Shashidhar Kotian

Infant rearing practices in South India: a longitudinal study.

Background: Rearing practices are a major determinant of nutritional and health status of infants. Therefore these practices need to be better understood. Objectives: To find out infant rearing practices in the study area. Materials and Methods: A longitudinal study was conducted on a birth cohort of 194 infants. Information on rearing practices and anthropometric measurements were recorded every month for a period of 1 year. Results: Only 67 (34.5%) newborns were breast fed within half an hour of delivery. Prelacteal feeds was given to 65 (33.5%) newborns and this was seen more among home deliveries (P=0.018). Demand feeding was practiced by 169 (87.1%) mothers. Exclusive breast feeding (EBF) for 6 months was practiced by 81 (41.7%) mothers. Bottle feeding was seen in 7 (3.6%) cases. Weight gain during infancy was found to be maximum when infants were EBF for 6 months (P<0.001) and weaned with semi-solid and solid diet alone in the following 6 months (P=0.002). Gain in all anthropometric measurements was more in the initial 6 months of infancy compared to latter. Four (2.1%) infants were malnourished. Oil massage before bath was practiced by 189 (97.4%) mothers. Over 50% mothers practiced oil application to eyes or ears of infants. Delayed initiation of bath (beyond 1week) was seen in 15 (7.7%) cases. Conclusion: Faulty rearing practices need to be corrected in order to improve the health status of infants.

Tobacco use among rural schoolchildren of 13-15 years age group: a cross-sectional study.

An estimated 186 million of the world population are school children of 13-15 years. Among them, approximately 34.8 million are current tobacco users.(1) In India, the most susceptible time for tobacco use is during adolescence and early adulthood (15-24 years). In rural settings, family members and neighbours who often ask young children to get tobacco from nearby shops. Media advertisements and colorfully packaged tobacco products act as pro-tobacco influences.(2) There is an urgent need to curb tobacco use among youth. Hence, this study was conducted to estimate the prevalence of tobacco use among rural school children of 13-15 years and to find the reasons for use of tobacco products. Also, reasons for initiation, access, availability, source of funding, knowledge about the dangers of tobacco consumption, tobacco use among family and teachers, and cessation behavior were assessed.

Factors associated with morbidities among infants in three sub centre areas of belgaum district of south India: A longitudinal study

Background: Health status of infants is a sensitive indicator of development and factors influencing it need to be better understood. Objectives: This study was conducted to search for factors associated with morbidity among infants and to find out their influence on weight gain during infancy. Materials and Methods: This longitudinal study was undertaken in south India from November 2004 till April 2006. A birth cohort of all children born during first 6 months of the study period were assessed at enrollment and followed up monthly till they attained 1 year of age. Results: Incidence of morbidity among infants was found to be least among those exclusively breast fed (EBF) for 6 months and most when EBF for less than 6 months (P = 0.045). It was also more when infants were weaned with a combination of animal milk, formula milk, semi-solids and solid diet and least when weaned only with semi-solids and solids (P = 0.018). Diarrheal episodes were more in infants who were bottle-fed (P < 0.001). Weight gain between 6th and 12th month of infancy was found to be significantly affected by various morbidities (P = 0.001). Incidence of morbidities was less among preterm babies and more among partially immunized (P < 0.001) babies with birth order ≥ 3 (P = 0.012), babies of mothers with low socio-economic and educational status. Delayed milestones during infancy was seen more in babies with history of birth asphyxia (P = 0.018). Conclusion: Several factors influenced incidence of morbidities and these morbidities had a negative effect on weight gain. Hence these factors need to be addressed to promote better child health.

Problem-based learning as an effective learning tool in community medicine: Initiative in a private medical college of a developing country

Background: Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology. Materials and Methods: This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires. Results: A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls. Conclusion: PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge and enhanced their group functioning and generic skills, we recommend PBL sessions: They would help optimize the training in Community Medicine at medical schools. Good correlation of tutor and self-assessment scores of participants in the brainstorming session suggests that the role of tutors could be restricted to assessment in presentation sessions alone. Demotivation, which hinders group performance in PBL, needs to be corrected by counselling and timely feedback by the tutors.

Quality of life among dentists in teaching hospitals in South Canara, India

OBJECTIVES This paper reports on the quality of life among dentists using World Health Organization Abbreviated Instrument for Quality of Life Assessment, comprising 26 items which measure the following broad domains: Physical health, psychological health, social relationships, and environment. MATERIALS AND METHODS The instrument was self-administered among dentists in four teaching dental institutions. A total of 191 questionnaires were given out. Of those, 187 were consented and answered, making up a response rate of 97.9%. The internal consistency of the questionnaire, measured by Cronbachs alpha was estimated at 0.75. RESULTS Highest mean score was seen for Domain 3 (Social relationships) (16.15 + 2.38) and the least score was for Domain 4 (Environment) (14.72 + 2.12). Higher proportions of respondents rated their quality of life as good (65.1 percent), and also majority of dentists (63.5 percent) were satisfied with their health. CONCLUSION Quality of life recognizes the value of an individuals health in the broader psychologic and social aspects of his/her life. In this study, the overall rating of quality of life among dentists in teaching hospitals is good.

Validity and Reliability of Montreal Cognitive Assessment and its Comparison with the Translated Hindi Mental Status Examination in an South Indian Geriatric Population

Introduction: Ever since the MMSE has been brought under exclusive copyright, there has been a search for an alternative test for routine bedside cognition testing. The Montreal Cognitive Assessment scale has been validated in several previous studies

Comparison of Normal Resident Flora on the Face of Medical Students who use and who do not use Cosmetics

Introduction: Normal flora of the skin plays a beneficial role in preventing the pathogenic organisms from colonizing the skin and causing infection. It is possible that the facial cosmetics may cause a change in the normal flora disrupting its protective function. Aim: To find out the effect of cosmetics, those that are applied on to the face on resident normal flora of the face. Materials and Methods: This was a cross-sectional study involving medical students aged 19 to 25 years, of whom 42 were regular cosmetic users and another 42 were non cosmetic users. Swabs were taken from the face of the subjects after a face wash with soap and water and eluted in 1 ml sterile peptone water. Tenfold dilutions of the sample were made and 100 μl of the diluted sample was spread over the surface of Trypticase soy agar, Mac Conkey’s agar and blood agar. The colonies were counted and also identified. Statistical evaluation was done by Chi square test using SPSS version 16. R esults: We isolated Coagulase Negative Staphylococci (CoNS), Micrococcus spp. and methicillin sensitive S.aureus, non-fermenting oxidase negative gram negative bacilli and diphtheroids from both the groups. We found that most of the students who were regular cosmetic users 22 (52.38%) yielded negligent growth in comparison with non-cosmetic users (16, 38%). CoNS was less frequently isolated from regular cosmetic users 10 (23.8%) in comparison with those who do not use cosmetics 17 (40.47%). Conclusion: It is possible that regular use of cosmetics does reduce the normal flora but further studies with larger sample size are required to prove and confirm this finding.

Faculty perception towards a “hybrid” problem based learning methodology

This sequential quantitative and qualitative study was done to assess the perception of faculties towards a hybrid Problem Based Learning (PBL) methodology. To begin with, all faculty members of the department featured in a round of PBL facilitation. Later in phase I, their perception was assessed using a validated self-administered questionnaire. In phase II, personalized interview was conducted with each faculty. Finally phase (III) involved a focus group discussion on issues identified in previous phases. Among the 10 faculties, 9 had good and 1 had average perception about PBL. The various issues brought out by faculty in phase (II) and (III) were; need of formalized training in PBL for facilitators, need of integrated PBL sessions, need of variety of PBL exercises and need of students assessment for every session.

Environmental sanitation and health facilities in schools of an urban city of south India

Background : Environmental sanitation and health facilities in schools are an important public health issue. Aims : To assess the school environment, sanitation and health related facilities and to compare the availability of these facilities between government, aided and private schools. Materials and Methods : This cross sectional study was done in 30 schools in Mangalore city of south India in February 2010. Results : Out of the 30 schools surveyed, four were government, 12 were aided and 14 were private schools. Overcrowding was seen in one third of schools. The recommended minus desks was lacking in 23(76.7%) and chairs with back rest was lacking in 11(36.7%) schools. More than a quarter of schools had no drinking water purification facility. Water storage units were not cleaned periodically in 6(20%) schools. Quarter of all government schools and half of all aided schools had no dining hall for serving mid-day meals. Toilets were not adequate in 10(33.3%) and it was not separated for boys and girls in 8(26.7%) schools. Four of the surveyed schools had no medical examination of students and in 13(43.3%) schools daily morning inspection by teachers was not done. Hardly few schools had staff trained to deal with medical emergencies and in counselling activities. None of the schools had an immunization register. Although the performance scores between the types of schools did not differ significantly, the combined performance of only private schools were found to be satisfactory. Conclusion : A good number of schools in this urban area were found to be falling short of several essential requirements regarding sanitation and health facilities which needs to be rectified.