Urvish Joshi

A Study on Prevalence of Chewing Form of Tobacco and Existing Quitting Patterns in Urban Population of Jamnagar, Gujarat

Background: Awareness towards tobacco hazards has increased with time but its role alone towards cessation is questionable. With widespread menace of tobacco in developing countries like India, not much tobacco chewing prevalence and their quitting patterns data are available in urban Saurashtra region. Objectives: 1. To find out prevalence of various forms of chewing tobacco and quitting attitudes in urban Jamnagar. 2. To study quitting patterns in relation with age of habit initiation, family background and habit duration. Materials and Methods: It was a cross-sectional study involving 2513 individuals as study population by 30-cluster sampling method. The study was carried out between June 2007 and March 2008. Pre-set, pre-tested questionnaire was used for interview purpose and the statistical analysis was done on proportion basis. Results: About 37.2% of study population was ever-tobacco-chewers; 32.9% of them were current-chewers and 4.3% were quitters. Approximately 28.4% of current-consumers were willing to quit. Mawa-masala (63.7%) and Gutka (57.6%) were preferred forms of chewing tobacco and 57.5% of the current-chewers chewed tobacco six to eight times a day. Tobacco initiation age between 20 and 30 years was commoner among quitters (84.2%), while a little younger in current-consumers (76.5%). About 58.3% quitters and 74.0% chewers showing willingness to quit had not consumed tobacco for more than five years, 63.8% of current-chewers had a family member consuming tobacco. With initiation of health problems, 72.2% subjects quit and 55.5% of them already knew about health hazards. Conclusions: Every 4 out of 10 residents was found to be exposed to chewing tobacco. With Mawa-masala and Gutka being the predominant forms, habit onset in late adolescence, years of consumption and family exposure seem to be hampering quitting. Awareness about tobacco hazards alone does not appear to be resulting in successful quitting.

Study on knowledge, attitude and practices regarding gender preference and female feticide among pregnant women

Skewed sex ratio is an issue of major concern and has long-term social and demographic consequences. At the heart of the problem is the low status of women in society a patriarchal social framework and value system based on .son mania.. The problem is getting worse as scientific methods of detecting the sex of the foetus and for termination of pregnancy are improving. This seems to be fulfilling the long felt need of the people through female feticide. In this light the study of factors influencing sex ratio becomes very relevant for better understanding of the problem. (excerpt)

Situation of P. vivax malaria in Ahmedabad city: A study in purview of national guidelines

Introduction: Malaria is still the most important cause of morbidity-mortality in India. National vector borne disease control program (NVBDCP) in urban areas is implemented through UHCs. In Gujarat, 89,764 malaria cases were reported in 2011 with 127 deaths, with 17.9% of them being the vivax cases. Ahmedabad is at the receiving end of malaria menace due to its rapid growth. Compared to 2011, significant rise in number of Plasmodium vivax (Pv) cases has been observed in Ahmedabad in 2012. Aims and Objectives: The study was carried out to assess the Pv malaria detection modalities, relevant indices, existing radical treatment strategies, and adherence to national guidelines in the urban areas of Ahmedabad. Materials and Methods: Data of all 9 UHCs of south zone, catering total population of approximately 1 million and showing significant rise in Pv cases, were verified clubbed with field analysis, for the corresponding quarters of March, April, and May of two consecutive years-2011-2012. Concerned healthcare staff was interviewed. Guidelines and definitions of national anti-malarial guidelines and operational manual were followed. Process indicators for surveillance, case finding, and disease burden were considered. Results: Out of total blood smears examined, Pv cases raised from 97 (2011) to 382 (2012). Statistically significant rise of Pv% was 0.35% and 2.79% in active and passive slide collection, respectively. 71% slides were actively collected in both years. Quarterly Blood Examination Rate (QBER) rose from 1.50% to 2.41%. Quarterly Parasite Index (QPI) rose from 0.12 to 0.39. Successful Radical Treatment of Pv Malaria (RT) completion decreased from 59.8% to 29.1%. Knowledge regarding national-anti-malarial-guidelines was satisfactory in more than 70% of healthcare functionaries. Interpretations: Number of cases significantly increased in two years, Pv-positivity rise being 1.04%. Active slide collection is static. Rise in Pv-positivity should trigger improvement in the same. Average QBER and QPI rose in two years. QBER never reached prescribed levels. Successful RT-completion is the key towards drug-resistance and relapse prevention. Adherence to national-anti-malarial-guideline is imperative.

Situational analysis of malaria in Ahmedabad city (India)

Introduction Malaria is one of the major public health problems in India. Malaria cases are on rise in major cities including Ahmedabad owing to rapid urbanization, industrialization and humidity. Monsoon patterns are changing due to global warming. Present study was carried out to analyze the situation of malaria in 2011 in selected wards of Ahmedabad in purview of NVBDCP. Methodology Field areas (urban slums) catered under public health service delivery of total 3 wards of south and east zones under AMC (population worth about 3 lakhs) were selected based on systematic random sampling. Situational analysis was done based on the locally adapted tool from national guidelines. Results More than 95% of smears were positive for P. vivax parasite with highest total positivity reporting from Isanpur (38.24%). Parasite incidence was highest in Danilimda (0.64 per 1000). RT completion was least in Amraiwadi (51.11%). Procurement of contact smears was not a uniform practice. The SPR was highest in Isanpur for both active and passive surveillance (7.14% and 2.11% respectively). MBER was highest throughout in Danilimda and lowest in Isanpur. Results were conveyed to the patients within 24 hours by all laboratories except the one of Danilimda ward. ACT packs for children were not available at Amariawadi. No injectable medicines were available at any of the centres. Knowledge about dilution process of the abate solution amongst link workers was faulty. ConclusionAPI more than 2 is an indication for starting IRS activities. Urgent measures are required to improve MBER and eventually ABER. Incomplete RT owing to loss of follow-up issues needs to be addressed with implementation of line-listing. Area of contact smears need to be emphasized upon. The slide positivity rate of active surveillance is significantly lower suggesting poor quality of active surveillance. Quality assurance of blood smear examination should be more stringent. Sufficient stock of medicine has to be ensured at all the centres specially during high transmission season. Situational analysis of malaria in Ahmedabad city (India) Introduction After sub-Saharan Africa having the highest burden of malaria cases and deaths, in Asia, India is one of the badly affected country in terms of vector-borne diseases especially malaria [1], Malaria is one of the major public health problems in the country. There are about 216 million cases of malaria (with an uncertainty range of 149 million to 274 million) and an estimated 655 000 deaths in 2010 (with an uncertainty range of 537 000 to 907 000). [1] Approximately 2 to 3 million new cases of malaria arise every year and it still remains the most important cause of morbidity and mortality in India. [2] l All preventive and control measures for vector-borne diseases are implemented through National vector borne disease control program (NVBDCP) in India and the programme is vertically implemented nation-wide. Around 1.5 million laboratory confirmed cases of malaria are annually reported in India. In Gujarat, 89764 malaria cases were reported in 2011 with 127 deaths with 17.9% of them being P. falciparum (Pf) cases. In Ahmedabad city the number of cases was 7,158 with P. Falciparum cases 1265 and percentage being 17.7% [3]. Death audit of malarial deaths in the year of 2011 revealed that majority of the cases reaching tertiary healthcare settings were already complicated in nature. [4] Ahmedabad is the financial capital of Gujarat state worth 6 million population and one of the biggest as well as fastest developing cities in India. Rapid urbanization, immense industrialization and constantly humid temperature are some of the factors responsible for mosquito breeding and resultant urban epidemic of malaria. Government healthcare delivery and implementation of NVBDCP in the urban areas are through 56 Urban Health Centers spread in 6 zones. Vectors for malaria are species of anopheline mosquitoes. Generally, the vector breeding increases during transmission seasons which is considered to be the rainy season. Transmission season for malaria in the city of Ahmedabad is believed to be from May to August. Monsoon patterns in the country are changing which might be the result of global warming. With changing trends in monsoons, breeding patterns of vectors are also assumed to be changing. Radical treatment of malaria cases in accordance with national guidelines is the mainstay to curb the menace. Present study was carried out to analyze the situation of malaria in selected wards of 3 zones of Ahmedabad city in context of national guidelines. METHODOLOGY Study design, area and duration Almost 6 million of population of the metro city of Ahmedabad is catered by 6 different geographical zones. More than half of

Awareness about HIV/AIDS amongst commerce students

Introduction HIV/AIDS is rapidly spreading,major public health problem in India. National response emphasises the preventive strategies by high-risk-behaiour-reduction at early age and dissemination of right messages during formative years. Present study was car- ried out to assess baseline levels of HIV/AIDS awareness and to assess the impact of on-hand, interventional training in improving them among commerce students. Methodology All 50, first year commerce students from a college were selected. Awareness levels on HIV/AIDS were checked by pre and post-training questionnaire-based interview method. Gain in knowledge and change in behaviour pattern was analysed. Results More than 50% gain was seen for questions related to highest concentration of HIV in body fluids, drugs available, incubation period of HIV, indicator cells for prognosis and commonest infections in HIV/AIDS. Definite gap areas were identified in knowledge about modes of HIV transmission and opportunistic infections. More than 75%, 50% and 25% gain respectively was seen in whereabouts of ART facilities, knowledge of HIV/AIDS helplineand whereabouts of testing facilities. 42% gain was reported post-training for question on pre-transfusion blood tests. Doctors were preferred as future source of information. Unsympathetic attitude towards seropositives was seen in 4% subjects pre-training. Conclusion Dissemination of right messages during formative years is imperative. BCC with correct technical, programmatic and health-seeking-behav- iour-related knowledge is need of hour. Short, on-hand, college-based trainings on HIV/AIDS should be incorporated in syllabus.