Vimal Kishore Gupta

Dietary aspects of pregnant women in rural areas of Northern India

The aim of this article is to document the current dietary profile of pregnant women in rural areas of Delhi. In order to explore the diet the combination of quantitative (24-h recall method) and qualitative methods (food frequency method) were used. The mean intake of macronutrients and micronutrients, namely, iron, folic acid and Vitamin C which play an important role in the pathophysiology of nutritional anaemia during pregnancy was calculated from the foodstuffs, using Nutritive Value of Indian Foods. The preferences and avoidance of various foods by the pregnant women were also elicited. The data were analysed using Epi Info 3.4. The intake of calories, protein, iron, folic acid and Vitamin C was found to be less than the recommended dietary allowance in 100%, 91.2%, 98.2%, 99.1% and 65.8% of pregnant women respectively. Folic acid intakes were significantly lower in younger, primiparous and poorly educated women from low-income families. Vitamin C intake was lower among non-Hindus only. The overall data suggested the presence of food gap rather than isolated deficiency of any particular nutrient.

Psychosocial effect and economic burden on parents of children with locomotor disability

ObjectiveTo assess the social and financial burden of parents of children with locomotor disability.MethodsA cross-sectional study was conducted in the Institute for Physically Handicapped (IPH), Delhi, where parents of 100 locomotor disabled children of age group 6 to 15 years were interviewed to estimate the socioeconomic burden of caregiving their children.ResultsThe study observed that the parents of the disabled children were severely burdened in terms of financial burden and mental health.ConclusionsThere is an urgent need for support activities for such families at a national level in order to curb the huge economic and social burden of care-giving. Counselling should be an integral part of rehabilitation for such families.

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.

An assessment of felt needs and expectations of people living with HIV/AIDS seeking treatment at NGOs in Delhi, India.

People living with HIV/AIDS (PLHAs) continue to face stigma and discrimination in society. The felt needs of PLHAs can be met by means of a comprehensive, holistic, and integrated approach by the concerned sectors. This study included 100 PLHAs admitted at 3 care homes run by nongovernmental organizations in New Delhi. As many as 22% of the patients had been diagnosed with pulmonary Koch’s. Unemployment rates were found to increase after disease onset. Majority were satisfied with the medical treatment and overall care provided at these centers. About 25% expressed that they would like the government to provide them with suitable jobs. Less than one third (30%) of the PLHAs expressed satisfaction with their family life whereas the rest yearned for love and acceptance from society. Study findings highlight the important role of nongovernmental organizations and stresses on the need for a holistic approach toward the care of these people.

Prevalence and correlates of tobacco smoking, awareness of hazards, and quitting behavior among persons aged 30 years or above in a resettlement colony of Delhi, India.

Aim: To assess the prevalence and correlates of current smoking, awareness of hazards, and quitting behavior among smokers 30 years and above. Materials and Methods: Study design: Cross-sectional; Setting: Gokulpuri, a resettlement colony in East Delhi, India; Sample size: 911, persons aged 30 years and above using systematic random sampling; Study tools: Semi-structured questionnaire. Results: Prevalence of current smoking was found to be 24.6% (95% CI 21.90 - 27.49). Majority 198 (88.4%) of current smokers smoked bidi exclusively, and on an average 13.5 bidi/cigarette were smoked per day. Multivariate analysis showed the factors associated with current smoking as male sex, advancing age, illiteracy, skilled occupation, low socio-economic status, and low BMI (P < 0.001). 64.2% were aware of the hazards of smoking. 63 (21.9%) had quit smoking in the past, majority due to the health problems. Low educational status was associated with poor hazard awareness and quitting behavior. Conclusion: Smoking is a significant problem among poor and illiterate males, shows an increasing trend with an advancing age and is directly associated with skilled occupation and low BMI. There are significant gaps in knowledge regarding hazards of smoking.

Do socio-demographic factors still predict the choice of place of delivery: A cross-sectional study in rural North India

Improving maternal health is one of the goals to be achieved under the Millennium Development Goal (MDG), especially MDG-5. One of the predictors of maternal health is place of child birth. This study was carried out to determine the prevalence of home delivery and different socio-demographic factors associated with them. This study was a community-based cross-sectional study. Women who delivered a baby in the past 1 year were included in this study. A total of 300 women responded (93.2%) and gave consent to participate in the study. Prevalence of home delivery was 37.7%. Bivariate analysis showed that religion, caste, education of women and their partners, occupation of the spouse, monthly family income and socioeconomic status had a significant association with the choice of place of delivery. But multivariate regression analysis showed only religion, caste, education of spouse and monthly income to be significant factors in determining place of delivery. The findings of this study suggest that individual countries have to formulate interventions which will target marginalized or vulnerable populations with reference to caste, religion and wealth. A significant improvement in reaching the 5th MDG can be achieved if the first three MDG goals are focused on, i.e., eradication of poverty, achieving universal education and women empowerment.

Prevalence of reproductive morbidity amongst males in an urban slum of north India

Studies assessing the prevalence of reproductive morbidity among males in India have chiefly focused on prevalence of Reproductive Tract Infections/Sexually Transmitted Infections (RTIs/STIs) among males attending Sexually Transmitted Disease clinics blood donors and other selected population groups with only few focused on the magnitude and the type of reproductive morbidity amongst Indian males at community level. The objective was to estimate prevalence of reproductive morbidity including (RTIs/STIs) among males in the age group of 20-50 years residing in an urban slum of Delhi. Out of 268 males in the targeted age group selected by systematic random sampling residing in an urban sum of Delhi 260 males were subjected to clinical examination and laboratory investigations for diagnosis of reproductive morbidity. Laboratory investigations were done for diagnosis of Hepatitis B and C Syphilis Gonorrhoea Non gonococcal urethritis and urinary tract infection. A total of 90 (33.6%) of 268 study subjects reported one or more perceived symptoms of reproductive tract / sexual morbidity in last six months. Overall reproductive morbidity based on clinical and laboratory diagnosis was present in 76 (29.2%) study subjects and of this sexually acquired morbidity accounted for 21.2% cases. Hepatitis B was most common (10.3%) reproductive morbidity followed by Urinary Tract Infection (5.0%) scabies (3.5%) and congenital anomalies (3.5%). High prevalence of reproductive morbidity (29.2%) amongst males in an urban slum highlights the need for more studies in different settings. There is a need for developing interventions in terms of early diagnosis and treatment and prevention. (authors)

Impact of nutritional counseling on dietary practices and body mass index among people living with HIV/AIDS at a tertiary care teaching hospital in Mumbai

Background: In India, human immunodeficiency virus (HIV) epidemic occurs in the population in which malnutrition is already endemic. The relationship between HIV and nutrition is multi-faceted and multi-directional. HIV can cause or worsen malnutrition due to decreased food intake, increased energy requirements, and poor nutrient absorption. Malnutrition in turn further weakens the immune system, increasing susceptibility to infections and worsening the disease impact. Materials and Methods: This interventional study was carried out in the antiretroviral therapy (ART) Centre of Topiwala National Medical College and BYL Nair Ch. Hospital, Mumbai during the period of July 2011 to February 2012. A total of 123 patients during the study period were included and a pre-designed and pre-tested questionnaire was used to collect data. Data were analyzed using Statistical Package of Social Sciences (SPSS) 16.0. Results: In the present study, out of 123 study participants taken into consideration, 47.15% were males and 52.85% were females. After nutritional counseling, the percentage of participants practice of using boiled or clean water for drinking purpose increased significantly from 30.90% to 82.12% ( P Conclusion: Effects of nutritional counselling in our study groups were favourable. There were improvements in dietary practices about nutrition in people living with HIV/AIDS.

Dengue Sero-surveillance in Delhi: A Community-Based Study

Background: IgG ELISA is useful as an epidemiological tool when used to establish sero-prevalence. Extensive background information is required before selecting sites for dengue vaccine trials like types of dengue virus that are causing disease, preferably over a number of years, sero-prevalence of dengue IgG antibodies, prevalence of each serotype, rates of infection, specific mortality, etc. Aims and Objectives • To study the prevalence of dengue IgG antibodies in the serum of adults in urban slums of Delhi • To study the knowledge, attitude and the practice of study subjects about the prevention of mosquito breeding and dengue fever Methodology: This cross-sectional study was conducted from January 2013 to December 2013 in two urban slums of Delhi, Balmiki Basti and Delhi Gate. All adults aged 20 years and above were included in the study irrespective of sex and previous history of dengue. Knowledge, attitude and practices against mosquito breeding were also taken through predesigned, pretested questionnaires. Results: A total of 49(20.5%) adults from Balmiki Basti and 190 from Delhi Gate were enrolled in the study. Mean IgG dengue OD levels of the study subjects was 1.62±0.568. Of the total, 86% were positive for dengue IgG positivity while 13% negative and 1% equivocal. Of all participants, 214(89.9%) were aware of mode of dengue transmission while 25(10.1%) were not. Majority of the participants 137(57.3%) used liquid vaporizers for prevention of mosquito bites. Discussion: The current study reported that 85.4% of the healthy population in urban slums of Delhi is seropositive for dengue IgG, which indicates the unprecedented extent of exposure to dengue virus. It is 7.8% higher than the study conducted in Delhi in 1998(77.6%). It coincides with the rising trend of dengue cases every year in Delhi, making it an endemic region now.

[PS 03-18] A SOCIO-EPIDEMIOLOGICAL STUDY OF HYPERTENSION AMONG INDIAN ADOLESCENTS

Objective: To study the prevalence of hypertension and prehypertension among Indian adolescents and the associated risk factors. Design and method: A community based cross-sectional study was conducted over a period of one year in urban areas of central Delhi. 1005 adolescents were included in the study. The study was carried out by conducting house-to-house survey. The subjects selected were interviewed and tested for hypertension. Initially the purpose of the study was explained to each person in the local language. Written and informed consent was taken from parents and assent from subjects <18 years while written informed consent was taken from subjects ≥18 years. Subjects were interviewed using a predesigned, pretested, semi structured questionnaire. The collected data was analyzed using SPSS-PE-17 version. The factors significant in univariate analysis were considered in multivariate logistic regression analysis. Odds ratio and 95% confidence interval were used to quantify the risk factors. P value<0.05 was considered significant. Results: Overall prevalence of hypertension and prehypertension was 6.5% and 11.8% respectively. Prevalence of hypertension was significantly higher among higher age group [5–19 years] (p = 0.01), obese (p = 0.001), sedentary (p = 0.01) subjects, smokers (p = 0.01), non-vegetarians (p = 0.004) and those with family history of hypertension (p = 0.01). Independent risk factors on multivariate logistic regression analysis for hypertension were: age 15–19 yrs [OR = 3.31, CI:1.88–5.27], obesity [OR = 2.38. CI:1.41–4.02], non-vegetarian diet [OR = 1.79, CI:1.09–2.58], smoking [OR = 2.24, CI:1.61–3.72] and positive family history of hypertension [OR = 2.71, CI:1.79–4.58]. Conclusions: It is concluded from the present study that overall prevalence of hypertension and prehypertension was found to be 6.5% and 11.8% respectively. Prevalence of hypertension was higher among subjects of higher age group, obese, smokers, non-vegetarians and those with positive family history. Hence it is recommended that healthy lifestyle changes should be promoted to reduce the prevalence of hypertension. Intensive IEC campaigns are needed to educate adolescents about hypertension.