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   2010| July-September  | Volume 54 | Issue 3  
    Online since January 18, 2011

 
 
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SPECIAL ARTICLE
Public health informatics in India: The potential and the challenges
AV Athavale, Sanjay P Zodpey
July-September 2010, 54(3):131-136
DOI:10.4103/0019-557X.75735  PMID:21245582
Public health informatics is emerging as a new and distinct specialty area in the global scenario within the broader discipline of health informatics. The potential role of informatics in reducing health disparities in underserved populations has been identified by a number of reports from all over the world. The article discusses the scope, the limitations, and future perspective of this novice discipline in context to India. It also highlights information and technology related tools namely Geographical Information Systems, Telemedicine and Electronic Medical Record/Electronic Health Record. India needs to leverage its "technology" oriented growth until now (e.g., few satellite-based telemedicine projects, etc.) simultaneously toward development of "information"-based public health informatics systems in future. Under the rapidly evolving scenario of global public health, the future of the public health governance and population health in India would depend upon building and integrating the comprehensive and responsive domain of public health informatics.
  17,835 1,579 2
SHORT COMMUNICATIONS
Obesity among adolescents of affluent public schools in Meerut
Seema Jain, Bhawna Pant, H Chopra, R Tiwari
July-September 2010, 54(3):158-160
DOI:10.4103/0019-557X.75740  PMID:21245587
The prevalence of obesity has increased worldwide in all segments of the population due to increased industrialization, urbanization, mechanization, and associated changes in diet and lifestyles. Change in diet habit of consuming more high energy fast foods and shifting to sedentary lifestyle has affected our children and also increased the risk of chronic diseases among adolescents. Childhood obesity has association with increased risk of coronary heart disease, stroke, and cancer in later life. Therefore, its control and prevention is one of the major concerns for all developing nations. The present school-based cross-sectional study was carried out among 2785 affluent adolescents of six public schools in Meerut during the period October 2003 to March 2004. The objective is to assess the magnitude of overweight and obesity in adolescents and associated risk factors, with the help of the ELIZ health pathway based on body mass index criteria. Prevalence of overweight and obesity was found to be 19.7% and 5.3% in girls and 18.36% and 10.82% in boys. Obesity was found to be significantly associated with high intake of junk foods (P < 0.05), binge eating, high calorie intake (P < 0.05), lower physical activity (P < 0.05), and prolonged TV watching (P < 0.05).
  7,069 1,114 11
PUBLIC HEALTH RESEARCH METHODS
Operations research in public health
Sumit Malhotra, Sanjay P Zodpey
July-September 2010, 54(3):145-150
DOI:10.4103/0019-557X.75737  PMID:21245584
Operations Research (OR) is gaining importance in public health interventions and programmes increasingly both nationally and internationally. The focus of these research techniques is to constantly guide the programme implementation to achieve best results. It modulates inputs and processes involved in the programme cycle and strive to produce optimal gains in achieving targets and goals. Utilizing the vast range of qualitative and quantitative tools, this research has produced significant results worth applying and testing in the real field. It also identifies problems; often programme managers encompass in operations of public health goods and test the feasible solutions for them. This paper highlights the relevance, themes, and methodological approaches in context to OR in public health. Multiple research and training opportunities currently exist locally and globally, to carry out OR for bringing out timely improvements.
  5,347 1,108 3
SHORT COMMUNICATIONS
Prevalence of knee osteoarthritis amongst perimenopausal women in an urban resettlement colony in South Delhi
Harshal Salve, Vivek Gupta, C Palanivel, Kapil Yadav, Bir Singh
July-September 2010, 54(3):155-157
DOI:10.4103/0019-557X.75739  PMID:21245586
A community-based cross-sectional study was carried out in an urban resettlement colony in South Delhi to study the prevalence of knee osteoarthritis in women aged ≥40 years and treatment seeking behavior of women suffering from osteoarthritis. Osteoarthritis was diagnosed by using clinical criteria given by American College of Rheumatology for diagnosis of Idiopathic Osteoarthritis of knee joints. A total 260 women were interviewed out of which 123 (47.3%) women were found to be suffering from knee osteoarthritis. Prevalence of osteoarthritis found to be increased with age. Less than half of those with osteoarthritis underwent treatment. With this high prevalence of osteoarthritis, there is need to spread awareness about the disease, its prevention, and rehabilitation in the community.
  5,567 827 7
ORIGINAL ARTICLES
Hand washing practices in two communities of two states of Eastern India: An intervention study
Sandip Kumar Ray, Forhad Akhtar Zaman, Nasrin Banu Laskar
July-September 2010, 54(3):126-130
DOI:10.4103/0019-557X.75734  PMID:21245581
Background : Public health importance of hand washing as well as its importance in reduction of communicable diseases such as diarrhea and acute respiratory infections have been highlighted in many studies worldwide. Objective: This study was designed to study the hand washing practices followed in two urban slums as well as to assess and compare the status of different components of hand washing at the pre- and post-intervention phases. Materials and Methods: A community-based cross-sectional intervention study on hand washing practices was carried out at two urban slums situated in two states of Eastern India with similar sociocultural and linguistic background. The study was carried out by using an interview technique as well as observation of hand washing practices. Interpersonal communication for behavioural change was chosen as a method of intervention. Results: The majority (>90%) practiced hand washing after defecation in both the study areas. However, hand washing following all six steps and for stipulated time period was seen to be poor before intervention. Significant improvement was observed in all the aspects of hand washing after intervention in both the areas. The poor practice of hand washing was observed in some situations and needed attention. Use of soap and clean material for drying hands after hand washing was poor initially followed by improvement after intervention. Conclusion: Based on the findings of the study, it could be suggested that Behaviour Change Communication program should be further planned with emphasis on different components of hand washing with a final objective to bring down the incidence of target diseases.
  4,775 861 4
SHORT COMMUNICATIONS
Awareness, perception and myths towards swine flu in school children of Bareilly, Uttar Pradesh
Varsha Chaudhary, RK Singh, VK Agrawal, Ashok Agarwal, Rajeev Kumar, Mahendra Sharma
July-September 2010, 54(3):161-164
DOI:10.4103/0019-557X.75741  PMID:21245588
The deadly disease swine flu is, without a speck of doubt, causing a massive havoc among the common people of India and has created fear across the various strata of the society. The objective was to find out the awareness, perception, and myths of school going children of class 9 th to 12 th toward swine flu. The present cross-sectional study was carried out in two randomly selected (using random number table) senior secondary schools of Bareilly among 400 students of class 9 th to 12 th . A total of 200 students were selected from each school. Chi-square test was applied for statistical analysis. Almost all the students (97.75%) have heard about of swine flu and are aware of it as a disease entity. Fever was found to be the main symptom while coughing and sneezing were main way of spread of swine flu known to them. About 97% of the students mention use of mask as most effective way to prevent them from swine flu. Knowledge of availability of medicine was present in less than half of the students. TV was found to be the main source from which they get knowledge (79%), and they are trying to get knowledge (53.2%) of swine flu. Among them, 74% students were taking precaution against swine flu.
  4,219 414 3
ORIGINAL ARTICLES
A review of tracking progress towards elimination of Iodine deficiency disorders in Tamil Nadu, India
Chandrakant S Pandav, P Krishnamurthy, R Sankar, Kapil Yadav, C Palanivel, MG Karmarkar
July-September 2010, 54(3):120-125
DOI:10.4103/0019-557X.75733  PMID:21245580
Background : Iodine deficiency disorders (IDD) are significant health problem in India. But there is dearth of regional/state level information for the same. Objective: This study was designed to study the current status of IDD in Tamil Nadu. Materials and Methods: A cross-sectional community-based survey was conducted in the state of Tamil Nadu. The study population was children in the age group of 6-12 years and the probability proportional to size 30 cluster methodology was used for sample selection. The parameters studied were prevalence of goiter, urinary iodine excretion, and iodine content in salt at the household level. Results: A total of 1230 children aged between 6 and 12 years were studied. The total goiter rate was 13.5% (95% CI: 11.1-14.9). The median urinary iodine excretion was found to be 89.5 μg/L (range, 10.2-378 μg/L). The 56% of the urinary iodine excretion values were <100 μg/L. The proportion of households consuming adequately iodized salt (iodine content ≥ 15 parts per million) was 18.2% (95% CI: 16.1-20.5). Conclusion: The total goiter rate of 13.5% and median urinary iodine excretion of 89.5 μg/L is indicative of iodine deficiency in Tamil Nadu.
  4,022 477 1
COMMENTARY
Is NDM-1 actually being imported to UK from India?
Shashi Kant, Partha Haldar
July-September 2010, 54(3):151-154
DOI:10.4103/0019-557X.75738  PMID:21245585
A recent article in Lancet Infectious Diseases suggested that Enterobacteriaceae containing New Delhi metallo-βlactamase (NDM-1) gene were being imported into UK from India. Since the study findings had widespread public health implications, it was necessary to scrutinise the adequacy of the evidence. The article was critically appraised on epidemiological, biological, and molecular evidence, the ethical principle of research, potential conflict of interest, and the justifiability of the recommendations. The study design was inappropriate to establish a causal chain between hospitalization in India and importation of NDM-1 in UK. Out of the total 29 NDM-1 positive UK patients, the NDM-1 gene was present in equal proportion among those who were hospitalized in India (44.3%) and those who were not (51.7%). Statistically significant strain relatedness between Indian and UK isolates could not be proved through dendrogram. There was a potential conflict of interest that was not disclosed. We found that the study findings did not support the authors' conclusion that India was a source for NDM-1 positive UK patients. Misplaced conclusions had the potential to cause unfounded scare and panic.
  3,245 461 4
SHORT COMMUNICATIONS
Prevalence of bronchial asthma and its association with smoking habits among adult population in rural area
BG Parasuramalu, N Huliraj, BM Rudraprasad, SP Prashanth Kumar, Gangaboraiah , NR Ramesh Masthi
July-September 2010, 54(3):165-168
DOI:10.4103/0019-557X.75742  PMID:21245589
A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 3194 adult individuals (18-70 years) were selected from 30 villages (clusters) using a cluster-sampling technique. Individuals with symptoms suggestive of asthma were subjected for clinical examination for the diagnosis of asthma. Among the 3194 respondents, 1518 (47.5%) were males and 1676 (52.5%) were females. The prevalence of bronchial asthma was 2.88%. The prevalence of asthma was higher among those reporting a history of current smoking. Among current smokers, the number of cigarettes/bidis/hookah smoked daily did not differ (P > 0.05) between individuals without asthma and with asthma, whereas the mean number of years of smoking did differ (P < 0.001). There was significant association between tobacco smoking and bronchial asthma.
  3,151 510 10
PUBLIC HEALTH EDUCATION
Public health manpower: An alternative model
FU Ahmed
July-September 2010, 54(3):137-144
DOI:10.4103/0019-557X.75736  PMID:21245583
The Bhore committee observed that "if nation's health is to be built, the health program should be developed on the foundation of preventive health work and that such activities should proceed side by side with the treatment of patients." The committee defined two categories of workforce: one for the personal care and the other for the public health namely, public health nurses and sanitary inspectors for public health and nurse, midwife, and pharmacist for personal care. Recommendations of successive health committees lead to amalgamation of personal care services and public health services. Single focus programs and amalgamation of different cadre of Grassroots staff lead to dilution of public health services and more focused on different program-based personal care services. To carry out public health services, we need a sufficiently knowledgeable, well-skilled and competent mid-level supervisory public health workforce who can support and strengthen the performance of the existing multipurpose workers. Increased understanding of the influence of different determinants on health and well-being and also scientific progress to combat the environmental and biological effects on health has widened the gap between the actual need of human resources and expanding public health services needs. Keeping in view of the above and meet the challenges, a 3-year course of Bachelor in Public Health is conceived by the Indian Academy of Public Health. Professional responsibilities expected from this new cadre of workforce are also discussed in this article.
  2,675 457 2
EDITORIAL
Health promotion: The new public health agenda
Madhumita Dobe
July-September 2010, 54(3):117-119
DOI:10.4103/0019-557X.75732  PMID:21245579
  1,735 370 -
LETTER TO THE EDITOR
Lymphatic filariasis in Andhra Pradesh paper mill colony, Rajahmundry, after nine rounds of MDA program
Ashok Kumar Mukhopadhyay
July-September 2010, 54(3):169-170
DOI:10.4103/0019-557X.75743  PMID:21245590
  1,729 166 -
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