Puja Dudeja

World Health Organization hemoglobin color scale: A useful point-of-care test to detect anemia

Background: Anemia is a global problem with higher prevalence in India. Anemia is known to affect endurance and will have a direct impact on the productivity of combatants. Hence, it is important to recognize and treat anemia in combatants. A cost-effective point-of-care test in the hands of the primary health-care provider will be a useful tool for diagnosis of anemia. This study endeavors to validate a point-of-care hemoglobin test-World Health Organization (WHO) hemoglobin colur scale (HbCS) against the gold standard test (GST) of cyan methhemoglobin method. Materials and Methods: The test validation study was conducted at a mid-zonal peripheral hospital. The participants were assessed for hemoglobin status by the WHO HbCS at the Outpatient department by means of capillary blood sample using a lancet. Subsequently, venous blood sample was drawn and processed by GST at the hospital laboratory. The hemoglobin values obtained were statistically analyzed. Results: A total of 200 participants were included in the study with a predominant age group of 19–40 years with most belonging to the male sex. The HbCS showed a mean difference of 1.21 g/dl in comparison with GST. The study showed HbCS to have a high sensitivity and negative predictive value. The ideal cutoff value was found to be 12 g/dl having the maximum area under the receiver operating characteristic curve. Conclusion: HbCS is an effective diagnostic tool to assess mild to moderate anemia in a resource-poor setting.

A cross-sectional study to assess awareness about menstruation in adolescent girls of an urban slum in western Maharashtra.

Abstract Introduction: Reproductive health of adolescent girls is crucial as it determines the health of future generations. School girls when experiencing menarche find themselves in a setting without water, toilets or a supportive female teacher to explain the changes happening in their body. An important concern for adolescent girls is to have adequate, correct knowledge along with facilities and the cultural environment to manage menstruation hygienically and with dignity. Hence, the present study was done to assess knowledge and practices about menstruation in adolescent school girls of an urban slum. Methodology: This was a descriptive cross-sectional study conducted among girls of a Government School located in an urban slum of western Maharashtra. A total of 250 girls participated. Data collection was through a pilot-tested questionnaire. The data thus collected were entered into Microsoft Excel and analyzed using the SPSS 20 software. All girls were educated about menstrual hygiene after the study. Results: The mean age of the students was 14.9±1.75 years. The mean age at menarche was 11.97 (95% CI: 11.94–11.99). It was observed that only half (56.4%) had acquired prior knowledge about attaining menarche. Out of these in a large proportion, the knowledge was imparted to them by their mothers (60.7%), followed by friends (31.8%). There was no significant association between educational status of mother and awareness in respondent about menstruation. Regarding the organ of menstrual blood flow, half (50.7%) knew the correct answer (i.e. uterus); whereas the rest believed that it was stomach/kidney, etc. Most of the school girls (90.5%) used sanitary pads. Almost 90% of the young women faced physical complaints or health problems during menstruation. Most of the participants had some kind of restrictions on them during the menstruation and most of these were religious restrictions (69.7%) followed by physical (41.2%) and social restrictions (22.3%). All of them were unsatisfied with the toilets and hand washing facilities available inside the school premises. Conclusion: Correct knowledge in adolescent young girls regarding menstruation is lacking. Lack of awareness is a roadblock in adopting safe and hygienic menstrual practices. It also hinders them from overcoming traditional beliefs, misconceptions and restrictions regarding menstruation. This will empower them as they transition into womanhood.

The zika virus threat: Should India worry?

The explosive spread of Zika virus (ZIKV) has warranted a great attention from national and international health agencies worldwide, including the World Health Organization, thus declaring the situation as a Public Health Emergency of International Concern in February this year. The virus bears a phenotypic and clinical resemblance to dengue, along with the vector Aedes aegypti . The abundance of vector along with favorable environmental conditions makes India a “ZIKV receptive” area, with just the virus itself missing from the epidemiological triad. High level of awareness regarding factors about re-emergence of the ZIKV decades after its discovery and preventive and control measures against the vector remains the cornerstone for planning, implementing, and monitoring surveillance activities against ZIKV and other emerging and re-emerging infections.

Reproductive health awareness among adolescent girls of a government school in an urban slum of Pune City

Introduction: Reproductive health of adolescent girls is crucial in determining the health of future generations. For ensuring informed decisions by adolescents regarding their sexuality and reproductive health, National AIDS Control Organisation has introduced life skills education in school curriculum. However, there exist many roadblocks in implementation from theory to practice. Hence, the present study was conducted to assess the reproductive health awareness and most preferred source of information. Materials and Methods: This was a descriptive cross-sectional study among girls of classes VI–XII of a Government High School in an urban slum of Maharashtra. Two hundred and fifty girls participated; 39 questionnaires were incomplete, hence 211 responses were analyzed. All girls were educated about reproductive health and life skills issues after the study. Results: Mean age of the participant girls was 14.9 ± 1.75 years. The level of awareness improved significantly with increase in class of respondent (P 0.05). Eighty percent of them were unaware of the appearance of secondary sexual characteristics in both the genders. Less than 30% of the girls were aware of contraceptives. Regarding effects of premarital sex, 57% of the participants were concerned about bringing a bad name to themselves and their family, while reproductive tract infections (9%), HIV/AIDS (29%), were cited as other ill effects. Seventy percent felt comfortable discussing or confiding regarding reproductive health issues with friends rather than parents, teachers, or medical professionals. Conclusion: Knowledge and awareness about reproductive and sexual health issues among adolescent girls was dismal.

A longitudinal study to assess the role of sanitary inspections in improving the hygiene and food safety of eating establishments in a tertiary care hospital of North India

Introduction: Food safety inspections serve two purposes; determine compliance with the law and gather evidence for enforcement if there is noncompliance. The present study was conducted to assess the role of regular inspections on food safety in hospital premises. Methodology: This was an intervention based before and after study. A tool was prepared based on the Food Safety and Standards Regulations (FSSR) (in India) 2011. This included major, critical, and highly critical domains. Each item in the tool scored between 1 and 3 (poor, satisfactory, and good). Based on this, each eating establishment (EE) was given a score on conformance to FSSR 2011. Monthly inspection was made over a year and corrective actions were suggested. Results: The minimum preintervention score was (41.28%), and maximum was (77.25%). There was no significant association between type of meal services and score EE (P > 0.05). Higher proportion of EEs within the hospital building had a satisfactory and good score as compared to EEs outside the hospital building but within hospital premises (P < 0.05). Postintervention, there was a significant change (increase) in the scores of EEs. There was a significant increase in mean scores of EEs under major domains namely maintenance, layout of equipment, monitoring an detection, and elimination of food sources to the pests. Under critical and highly critical domains personal cleanliness, training, and self-inspection by food business operators improved significantly. Conclusion: Regular inspections can improve the food safety standards in EEs.

Assessing the assessors: Use of statistical tests to find out the inter examiner reliability of examiners in a post graduate medical examination

Context: A robust evaluation system is the backbone of any education system. There are different methods of evaluating answer sheets in a subjective exam such as glance and grade method, scoring pattern system, and training the examiners on model answers before evaluation. However, inter-examiner reliability varies with each of these methods. Aim: The present study was done to find out the inter-examiner reliability in a postgraduate (PG) exam with a glance, grade, and assess method. Materials and Methods: This was a cross-sectional study conducted done during a PG examination in community medicine in a medical college setting. There were four independent assessors who rated 8 PG students over 36 different items in four theory exams. The examiners were blinded during evaluation of answer sheets. Statistical Analysis Used: Reliability statistics, inter- and intra-class correlation coefficients, Pearsons correlation coefficient, and Spearmans rho coefficient between assessors were calculated. Results: There was a significant difference in the mean scores (P < 0.001) of different assessors. However, there was significant reliability and correlation between the assessors (P < 0.05). Pearsons correlation coefficient varied between 0.736 and 0.893 and Spearmans rank coefficient varied between 0.741 and 0.891 this could be due to the fact that the assessors were experienced teachers. Conclusions: Glance and grade method of assessing PGs has good reliability between the assessors. However, the scores can vary significantly between different assessors.