Indian Journal of Preventive Medicine

  A five day orientation programme was held at the in the Pharmacology Lecture Hall, CIMS and organized by the Medical education unit, CIMS. The program have attended by 98 interns Chhattisgarh Institute of Medical Sciences, Bilaspur, during 02/04/2018 to 06/04/2018 for all students who passed their final professional MBBS examinations in march 2018. New graduates were invited to attend the programme. The faculty for the programme included heads of various departments and administrators, who apprised the interns about the expectations from them and their responsibilities. The faculty also helped to clear any doubts or misconceptions. The programme included interactive lectures, structured panel discussions. Adult learning principles were used to involve the interns in a highly interactive process in a non­threatening environment. Evaluation of the programme was done using a feedback questionnaire, an interactive session between the interns and the coordinating faculty, and a pre­ and post­test evaluation. The questionnaire involved subjective assessment of the quality of the programme, the faculty and time management, and invited the interns to suggest ways of improving the programme and making it more target­oriented. A qualitative asse ssment was done by the faculty members involved and the interns were encouraged to express their opinions in an informal environment. The pre­ and post­test evaluation consisted of 30 questions that tested theoretical knowledge and clinical problem­solving skills. The questions were derived from the content covered during the programme. Issues such as blood transfusion and medico­legal and ethical concerns were included.

Keywords: CIMS=Chhattisagrh Institute of Medical Sciences.

  Context: Mortality rate can be brought down to up to 20% lesser if the correct breast feeding and weaning practices are followed. 

Aims: To study of breast feeding practices among mothers. Settings and Design: A community based cross sectional study was carried out in Anganwadi centers of field practice area of urban health training center.

Methods and Material: Data was collected in a pre designed pre tested study questionnaire.
Information was obtained on demo demographic profile, questions regarding knowledge and practices of Breast Feeding practices were asked.

Statistical Analysis: Data was analyzed using proportions. Chi square test was applied. p value of less than 0.05 was taken as statistically significant. 

Results: Majority of women had correct knowledge about breast feeding. Bottle feeding prevalence was 21.2%. About one fourth of the mothers did not feed colostrums to their babies. 17.2% of the mothers gave pre lacteal feeding to their babies. Honey was the most common pre lacteal feed used. Even 32.3% of the mothers who gave pre lacteal feed were advised to do so either by doctor or by nurse. 64.7% believed that pre lacteal feed was beneficial to their child. Elderly and literate mothers were found to have significantly better knowledge compared to the younger mothers. Other factors were not found to be significantly associated with knowledge.

Conclusion: Majority mothers had shown correct knowledge and practices. But still a significant gap of 25­30% was found. Worst finding was doctors or nurses advising pre lacteal feeding.

Keywords: Breast Feeding; Colostrum; Mothers; Infants; Bottle Feeding.

  Background: Accidents have serious implications to the construction industry both in financial and humanitarian terms. Construction accidents may cause many problems, such as de­motivation of workers; disruption of site activities; delay of project progress; and adversely affecting the overall cost, productivity and reputation of the construction industry. The human suffering caused by these accidents and ill health is distressing to all concerned, the extent of which is impossible to calculate.Accidents and ill health also have a huge financial cost, which makes for a compelling business case for improving safety and health.

Objectives: To assess the prevalence and types of work­related injuries among road construction workers in construction sites in Egor Local Government Area of Edo State.

Methods: A cross­sectional descriptive study was done amongst all construction site workers. and their supervisors involved in road construction that have spent at least 6 months on the job in Egor LGA, Edo State. A one stage cluster sampling technique was used to select the study population. Data were collected using a structure questionnaire and were analyzed using SPSS version 16.

Results: About 101 (47%) of the workers had experienced work related injuries at their construction sites. Among those respondents who had experienced work­related injuries, 69 (68.3%) reported having experienced work­related injury twice in the last 6 months, while 32 (31.7%) had experienced work­ related injury three times or more in the last 6 months. The association between hours worked per week and workrelated injury was found to be statistically significant.

Conclusion: The study revealed that nearly half (47%) of the workers had experienced work­related injuries in the last 6 months preceding the study and the most common type of injury experienced by these workers were cuts. The majority of the workers, who reported work­related injuries, were working for greater than 48hours per week.

Keywords: Prevalence; Work­Related Injuries; Road Construction; Workers.

  Introduction: As per 2011 census, there are about 253.2 million adolescents in India, which accounts to 20.9) of the population. Adolescence is considered as a nutritionally critical period of life and among adolescents; girls constitute a more vulnerable group. They suffer from various nutritional deficiencies among which majority of them suffer from anemia of different severity mainly due to nutrition (inadequate intake/absorption). Improving the haemoglobin status will not only reduce the mortality and morbidity among adolescent but will also have impact on the intergenerational cycle of malnutrition. The objectives of the present study was to determine the prevalence of anemia among rural adolescent girls and to determine the association between anemia and socio demographic variables.

Settings and Design: This is a cross sectional study, conducted in a rural area of Mandya district from August 2014 to July 2015. Methods and Materials: Adolescent girls (10 to 19 years) included in the study were 302 from randomly selected villages under the purview of Rural Health Training center, MIMS Mandya. The data was collected using petested semistuctured questionnaire and hemoglobin estimation was done by using Sahlis method.

Statistical Analysis used: Descriptive statistics and Chi square test.

Results: Prevalence of anemia was 87.1% (mild anemia­46.4, moderate anemia­40.7). None of the adolescent girls were having severe anemia. There was significant association between anemia and education level of adolescent girls, socio economic status, menarcheal status.

Conclusions: Prevalence of anemia among adolescent girls was high. Improving their socio economic status/affordability to consume more nutritious diet may improve their haemoglobin status

Keywords: Adolescent Girls; Malnutrition; Anemia; Nutrition.

  Background: Tobacco use is one of the leading and preventable causes of death, spreading as epidemic in all regions of the world, killing about 6 million people in a year. Many forms of tobacco products like smoke and smokeless form use is an age­old practice in India. Health professionals and other staffs at the health facility play a pivotal role in motivating the patients and care givers not to initiate the use of tobacco and its products.

Methods: Cross sectional study was conducted among all non teaching staffs those who consented to participate in the study in June 1st to June 30th 2017. 192 non teaching staff was interviewed and was given a pre­tested, semi­structured questionnaire to obtain information regarding the knowledge, attitude and practices on the use of tobacco and its products.

Results: of the 192, majority of them ( 68.85%) were males. Majority of them chew Gutka (70%) followed by cigarette smoking (28%). 48.95%( 94) of them opined that bus stand and market place are most frequent places of tobacco use. 31.77% (61) people were found to be using Tobacco. Of the 190 those who want to quit tobacco 70 of them opine that they want to quit because of health problems like heart attack and respiratory disease.

Conclusion: Inspite good knowledge on ill effects of tobacco, use of tobacco is common among the nonteaching staffs at health care setting. 

Keywords: Tobacco; Knowledge; Attitude; Practice; Non­Teaching Staffs.

  Context: Effect of menstrual hygiene on health of women is still not given sufficient attention in developing countries. Adolescent girls are vulnerable if they do not have awareness and good menstrual hygiene practices. 

Aims: To study menstrual hygiene practices and factors affecting it among school going adolescent girls.

Settings and Design: A school based cross sectional comparative study. Methods and Material: Present study was conducted at selected government and private schools among 171 adolescent girls (74 from government school) and (97 from private school) belonging to class 8th to class 10th.

Statistical Analysis: The data were analyzed by Chi­Square test and p value less than or equal to 0.05 was taken as statistically significant.

Results: 90.8% of the girls belonging to government school used sanitary napkins compared to 98.9% of the girls belonging to private school and this difference was statistically significant. There was no significant difference between the girls of two schools relating to sanitary disposal method. Myths related to menstruation were also found to be similar among girls of both the schools. It was found that mother was the main source of information related to menstruation in 74.7% of the cases. 51.9% of the girls were found to be aware about the government scheme of free distribution of sanitary napkins. It was found that majority (72.5%) received the sanitary napkin under government scheme among those who were aware about the scheme. Except mother’s education, other factors like father’s occupation, mother’s occupation, father’s education, and type of school were not significantly associated with good menstrual hygiene practices.

Conclusion: Mother’s education level played a significant role in good menstrual hygiene of the daughter. Health education programs should target the awareness of the mothers in the community.

Keywords: Menstrual Hygiene; Adolescent Girl; Mother’s Education.

  Introduction: Menstruation is the physiological process. However, its physiology and nature have been poorly understood by adolescent girls and women especially in rural areas due to lack of education and multiple socio­cultural factors, leading to poor menstrual Hygiene practices. This study was undertaken with the objectives of exploring the menstrual practices being followed among rural female adolescent girls. 

Methodology: This study was a cross sectional study and carried out in a rural private school among 8th, 9th and 10th standard students in rural field practice area of AJIMS &RC Mangalore, (Dakshin Kannada) Karnataka 

Results: Thestudy comprised of 186 adolescent girls from a rural school in Dakshin Kannada district (Karnataka), studying in 8th, 9th and 10th standards belonging to the age group of 11­19 years, with mean age of 15.4 years. The girls primarily belonged to poor families (69.4% BPL). Although, 44.1% of the mothers and 44.8% of fathers of the respondents were educated up to high school, but only 2.1% mothers and 4.8% of the father were graduate Mother was the prime source of information for 71% of the respondents. Majority of the respondents were aware that a sanitary pad is the ideal menstrual absorbent, but only 57.2% of them practiced it. The main reasons for not using sanitary pads were its high cost (19%) and lack of family support (20%). Figure 2. Out of remaining girls 30.1% used old clothes while 12.3% used new clothes. The sanitary pads were mostly disposed with routine waste in dust bins, flushed or burnt. Majority (55.4%) of the girls changed their absorbents within 8 hours while a small percentage (14.5%) changed their absorbents after more than 10 Hours.

Conclusion: Present study reveals that menstrual hygiene Management (MHM) is often sub optimal among adolescent girls in rural areas. Ignorance, various myths and taboos, lack of affordability of good quality menstrual absorbent material i.e. sanitary pads, unsafe menstrual practices and reluctance on part of the mothers to educate their children about menarche and menstruation, are some of the grey areas which require to be addressed. 

Keywords: Menstruation; Sanitary Pads; Taboos; MHM.

  Background: Morbidity patterns among migrants vary with the type of migration and its scope for generation of health risk. Malaria, hepatitis, typhoid fever, and respiratory infection are found with a higher incidence among migrants. They have low rates of education and employment, lower salaries and less access to public health care services. This study was carried out to determine the socio­demographic profile and the health status of migrant labourers.

Methods & Material: A cross­sectional study was carried for a period of one year from 01 January 2016 to 31 December 2016 within the Mangalore City Corporation (MCC) limits. MCC has six Urban Family Welfare Centre [UFWC]. A total of 855 migrant labourers from 675 families were included in the study. Informed written consent was obtained from the participants prior to the inclusion. Multi­stage sampling was designed to select the participants and a pre structured questionnaire was used to collect the data. SPSS 22 version software was used for statistical analysis and Chi­square test was used as test of significance for qualitative data. p­value of <0.05 was considered as statistically significant.

Results: Majority of the subjects (76.7%) were in the age group <30 years, 85.8% were males, 52.6% were unmarried, 84.1% of them were illiterate, 89.6% were construction workers, 73.9% were earning between 1000 to 2000 rupees per week. Tobacco consumers were 52.51% and 63% were alcoholics. Out of these , 38.8% contracted illnesses within 3 months of coming to Mangaluru, 29.8% had past illness between 3 months to 1 year and 31.4% had past illness >1 year duration. Musculoskeletal disorders were the most common (48.3%) health problem. It was
observed that 42% of the migrants visited private facility, 31.1% utilized government facility, 26% took treatment directly from pharmacy while 1% visited traditional healer for illness. Significant association was observed between Health care utilized and reason for utilization (p < 0.001).

Conclusion: The study brought out that majority of respondents had migrated for economic reasons and lived in abysmal conditions doing physically demanding work. Their health was affected by the pattern of migration along with the ignorance of the available health facilities especially the public health services. 

Keywords: Migrants; Health Status; Socio­Demographic Profile; Health Services.

  Introduction: Older people face special physical and mental health challenges which need to be recognized. High prevalence of functional disability is observed in the older adult population Addressing these areas will improve their quality of life. Objectives: To assess the quality of life, determine the level of dependency in instrumental activities of daily living and study the morbidity profile among the elderly population.

Method:
A cross sectional study was conducted among 211 elderly population in a rural area of South India. Data was collected by interview method. WHO’s Quality of Life ­ BREF scale and Lawton Instrumental Activities of Daily Living (IADL) Scale was used. Descriptive analysis was done and Two sample independent t test was used.

Results: The mean age of the study participants was 67.55 years ± 6.612 years. Highest score of 52.57 was observed in environmental domain and lowest score of 47.31 was observed in social domain of Quality of life. More than 1/3rd of the participants were unable to do the activities related to using telephone, preparing meals and handling money. Lower scores of IADL was seen among those aged 65 years and above and this difference was statistically significant.

Conclusion: Poor quality of life and higher dependency in carrying out
the activities among the elderly was observed reflecting the need to focus on provision of comprehensive
geriatric care.

Keywords: Elderly; Quality of Life; Instrumental Activities of Daily Living; Rural Area.

  Background: India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the “diabetes capital of the world”. Due to rising prevalence across all countries and it has been granted the status of “public health priority in most of the nations.

Objectives: To find out the glycemic  status and also the expenditure spent by the diabetics. Material and Methods: The present study is conducted over 510 subjects, in Rajeev Nagar (Urban Slum), which is a field practice area of Siddhartha Medical College, Vijayawada.

Results: In the present study, 510 subjects were analyzed. Among them, the majority (208) 40.8% accounted for the age group of 55­64 years and least (11) 2.2% were in the age group of 35­44 years. The overall mean age of the study subjects was 62.63. The mean HbA1C value for females was 8.5 and for males 8.6 and the overall mean HbA1C value in both sex were 8.5 and it ranges from 4.8 to12.5.The monthly mean direct expenditure was Rs.670, maximum expenditure was Rs.2450 and minimum expenditure was Rs.150.

Conclusion: The expenditure incurred in the management of Diabetes depends on the duration of diabetes, the source of health care and the glycemic status and it does not depend on gender, education, and socio­economic status and awareness levels. On the whole, the present study shows that there is still a lot of scopes to reduce the expenditure incurred in the management of diabetes.

Keywords: Diabetes; Glycemic Status; Expenditute.

  Background: Domestic violence against married women is prevalent in our society. Reported cases of domestic violence against women and homicide of women by their intimate partners represents only the tip of the iceberg and most of the cases are submerged, allegedly invisible to society.

Aim: To study the proportion and contributory factors for domestic violence against married women.

Methodology: Cross­sectional descriptive study was done for a period of two months (1st Feb to 31st Mar 2016). Houses where married women were residing was listed and selected using simple random technique and only one married women was interviewed using well designed pretested questionnaires after considering inclusion and exclusion criteria and obtaining written informed consent. Percentage and chi square tests were used to analyse the data.

Results: Results showed 186 (33.8%) of married women experienced domestic violence in last one year in our study area, of them majority faced verbal abuse (96.7%) followed by emotional abuse (78.4%). Women who experienced domestic violence, most of them studied till high school (34.4%), more than half of them were living in nuclear family (60%) and unemployed (56.4%). Majority told domestic violence was by their husbands (73.11%) and more among the women whose husbands are unemployed (57.6%) (P< 0.05) and 46% of women experiences domestic violence at least once in a week. Husbands habit of substance abuse (48.9%) was observed as common reason for domestic violence and commonly seen among women whose husbands are addicted to alcohol and this association was significant statistically (P < 0.05).

Keywords: Domestic Violence; Married Women; Urban Slums.

  Introduction: The Acquired Immuno­Deficiency Syndrome (AIDS) is emerging as one of the major public health problems in India. It is rapidly diffusing into the “general population” and particularly women are found to be more vulnerable to contract HIV/AIDS and other Sexually Transmitted infections (STI) within the context of marriage. This could be due to inadequate knowledge and awareness regarding HIV/AIDS and its modes of transmission and HIV related stigma and discrimination.

Objectives: To assess awareness of women of reproductive age group about modes of transmission of HIV/AIDS and to assess the attitude of women of reproductive age group towards Patients Living With HIV/AIDS (PLWHA).

Methods: The study was conducted in rural field practice area of Shivamogga institute of medical sciences, Shivamogga. All the households were  covered and one woman between 15­45 years age group from each house, willing to participate was included. Data was collected after informed consent using pre­tested semi­structured questionnaire and analyzed in SPSS 21.

Results: Out of 150, Majority of the women were aware that unsafe sex (69.3%), Needle sharing
(70.7%), Breast feeding (55.5%) are the possible ways of transmission of HIV. Illiterates and women with education ï‚£10th standard had less awareness about modes of transmission and showed discriminatory attitude towards HIV positive people.

Conclusion: Based on the results, we conclude that the level of education has an impact in understanding the modes of transmission and changing the attitudes of public towards PLWHA. Hence there is increased need for educating more and more women especially in rural areas and strengthening of IEC activities.

Keywords: HIV/AIDS; PLWHA; Awareness; Attitude.

  Introduction: Malnutrition is a serious global issue. Each year nearly 25 million low birth babies are born . Recent reports show that , among under five children in developing countries, 206 million are stunted (low height for age), 50 million are wasted (low weight for height) and 167 million are underweight (low weight for age). Further, under­nutrition accounts for 3 million deaths among children and threatens the futures of hundreds of millions more. Studies indicate that nutrition affects the cognitive development, and in turn affects the academic performance. This study was conducted to assess the prevalence of under nutrition and association between under nutrition and academic performance among rural school students

Materials & Methods: A total of 400 students were enrolled in the study, studying in 5th, 6th, and 7th standards from the selected schools. Height and weight were measured and indicators of nutrition such as Height for age, Weight for Age and BMI for age were determined for each student for both girls and boys separately using IAP growth centile charts. Academic performance was assessed by taking average scores of mathematics and science. Chi square test and multiple regression analysis were used to test the association.

Results: 400 students participated in this study. Out of these, 210 (52.4%) were boys and 190 (47.6%) were girls. Out of these, 30.8% of the students were from lower socio­economic status while 29% were from middle class. A total of 80 (20%) students were found stunted while 114 (28.5%) children were found to be under weight. Further, 96 (24%) students were under nourished (BMI for age <3rd centile for age). On multiple regression analysis after adjusting confounders, a significant positive co­relation was observed between under nutrition and poor academic performance (p<0.05),

Conclusion: The study brought out a positive co­relation between undernutrition and poor academic performance.

Keywords: Under­Nutrition; Co­relation; Academic Performance; Rural.

  Introduction: Colostrum is considered as the first vaccine which needs a “warm chain” made by motherinfant contact. There are certain barriers preventing early initiation and colostrum feeding to the newborn babies. One of the main causes of neonatal mortality and morbidity is inadequate breastfeeding, following faulty breastfeeding techniques.

Aim: The present was conducted to study the current breast feeding practices and various sociodemographic determinants affecting it.

Material and Methods: The present descriptive, crosssectional study was conducted at Immunization clinic of MGM’s Medical College, Aurangabad district (M.S) amongst the mother­child pair attending the immunization clinic during 1st January 2014 to 31st December 2014. A total of 325 Mothers­child pairs were included in the study. A structured questionnaire having open and closed­ended questions were used.

Results: Prelacteal was given to 85 (26.15%) newborns consisting of honey to 54 (63.52%), sugar water to 17(20%). It was given as a custom 38 (44.7%), helps digestion 34 (40%) and 22 (25.88%) for the early development of speech. 134 (41.2%) newborn received first feed within half an hour of delivery while 102 (31.4%) within one hour. Only 286(88%) mothers feed their newborns with colostrum. 100 (30.8%) mothers said that colostrum increases immunity, 66 (20.3%) said its best for baby.

Conclusion: It was concluded that though a significant difference was found between practices and various sociodemographic factors, as a whole the practices and understanding were found to be of mediocre quality.

Keywords: Breastfeeding; Prelacteal; Colostrum; Exclusive Breastfeeding.

  Background: Cardiovascular diseases are the number one cause of death globally. Over three quarters of CVD deaths take place in low and middle income countries. The mortality varies from <10% in rural locations in less developed states to >35% in more developed urban locations. Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population­wide strategies. 

Objectives: 1. To study the demographic profile of study population.  2. To determine the prevalence of cardio­vascular disease risk factors among study population. 3. To suggest measures for prevention of cardio­vascular diseases. 

Methods: This study is a community based cross­sectional study conducted from June 2017 to July 2017 involving adolescents of the age group 10 to 19 years from the Urban Field Practice area of MIMS Medical College. Data was collected in a predesigned and pretested schedule and analyzed using SPSS version17.
Results: Out of 328 participants, 185 (56.4%) were male and rest 143 (43.6%) were female. Among them 3.6% were hypertensive, 6.7% were Obese, tobacco intake and history of alcohol intake in last 30 days was present in 11.9% and 4.3% of male participants respectively.

Conclusion: Many CVD risk factors are prevalent in the adolescents of the study area which can be prevented by healthy lifestyles such as healthy diet, regular exercise and personal awareness.

Keywords: Adolescent; Cardio­vascular Disease; Risk Factor; Urban Population.