A Meta-Analysis: Colostrum Feeding Practices in Uttar Pradesh, India

Background: Breast milk is the natural first food for babies. It continues to provide up to half or more of the child’s nutritional needs during the second half of the first year, and up to one third during the second year of life. Breastfeeding is the safest, least allergic and best infant feeding method. It has nutritional, immunological, behavioral and economic benefits and provides desirable mother infant bonding. Objective: To do the meta- analysis of Colostrum feeding practices of baseline study of 2004 with other studies conducted after 2004 in Uttar Pradesh. Material & Methods: The Baseline study on Colostrum feeding practices in Uttar Pradesh was done in 2004. The meta-analysis was done taking seven other studies following this one taking same variable. Results: In baseline study of 2004, the colostrum given was found to be 22.22%. Conclusion: Deprivation from colostrum feeding and suboptimal breast feeding practices are significant risk factors for under-nutrition among under-fives. There is need for promotion and protection of optimal breast feeding practices for improving nutritional status of children

Depression, its correlates and quality of life of undergraduate medical students in the Kumaon region of Uttarakhand state, India

Background: Medical students are future health care providers and experience a lot of stress during their training years. They are more likely to suffer depressive disorders than the general population and have a poorer quality of life. Objectives: To determine the prevalence of depressive disorder, its correlates and quality of life of medical students studying at a medical college in North India. Methods and material: It was a cross sectional study which included all the students enrolled at the study medical college. Data was collected using pre-validated questionnaires namely - 20 item ‘Center for Epidemiologic Studies Depression Scale (CES-D)’, WHO Quality of life (QoL) – BREF questionnaire and ‘Smartphone Addition Scale - Short version’ (SAS-SV) questionnaire to assess for depression, quality of life and smartphone addiction respectively which was distributed in the classroom to be filled. Multivariate logistic regression was employed to ascertain association between depression and the other variables. Results: The study had an effective response rate of 79%. Using a score of 16 or above as cut-off on CES-D scale145 study participants (36.7%) were found to be depressed. Participants who negatively compared themselves with their peers/friends and also those who were addicted to smartphone were significantly more likely to be depressed [1.85(1.12-3.05) and 1.96 (1.29-2.97) respectively]. We report a statistically significant negative relationship between physical domain score [0.97(0.95-0.99)], psychological domain score [0.95(0.93-0.97)] and social relationship domain score [0.97(0.95-0.99)] on BREF Quality of life questionnaire and the presence of depression among the study participants. Conclusion: The prevalence of depression among medical students was high and those with depression have significantly poor quality of life

Awareness and Pattern of Tobacco Use among the Medical Students of Government Medical College

Introduction: Nearly 6 million people die due to tobacco every year and this figure will increase to 8 million tobacco-attributed deaths per year by 2030 with 80% of them occurring in developing countries. Objective: To study the awareness and pattern of tobacco use among the undergraduate medical students of Government Medical College, Haldwani. Material and Methods: A Cross-sectional study was conducted among 303 medical students using a predesigned and pretested, semi-structured self-administered anonymous questionnaire. Data was analyzed by using SPSS v 16. Results: Among 303 participants, 44(14.5%) were smokers.  Majority of the students (97.73%) were more than 20 years of age at the time of initiation of tobacco use. Cigarette smoking was most common form (79.55%) of abuse. Male students were using tobacco significantly higher than that of females (?2=36.68). The effect of parental tobacco use on tobacco consumption habits of the users were significantly higher than non-tobacco users (?2=180.75). The tobacco consumption was significantly increased among the senior students as compared to that among the juniors (?2=15.29). Awareness about harmful effects of tobacco abuse was very high (90.76%) and mainly they got knowledge from media. 84.16% students support ban on tobacco use in public places. Conclusion: We can conclude that though the awareness among medical students regarding harmful effects of tobacco use was very high but they got this knowledge mainly from the electronic media, so it is necessary to introduce teaching on tobacco dependence and cessation early in the courses of the medical colleges

Drug adherence to anti-tubercular treatment during COVID-19 lockdown in Haldwani block of Nainital district

Background: India saw one of the stringent lockdowns during the COVID-19 pandemic. In the wake of this period, the normal functioning of medical services was affected. People were reluctant to seek medical attention and notification of Tuberculosis dipped. The aim of the study was to estimate the proportion of non-adherence to anti-tubercular treatment and to identify the factors affecting the non-adherence to treatment. Methods: A retrospective community-based study was conducted among 284 tuberculosis patients. They were interviewed using a pre-designed questionnaire consisting of WHO dimensions of non-adherence and lockdown related questions. Results: The proportion of non-adherence to treatment was found to be 5.3%. Factors like chronic diseases, depression, without knowledge on how the disease is transmitted and that medication can be discontinued once the symptoms subsided, alcohol consumption, and trouble accessing medicine were found to be the determining factors in non-adherence to the treatment. Conclusions: Non-adherence to anti-tuberculosis treatment in our study was low but the various dimensions of adherence along with lockdown related factors had significant impact on it. To further minimize non-adherence during emergency like the lockdown due to COVID-19 pandemic, corrective measures must be explored and implemented

Prevalence of obesity and its correlates in school going adolescents of Haldwani, Nainital, Uttarakhand, India

Background: With a rising trend of Non-Communicable Diseases (NCDs) in the present world, overweight and obesity has gained importance as it is not only a disease in itself but also risk factor for majority of other NCDs. A dramatic increase in overweight and obesity among children and adolescent has raised the concern of various public health physicians especially in developing country like India. Aims & Objective: To study the prevalence of overweight and obesity & its correlates among school going adolescents of Haldwani block. Material & Methods: School based cross sectional study was done among the adolescents of 8th to 12th standard. To calculate the maximum sample size prevalence of obesity was assumed to be 50%, taking absolute error of 5%, design effect of 2 and 10% non-response rate the sample was calculated to be 880, rounded off to 900. Samples were collected from 30 clusters/schools using simple random sampling. Data was collected using a pre-designed, semi-structured and pre-tested questionnaire and analyzed by using SPSS version 22. Results: Prevalence of overweight and obesity was 13% (CI = 10.8 - 15.2%). Overweight and obesity was found to be significantly associated with urban area, private school, Socio-economic class I, non-vegetarian diet, physical inactivity and playing videogames, working on laptops and computer on univariate analysis. On applying binary logistic regression factors like private schools, socioeconomic class I, non-vegetarian diet and physical inactivity were again found to be significantly associated with overweight and obesity. Conclusion: Prevalence of obesity was found to be more in adolescents having modifiable risk factors. &nbsp

Mapping and vulnerability assessment in urban slums of Nainital and Udham Singh Nagar districts of Uttarakhand: A Cross-sectional Survey

Background: With increasing urbanization, number of urban slums is also rising. The health facilities and indicators in urban slums are poor as compared to other urban population. The present study presents an analysis of the health problems, utilization of health services and vulnerability of urban slums. Aims & Objectives: To map the slums in urban areas and assess the vulnerability of households. Methodology: The study was conducted in all urban slums of five cities of Nainital and Udham Singh Nagar districts namely Haldwani, Ramnagar, Rudrapur, Jaspur and Kashipur. Group discussions involving community members, ward surveys by ASHA workers and household level vulnerability assessment were done using standard format according to “Guidelines and Tools for Vulnerability Mapping and Assessment of Urban Health, 2017”. Results: Most urban slum dwellers are daily wage laborers with major population suffering mainly from diabetes, hypertension, respiratory infection. Lack of drugs and diagnostic facilities are the major concerns. Infrastructure needs strengthening in most of the slums. Around three fourth of population belonged to vulnerable group with remaining in highly vulnerable group. Conclusion: There are social problems in urban slums like illiteracy, lack of awareness, unemployment which worsen the health problems. So, a holistic approach is needed for the solution

Profile of Multi Drug Resistant Tuberculosis patients: A Study at Drug Resistant Tuberculosis Centre in Kumaun Region, Uttarakhand

Background: Drug Resistant Tuberculosis (DR-TB) has frequently been encountered in India, and its presence has been known virtually from the time anti-TB drugs were introduced for the treatment of Tuberculosis. Multi Drug Resistant Tuberculosis (MDR-TB) is a man-made phenomenon and has become a formidable challenge to effective Tuberculosis control in India. Objectives: To study the Socio-demographic and Clinical profile of Multi Drug Resistant Tuberculosis (MDR-TB) patients presenting to Drug Resistant Tuberculosis (DR-TB) Centre at Govt. Medical College, Haldwani in the Kumaun region, Uttarakhand. Methodology:  This study is a Record based study, where in service data available at Drug Resistant Tuberculosis (DR-TB) Centre at Govt. Medical College, Haldwani in the Kumaun region, Uttarakhand, was accessed and analyzed. Inclusion criteria included all patients with diagnosis of Multi Drug Resistant Tuberculosis (MDR-TB) presenting to the centre from 1st April 2015 to 31st December 2015. Results: The present study showed that younger age group particularly males were more affected with MDR-TB. Under-nutrition was quite prevalent among the MDR-TB patients. 56.7% cases were addicted to alcohol and 54.3% cases were addicted to smoking. 85.8% patients took treatment for TB and 44.1% not completed their treatment. Relapse of previous anti-tuberculosis treatment was found to be the major contributor in MDR-TB suspect cases. Prevalence of XDR-TB was also found to be low. Conclusion: The findings of the study emphasize the importance of studying the socio-demographic factors and baseline clinical characteristics in different MDR-TB patient categories to timely modify and strengthen the national programs

Is the Revised National Tuberculosis Control Programme achieving early initiation of treatment post two decades of its operation?: A cross-sectional study from Uttarakhand, India

Background: Early case finding and prompt initiation of treatment of pulmonary Tuberculosis (PTB) is the most effective strategy to achieve successful TB control. In order to achieve early initiation of treatment, the Revised National TB Control Programme (RNTCP) since its launch in 1997 has been using advocacy, communication and social mobilization (ACSM) strategy targeted at health care providers (HCP) and other stake holders by large scale utilization of electronic and print media. Objective: To study whether RNTCP is really achieving early initiation of TB treatment among infectious PTB patients. Methods: A cross- sectional study among new smear positive PTB patients at Haldwani block of Nainital district of Uttarakhand State of North India. Data was analyzed using the software Epi Info version 7.2.0.1. Results: Of the 85 infectious PTB patients included in the study, the median time consumed between onset of cough and contact with the first HCP, between first HCP contact to confirmation of diagnosis, and between confirmation of diagnosis to initiation of treatment were 6 days, 43 days and 6 days respectively. Overall, median time consumed between onset of cough to initiation of treatment was 61 days. HCPs working in the public health settings fared no better than those in the private health sector in this regard. Conclusions: Although majority patients sought medical care timely, a considerably unacceptable long time was consumed by HCPs in initiation of treatment of PTB

Awareness and Pattern of Tobacco Use among the Medical Students of Government Medical College

Introduction: Nearly 6 million people die due to tobacco every year and this figure will increase to 8 million tobacco-attributed deaths per year by 2030 with 80% of them occurring in developing countries. Objective: To study the awareness and pattern of tobacco use among the undergraduate medical students of Government Medical College, Haldwani. Material and Methods: A Cross-sectional study was conducted among 303 medical students using a predesigned and pretested, semi-structured self-administered anonymous questionnaire. Data was analyzed by using SPSS v 16. Results: Among 303 participants, 44(14.5%) were smokers.  Majority of the students (97.73%) were more than 20 years of age at the time of initiation of tobacco use. Cigarette smoking was most common form (79.55%) of abuse. Male students were using tobacco significantly higher than that of females (ᵡ2=36.68). The effect of parental tobacco use on tobacco consumption habits of the users were significantly higher than non-tobacco users (ᵡ2=180.75). The tobacco consumption was significantly increased among the senior students as compared to that among the juniors (ᵡ2=15.29). Awareness about harmful effects of tobacco abuse was very high (90.76%) and mainly they got knowledge from media. 84.16% students support ban on tobacco use in public places. Conclusion: We can conclude that though the awareness among medical students regarding harmful effects of tobacco use was very high but they got this knowledge mainly from the electronic media, so it is necessary to introduce teaching on tobacco dependence and cessation early in the courses of the medical colleges