Indian Journal of Preventive Medicine

Background: Tuberculosis is a major global public health problem. In 2017, 10 million people fell ill with TB, while 1.6 million died from the disease which included 0.3 million people with HIV and 230 000 children. India is the country with the highest burden and accounted for 27 per cent of the total cases. Although tuberculosis mainly affects the lungs, it may also involve many other sites i.e. lymph nodes, pleura, bones etc. called as extra-pulmonary tuberculosis (EPTB); and its prevalence in developing countries like India, ranges from 15- 20%; which goes further high if the patient is co-infected with HIV or has other co-morbidities like diabetes mellitus, malnutrition etc. Objective: To determine the prevalence of PTB and EPTB among admitted cases, study their clinical and demographic profiles and determine various risk factors associated with EPTB. Methods: A record- based observational study was undertaken to determine the demographic and clinical profile and associated risk factors, of all TB cases who were admitted to a tertiary care hospital, over a period of five years, and included all cases of EPTB and PTB. Results: The study comprised of 651 cases, which included 479 (73.6%) males and 173 (26.4%) females. Majority (26.6%) of cases belonged to the age group of > 60 yrs. Rural patients accounted for 55.5% of the cases. Out of 651 cases, 372 (57.1%) had PTB, while 279 (42.8%) had EPTB. Pleura was the commonest site involved (58.7%), followed by lymph node (37.9%) and abdominal cavity (6.8%). Further, 12.5% patients had COPD, 9.5% had Diabetes mellitus, 2.4% had HIV, and 3.9% had MDR TB. Conclusion: Extra-pulmonary TB accounts for a significant proportion of TB cases, though, due to its variable clinical picture and low index of suspicion on part of clinicians, it's often under-diagnosed. Therefore studies are required to determine the actual burden of pulmonary and extra pulmonary cases of tuberculosis in the community .

Keywords: PTB; EPTB; HIV; Diabetes; Tertiary Care Hospital; Pleura; Lymph Nodes.

Perinatal deaths are responsible for about 7% of the total global burden of disease. The present study was conducted in tertiary referral institute in Western Maharashtra, India, with a aim to study the frequency, classify the types and analyze the risk factors associated with perinatal mortality. Total number of perinatal mortality and analysis regarding maternal and fetal particulars, the mode of delivery, period of gestation, associated maternal risks, fetal parameters such as sex, birth weight, apgar score were recorded. The total number of births during the study period was 6460, with 249 perinatal mortalities accounting to perinatal mortality rate of 50.77 per 1000 live births, comprised of 260 still births and 169 early neonatal deaths. The corrected, extended and factual perinatal mortality rates accounted to 48.14, 66.40 and 19.19 per 1000, respectively. Perinatal mortality rates were highest in teenage group mothers, second gravidae, maternal anemia and preterm delivery group. The present study to estimates of perinatal mortality rate (PNMR) can be derived directly as well as indirectly. The direct estimates are usually based on the number of still deaths and Early deaths reported during the last one year per 1000 live births. The NFHS -4 report adopts this technique for providing the estimates. Indirectly estimates of dependent variable as perinatal mortality rate (PNMR) of region by multiple regression method involving still birth (SBR), and early neo natal mortality rates (ENMR) as independent variables.

Keywords: NFHS- National Health Family Survey; PNMR-Perinatal Mortality Rate; ENMR-Early Neonatal Mortality Rate; SBR-Still Birth Rate.

Background and Aim: More thrust is being given by the National Leprosy Eradication Programme (NLEP) of the Government to achieve the goal of leprosy elimination in the districts and blocks reported to be high endemic for leprosy in the country. Present study was done with an aim to determine current epidemiological situation in context of social-political disturbance and difficult geographical terrain of Gadchiroli district and to identify and assess factors and determinants for leprosy endemicity in Gadchiroli district. Material and Methods: The study was conducted during 2013-14 (April to June 2013) in 10 PHCs in 3 blocks of Gadchiroli district. As per the guidelines of EVD, average 5000 population per Primary Health Center (PHC), (total-50,000 population) was the target for the study in 10 PHCs. To reach these population 129 villages from 29 sub-centres under 10 PHCs in 3 blocks of the district were selected. The leprosy suspects were screened by experienced NLEP personnel and leprosy diagnosis was confirmed. Results: 44,650 (95.3%) people were examined out of 46,862 people enumerated of by the trained PHC staff under the guidance of NLEP staff. No significant difference was observed between the genders among the population examined. The block wise population examination ranges from 93.6% to 96.6% and highest was achieved in Aheri block. The mean NCDR was 31.4 per 100,000 populations in the 3 selected blocks of Gadchiroli district. Maximum NCDR (16.2) was reported from Etapalli block while lowest NCDR (54.4) was reported from Aheri block per 100,000 populations. Conclusion: The study concludes the imperative need for periodical validation of the leprosy burden in areas with uneven distribution of leprosy especially in difficult terrain and affected by socio-politically disturbance as revealed in the study.

Keywords: Geographical; Leprosy; Primary Health Center; Sub-center.

There is rapid growth in the usage of internet globally mainly in urban areas. Usage has been rising exponentially. In Asia around 50% of them use internet with rise in 1.7% between 2000-19. This study was conducted to explore the level of internet addiction among high school students of rural area Methodology: it’s a cross sectional study conducted in the rural field practice of Dr BR Ambedkar medical College, Bangalore among high school students with the sample size of 206. Data was collected using pretested semi structured questionnaire and Young’s internet addiction scale. Data was analysed for frequencies and percentages Results: Age group of study subjects ranged from 13-18 years of age. Maximum belonged to Hindu religion and were studying SSLC. Most common gadget used was laptop and purpose was for social networking. In our study only 0.5% had severe level of internet addiction and more than 90% were normal without internet addiction.

Keywords: Internet Addiction; Young’s Scale; Addiction.

Objective: Psycho-social problems associated with the use of mobile phones are common among medical students. There is overuse of mobile phones among medical students which would have led them to deteriorate in academics due to stress, sleep disturbance or depression. This study was conducted to assess the pattern of mobile phone usage, its psycho-social impact namely stress, sleep disturbance and depression among professional college students and to find any association between usage pattern and the psychosocial impacts. Methods: After the ethical and departmental clearances were received, 100 medical students using a smart phone or feature phone and those willing to take part in the study were selected by purposive sampling. A cross-sectional type of study was conducted. An informed consent was given to each of them and questionnaires were administered by hand. It was then collected and analyzed using Epi Info 2007. The responses from 92 students out of 100 were received of which 71 were from girls and 21 were from boys. Frequency distribution of variables such as age groups and sex were worked out and tabulated. Mean and standard deviations of continuous variables were calculated. T-test was used to test the differences. Outcomes variables were categorized using known class intervals and cross-tabulated with usage pattern. Chi-square test was used to test the association. P-value was considered as significant when it was less than 0.05. Results: The results obtained were in accordance to the objectives i.e. increase in the number of hours of mobile phone usage led the students to have sleep disturbances such as reduced sleep, fragmented sleep or insomnia. Also there was a positive association the same with depression. But a third variable, stress was seen to be an incidental finding. Medical students are generally stressed as part of their busy schedule and use of mobile phones does not directly increase their stress levels. It may, thus, be concluded that there is a positive association between usage pattern of mobile phones, sleep disturbance and depression. Stress is an incidental finding unrelated to the use of mobile phones as such.

Keywords: Psycho-Social Problems; Mobile Phone Usage; Depression; Sleep Disturbance; Stress.