48 research outputs found

    Health seeking behaviour of women with unwanted pregnancies: a tertiary care centre based study of eastern Uttar Pradesh, India

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    Background: Termination of an unwanted pregnancy is legal in India. Many women in this region are still not aware about safe abortion services and its consequences. Especially young, economically deprived and those without a supportive male partner are at higher risk of unsafe abortion. There is no clear and established evidence on this issue in our region. In the study, the aim was to explore the health seeking behaviour of women with unwanted pregnancies.Methods: Present cross-sectional study was conducted among 303 patients visiting to obstetrics and gynecology ward of BRD Medical College, Gorakhpur from April 2018 to September 2018. Their socio demographic profile, reasons for current termination of pregnancy and health seeking behaviour was explored.Results: Most common reason given for terminating the current pregnancy was completed family size 65.3%. Unmarried girls with pregnancy were 5.6 % who wanted termination of pregnancy. Majority (67.0%) took medication for termination of pregnancy from nearby medical store without an expert consultation 15.8% of women consulted to a local quack or local dai for termination of pregnancy. 12.9% of women tried a method as advised by family/friends for termination of pregnancy. About 4% of women 1st tried traditional and herbal medicines, drinking tea or juice for termination of pregnancy. Majority of women (84.5%) visited to medical college for management of complications of earlier tried method of termination of pregnancy.Conclusions: Completed family size was found most common reason for termination of pregnancy. Self medication without consultation of authorised doctor was found most common practice of abortion leading to complications.

    Diabetes control, dyslipidemia, hsCRP and mild cognitive impairment in non-elderly people with type 2 diabetes mellitus

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    Background: Mild Cognitive Impairment (MCI) a transitional stage between normal aging and dementia has been observed more in people with diabetes when compared with general population. The risk factors for MCI in type 2 diabetes mellitus (T2DM) have been defined in elderly patients and aging may itself contribute to declining in cognitive functions. As the large number people with T2DM are under 60years, the prevalence of MCI and factors contributing to it are not much studied. So, this study aimed to find out the factors contributing to MCI in non-elderly T2DM patients.Methods: In this cross-sectional study, 257 patients with T2DM underwent cognitive assessment by Montreal cognitive assessment test and the cognitive levels were correlated with their glycosylated hemoglobin, lipid profile, and highly sensitive C-reactive protein (hsCRP).Results: The prevalence of mild cognitive impairment (MCI) was 64.2%.  MCI significantly correlated with duration of diabetes, socioeconomic status, HbA1c, serum triglycerides, low-density lipoprotein, very low-density lipoprotein and hsCRP levels. The factors that were statistically insignificant were body mass index and high-density lipoprotein levels.Conclusions: Cognitive impairment is seen even in non-elderly T2DM patients. It should be considered along with the other complications of diabetes and individuals with T2DM should be screened for cognitive impairment to prevent progression to dementia

    Knowledge, attitudes and practices (KAP) towards rabies and free-roaming dogs (FRD) in Shirsuphal village in western India: A community based cross-sectional study

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    The lack of awareness about dog-bite related rabies in the rural population of developing countries, including India, is a major impediment to controlling the incidence of disease in humans. A survey of 127 rural residents was undertaken in Shirsuphal village in western India using a structured questionnaire to assess the influence of demographic and pet/livestock owning characteristics on the knowledge, attitudes and practices of the respondents towards rabies and free roaming dogs (FRD). Multivariable logistic regression models were constructed and the knowledge of the rural residents of Shirsuphal village was found to be significantly influenced by family size (OR 2.1, 95%CI 1.0–4.6, p = 0.04) and poultry ownership (OR 2.3, 95%CI 1.1–4.9, p = 0.03), while their attitudes towards FRD was significantly influenced by age of the respondents (OR 2.6, 95% CI 1.2–5.8) and ownership of cattle/ buffalo (OR 2.2, 95% CI 1.1–5.5). Although the knowledge score about rabies was high, a comprehensive understanding of the disease was lacking. Concerted efforts to widen the knowledge about rabies and promote healthier practices towards FRD are recommended

    Knowledge, attitudes and practices towards dog-bite related rabies in para-medical staff at rural primary health centres in Baramati, western India

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    The lack of awareness regarding rabies amongst rural primary care health staff and their adverse practices towards the management of dog-bite wounds is a major contributor to the high incidence of rabies infection and subsequent human mortality in India. A Knowledge, Attitudes and Practices survey was carried out involving 54 nursing and non-nursing staff working in 18 rural Primary Health centres and sub-centres around Baramati town of Pune district in Western India. Multivariable logistic regression models were constructed to assess factors that influenced knowledge of rabies and practices towards management of dog-bite related wounds. The more experienced and better-educated workers were found to have a good awareness of rabies (OR 3.4, 95%CI 1.0–12.1) and good practices towards dog-bite wound management (OR 5.6, 95%CI 1.2–27.0). Surprisingly, non-nursing staff were significantly more knowledgeable about rabies (OR 3.5, 95%CI 1.0–12.3), but their practices towards dog-bite wound management were inadequate (OR 0.18, 95%CI 0.04–0.8) compared to the nursing staff. It is recommended that a mandatory training module for primary care health staff be developed and implemented to improve their knowledge regarding rabies and management of dog-bite wounds to reduce the incidence of human rabies in rural India

    Evaluation and comparison of the constitutive expression levels of Toll-like receptors 2, 3 and 7 in the peripheral blood mononuclear cells of Tharparkar and crossbred cattle

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    Aim: This study was undertaken to assess the differential expression levels of toll-like receptors (TLRs) 2, 3 and 7 in peripheral blood mononuclear cells (PBMCs) isolated from Tharparkar and Crossbred cattle belonging to different regions of India. Materials and Methods: PBMCs were isolated from blood samples of Tharparkar cattle from Indian Veterinary Research Institute (IVRI) farm (n=30); Suratgarh farm (n=61); Jaipur farm (n=8) and cross breed cattle from Jaipur (n=47). RNA was isolated from PBMCs and cDNA was synthesized using random hexamers. The expression profiles of TLR 2, 3 and 7 were estimated by real-time PCR and normalized to the expression of β-actin. Results: PBMCs of Tharparkar cattle from Suratgarh, exhibited a significantly higher (p<0.05) constitutive expression levels of TLR2, TLR3 and TLR7 genes as compared to Tharparkar cattle from IVRI or Jaipur as well as the crossbred cattle from Jaipur. PBMCs of crossbred cattle from Jaipur showed higher expression profiles of all the TLRs than Tharparkar cattle from Jaipur and IVRI. Conclusion: Our study indicates, expression levels of TLR2, TLR3 and TLR7 are significantly higher for Tharparkar cattle from Suratgarh than the cattle from Jaipur and IVRI and crossbred cattle from Jaipur. However, crossbred cattle from Jaipur showed higher basal expression levels of all the three TLRs than Tharparkar cattle from Jaipur and IVRI. Results also indicate that PBMCs of Tharparkar cattle show a regional variation in the expression pattern of TLRs

    Free roaming dog population, community perception and control of dog related rabies: The Indian story

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    Most human deaths from rabies in India are caused by the bites of free roaming dogs (FRD), however studies on the demography of FRD and the community perception of rabies and FRD are virtually lacking in the country. This study was conducted in rural and urban India to: recommend a reliable enumeration method for FRD; describe the demography of FRD; assess the knowledge, attitudes and practices (KAP) of communities towards rabies and FRD; and assess the KAP of rural para-medical staff on dog-bite wound management. The Application SuperDuplicates online tool was found to reliably enumerate the FRD population size with minimal resources. In the rural site fewer dogs were sighted within 20 metres of garbage points (OR 0.3) than more distant; while in the urban site more FRD were sighted near garbage points (OR 1.6) than away from these sites. The re-sight probability (β = 0.3) and de-sexing status (β = -0.07) of FRD had a positive and negative influence, respectively on urban FRD forming groups. The tendency to form groups in the rural FRD was influenced by frequency of being re-sighted (β = -0.1) and presence of garbage within 20m (β = 0.2). The FRD in the rural setting that were sighted in groups had a larger home-range (>0.11 ha) than those sighted alone (≤0.11 ha). Rural respondents with a smaller family size (OR 2.1) were more knowledgeable about rabies, than those with bigger families and older respondents (OR 2.6) had a more positive attitude towards FRD than did younger respondents (<35 years). Urban respondents from high/middle socio-economic sections were more knowledgeable (OR 3.03) with positive attitudes and practices (OR 3.4) towards rabies than those from lower socio-economic sections. Urban households containing children (≤ 14 years) (OR 0.5) had a lower level of knowledge about rabies compared to households with older or no children. Experienced and graduate paramedical staff were more aware (OR 3.4) and adopted adequate practices (OR 5.6) regarding the management of dog-bite wounds than less experienced or non-graduate staff. It is recommended that control of dog-related rabies in India requires: enumeration and interpretation of the demographic characteristics such as tendency to form groups and the spread of home ranges of FRD to strategically adopt mass-immunisation; concerted efforts to promote knowledge and adoption of healthier practices in rural communities; educational outreach directed towards the lower socio-economic sections in the urban community; and the development and implementation of compulsory training modules for rural paramedical staff on dog-bite wound management
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