Tanu Anand

Prevalence of depression in students of a medical college in New Delhi: A cross-sectional study

BACKGROUND Medical education is associated with various pressures and stresses which can lead to depression. This study was undertaken to discover the prevalence of depression in medical students and various factors contributing to depression. METHOD This is a cross-sectional, questionnaire-based study. Using stratified random sampling, 237 students were selected according to year of study. Patient Health Questionnaire (PHQ-9), based on PRIME-MD Today, was used to make a provisional diagnosis of depression. RESULTS The overall prevalence of provisionally diagnosed depressive and major depressive disorder using PHQ-9 was 21.5% and 7.6%, respectively. Year of study and academic performance of students had a statistically significant association with depression. Other factors, including gender, self-reported past history of depression, family history of psychiatric disorders, type of social support, family structure, number of siblings and education of parents were not found to have any significant association with prevalence of depression in the study. It was also observed that students were reluctant to seek help for depressive symptoms.

Issues in prevention of iron deficiency anemia in India

Iron deficiency anemia (IDA) continues to be major public health problem in India. It is estimated that about 20% of maternal deaths are directly related to anemia and another 50% of maternal deaths are associated with it. The question, therefore, is why, despite being the first country to launch the National Nutritional Anemia Prophylaxis Programme in 1970, the problem of IDA remains so widespread. As is to be expected, the economic implications of IDA are also massive. The issues of control of IDA in India are multiple. Inadequate dietary intake of iron, defective iron absorption, increased iron requirements due to repeated pregnancies and lactation, poor iron reserves at birth, timing of umbilical cord clamping, timing and type of complementary food introduction, frequency of infections in children, and excessive physiological blood loss during adolescence and pregnancy are some of the causes responsible for the high prevalence of anemia in India. In addition, there are other multiple programmatic and organizational issues. This review, therefore, is an attempt to examine the current burden of anemia in India, its epidemiology, and the various issues regarding its prevention and control, as well as to offer some innovative approaches to deal with this major health problem.

Low back pain and associated risk factors among undergraduate students of a medical college in Delhi

CONTEXT Low back pain (LBP) is the most common orthopedic problem worldwide and is known to affect both younger and older adults. The stressful and time consuming curriculum of medical students predisposes them to this problem. Few statistics are available on prevalence rates of LBP among medical students in India. This study assesses the prevalence and risk factors of LBP in students of a medical college in Delhi. METHODS A cross-sectional study was carried out in a medical college in Delhi. The study subjects (n = 160; 100% participation) were selected via stratified random sampling from all undergraduate medical students (aged 17-25 years). A validated questionnaire was used to collect the data. RESULTS The overall prevalence of LBP among the students over the past one year was 47.5% (n = 76) with a prevalence of 32.5% at the time of data collection. Prevalence among males and females was 45.3% and 50%, respectively. Significant associations were found between LBP in the past year and coffee drinking (Regular = 57%, Occasional = 38.9%, Never = 65.2%, χ2 = 7.24, P= 0.02), body posture (Normal = 32.6%, Abnormal = 75%, χ2 = 18.97, P < 0.001), place of study (Study table = 33.8%, Bed = 58.6, Both = 61.5% χ2 = 10.51, P = 0.01), family history of LBP (Present = 75%, Absent = 38.3%, χ2 = 16.17, P < 0.001) and carrying backpacks (Regular = 50%, Occasional = 33%, Never = 0%, χ2 = 16.17, P < 0.001). The mean scores of depression (2.7 vs. 1.6), anxiety (3.5 vs 1.9), and monotonous work (3.9 vs. 1.8) were found to be significantly higher in group with LBP than in the non-LBP group. However, no association with LBP was seen for weight lifting, watching television/working on computers, driving, wearing heels, or body mass index. DISCUSSION The high prevalence of LBP among medical students and its association with poor study habits, lifestyle habits, and psychological factors highlight a need for life skills training, education, counseling, and restructuring of the medical curriculum.

Knowledge, attitude, and level of physical activity among medical undergraduate students in Delhi.

INTRODUCTION Physical inactivity has been implicated as a major risk factor for cardiovascular diseases. The healthy lifestyle of medical students could facilitate the formation of healthy physicians who is more likely to give effective preventive counseling to their patients. Therefore, this study was undertaken to assess the knowledge, attitude, and pattern of the physical activity among the medical students. MATERIALS AND METHODS A cross-sectional study was conducted amongst 161 eligible sixth semester medical undergraduate students. A pretested questionnaire was used to collect the data. Anthropometric measurements were also taken. The data were fed and coded in Microsoft Excel 2007 and analyzed using SPSS 17.0 and Epi Info software of World Health Organization. RESULTS Knowledge regarding different types of exercise and anthropometric variables was fairly low among the study participants. Only 9.3% of the students were aware of the recommended level of the physical activity but nearly all (96.27%) were aware of the benefits of it. The attitude of the participants toward the physical activity was favorable, yet only one-third (32.3%) subjects adhered to recommended guidelines. Boys (39.8%) were found to be significantly more active than girls (20.6%) (P = 0.01). CONCLUSION The knowledge and practices regarding the physical activity was found to be low amongst the medical students. There is a need to provide an enabling environment for promoting the physical activity amongst them so that can inculcate the same in their patients.

Occupational stress amongst nurses from two tertiary care hospitals in Delhi.

Background Nursing is known to be a stressful profession. Nursing staff working at the bottom of the hierarchy and in public hospitals are the ones who are more stressed out. There is a paucity of data on prevalence of stress amongst nurses in the Indian setting. The individual contribution of various stressors, operational in nurse’s personal and professional life, to the overall stress levels also needs to be studied. Method A hospital based cross sectional study was carried out on 87 randomly selected staff nurses working in two tertiary care teaching hospitals of Central Delhi. Data was collected using pre-tested and self-administered questionnaire. Sociodemographic profile, stressors in daily life, stressors at workstation and total stress level was also assessed. The data was fed and analysed using WHO’s EPI-INFO 2005 software.

Knowledge and Use of Personal Protective Measures Against Mosquito Borne Diseases in a Resettlement Colony of Delhi

Background: Mosquito borne diseases (MBDs) are major public health problem in India. State of Delhi is endemic for dengue and other MBDs. The increasing incidence of MBDs in Delhi in recent years warrants a pro-active approach for their prevention. Knowledge and use of personal protective measures (PPMs) presents an effective strategy for prevention and control of MBDs. Aim: The present study was conducted to assess the knowledge and use of PPMs against MBDs in an urban resettlement colony of Delhi. Subjects and Methods: It was a cross-sectional study carried out in a resettlement colony of Delhi. A total of 100 families were selected by systematic random sampling. Data was collected using semi-structured questionnaire and supplemented by spot survey by the investigator in the community. The results were analyzed in SPSS version 16.0 (Chicago Illinios, USA). Results: Out of the 100 respondents, 65% (65/100), 58%(58/100) and 13% (13/100) had heard about dengue, malaria and chikungunya, respectively. Nearly, one-fifth (20/100; 20%) of the participants reported incorrect breeding sites for mosquitoes. The knowledge regarding PPMs was very high (93/100; 93%) and about (90/100; 90%) families were actually using at least one of the PPMs. However, very few families were using them correctly (1/90; 1.1%) and adequately (5/90; 5.6%). The most common PPM being used by the study population was liquid vaporizers (54/90; 60%). Nearly one-third (29/90; 32.2%) of the participants reported side-effects due to PPMs with irritation to smell being the most common reported side-effect. On house visit, adult mosquitoes were seen in 67% (67/100) of the houses, while potential mosquito breeding sites were found in and around 56% (56/100) houses. Conclusions: There were crucial gaps in knowledge and practices of participants with regard to prevention and control of MBDs. Thus, there is a need to intensify efforts toward creating public knowledge and mobilizing community about correct use of preventive measures against MBDs.

Menstruation related myths in India: strategies for combating it

Menstruation is a phenomenon unique to girls. However, it has always been surrounded by taboos and myths that exclude women from many aspects of socio-cultural life. In India, the topic has been a taboo until date. Such taboos about menstruation present in many societies impact on girls’ and womens emotional state, mentality and lifestyle and most importantly, health. The challenge, of addressing the socio-cultural taboos and beliefs in menstruation, is further compounded by the low girls’ knowledge levels and understandings of puberty, menstruation, and reproductive health. Thus, there is the need to follow a strategic approach in combating these issues. The current paper aims to discuss menstruation related myths prevalent in India, their impact on womens life, relevance of addressing these issues in primary care and a brief description about various strategies to combat them.

Occupational hazard exposure and general health profile of welders in rural Delhi

Background: Welding is a common industrial process associated with various health hazards. The aspect of duration of hazard exposure among welders at their workplace has been studied to limited extent in India. Objective: To assess the duration of occupational hazard exposure and its association with symptoms among the welders. Materials and Methods: A cross-sectional study was conducted amongst 106 welders in North Delhi. Data was collected using a questionnaire containing items to assess the socio-demographic profile, their medical history and individual hazard exposure. Results: Majority of them were involved in skilled/semi-skilled job (n = 99; 93%). The predominant nature of work for majority was manual. More than half reported their work to be physically hard (n = 56; 53%), involves much lifting of weight (n = 61; 57%), and is dangerous (n = 59; 56%). Dust/smoke followed by noise was reported to be most common hazards at the workplace by them. Most of them were suffering from eye related symptoms (n = 63; 59%) followed by skin conditions (n = 28; 26%). Skin diseases were reported to be significantly common among group of welders who were exposed to dust and radiation for ≥4 hours in a day (P < 0.05). Conclusions: Nearly half of the welders found their job to be dangerous and were being exposed to at least one hazardous substance at their workplace. Majority of them complained of eye symptoms. There is a need for health and safety training of this economically productive group.

Effect of Life Skills Training on Dietary Behavior of School Adolescents in Delhi A Nonrandomized Interventional Study

Skill-based education has been shown to reduce high-risk behavior among adolescents, but in India, life skills have often been looked at only from the reproductive health perspective. Therefore, the current study was undertaken to assess the effect of life skills training on dietary behavior of adolescents studying in grades 9 and 11 of 2 schools in Delhi. This was a nonrandomized interventional study with a control group. A self-administered questionnaire was used for assessment of dietary behavior at baseline, 15 days, and 3 months after the life skills training. Two life skills training sessions were imparted to the intervention group, focusing on the use of life skills in making healthy choices. Participants in the intervention group (n = 180) showed significant improvement in knowledge (P < .001), attitude (P = .007), and practices (P < .001) following the life skills training. To conclude, a skills-based approach does help improve the dietary behavior in adolescents.

Prevalence of risk factors for chronic non-communicable diseases using who steps approach in an adult population in Delhi

Objective: The burden of non-communicable diseases (NCDs) is increasing worldwide largely due to prevalence of various risk factors, which can be controlled. Therefore, the present study was undertaken to measure the prevalence of major preventable risk factors for chronic non-communicable diseases in an urban resettlement colony of Delhi, using STEPS approach. Materials and Methods: A cross-sectional study, that included a random sample of 200 adults, was conducted. A study tool based on the WHO STEPS questionnaire for assessing non-communicable diseases and their risk factors was used. Fasting venous blood sample was collected to assess the lipid profile and fasting blood sugar. Anthropometric measurements of the participants were also taken. Data was analyzed using SPSS version 17. Results: Out of the 200 participants, 26% (n = 52) were consuming alcohol and 17% (n = 34) were smoking. Majority (77.5%) had a raised waist circumference, and more than two-thirds were either overweight or obese. Fasting blood sugar levels were found to be raised in 18% of the study population. More than third participants had raised systolic and diastolic blood pressures and abnormal lipid profiles. More males were found to be overweight in comparison to females (P < 0.01), but in contrast, obesity (P < 0.05) and raised waist circumference (P < 0.001) were more common in females. Tobacco use was more common in lower class (P < 0.05), whereas obesity was commoner in the upper socio-economic class (P < 0.05). Conclusions: Study showed a high burden of risk factors for NCDs in the study population, pointing towards changing disease epidemiology of non-communicable diseases in India.