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   Table of Contents - Current issue
Coverpage
January-March 2017
Volume 61 | Issue 1
Page Nos. 1-63

Online since Thursday, February 16, 2017

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EDITORIAL  

Vision 2030: Dog-mediated human rabies-free India: Action must begin now p. 1
MK Sudarshan
DOI:10.4103/ijph.IJPH_20_17  PMID:28218154
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ORIGINAL ARTICLES Top

Perceptions of nonsurgical permanent contraception among potential users, providers, and influencers in Wardha district and New Delhi, India: Exploratory research p. 3
Jennifer C Aengst, Elizabeth K Harrington, Pramod Bahulekar, Poonam Shivkumar, Jeffrey T Jensen, BS Garg
DOI:10.4103/0019-557X.200261  PMID:28218155
Background: New permanent contraceptive methods are in development, including nonsurgical permanent contraception (NSPC). Objective: In the present study, perceptions of NSPC in India among married women, married men, mothers-in-law, providers, and health advocates in Eastern Maharashtra (Wardha district) and New Delhi were examined. Methods: We conducted semi-structured interviews with 40 married women and 20 mothers-in-law; surveys with 150 married men; and focus group discussions with obstetrics/gynecology providers and advocates. Transcripts were coded and analyzed using a grounded theory approach, where emerging themes are analyzed during the data collection period. Results: The majority of female respondents expressed support of permanent contraception and interest in NSPC, stating the importance of avoiding surgery and minimizing recovery time. They expressed concerns about safety and efficacy; many felt that a confirmation test would be necessary regardless of the failure rate. Most male respondents were supportive of female permanent contraception (PC) and preferred NSPC to a surgical method, as long as it was safe and effective. Providers were interested in NSPC yet had specific concerns about safety, efficacy, cost, uptake, and government pressure. They also had concerns that a nonsurgical approach could undermine the inherent seriousness of choosing PC. Advocates were interested in NSPC but had concerns about safety and potential misuse in the Indian context. Conclusion: Although perceptions of NSPC were varied, all study populations indicated interest in NSPC. Concerns about safety, efficacy, appropriate patient counseling, and ethics emerged from the present study and should be considered as NSPC methods continue to be developed.
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Risk factors for death during a resurgence of influenza-A (H1N1) pdm09 in Punjab State in 2013 Highly accessed article p. 9
Tripurari Kumar, Deepak Bhatia, Pinnaka Venkata Maha Lakshmi, Kayla F Laserson, Jai Prakash Narain, Rajesh Kumar
DOI:10.4103/0019-557X.200246  PMID:28218156
Background: In 2013, high mortality from influenza-A (H1N1) pdm09 (pH1N1) was observed in Punjab, India. Objectives: To describe cases and deaths of 2013 pH1N1 positives, to evaluate the high case fatality ratio and risk factors for pH1N1-associated mortality among the hospitalized cases in Punjab for 2013. Methods: A case–control study was conducted and compared those who died from confirmed pH1N1 with those who survived in the hospital between January 1, 2013, and April 30, 2013. Sociodemographic and clinical details were extracted from hospital records and from telephone interviews with controls and next of kin of cases using pretested questionnaires. Logistic regression analysis was performed. Results: A total of 182 laboratory-confirmed pH1N1 cases (99 males and 83 females) were hospitalized in 30 hospitals in Punjab; 42 (23%) patients died. Those who died were significantly more likely to be younger than 50 years of age (adjusted odds ratio [AOR] =10.6, 95% confidence interval [CI] =1.8–21.1), be obese (AOR = 16.7, 95% CI = 1.6–170.7), and have visited more than two health-care facilities before laboratory confirmation (AOR = 25.8, 95% CI = 5.4–121.6). Conclusions: The health-care community should have a high index of suspicion for influenza, and general community should be sensitized about risk factors and to seek medical advice early in the illness.
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Depression in cancer patients undergoing chemotherapy in a tertiary care hospital of North Bengal, India p. 14
Sutanay Bhattacharyya, Sharmistha Bhattacherjee, Tanuka Mandal, Dilip Kumar Das
DOI:10.4103/0019-557X.200252  PMID:28218157
Background: Detection of cancer and subsequent chemotherapy can lead to clinical depression in many cancer patients. Objectives: The study was conducted to find out the extent of depression in cancer patients undergoing chemotherapy and determine the factors associated with depression. Methods: A cross-sectional descriptive study was conducted at the Chemotherapy Day Care Centre of North Bengal Medical College and Hospital from May to June 2013. A total of 174 cancer patients were selected and interviewed after obtaining informed consent and Institutional Ethics Committee Clearance. Brief Edinburgh Depression Scale was used to find out depression with a score of 6 and above indicating depression. Data obtained was analyzed using SPSS software version 20. Logistic regression was used to see the relative importance of multiple contributing factors toward depression. Results: Out of 174 cancer patients, 97 (55.7%) were found to be depressed. Depression was comparatively higher in patients ≥50 years; in males; those belonging to religion other than Hindus; who received higher education; had monthly family income ≥5000 rupees and were involved in moderate or heavy work. Nearly 70.6% of blood cancer patients; 64.3% of those who had been receiving chemotherapy for ≥6 months and 56.9% of those in their 4th or less cycle of chemotherapy were found to be depressed. Conclusion: The study revealed depression is substantially high among cancer patients undergoing chemotherapy in this area. Diagnosis and treatment of cancer patients need to be complemented by psychological support for the cancer patients.
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Influence of integrated community- and facility-based interventions on select maternal and neonatal outcomes in Northern Karnataka, India: Lessons for implementation and measurement p. 19
Rajaram Subramanian Potty, Mohan Harnahalli Lakkappa, Arin Kar, Mallika Bidappa, Ramesh Banadakoppa Manjappa, Krishnamurthy Jayanna
DOI:10.4103/0019-557X.200256  PMID:28218158
Background: Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services. Objectives: To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts. Methods: An innovative strategy was designed to collect routine monitoring data, namely community behavior tracking survey using mobile technology. The catchment area of an Accredited Social Health Activist (ASHA) was the primary sampling unit, and in each district 200, ASHA areas were selected. Women from these selected ASHA areas were interviewed and information collected on various MNCH care outcomes. Multivariate logistic regression was used to assess changes in selected MNCH care indicators. Results: Gradual increase was noticed in institutional delivery, hospital stay for 48 or more hours, initiation of breastfeeding within 1 hour and continuum of MNCH care. Forty-eight hours stay and initiation of breastfeeding improved marginally possibly due to health systems and cultural norms. Conclusions: Results indicated that the interventions were successful in changing the critical MNCH care indicators and hence have potential for replication in similar high priority district settings.
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Awareness of legal and social issues related to reproductive health among adolescent girls in rural Varanasi p. 26
Sangeeta Kansal, Sweta Singh, Alok Kumar
DOI:10.4103/0019-557X.200248  PMID:28218159
Background: Data on awareness of adolescent's on the legal and social issues/acts related to reproductive health, especially in rural areas, are scarce. Objectives: The aim of the present cross-sectional study is to assess the awareness level of legal and social issues related to reproductive health and its association with the various individual and family/household level characteristics. Methods: 650 adolescent girls in the age group of 15–19 years were interviewed with the help of pretested and semistructured questionnaire and focus group discussions were also conducted for qualitative findings in Chiraigaon block of district Varanasi. Results: It was observed that 42.9% of the respondents were aware of legal age of marriage, 14.9% knew about the right age of childbearing. Dowry prohibition act and domestic violence act were known to 46% and 27% respondents, respectively, and only 2.6% were aware of medical termination of pregnancy act. Logistic regression analysis shows the significant effect of education on awareness of legal age of marriage, right age of childbearing, domestic violence, and dowry prohibition acts, which is also supported by qualitative findings. Conclusion: All the important legal issues/acts should be included in high school curriculum and female teachers should be involved in training program for adolescents. Role of mass media in creating awareness about these issues in their routine programs should be ascertained. Accredited Social Health Activist and Anganwadi workers should be aware of and include these issues/acts in adolescent meetings.
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REVIEW ARTICLES Top

Research misconduct: A neglected plague p. 33
Manjiri A Deshmukh, Arun S Dodamani, Mahesh R Khairnar, Rahul G Naik
DOI:10.4103/0019-557X.200255  PMID:28218160
Truthfulness and honesty are absolute essentials of research. But to sustain in the not-so-pleasant “publish-or-perish” environment and “cut-throat” competition to increase the credibility associated with one's name, many individual researchers as well as research groups are turning towards research misconduct and this plague is gradually reaching epidemic and pandemic proportions. This overview highlights the various types and means of research misconduct and gives suggestions aiming to curb this academic menace so that research sanctity and integrity can be preserved and scientific research does not get polluted by the dirt of misreported or fabricated data.
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Directly observed iron supplementation for control of iron deficiency anemia p. 37
Mohan Bairwa, Farhad Ahamed, Smita Sinha, Kapil Yadav, Shashi Kant, Chandrakant S Pandav
DOI:10.4103/0019-557X.200250  PMID:28218161
Anemia is major public health problem affecting 1.6 billion people worldwide. The poor compliance of iron supplementation remains main contributor for high prevalence of anemia. The current paper reviewed the effectiveness of direct observation of oral iron supplementation on anemia. A systematic search was performed through electronic databases and local libraries. Search strategies used subject headings and key words “directly observed” and “iron supplementation.” Searches were sought through April 2014. A total of 14 articles were included in the study. Findings were presented in three categories. First, all of those reported an improvement in compliance of iron supplementation. Second, reduction in the prevalence of anemia was reported by all and third, all except one reported increased blood hemoglobin level. Directly observed an iron supplementation is an effective approach for prevention and management of anemia in vulnerable groups. However, larger trials are needed before concluding that scaling up directly observed iron supplementation through community health volunteers would be beneficial.
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BRIEF RESEARCH ARTICLES Top

Factors associated with survival and lost to follow-up of cervical cancer patients in a tertiary cancer centre in rural Kerala p. 43
T Bindu, Saina Sunil Kumar, K Ratheesan, Satheesan Balasubramanian
DOI:10.4103/0019-557X.200254  PMID:28218162
Cancer cervix is the second common cause of cancer death in India. It is the most curable form of any human cancer if detected at the precancerous stage. Although several factors determine the survival of the disease, the clinical stage at presentation is the single most important predictor of long-term survival. The present study aimed to describe the performance and follow-up status and 5-year survival experience of the cervical cancer patients registered between 2010 and 2011 by the hospital registry of Malabar Cancer Centre, Kerala, and factors affecting lost to follow-up and survival among them. The case sheets of 227 patients retrospectively scrutinized during May–July 2014. The mean age of patients was 58.8 years (standard deviation = 11.67 years). The majority of the patients completed the initially planned treatment, but a low proportion of patients were likely to be on regular follow-up. This study revealed that most of the patients registered at the hospital only at an advanced stage. Using Kaplan–Meier method, the estimated 5 years survival rate was found to be 66.8%. It was noted that performance status before treatment and Federation of Gynecology and Obstetrics staging were significantly associated with lost to follow-up and survival rate majority of the cervical cancer patients are observed to be highly noncomplaint to complete treatment and on follow-up. Thus, these findings stress the importance of counseling family members regarding the importance of follow-up and formulating public health policies aimed at increasing the awareness and implementation of cervical cancer screening programs in North Malabar.
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Preliminary risk maps for transmission of kyasanur forest disease in Southern India p. 47
A Townsend Peterson, Gautam Talukdar
DOI:10.4103/0019-557X.200262  PMID:28218163
Kyasanur forest disease is known to be transmitted across forested regions of Southern India. The disease appears to be hosted in wild mammals and transmitted by tick vectors although the diversity and identity of host and vector species remain unclear. The area across which risk exists of contracting the disease through transfer from the hosts or vectors, however, has never been mapped in detail, such that the area that surveillance, education, and investment in diagnostic facilities should cover remains unknown. This contribution uses known occurrences of the disease from the year 2000 till date to create and test a correlational ecological niche model that translates into preliminary transmission risk maps, which are summarized in terms of risk presented in each district in the region, as well as across peninsular India.
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Prevalence of obesity and overweight and their comparison by three growth standards among affluent school students aged 8–18 years in Rajkot p. 51
T. K. M Eshwar, Rajesh K Chudasama, Subhasini T Eshwar, Dhara Thakrar
DOI:10.4103/0019-557X.200251  PMID:28218164
Obesity and overweight emerged as an important public health problem in India. The present study was conducted to estimate the prevalence of obesity and overweight and compare it using three different standards among affluent school students aged 8–18 years from Rajkot, Gujarat. Anthropometric measurements of students of four schools from 3rd to 12th standards were taken. The prevalence of overweight and obesity was assessed using three standards – revised Indian Association of Pediatrics (IAP) 2015, WHO 2007, and International Obesity Task Force (IOTF) standards. A total of 1496 children including 79.1% boys and 20.9% girls participated in the study. The prevalence of obesity was reported 14% by IAP standards, 11.1% by WHO standards, and 5.1% by IOTF standards. Overweight children prevalence was reported more (19.1%) with IAP standards, followed by 15.8% with IOTF standards and 15.3% by WHO standards. High prevalence of obesity and overweight was reported with IAP 2015 standards and WHO 2007 standards.
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Perceived psychological stress among undergraduate medical students: Role of academic factors p. 55
Ranadip Chowdhury, Abhijit Mukherjee, Kaushik Mitra, Somnath Naskar, Prasanta Ray Karmakar, Saibendu Kumar Lahiri
DOI:10.4103/0019-557X.200253  PMID:28218165
Recently, there is a growing concern about stress during undergraduate medical training. The objectives of our study were to assess perceived stress among undergraduate medical students and to find out academic factors as determinants. A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of R. G. Kar Medical College, India, during July 2011–June 2012. Perceived stress was assessed using the Perceived Stress Scale-14. A 10-item questionnaire was used to assess academic sources of stress and their severity. The overall mean perceived stress score was 29.58 (standard deviation [SD] = 6.60), and 46.3% of the participants were in the group of more stressed (perceived stress score ≥28). The academic stressor factors predicted 78% of variability of perceived stress. A higher level of perceived stress was reported by the students. The students should be taught different stress management techniques to improve their ability to cope with a demanding professional course.
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LETTER TO EDITOR Top

Patient and health system delays among adult smear-positive tuberculosis patients at medical colleges of Puducherry in South India: A comment p. 58
Madhavi Bhargava
DOI:10.4103/ijph.IJPH_155_16  PMID:28218166
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AUTHORS REPLY Top

Patient and health system delays among adult smear-positive tuberculosis patients diagnosed at medical colleges of Puducherry in South India p. 59
Ramesh Chand Chauhan, Anil Jacob Purty
DOI:10.4103/ijph.IJPH_357_16  PMID:28218167
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LETTER TO EDITOR Top

A comparative study of skeletal fluorosis among adults in two study areas of Bangarpet Taluk, Kolar p. 60
Javed Ahsan Quadri, A Shariff
DOI:10.4103/0019-557X.200258  PMID:28218168
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AUTHORS REPLY Top

A comparative study of skeletal fluorosis among adults in two study areas of Bangarpet Taluk, Kolar p. 61
MN Shruthi, Anil N Santhuram, HS Arun, BN Kishore Kumar
DOI:10.4103/0019-557X.200260  PMID:28218169
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BOOK REVIEW Top

Essentials of biostatistics p. 62
Sanjiv Kumar Bhasin
DOI:10.4103/0019-557X.200259  
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ERRATA Top

Erratum: Potential of probiotics in hypercholesterolemia: A meta-analysis p. 63

DOI:10.4103/0019-557X.200263  PMID:28218172
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Erratum: Rolling out of kangaroo mother care in secondary level facilities in Bihar - some experiences p. 63
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DOI:10.4103/0019-557X.200264  PMID:28218172
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Erratum: Using non-pneumatic anti-shock garment at the public health facilities- a pilot study in two districts of Bihar p. 63
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DOI:10.4103/0019-557X.200265  PMID:28218172
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