Indian Journal of Preventive Medicine

The number of people living with hypertension (high blood pressure) is predicted to be 1.56 billion worldwide by the year 2025. Hypertension is the most important preventable risk factor for premature death worldwide it increases the risk of ischemic heart disease, strokes, peripheral vascular disease, and other cardiovascular diseases, including heart failure, aortic aneurysms, diffuse atherosclerosis, chronic kidney disease, and pulmonary embolism. Growing burden of hypertension is mainly due to modern life style factors such as sedentary lifestyle, poor dietary choices, alcohol consumption, stress etc. Intake of modified therapeutic healthy diet and increased physical activity helps to prevent hypertension.

Keywords: Hypertension; Risk Factor; Modern Life Style; Healthy Diet. 

Background: Adolescents group is usually perceived as a healthy age group, and yet the reports shows that 20% of them at any given point of time suffer from mental health problems like depression or anxiety which is most common among them. Depression among medical students is one of the most neglected aspects of public health problem in our country which has a substantial impact on their educational achievement and career. Hence this study was undertaken to find out the prevalence and associated risk factors of depression among medical students. Materials and Methods: A crosssectional study was conducted during April 2017 on first year medical students at a medical institution in Madikeri in Karnataka. The aim of the study was to screen the medical students for depression using Beck Depression Inventory scale and to determine its associated factors of depression. Results: The overall prevalence of depression according to Becks Depression Inventory Scale was 41.1%. Among them three quarter (74.5%) of the study population had mild to moderate depression. In the present study it was found that the prevalence was more in females (42.7%) when compared with male counterparts. there was significant association was found between the prevalence of depression and factors like alcohol use, those participants having family problems and those medical students who had a family history of depression. Conclusion and Recommendations: Measures like screening of the medical students, early diagnosis and interventions like counseling, consultation with the psychiatrist will play a huge role in healthy professional career of medical students.

Keywords: Depression; Medical Students; Prevalence; Teaching Hospital. 

Introduction: Tobacco consumption is a major public health issue and is the major risk factor for six leading causes of death, namely ischemic heart disease, cerebrovascular diseases, tuberculosis, lower respiratory tract infections, chronic obstructive pulmonary disease, and cancers (trachea, bronchus and lungs) 12 million cases of preventable tobacco related illnesses takes place each year. In India, 90% of the oral cancer patients were tobacco chewers. The mortality attributable to tobacco has been estimated to be about 900,000 per year in India. Aims and Objectives: The study was done with the objective of assessing the prevalence and patterns of tobacco usage among rural population at Kuppam field practice area, A.P. Methods and Materials: Prevalence study was done at field practice area of Kuppam in A.P. Result: Total 1500 individuals above 15 yrs were studied. The overall prevalence of tobacco use among the subjects was 61.3%. The prevalence of smoking, chewing and snuff use was 19.5%, 56.6% and 2.7% respectively. The most common type of mixed use was found to be smoking and chewing (88.9%). Most common smoking product was beedi (98.3%). Tobacco chewing was mostly with betel leaf and areca nut (83.6%).

Keywords: Tobacco; Pattern; Smoking; Rural. 

Introduction: Women of reproductive age have been defined by World Health Organization (WHO) as those between 1549 years. The primary aim of antenatal care is to achieve, at the end of pregnancy, a healthy mother and a healthy baby. To provide universal access to equitable, affordable and quality maternal health care, and also to bring about an improvement in the health status of the pregnant women. In this perspective the current study was undertaken to assess the magnitude of utilization of maternal health care services. Aim: To assess the magnitude of utilization of maternal health care services. Method: 160 lactating women were interviewed by house to house visit by simple random technique and were assessed as per the study objective by semistructured questionnaire. Results: As per our study 48.2% of the mothers were in the age group of 18 – 22 years and 12.50% of mothers were illiterates whereas 13.125% of the fathers were illiterates. Majority of the mothers were 96.3% (154) home makers. As per the number of antenatal visit the mean visits was 6.57. 100% were aware of JSY scheme and 51.4% had received cash incentive. Conclusion: It is commendable to note that, all the mothers (100%) had registered their pregnancies. Probably due effective work done by health care workers at gross route level. Out of 160 deliveries, all were institutional deliveries in the study area and this may be due to the various state and central government programmes and schemes like Janani Suraksha Yojana.

Keywords: Antenatal; Utilization; Janani Suraksha Yojana; Institution. 

Introduction: Sanitation workers are the backbone of the civic cleaning system. In a developing country, like India, with limited resources, most of the cleaning process in urban localities is done manually. With improper segregation of waste materials at the source and all types of garbage being disposed on the streets, these workers are exposed to dirt, infective organisms, and other hazardous materials like chemicals, animal excreta, and sharp objects. As a result of this, they suffer from various morbidities. Aim and Objectives: The study was carried out to study the morbidity profile and knowledge and practices regarding use of personal protective equipments amongst sanitary workers in Aurangabad Municipal Corporation. Material and Methods: The present Cross sectional study was conducted by Dept. of Community Medicine MGM Medical College, Aurangabad during January 2016 – June 2016 including all the sanitation workers in Aurangabad Municipal Corporation. Data was collected by personal interview technique using pretested semistructured questionnaire& clinical examination and laboratory investigations. Permission was obtained from the institutional ethical committee for conduction study. Results: Out of total 182 workers, 78 (42.85%) were in the age of 36 to 45 years, 115 (63.18%) were males and 136 (74.71%) workers were educated above middle class. Injuries caused during working was most common morbidity 89 (48.9%), followed by musculoskeletal complaints 86 (47.25%). Other common complaints were indigestion (65.3%), worm infestation (24.5%), the eye problems 54 (29.67%) workers, 34 (18.68%) presented with respiratory problems like a cough (17.3%), breathlessness (15.2%), 26 (14.2%) workers presented with dermatological disorders . A total of 151(82.96%) workers didn’t use any protective devices while working. Out of 182 workers, 64 (35.16%) workers were not immunized against hepatitis B and 35 (19.24%) didn’t receive injection TT in recent past. 138 (75.82%) workers were addicted to one or the other addiction like tobacco, alcohol, gutkha, and smoking. Conclusion: It was concluded that the sanitary workers are suffering from various morbidities because of lack of knowledge and practices of safety devices. The health status should be reviewed on regular basis and continued health education and counseling must be made available.

Keywords: Sanitation; Workers; Corporation; Health Status; Occupational. 

Background: In India, Tuberculosis (TB) is a major public health problem since ages. Awareness about the disease and transmission, its diagnosis and treatment among community will help in controlling the notorious disease. So, periodic assessment of the awareness regarding TB will help in control of disease. Objectives: To assess awareness regarding symptoms, causes,spread, and treatment of TB in a rural area of North Kerala. Materials and Methods: A community based cross sectional study was conducted in rural field practice area of a medical college in North Kerala. The sample size calculated was 240. Convenient sampling method was used for the sampling. By visiting homes, data was collected from the adults aged >18 years by using pretested semistructured selfadministered questionnaire in local language. The descriptive statistics and chisquare test were used for analysis. Results: Out of 240 people, almost all heard about TB. About 90% were aware that cough is a symptom of TB, 90% know that TB can spread from one person to another and 87% said cough as one of the important mode of spread. Regarding, diagnosis of TB, 84% said availability of test and 77% of the subjects were aware of the free treatment in government health centres. About 74% were willing to share the status of TB to family and friends. Around 90% told they will dispose the sputum safely. Conclusion: Knowledge, attitude and practice about TB among study population was good. Awareness about availablity of diagnostic test, usage of hand kerchief or cloth during coughing and free treatment has to stress during health education activities.

Keywords: Awareness; Tuberculosis; Rural Population; North Kerala. 

Recognizing the need for augmenting the private sector’s response to HIV/AIDS, an initiative was started in the southern state of India. A programmatic evaluation of Andhra Pradesh AIDS Consortium (APAIDSCON), examining its impact on HIV/AIDS care and treatment service delivery was undertaken. The APAIDSCON program evaluation, based on U.S. Centers for Disease Control and Prevention’s evaluation protocols, was conducted in 20132014 at four randomly selected private medical colleges. Mixed method approach was used, including focus group discussions, indepth interviews, and review of program monitoring data, to ascertain impact on HIV/AIDS care and treatment service delivery. Respondents, randomly selected, included 115 clients accessing HIV testing and counseling and 115 HIVpositive inpatient clients. Patient satisfaction was assessed through descriptive analysis of median and mode scores, followed by nonparametric tests. Findings indicate increased HIV/AIDS service utilization at evaluation sites. A total of 47,260 clients availed HIV testing at evaluation sites during April 2008March 2011. Significant increase was noted in the proportion of highrisk group individuals being tested (Z score 10.68; p< 0.01) and the proportions of HIVpositive outpatients (Z score 2.29; p <0.02) and inpatients (Z score 3.41; p <0.01). Stipulated standards for HIV treatment and care were adhered to. 118 positive pregnant women had institutional delivery; and 93.3 percent (n=10) of the women and 95% (n=112) children received Nevirapine. The overall patient satisfaction was high. Participation of private medical providers and a board basket of services may enhance institutional performance and improve access to HIV care and treatment services.

Keywords: Partnership; PPP; National AIDS Control Programme; India; Stigma and Discrimination. 

Objectives: Metabolic syndrome conveys significant risk for future atherothrombotic cardiovascular events and has important correlation with the working environment. So, we aimed to see prevalence of metabolic syndrome among medical professionals of Bikaner, Rajasthan. Material and Methods: It is a cross sectional study. We recruited 390 (180 doctors and 210 paramedical staff) medical professionals. Detailed physical and laboratory examination were done. Data was collected in a proforma having questionnaires about physical activity, job stress, sleeping hours, working hours, and alcoholism and smoking habits. IDF Criteria in Indian Reference were used to reveal prevalence of metabolic syndrome. Correlation with multistep regression analysis and coefficient of contingency were derived from the results. Results: The overall prevalence of metabolic syndrome is 47.95% while according to gender that is 49.19% and 43.37% in females and males respectively. The prevalence in doctors is 50.56% and in paramedical staff is 45.71%.The prevalence of various abnormal components of metabolic syndrome is as: waist circumference (51.28%), FBS (26.15%), SBP (36.97%), DBP (21.79%), HDL (46.92%), and TG (51.28%). The coefficient of contingency of physical inactivity and job stress is 0.30263 and 0.26278 respectively. Conclusion: Prevalence of metabolic syndrome is very high in medical professionals while physical inactivity and job stress are the most important risk factors.

Keywords: Metabolic Cardiovascular Syndrome; Dyslipidemia; Hospital Medical Staff; Central Obesity. 

Background: General health awareness is less among the persons in developing nations compared to developed nations. Kerala is a state in India with a very good literacy rate and with a very low infant mortality and maternal mortality rates per live birth, but, there is increasing burden of noncommunicable diseases. Since health education is one of the key component in prevention of diseases in the community, so we conducted this study. Objectives: To assess the general health awareness among the rural population of Kannur, North Kerala, and India. Materials and Methods: A cross sectional study was conducted in Pinarayi grama panchayath under the rural field practice area of Community Medicine Department, Kannur Medical College, Kannur. Convenient sampling method was used for the sampling. By visiting homes, data was collected from the adults aged >18 years by using pretested semistructured selfadministered questionnaire in local language and the descriptive statistics were analysed. Results: 300 persons were participated with a mean age of 58.62±10.25 years and 52% of females were participated in the study. The general awareness about maternal and child health, family planning and communicable diseases was average to good whereas about HIV/ AIDS and STIs was good. Awareness about tobacco and alcohol as noncommunicable diseases risk factors was good whereas importance of second hand smoking, regular blood pressure monitoring was poor. Conclusion: In our study, overall, the general health awareness among the study population was average to good. So, we recommend strengthening the existing health education component to create more awareness among the study population.

Keywords: General Health; Awareness; Rural Population; North Kerala. 

Background: Cancer of esophagus is one of the common cancers in the whole world. Recent estimates have placed cancers of the esophagus in the 5th place among males and 7th place among females. Studies had shown that bidi smoking, paan chewing, alcohol and nutritional habits like spicy foods & malnourishment are strongly associated with cancer esophagus. Aim: To assess the clinical and epidemiological profile of the patients with carcinoma of esophagus and to study their various treatment modalities and the prognosis over a period of one year for the patients with carcinoma esophagus. Methodology: A prospective longitudinal study was conducted at Kidwai Memorial Institute of Oncology from Jan 2012 to June 2012, a regional cancer center in South India. A total of 356 confirmed cases of carcinoma esophagus were included in the study. For assessing the association of risk factors equal number of age and sex matched controls were selected, from the attenders and relatives of the patients. For all the patients endoscopy was done to assess the exact site of location of cancer of esophagus and a small sample of the cancer site was taken and sent for hitopathological examination to identify the pathological type of cancer esophagus. All the patients were followed for a period of one year for assessing the prognosis of the disease. Results: Among the various factors smoking, alcohol, non vegetarian diet, high intake of spicy foods and oily foods and high amount of coffee consumption had shown a strong association for the incidence of esophageal cancer as their odds ratio were more than one. More than 50% of the study subjects had the cancerous lesion in the middle one third of the esophagus and the most common type of cancer was squamous cell carcinoma. The overall survival with a fair to good prognosis with effective treatment at the end of one year was found to be 20%. Conclusion: Early diagnosis is a key element in the management of cancers, which would have a direct impact in the prognosis of cancers. So, timely intervention on the dietary and lifestyle habits in addition to the improvement in the economic status may address the problem to a considerable extent.

Keywords: Esophageal Cancer; Risk Factors; Squamous Cell Carcinoma; Prognosis. 

Breast cancer is a leading cause of death among females worldwide and accounts for 25% of all cancer cases and 15% of all cancer deaths among them. Early diagnosis and timely treatment can save millions of lives. Present study is a community based cross sectional survey carried out among rural women in South India, with an aim to find out their awareness levels and knowledge on breast cancer and prevalence of practice of Breast Self Examination (BSE) among them and also examine the existing relationships between certain demographic variables i.e. age, education levels and marital status and practice of BSE. The study population comprised of 1370 rural women. Two research questions and three null hypotheses guided the study. The instruments used for data collection were validated structured questionnaire and a Health Educational Interventional Package (HEIP). Demographic information on the rural women was also obtained and analysed. The result of the study indicated dismal levels of awareness on breast cancer and low levels of practice of BSE among the participants. Further, the study revealed significant association between respondent’s educational level/age and practice of BSE. The study reinforces the need to develop interventional strategies to increase BSE practices, especially among the rural women and empower women with information about early detection methods of breast cancer which in turn will change the outcome of the disease.

Keywords: Demographic Variables; Breast SelfExamination; RuralWomen; Health Education; Educational Level.