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Table of Contents
January-March 2015
Volume 59 | Issue 1
Page Nos. 1-77
Online since Monday, March 9, 2015
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EDITORIAL
Emplementation of national iron plus initiative for child health: Challanges ahead
p. 1
Sila Deb
DOI
:10.4103/0019-557X.152844
PMID
:25758723
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ORIGINAL ARTICLES
Prevalence of depression and associated risk factors among the elderly in urban and rural field practice areas of a tertiary care institution in Ludhiana
p. 3
Paramita Sengupta, Anoop I Benjamin
DOI
:10.4103/0019-557X.152845
PMID
:25758724
Background:
Depression, the most common psychiatric disorder among the elderly, is not yet perceived as an important health problem in India, where few population-based studies have addressed this problem.
Objectives:
To estimate the prevalence of depression and identify the associated risk factors in the elderly population.
Materials and Methods:
3038 consenting elderly (>60 years old) rural and urban residents of both sexes from the field practice areas were interviewed and examined in a cross-sectional study. Physical impairment in the subjects was assessed with the Everyday Abilities Scale for India (EASI), depression by the 15-item Geriatric Depression Scale (GDS-15), and cognitive impairment by the Mini-Mental State Examination (MMSE). Data were analyzed using Epi Info version-6 software. Statistical analysis included proportions, χ
[2]
-test, odds ratio, and its 95% confidence interval. Multiple logistic regression was done using SPSS version 21.
Results:
The prevalence of depression in the study population was 8.9%. It was significantly higher in urban residents, females, older elderly, nuclear families, in those living alone, those not working, illiterates, poor, functionally impaired, and cognitively impaired. In the multivariate analysis, unmarried/widowed status, unemployment, and illiteracy did not emerge as risk factors.
Conclusions:
Urban residence, female gender, higher age, nuclear family, poverty, and functional and cognitive impairment were found to be associated with depression even after controlling for other factors.
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Inequity in awareness and utilization of adolescent reproductive and sexual health services in union territory, Chandigarh, North India
p. 9
Madhu Gupta, Nidhi Bhatnagar, Pankaj Bahugana
DOI
:10.4103/0019-557X.152846
PMID
:25758725
Background:
Adolescents are a heterogeneous, vulnerable, and sexually active group. Geographical and educational health disparities exist among urban, rural, and slum adolescents and among out-of-school and school-going adolescents, respectively. Adolescent reproductive and sexual health (ARSH) services should be implemented in a manner to minimize health inequities among them.
Objectives:
To ascertain the extent of awareness and utilization of ARSH services provided under reproductive and child health(RCH) program among adolescents in Chandigarh.
Materials and Methods:
A cross-sectional study was conducted among 854 adolescents (402 household, 200 out-of-school, and 252 school-going adolescents) in Chandigarh using pretested validated interview schedule on awareness and utilization of adolescent reproductive and sexual health services from February to April 2011 in North Indian Union Territory of Chandigarh. Ordinal regression analysis was done to study the association of socio-demographic variables with awareness and utilization of ARSH.
Results:
Awareness about contraception and health services was significantly less among rural (12.7% and 1.1%, respectively) adolescents as compared to slum (17.9% and 4.6%, respectively) and urban adolescents (33.5% and 7.8%, respectively) (
P
< 0.05). Out-of-school adolescents were utilizing the preventive [odds ratio (OR) 0.39,
P
< 0.001] and curative services significantly lesser (OR = 0.54,
P
< 0.001) and had higher substance abuse (OR = 4.26,
P
= 0.006). Awareness was significantly associated with older age of adolescents (OR = 4.4,
P
< 0.001), poor education of father (OR = 0.5,
P
= 0.002), rural area (OR = 0.56,
P
= 0.001), and out-of-school status (OR = 0.35,
P
< 0.001).
Conclusion:
Awareness and utilization of ARSH services was inequitable and was more among urban and school-going adolescents. Educational status was the most important factor affecting it.
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Identifying psychological distress in elderly seeking health care
p. 18
Prafulla Shivakumar, Shilpa Sadanand, Srikala Bharath, N Girish, Mathew Varghese
DOI
:10.4103/0019-557X.152849
PMID
:25758726
Background:
Psychological distress in the elderly with various illness conditions often goes unrecognized. Since psychological distress is treatable, it is important to recognize it at the earliest to enhance recovery. This is an interim analysis of screening data of the elderly seeking health care in a hospital in India, with a focus on the 12-item General Health Questionnaire (GHQ-12), a screening instrument for psychological distress and a rationale for a higher cutoff score in help seeking elderly.
Materials and Methods:
A retrospective analysis of screening data of psychological distress using GHQ-12 in the elderly seeking care for neuropsychiatric conditions was carried out. Traditionally, ≥2 is considered positive for distress by GHQ-12. Receiver Operating Characteristic (ROC) curve was used to define new cutoff points for psychological distress.
Results:
At ≥2, 2443 (50%) of the elderly screened were recognized to be psychologically distressed. Using an ROC and optimum sensitivity and specificity measures, a cutoff score of ≥4 was observed to detect 30% of the elderly who had diagnosable mental health disorders. Female sex, illiteracy, and multiple co-morbidities were the factors that were associated with higher cutoff scores on GHQ-12 proposed here and psychiatric morbidity thereof.
Conclusion:
There is greater psychological distress among the elderly seeking health care. Hence, it is important to screen them and identify those at higher risk. Using a higher cutoff score with a standardized instrument like GHQ-12 indicated that it was statistically valid to identify those elderly with higher distress in a busy out-patient setting.
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Assessment of oral mucosal lesions among eunuchs residing in Bhopal city, Madhya Pradesh, India: A cross-sectional study
p. 24
Nilesh Arjun Torwane, Sudhir Hongal, Pankaj Goel, Byarakele Chandrashekar, Vrinda Saxena
DOI
:10.4103/0019-557X.152851
PMID
:25758727
Aim:
The present cross-sectional study following the
STROBE
guidelines was conducted to assess the prevalence of oral mucosal lesions among males, females, and eunuchs residing in Bhopal city, Madhya Pradesh India.
Materials and Methods:
Based on convenient non-probability snowball sampling technique, all the self-identified eunuchs residing in the city of Bhopal who were present at the time of examination and who fulfilled the selection criteria were examined. A cross section of the general population (males and females) residing in the same locality where these eunuchs live was also examined. The World Health Organization (WHO) oral health assessment proforma (1997) was used to collect the information on oral mucosal lesions. All the obtained data were analyzed by using a Statistical Package for Social Sciences version 20.
Results:
Overall prevalence of oral mucosal lesions was 127 (19.9%) among the study subjects. Fifty-nine (28.5%) eunuchs, 56 (25.7%) males, and 12 (5.6%) females were observed to have some oral mucosal lesions. Oral submucous fibrosis (6.4%), leukoplakia (5.5%), and traumatic ulceration (4.2%) were the major oral mucosal conditions observed.
Conclusion:
The information presented in this study adds to our understanding of the common oral mucosal lesions occurring in the eunuch population. Efforts to increase patient awareness of the oral effects of tobacco use and to eliminate the habit are needed to improve the oral and general health of eunuchs.
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Prevalence and determinants of sexually transmitted infections (STIs) among male migrant factory workers in Haryana, North India
p. 30
Rizwan Suliankatchi Abdulkader, Shashi Kant, Sanjay Kumar Rai, Kiran Goswami, Puneet Misra
DOI
:10.4103/0019-557X.152854
PMID
:25758728
Background:
Male migrant workers display high risk sexual behavior and have been shown to have higher prevalence of sexually transmitted infections (STIs), which make them more vulnerable to HIV infection. We aimed to estimate the prevalence of self-reported STIs and delineate their determinants among male migrant factory workers in Faridabad, Haryana.
Materials and Methods:
Male workers in two selected factories, who were aged ≥18 years, were born outside Haryana (destination), and who had migrated to Haryana after the age of 15 years were eligible. Socio-demographic information, HIV/AIDS knowledge and behavior, and self-reported STI symptoms in the last 1 year were ascertained by face-to-face interview. Determinants of STIs were identified by regression analysis.
Results:
Totally 755 eligible workers participated. Mean ± SD age was 31.4 ± 8.2 years and migration duration was 9.5 ± 6.7 years. At least one STI symptom was reported by 41.7% of the participants (burning micturition- 35%, inguinal bubos-5.2%, genital ulcers- 2.6%, urethral pus discharge- 1.3%). Factors associated with STIs were higher age at migration, lower HIV/AIDS knowledge, paid sex in the last year, non-use of condoms during the last non-spousal sex, and unfavorable intention to use condom.
Conclusion:
Prevalence of self-reported STIs among these migrant men was high. Targeted Interventions among migrant workers need to be strengthened for control and prevention of STIs.
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COMMENTARIES
Mobile phones: Time to rethink and limit usage
p. 37
Bobby Paul, Indranil Saha, Sanjay Kumar, SK Samim Ferdows, Gautam Ghose
DOI
:10.4103/0019-557X.152856
PMID
:25758729
Radiofrequency waves generated from mobile phones cause potential public health problems. Short-term effects like changes in sleep, heart rate, and blood pressure, and long-term effects like carcinoma are well documented. The Government of India's efforts in laying down regulations regarding the safety limits, manufacture, marketing, and mobile use are still in nascent stage. The need for stringent enforcement of laws for prevention of phone usage while driving and guidelines of medical regulatory bodies regarding rules and regulations of phone usage while at class or attending patients is of utmost importance. This should be supplemented by mass media to raise awareness among people regarding the possible health effects of radiofrequency emissions from mobile phones and the guidelines to minimize its exposure. It is the need of the hour to teach young people to be structured, to know when to have the cell phone on, and to avoid becoming the slave of technology instead of its mastery.
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Updated BG Prasad socioeconomic classification, 2014: A commentary
p. 42
Abha Mangal, Varun Kumar, Sanjeet Panesar, Richa Talwar, Deepak Raut, Saudan Singh
DOI
:10.4103/0019-557X.152859
PMID
:25758730
Modified BG Prasad socioeconomic scale is widely used to determine the socioeconomic status of study subjects in health studies in India. It is an income-based scale and, therefore, has to be constantly updated to take inflation and depreciation of rupee into account. The Consumer Price Index (CPI) for industrial workers (IW) is used to calculate updated income categories for January 2014. Details of the calculations involved will enable young researchers to calculate specific income categories for their research work. State-specific CPI values are also available on the Department of Labour website and should be used to determine more accurate income categories for the study area.
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BRIEF RESEARCH ARTICLES
Risk factors for cancer cervix among rural women of a hilly state: A case-control study
p. 45
Anita Thakur, Bhupender Gupta, Anmol Gupta, Raman Chauhan
DOI
:10.4103/0019-557X.152862
PMID
:25758731
In Himachal Pradesh, cancer cervix is a major public health problem since it ranks as the number one female cancer. A case-control study of 226 newly diagnosed, histopathologically confirmed cases of cancer cervix and equal number of matched controls was conducted at Regional Cancer Center, Himachal Pradesh during the period from July 2008 to October 2009 with the objective to study the common factors associated with cancer cervix. Univariate analysis identified 10 risk factors associated significantly with the disease. On multiple logistic regression, however, only seven risk factors were found to be associated significantly with the disease. These were: Age at birth of first child, spacing between two children, age at marriage, literacy, socioeconomic status, multiparity, and poor genital hygiene. Risk factors such as poor genital hygiene, age at birth of first child <19 years, early marriage, illiteracy, multiparity, and low socioeconomic status were highly prevalent in the study subjects and were found to be significantly associated with cancer cervix.
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Desirable factors for maintaining normal BMI of urban affluent women of Delhi
p. 49
Anu Taneja Gupta, Anupa Siddhu
DOI
:10.4103/0019-557X.152864
PMID
:25758732
The study aimed to identify desirable social, familial, reproductive, dietary, and lifestyle factors for maintaining normal body mass index (BMI) of urban affluent women (25-45 years) in Delhi, India. A total of 387 urban affluent women with at least one living child participated in this cross-sectional study conducted from March 2008 to April 2010. Women were classified into four BMI categories on the basis of World Health Organization (WHO; 2004) classification for Asians. Significant factors for maintaining normal BMI were: Younger age, less parity, nuclear family, normal weight status of parents, postpartum weight gain between 2 and 3 kg, regularity in taking meals, fixed meal size, self-perceived normal weight, and shorter sitting time and television viewing time. Multivariate regression analysis identified five determining factors for maintaining BMI, which are normal weight of father, self-perceived normal weight, fixed meal size, sitting time less than 6 h/day, and television viewing time less than 1 h/day. By small lifestyle modifications, normal BMI can be maintained.
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A study on the effect of
janani suraksha yojana
on antenatal registration and institutional deliveries in the Agra district of Uttar pradesh
p. 54
Vikas Kumar, Sunil Kumar Misra, Suneel Kumar Kaushal, Subhash Chand Gupta, Amir Maroof Khan
DOI
:10.4103/0019-557X.152865
PMID
:25758733
Janani Suraksha Yojana
(JSY) was launched in April 2005, to promote institutional deliveries through provision of cash assistance, transport, escort, and referral services. An observational cross-sectional study was conducted to assess the antenatal registrations, postnatal checkups, and institutional deliveries, and to compare the various social groups. Married women of the reproductive age group, having at least two children, were interviewed regarding antenatal care, delivery, and postnatal care in both pregnancies, latest as well as previous. Post JSY implementation, antenatal registrations increased from 61.79 to 96.34%, Deliveries at the Government Health Facility increased from 25.20 to 53.25% and postnatal check-ups increased from 45.93 to 69.51%. In the post-JSY-implementation phase, the Government Health Facility was preferred more by Scheduled Castes (SC), Scheduled Tribes (ST), Other Backward Classes (OBC) (SC/ST = 56.87%, OBC = 60.2%, and general = 43.68%), educated (Illiterate = 17.39%, Primary = 88.14, and Middle or above = 81.94%) and the lower socioeconomic classes (Lower SEC 71.83% and Upper lower and above = 45.71%) for their deliveries. It appears that the socially backward groups have benefited more from JSY.
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Compliance to anti-rabies vaccination in post-exposure prophylaxis
p. 58
Ravish Haradanahalli Shankaraiah, Rachana Annadani Rajashekar, Vijayashankar Veena, Ashwath Narayana Doddabele Hanumanthaiah
DOI
:10.4103/0019-557X.152867
PMID
:25758734
Complete post-exposure prophylaxis is necessary to prevent rabies among all animal bite victims. It is essential for the bite victims to complete the full course of vaccination as recommended for complete protection. The present study was conducted to determine the compliance rate for anti-rabies vaccination by both intramuscular route and intradermal route and to determine the major constraints. The study was done at two municipal corporation hospitals in Bangalore, India. The compliance rate for intramuscular rabies vaccination was 60.0% and for intradermal rabies vaccination 77.0%. The major constraints were loss of wages, forgotten dates, cost incurred and distance from the hospital. Hence, the present study showed that the compliance to anti-rabies vaccination for post-exposure prophylaxis is low and is a cause of concern, as animal bite victims who do not complete the full course of vaccination are still at risk of developing rabies.
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Anthropometric and behavioral risk factor for non-communicable diseases: A cluster survey from rural Wardha
p. 61
Rakesh Kumar
DOI
:10.4103/0019-557X.152868
PMID
:25758735
Monitoring of risk factors for non-communicable diseases (NCDs) over a period of time would be useful to make an indirect assessment of the actual disease burden. A cross-sectional survey was done among males aged 15-64 years, to study the prevalence of anthropometric and behavioral risk factors of NCDs. Information was collected on the sociodemographical factors, tobacco use, alcohol intake, diet, salt consumption, and physical activity, using a predesigned and pretested interview schedule. Anthropometric measurements were taken. A study found that prevalence of current smoking and use of smokeless tobacco was 14.2 and 54.9%, respectively. Alcohol intake was present in 22.7% of the study population. Per capita salt consumption per day was 14.6 g. A sedentary lifestyle was present among 19% of the men. Prevalence of overweight and obesity was 8.8% and 9.5%, respectively. Our finding suggested that greater surveillance of the NCD risk factors should be initiated as early as possible, in parallel with surveillance for communicable diseases.
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LETTERS TO THE EDITOR
Psychological morbidity among undergraduate medical students
p. 65
Shantibala Konjengbam, Jalina Laishram, Brogen Akoijam Singh, Vijaya Elangbam
DOI
:10.4103/0019-557X.152872
PMID
:25758736
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Importance of mediclaim policies covering congenital anomalies in India
p. 67
Meely Panda, Shasanka Shekhar Panda, Rashmi Ranjan Das, Pankaj Kumar Mohanty
DOI
:10.4103/0019-557X.152877
PMID
:25758737
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Implementation of ICD 10: A study on the doctors' knowledge and coding practices in Delhi
p. 68
Kayia Priscilla Kayina, Arun K Sharma, Kamal Agrawal
DOI
:10.4103/0019-557X.152879
PMID
:25758738
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Are confounders important in a study?
p. 70
Neha Singh, Taramangalam Ramakrishnan, Anurag Khera
DOI
:10.4103/0019-557X.152880
PMID
:25758739
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Infectious agents and acute myocardial infarction
p. 71
Sim Sai Tin, Viroj Wiwanitkit
DOI
:10.4103/0019-557X.152882
PMID
:25758740
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ESSAY
Prize winning essays: Undergraduate submissions to road to ISMoPH- environment - agenda for health promotion
p. 72
Debaditya Das, Akanksha Jha, Anindita Bag
DOI
:10.4103/0019-557X.152884
PMID
:25758741
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