Rashmi Kumari

Goiter prevalence in school-going children: A cross-sectional study in two border districts of sub-Himalayan Jammu and Kashmir

Introduction: Iodine deficiency disorder remains one of the major public health problems, despite it being easily preventable. Initially thought as the disorder of Himalayan goiter belt, the disorder has been found to have a pan-India presence. The study was planned with the aim to assess the prevalence of goiter among 6–12 years school-going children and to identify levels of iodine in salt consumed at the household level in the study area. Materials and Methods: The study was conducted among 3955 school-going (2162 children from Rajouri and 1793 children from Poonch) children age 6–12 years in Rajouri and Poonch districts of Jammu Province. The children were examined clinically to detect and grade the goiter. Salt samples were collected from subsample (n = 400) to estimate iodine content in the salt. Results: The prevalence of goiter in the study population was found to be 18.87% and 9.70% in Rajouri and Poonch districts, respectively. Goiter prevalence was higher in 9–12 years age group as compared to 6–9 years age group and the difference in goiter prevalence in males of these two age groups was statistically significant (P = 0.02). Estimation of iodine content of the salt samples revealed that all of them (100%) had adequate iodine content. Conclusion: Despite the implementation of Universal Iodization Program and adequate content of iodine in salt consumed by the families, the goiter prevalence in both the districts is high. The future research should focus on identifying the reasons for this high prevalence.

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.

Does being under treatment improve knowledge attitude practice for hypertension: A hospital-based study from North India

Background: Studies suggest that approximately half of patients with raised blood pressure (BP) are undetected, that half of those detected are not treated, and that half of those treated are not controlled, famously described as the “rule of halves.” Importantly, the cornerstone of the primary prevention of cardiovascular diseases is early detection and drug treatment (antihypertensive) of patients with high BP. Studies across populations in developed world have shown that awareness and management of high BP levels are far from optimal. The present study was planned with the aim to assess the knowledge, attitude, and practices (KAP) regarding hypertension in hypertensive patients visiting Tertiary Care Hospital in North-West India. Materials and Methods: Already diagnosed hypertensive patients seeking care at the tertiary care center were selected for this study. The participants were recruited using consecutive sampling technique. All participants were interviewed with the help of a semi-structured questionnaire after obtaining a written informed consent. The components of the KAP were recorded using a score sheet. Results: In all, 394 hypertensive patients of whom majority (239/394; 61%) were males, were included in the study. The KAP score among the study subjects was 88.4%, 90.83%, and 95.83%, respectively. Males had higher knowledge about normal BP levels which was statistically significant (P < 0.01). Among the attitude, regular intake of anti-hypertensive drugs, regular investigations, lifestyle changes, avoidance of salt and allopathic medicines being the best for the treatment of hypertension were found to be significant statistically (P < 0.01). Conclusion: The high score among the study population can be attributed to the fact that all study participants were diagnosed patients of hypertension seeking care in a tertiary care hospital.

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.

Prevalence of chronic respiratory disorders in a rural area of North West India: A population-based study

Introduction: Chronic respiratory diseases are an important cause of disability across the globe. The global burden of these diseases is showing a discernible upward trend. It is estimated that 500 million people suffer from them. Materials and Methods: The study was conducted with the aim to estimate the prevalence of chronic obstructive pulmonary disease (COPD) in a rural Indian population. For this, a population-based survey was conducted using modified British Medical Research Council questionnaire. This was followed by subjecting the respondents to Wrights mini peak flow meter to find out the peak expiratory flow rate to diagnose the COPD cases. Results: The prevalence of chronic bronchitis, bronchial asthma, and COPD was found to be 3.36%, 1.18%, and 4.21%, respectively. Conclusions: Chronic respiratory disorders are more prevalent among rural adults hinting to a rural-urban divide. Therefore, the focus of preventive strategies should take into account this difference.