Singh Mm

Medical students' perception on eye donation in Delhi

Corneal transplantation remains a major treatment option for restoring sight among those suffering from corneal blindness. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate numbers of corneas collected. Medical students can be involved in the motivation of patients and relatives to pledge their eyes and to do grief counseling for donating eyes. The aim of the study was to assess the perception and willingness of 180 first-year medical students towards eye donation in Delhi. They were administered a pretested semi-structured questionnaire on eye donation. Data were analyzed using Epi-Info software package 6.04 version. The majority (99.4%) of students knew that eyes can be donated after death but only 41.1% knew that the ideal time of donation was within six hours of death. Most participants (87.2%) were willing to donate eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.5% of students. Perceived reasons for not pledging eyes by the people were: lack of awareness (32.7%), objection by family members (27.7%), unsuitability to donate because of health problem (17.7%) and the unacceptable idea to separate the eye from the body (15.5%). Mass media such as television, newspapers, magazines and posters were important sources of information on eye donation. Perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community.

Prevalence and awareness about sexually transmitted infections among males in urban slums of Delhi.

BACKGROUND India is at present facing an emergence of sexually transmitted infections (STIs) and human immunodeficiency virus. Community-based studies on the prevalence of STIs among males are scanty. AIM (i) To study the prevalence of STIs and (ii) to assess the level of awareness about STIs among males belonging to the reproductive age group residing in an urban slum. SETTING AND DESIGN This is a cross-sectional study conducted in selected areas of Delhi, using a camp approach. MATERIALS AND METHODS One hundred ninety-six males in the reproductive age group were interviewed regarding their awareness about STIs, past history and present complaints of any symptoms suggestive of an STI. This was followed by a clinical examination. Required samples were also collected for microbiological tests. STATISTICAL TESTS Simple proportions and Chi-square test. RESULTS AND CONCLUSIONS As many as 70% of the study participants were unable to mention even one symptom of an STI. About 73.4% of the study participants stated that staying in a monogamous relationship could help prevent STI, while only 39.2% were aware that condoms could afford protection against an STI. As many as 8.7% complained of urethral discharge, while 5.6% complained of itching, 2.5% reported presence of genital ulcer and 1.0% complained of groin swelling. We found a seroprevalence rate of 1.5% for trichomoniasis and 3.6% for syphilis. Thus the overall awareness level about STIs and their prevention was rather low. Poor treatment-seeking behavior was also observed. The actual prevalence rate in the general population might be higher due to the likelihood of presence of an asymptomatic infection. The present study calls for a multipronged approach which also includes targeted interventions and strategies to be adopted in the reproductive health programs for males who have been neglected by the program managers so far.

Screening for abuse and mental health problems among illiterate runaway adolescents in an Indian metropolis

Objective To evaluate the prevalence of physical and sexual abuse, and their relation to mental health problems among the illiterate/semiliterate runaway adolescents in New Delhi, India. Design Cross sectional. Setting New Delhi, India. Patients Runaway adolescent boys (n=119) aged 11 to 18 years at an observation home. Methods Study subjects were screened for physical and sexual abuse using the Child Maltreatment History Self Report and Finkelhors sexual abuse scale. Mental health problems were identified using the Achenbachs Youth Self-Report scale. As the participants were illiterate or semiliterate with Hindi being their primary language, the screening tools were appropriately translated, read out to them and their responses recorded. Results A total of 72 (62%) boys experienced domestic violence, 70 (59%) had engaged in substance abuse and 103 (87%) boys had been employed as child labourers. Physical abuse was reported by 86 (72%) and sexual abuse by 42 (35%). Mental health problems were recognised in 83 (70%) boys, which included internalising syndromes (59%) and externalising syndromes (34%). Multivariate analysis demonstrated that physical abuse was an independent predictor of internalising syndromes (OR: 3.3; 95% CI 1.2 to 9.1; p<0.01), while substance abuse and sexual abuse were independent predictors of externalising syndromes. Conclusions Our study demonstrates that childhood abuse and mental health disorders are widely prevalent among the runaway adolescents evaluated at an observation home in New Delhi. Appropriate modification of the standardised self-report screening tools may allow the identification of mental health disorders in this vulnerable illiterate/semiliterate population.

Community-based study on seroprevalence of herpes simplex virus type 2 infection in New Delhi

PURPOSE To determine the seroprevalence of herpes simplex virus type 2 (HSV-2) in two urban communities in Delhi and to correlate the presence of HSV-2 seroprevalence with sociodemographic profile, risk factors and presence of other reproductive tract infections (RTIs). METHODS Men and women aged between 15-49 years from an urban slum and an urban middle class colony were invited to participate in the study. They provided interview information; blood for HSV-2, HIV and syphilis serology; first void urine specimens for diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infection; and genital specimens for diagnosis of bacterial vaginosis, vaginal candidiasis and trichomoniasis. RESULTS The prevalence of HSV-2 seropositivity was found to be 7 and 8.6% in men and women, respectively. HSV-2 seropositivity was found to be significantly associated with urban middle class community and older age. No statistically significant correlation was found between HSV-2 seropositivity and other laboratory-confirmed RTIs. CONCLUSIONS The findings of our study indicate a relatively low prevalence of HSV-2 seropositivity and other sexually transmitted infections in the two communities that were studied.

Adherence to self-care practices, glycemic status and influencing factors in diabetes patients in a tertiary care hospital in Delhi

AIM To assess the adherence to self-care practices, glycemic status and influencing factors in diabetes patients. METHODS This was a cross-sectional observational analysis of baseline data from a quasi-experimental study conducted among 375 diabetic patients aged between 18 to 65 years at a major public tertiary care centre in New Delhi, India during February-September’ 2016. The Summary of Diabetes Self-care activities measure was used to assess medical adherence in diabetic patients. Open ended questions were used to identify facilitators and inhibitors of medical adherence. RESULTS Mean age of the study subjects was 49.7 ± 10.2 years. A total of 201 men and 174 women were enrolled in the study. Three hundred nine (82.4%) subjects were adherent to their intake of anti-diabetic medication. On binary logistic regression, education level below primary school completion and absence of hypertension comorbidity were found to be independent predictors of medication non-adherence. Sociocultural resistance was an important factor impeding outdoor exercise among younger women. Knowledge of diabetes in the study subjects was low with mean score of 3.1 ± 2 (maximum score = 10). Suboptimal glycemic control was found in 259 (69%) subjects which was significantly more likely in patients on Insulin therapy compared to those on Oral Hypoglycemic agents alone (P < 0.006). DISCUSSION Our study found a large gap existed between self-reported medication adherence and glycemic control. This suggests the need for enhanced physician focus for diabetic patient management.

Addiction-like behavior associated with mobile phone usage among medical students in Delhi

Background: Mobile phone addiction is a type of technological addiction or nonsubstance addiction. The present study was conducted with the objectives of developing and validating a mobile phone addiction scale in medical students and to assess the burden and factors associated with mobile phone addiction-like behavior. Materials and Methods: A cross-sectional study was conducted among undergraduate medical students aged ≥18 years studying in a medical college in New Delhi, India from December 2016 to May 2017. A pretested self-administered questionnaire was used for data collection. Mobile phone addiction was assessed using a self-designed 20-item Mobile Phone Addiction Scale (MPAS). Data were analyzed using IBM SPSS Version 17. Results: The study comprised of 233 (60.1%) male and 155 (39.9%) female medical students with a mean age of 20.48 years. MPAS had a high level of internal consistency (Cronbachs alpha 0.90). Bartletts test of sphericity was statistically significant (P < 0.0001), indicating that the MPAS data were likely factorizable. A principal component analysis found strong loadings on items relating to four components: harmful use, intense desire, impaired control, and tolerance. A subsequent two-stage cluster analysis of all the 20-items of the MPAS classified 155 (39.9%) students with mobile phone addiction-like behavior that was lower in adolescent compared to older students, but there was no significant difference across gender. Conclusion: Mobile phone use with increasing adoption of smartphones promotes an addiction-like behavior that is evolving as a public health problem in a large proportion of Indian youth.

An Epidemiological Study on Burden of Hearing Loss and Its Associated Factors in Delhi, India.

Introduction: Hearing loss is the second most common cause of years lived with disability (YLD). The present study was conducted with an objective to determine the prevalence, severity, and sociodemographic correlates of hearing loss among people aged 3 months and above in selected areas of Delhi, India. Material and Methods: A community-based cross-sectional study was conducted in selected rural and urban areas of Delhi among population aged 3 months and above. Of the total sample size of 664, 85 study subjects (17 households) were taken from the rural area, and 579 (116 households) were taken from urban areas. The hearing test and ear examination was carried out using handheld oto-acoustic emission (OAE) in children <5 years of age and pure tone audiometry in individuals above 5 years of age. SPSS software was used for data analysis. Chi-square test was used to analyze difference between proportions. Results: Overall prevalence of hearing loss was 25.1%. Conductive hearing loss was present among 61 (10.3%) subjects, mixed hearing loss was found among 5 (0.8%) subjects, and sensorineural hearing loss among 94 (15.8%) subjects. On OAE, 62 (89.9%) children passed the test, and 7 (10.1%) were referred. Increasing age, female gender, and low education were significantly associated with hearing loss. Conclusion: There was high prevalence of hearing loss in the study sample. Urgent interventions are required to identify individuals with hearing loss so that its serious complications can be reduced.

Sociodemographic Profile and Treatment-Seeking Behavior of HIV Infected Children Accessing Care at Pediatric ART Clinic of a Tertiary Care Hospital in Delhi

Background: Acquired immunodeficiency syndrome (AIDS) has emerged as one of the most serious public health problems in India. The parents of HIV-infected children are more likely to die and thus render the children orphan. The sociodemographic characteristics of children with HIV infection are different than the other children of the same age group. With the diverse range of manifestations, the symptoms of HIV/AIDS can appear in children at any time during the course of infection. After appearance of various signs/symptoms, the parents wander to various health agencies for relief and thus lose their vital time. Aims: The present study was conducted (1) to study the sociodemographic profile of children living with HIV/AIDS and (2) to know the treatment-seeking behavior of HIV/AIDS patients before coming to the tertiary hospital. Materials and Methods: The study was a hospital-based cross-sectional study where 216 children registered at the pediatric ART clinic of a tertiary care hospital in Delhi and their caregivers were included in the study. Semi-structured, pretested interview schedule was used for data collection through face-to-face interviews. Results: Out of the 216 children, males outnumbered females in the ratio of 2.48:1. Most of the children were in the age group of 10–14 years (48.1%) and the majority belonged to urban areas (63.4%). Most of the children were going to school. Majority of children (46.3%) belonged to social class-4. Hospitals (62.5%) were consulted first followed by private practitioners (33.3%) by these patients after appearance of earliest symptoms. Presenting symptoms of HIV in children were not specific and the most common symptom was fever (79.1%) followed by not gaining weight (69.4%), recurrent diarrhea (65.3%), cough (41.7%) and vomiting (30.6%). The average number of consultations sought by these patients before coming to this hospital was 2.34 per patients. Hospitals (39.8%) and prior experience at same hospital (33.3%) were the most common source of information about the ART center.