regarding sex determination as well as PC-PNDT Act. Results: 80% respondents knew about the declining sex ratio and 95% knew that sex determination is possible during pregnancy. Only 24.29% had heard about PC-PNDT Act although 95% knew that prenatal sex determination is punishable. Higher proportions of female respondents were aware of both fine and imprisonment as punishment under the act. (p<0.05). Regarding technique used for sex determination, males had better knowledge about ultrasonography than their female counterparts (p<0.05). More females would like to have male child as preferred first child (p<0.05) and 87.14% of respondents preferred that sex determination be punished more vigorously. Conclusions: Awareness about some of the parameters about PC-PNDT Act among the medical undergraduates was poor and it would be pertinent to hold more educational sessions for them.

Tobacco and alcohol use in elderly population of rural India

Background: Tobacco and alcohol are among the most widely abused psychoactive substances among elderly population, especially in rural areas. Fewer research in this domain leads to the conduction of this study. Objectives: The present study was conducted in rural geriatrics to know the prevalence of smoking and alcohol and to find their association with various sociodemographic factors. Materials and Methods: Eight villages of RS Pura block were selected using multistage random sampling technique. Men and women aged 60 years and above were interviewed using predesigned questionnaire which included questions on sociodemographic, smoking, and alcohol consumption status. Results: Nearly 518 persons were interviewed of whom 53.5% were females. 33.20% were smokers and 11.39% were ex-smokers with high prevalence in males 54.35%. 7.47% of the men and 6.86% were current tobacco chewers. 19.30% respondents were current alcoholics, whereas 4.25% were ex-alcoholics. 38.59% males and only 2.53% females were alcoholic. There was a progressive decline in a number of smokers with advancing age. Majority of men were moderate-to-light smokers (42.75% and 37.40%, respectively) and only 19.85% were heavy smokers. Conclusion: More knowledge needs to be acquired about factors that have a bearing on cessation. Medical and family support to those willing to quit will play a pivotal role.