Swaroop Kumar Sahu

Malnutrition among under-five children in India and strategies for control.

Malnutrition among under-five children is an important concern for the health authorities in India. The aim of the present review was to assess the burden of under-nutrition and over-nutrition, its determinants and strategies required to tackle malnutrition among under-five children in India. Recent data were collected from Google search, Medline, and others. The information retrieved was reviewed and analyzed for discrepancies. Existing evidence shows that the prevalence of under-nutrition among under-five children was high and varied widely (under-weight: 39-75%, stunting: 15.4-74%, wasting: 10.6-42.3%) depending on the assessment methodology adopted. Studies on assessment of over-nutrition status among under-five children were limited. Distribution of various types of risk factors and its influence on nutrition status of children in a given set up should be analyzed for planning the control measures. Strengthening public health interventions for mild malnutrition cases and vulnerable groups, effective implementation and evaluation of the strategies at regional level, research on overweight, obesity and its etiological factors and steps for improving socioeconomic development are the prerequisites for tackling malnutrition among under-five children in India.

Use of Portfolio-based Learning and Assessment in Community-based Field Curriculum

Portfolio-based learning is recognized in medical education. It helps students to assess themselves as per the key learning objectives and outcomes expected out of them. The faculty could also get feedback regarding individual students progress toward learning outcomes and facilitate the students achieve the same. This article addresses the process of portfolio development and assesses from students feedbacks, if portfolio-based learning is an improvement over record-based study in community-based field studies. The results of this study shows that involving students in framing objectives, developing a mechanism for self-introspection and self-assessment by the students and a mechanism by which faculty can monitor each students progress toward the defined objectives can significantly enhance the learnability of the students.

Prevalence of bronchial asthma and its associated factors among school children in urban Puducherry, India

Background: Bronchial asthma is an important public health problem at the global level. There is paucity of studies on bronchial asthma among school children in Urban India. Objective: To assess the prevalence and associated factors of bronchial asthma among school children. Materials and Methods: A cross-sectional study was conducted among 263 children studying in the 8th, 9th, and 10th standard using the modified International Study on Allergy and Asthma in Childhood questionnaire in Urban Puducherry. Data on associated factors that include family history of asthma, type of fuel used for cooking, placement of kitchen in the house, number of windows in sleeping room, pet animals, smoking among family members, birth order, and smoke outlet were collected. Data were analyzed by univariate analysis and expressed in proportion or percentages. Results: Prevalence of ever bronchial asthma was found to be 5.3%, of which 4.2% had current episode of asthma during the last 1-year period. About 72.7% of the current asthmatics had cold or rhinitis and 54.5% each had itching or rashes and nocturnal dry cough. Prevalence is more among the 12-13 years age group (6.5%) compared to the 14-16 years age group (3.6%). Boys (5.4%) and girls (5.2%) had comparable prevalence rates. The prevalence was significantly more among those with a family history of asthma, having smoking habits in any of the family members, and the absence of smoke outlet in the house (P < 0.05). Conclusion: Bronchial asthma is an important health problem among children in urban Puducherry. Intervention on exposure to passive smoking and provision of smoke outlets may help to reduce the burden of disease at the community level.

Isoniazid Preventive Therapy among Children Living with Tuberculosis Patients: Is It Working? A Mixed-Method Study from Bhopal, India

Abstract Objective We assessed uptake of isoniazid preventive therapy (IPT) among child contacts of smear-positive tuberculosis (TB) patients and its implementation challenges from healthcare providers’ and parents’ perspectives in Bhopal, India. Methods A mixed-method study design: quantitative phase (review of programme records and house-to-house survey of smear-positive TB patients) followed by qualitative phase (interviews of healthcare providers and parents). Results Of 59 child contacts (<6 years) of 129 index patients, 51 were contacted. Among them, 19 of 51 (37%) were screened for TB and one had TB. Only 11 of 50 (22%) children were started and 10 of 50 (20%) completed IPT. Content analysis of interviews revealed lack of awareness, risk perception among parents, cumbersome screening process, isoniazid stock-outs, inadequate knowledge among healthcare providers and poor programmatic monitoring as main barriers to IPT implementation. Conclusion National TB programme should counsel parents, train healthcare providers, simplify screening procedures, ensure regular drug supply and introduce an indicator to strengthen monitoring and uptake of IPT.

Screening for skin diseases among primary school children in a rural area of Puducherry

How to cite this article: Saurabh S, Sahu SK, Sadishkumar A, Kakkanattu JC, Prapath I, Ralte IL, et al. Screening for skin diseases among primary school children in a rural area of Puducherry. Indian J Dermatol Venereol Leprol 2013;79:268. Received: September, 2012. Accepted: November, 2012. Source of Support: Nil. Conflict of Interest: Nil. Screening for skin diseases among primary school children in a rural area of Puducherry

Risk factors and reporting status for attempted Suicide: A hospital-based study

Context: Suicide is a major public health problem and ranks second among the leading causes of death in both genders in 15-34 years. Suicidal attempts are 20 times higher than the completed suicides. Aims: The aim was to identify background risk factors and precipitating factors for suicide attempts in Pondicherry district and to find out the reporting status of suicide attempts. Settings and Design: Hospital-based descriptive study. Subjects and Methods: 200 subjects who have attempted suicide from JIPMER and Indira Gandhi Government Hospital and Post Graduate Institute Pondicherry were interviewed. Monthly data on attempted suicide were collected from Crime Record Bureau of Pondicherry and Villupuram district and Medical Records Department of these two hospitals was collected. Statistical Analysis Used: SPSS version 16.0 was used. Chi-square test was used to test the significance of the difference between two proportions. Results: Most common precipitating factor found among those who attempted suicide was verbal abuse, most often by parents (31.9%). The most common mode of suicide attempt was consumption of chemical poison in 56% of subjects followed by plant poison 41.5%. The suicide intention was high in 81.5% of subjects. No significant difference in risk factors could be found between subjects from Pondicherry and villupuram district. It was found that there was gross under-reporting of attempted suicides to Crime Records Bureau. Conclusions: Measurement of suicide intention enables us to predict the future suicidal behavior in adults; individuals with a high suicide intent index pose a major public health problem. Hence, there is a need for opportunistic screening of those with suicidal ideations as well as counseling and follow-up of those with suicide attempts to prevent further attempts.

Use of insecticide-treated bednets in an urban coastal area of Puducherry, India: A cross-sectional study

Use of Insecticide-Treated Bednets (ITNs) has been shown to reduce the incidence of mosquito-borne diseases. However, the impact of ITNs depends on its community acceptance. We studied the ITN usage and factors influencing it, following the distribution of one ITN to each family in an urban area of Puducherry. Around 93.6% of the 157 respondents surveyed were aware of mosquito-borne diseases. Coils and vaporizers were used in 91.1% of the families. Around two-fifths (41.3%) of the 116 families who received the ITNs used it regularly with another 5.1% using it irregularly. Majority of the users (85%) reported reduced mosquito bites and pleasant sleep after use. Small size of ITNs was the most common reason for non-use (46.3%). Families not using normal bed nets at the time of distribution of ITNs were unlikely to use ITNs at present (odds ratio = 5.22, P < 0.001). Therefore, ITN size should be increased and distribution in urban settings should accompany behavior change communication.

Comorbidities in pulmonary tuberculosis cases in Puducherry and Tamil Nadu, India: Opportunities for intervention

Background We aimed to define characteristics of TB patients in Puducherry and two districts of Tamil Nadu, India and calculate the population attributable fractions (PAF) of TB from malnutrition and alcohol. Methods New smear-positive TB cases were enrolled into the Regional Prospective Observational Research for Tuberculosis (RePORT India) cohort. Census and National Family Health Survey data were used for comparisons. Results Data were analyzed for 409 participants enrolled between May 2014-June 2016; 307 (75.1%) were male, 60.2% were malnourished (body mass index [BMI] <18.5 kg/m2), and 29.1% severely malnourished (BMI <16). “Hazardous” alcohol use (based on AUDIT-C score) was reported by 155/305 (50.8%) of males. Tuberculosis cases were more likely than the Puducherry population to be malnourished (62.6% v 10.2% males and 71.7% v 11.3% of females; both p<0.001), and male cases were more likely to use alcohol than male non-cases (84.4% v 41%; p < .001). The PAF of malnutrition was 57.4% in males and 61.5% in females; the PAF for alcohol use was 73.8% in males and 1.7% in females. Conclusions Alcohol use in men and malnutrition are helping drive the TB epidemic in Southern India. Reducing the TB burden in this population will require efforts to mitigate these risk factors.

Smoked and smokeless tobacco use among pulmonary tuberculosis patients under RNTCP in urban Puducherry, India.

BACKGROUND Smoking is associated with unfavourable treatment outcomes like failures and defaults among the TB patients. OBJECTIVES To study the prevalence and pattern of tobacco use among the pulmonary tuberculosis (PTB) patients in urban Pondicherry and study the association of various socio-demographic variables with current smoked and smokeless tobacco users. METHODS A cross-sectional study was conducted among 235 PTB patients from 6 randomly selected urban PHCs of Pondicherry from Jan 2013 to March 2014. Fagerstrom Test for Nicotine Dependence was used. Chi-square test and multiple-logistic regression were done. RESULTS Prevalence of smoking among the PTB patients at the time of TB diagnosis was 35.3%, whereas the same during the continuation phase (CP) was 23.4%. Among 83 smokers at the time of diagnosis, 52 modified and 31 did not modify their smoking after TB diagnosis. Similarly, prevalence of smokeless tobacco use both at the time of TB diagnosis and during CP was 9.8%. Male and lower education level was associated with current smoking. Similarly, female and lower education level was associated with current smokeless tobacco use. CONCLUSIONS One-third of PTB patients used smoked or smokeless tobacco during their CP. Health programme needs to concentrate on PTB patients who continue to use smoked or smokeless tobacco during their treatment; necessary interventions need to be planned.

Magnitude of suicide attempt in Pondicherry: An under estimate

© 2016 International Journal of Advanced Medical and Health Research | Published by Wolters Kluwer Medknow to be treated as a criminal offence under the section IPC 306 (suicide) and 309 (suicide attempt).[13] Criminalization of suicidal acts causes the problem of suicide to go underground, making it difficult for suicidal persons to receive necessary assistance.[14] Hence, the magnitude of suicide attempts is an underestimate because of the associated social stigma. In India, many deaths, particularly in rural areas, are not registered at all partly because of an inefficient registration system[15] and partly because of the fear of social and legal consequences associated with suicide.