Family planning: its practice and determinants among eligible couples in an urban slum of Tripura

Background: Contraceptive use in India is poor so this study was designed to detect the prevalence of contraceptive use and its determinants among eligible couples in an urban slum of Tripura. Methods: Community based cross-sectional study, conducted in the urban field practice area of Agartala Government Medical College during 15th June 2010 to 14th August 2010 among 180 eligible couples chosen by systematic random sampling. Descriptive statistics and chi-square test were used. Results: Majority were Hindu from nuclear families. 56.7% wives and 62.8% husbands studied up to secondary level. Prevalence of contraceptive use was 43.9% and 88.9% of the study couples were aware about family planning. Tubal ligation was the most adopted and condom was the least practiced method. Decision regarding family planning was mostly made by the husband and wife jointly. Public health facilities were the main source of family planning materials and most of the study couples opined family planning as essential. Commonest reason for not practicing family planning was the desire for a son and the rest were fear of adverse effects and some non-specific reasons. The affect of caste, religion, occupation, education etc. was insignificant in determining the practice of family planning. Conclusions:Despite a high rate of desire to limit family size, less than half of the couples were currently using contraception. It was mostly due to desire for more male babies. Hence behaviour change communication for eliminating preference for male babies and measures favouring girl children may promote couple protection in this community.

Intimate partner violence against women during pregnancy in Tripura: a hospital based study

Background: Intimate partner violence is increasing day by day and has become a matter of public health concern. Methods: To estimate the prevalence of intimate partner violence during pregnancy, to find out the pattern of violence and its determinants, a hospital based cross-sectional study was conducted among 1005 women admitted in the maternity wards of Agartala Government Medical College and Mohanpur Community Health Centre using multistage sampling and structured interview schedule during 20th November 2009 to 19th November 2010. Descriptive statistics, chi-square test and binary logistic regression analysis were used. Results: Mean age of the study women was 23.21 (± 4.229). Prevalence of physical assault during pregnancy was 23.8 %, verbal abuse 40.6 %, forced intercourse 21.2 %. Violence was faced by 43.2 % women before pregnancy, and in 29.5 % cases, it continued during pregnancy also. 37.815 % violence occurred without any reason; 34.873 % due to financial matters, 12.605 % due to family affairs, 6.302 % for not giving birth to son, 8.403 % due to household work and suspicion of infidelity. Violence was more prevalent among Christian, daily labours (n = 31, 75.6%), illiterate and rural women. Women faced more violence from addicted husbands (n = 239, 26.3%) and in families where decision makers were illiterate (n = 201, 47.2%). Conclusions: Improving literacy, eliminating addiction and marriage of women with men of lesser age difference may help in minimizing intimate partner violence in Tripura.

Prevalence of pre-hypertension and its relationship with body mass index among the medical students of Agartala government medical college

Background: Body Mass Index (BMI) is found to be positively co-related with the increased prevalence of elevated blood pressure among younger individuals. The present study was designed to find out the prevalence of pre-hypertension and its relationship with BMI among the medical students.  Methods: A cross-sectional study was conducted during June - July 2013 among 306 medical students of Agartala government medical college, chosen by stratified random sampling.  Results: Prevalence of pre-hypertension, hypertension and optimum BP were found to be 45%, 4% and 51% respectively. Mean BMI was found to be 21.68 ± 3.55, 80% of the students had ideal waist hip ratio, 19% were underweight, 61 % had normal weight, 18 % were overweight, and 2% were found to be obese. Pre-hypertension was significantly more prevalent among the senior medical students (χ2 = 4.933, P = 0.026), males (χ2 = 10.826, P = 0.001) and those who had family history of hypertension (χ2 = 4.228, P= 0.039). Pre-hypertension was significantly higher among the obese medical students (χ2 = 6.941, P = 0.008). Logistic regression analysis revealed that medical students had 12.8% more chance of having pre-hypertension with one unit increase in their BMI.  Conclusion: Prevalence of pre-hypertension among medical students is high and BMI is found to be significantly associated with pre-hypertension. Hence it can be used as an effective tool for predicting pre-hypertension and development of hypertension among medicos later on.

Prescription audit in outpatient department of a teaching hospital of North East India

Background: Quality of the prescriptions generated from OPD of Agartala Government Medical College and Govinda Ballabh Pant Hospital is never assessed. The study objectives were to find out the quality in terms of legibility, completeness and adherence to WHO core prescribing indicators of the prescriptions generated from OPD of this hospital.Methods: This hospital based cross-sectional study was conducted during 11th to 16th December 2017 among 442 prescriptions picked up from 12 OPDs by multi stage sampling technique and examined using a checklist designed to assess adherence to WHO core prescribing indicators, legibility and completeness. Data entry and analysis were performed with computer using SPSS 15.0. Descriptive statistics and Chi-square test were used to present data.Results: Total 1169 items were prescribed in 442 prescriptions. Only 50.90% prescriptions were legible. Average number of drugs prescribed per encounter was 2.64, 223 (19.07%) were generic drugs, 14 (1.19%) were injections, 176 (15.05%) were antibiotics and 618 (52.86%) items were from the national essential drug list. History was written in 62.70%, findings were written in 52.70%, diagnosis was written in 40.00%, 87.80% prescriptions contained no review instructions, 84.60% contained complete directions to the pharmacist, 87.10% did not contain complete direction to the patients and signature section was incomplete in 99.80% of the prescriptions. Significantly higher proportions of the high ranked prescribers wrote generic items, review instructions and complete directions to the patients in their prescriptions (p < 0.05).Conclusions: Most of the prescriptions generated from OPD of Agartala Government Medical College and Govinda Ballabh Pant Hospital were found to be incomplete, about half of them were illegible and sizeable proportions did not adhere to the WHO core prescribing indicators

Sero-prevalence of SARS CoV-2 specific antibody among general population of Tripura, India: A baseline observation

Background: Spectrum of COVID-19 disease ranges from asymptomatic or mild symptomatic to life threatening cases. Population based sero-epidemiological studies are useful for assessing the magnitude of COVID-19 infection in a geographic area and it is helpful for planning control measures. Objectives: To estimate the sero-prevalence of SARS CoV-2 antibody in the general population of Tripura and to study the factors associated with it. Methodology: This community based cross-sectional study was conducted from 15th October to 14th November 2020 among 4800 subjects selected from the whole state of Tripura, India by probability proportionate to size sampling technique using 30 clusters. Electrochemiluminescence (eCLIA) based assay was used to test the serum samples for SARS-CoV-2 specific antibody. Data entry and analysis was performed using SPSS-25 for windows and sero-prevalence was expressed in percentages. Binary logistic regression model was used for predicting sero-positivity by including the significant factors associated with SARS-CoV-2 infection as found out by univariate analysis. Result: Sero-prevalence of SARS-CoV-2 antibody was found to be 34% among the general population of Tripura and it varied from 42.4% to 19.7% across different districts. Logistic regression model has identified, urban residency (OR: 1.21, 95% CI: 1.03-1.42), ethnic community (OR: 0.55, 95% CI: 0.48-0.64) and literacy (OR: 1.41, 95% CI: 1.13-1.77) as the independent risk factors for SARS-CoV-2 sero-positivity (p&lt;0.05). Conclusion: Approximately one out of three residents of Tripura has already acquired the novel SARS CoV-2 infection. As the threshold required for achieving herd immunity against COVID-19 is not yet known, control measures need to be continued for preventing further spread of disease in the community

Bacteriological quality of water and diarrhoea among ethnic and non-ethnic communities of rural area of West Tripura, India

Background: Waterborne diseases are the major causes of health seeking by ethnic and non-ethnic communities of West Tripura district of India. Safe and wholesome water is a basic requirement for good health. Microbiological contamination of water is responsible for most of the waterborne diseases and diarrhoea is still a major killer of childhood.Methods: A community based cross-sectional study was conducted among 177 ethnic and non-ethnic households chosen by multi stage sampling from West Tripura District of North East India during June - July 2016 to assess the bacteriological quality of water and to find out its association with the occurrence of diarrhoea.Results: Among the ethnic and non-ethnic households shallow tube wells were the source for 52.18% and 62.35 %, deep tube wells for 19.56% and 29.41%, and pipe water for 20.65 % and 5.89 households respectively. Sanitary latrines ware used in 46.73% ethnic and 50.59% non-ethnic households. In both the group filtration was practiced by 85% and no purification by 1%. Covered vessels were used for storing water in 94.57% ethnic and 95.30% non-ethnic households. Source of water was mildly contaminated in 15% ethnic and 10% non-ethnic, moderate and heavy contaminations were 11% and 8% each respectively in both the groups. At the point of consumption moderate and heavy contaminations were 2% each in ethnic households. Mild and severe contaminations were 3% and 1% respectively in non-ethnic group. Diarrhoea was significantly more frequent among households consuming coliform contaminated water (p<0.05).Conclusions: Half of the study population was using insanitary latrine and one fifth were collecting water from contaminated sources. Hence provision of safe water and promotion of sanitary latrine is needed to prevent waterborne diseases in this community

A study to assess the emotional disorders with special reference to stress of medical students of agartala government medical college and govinda ballabh pant hospital. Indian J Community Med

Background: Stress is very common psychological phenomena where medical students faced in day to day activities. Epidemiological studies have asserted that about 70-80% of the diseases may be related to stress. Research related to this stress especially among medical students is essential, considering their learning, role and responsibilities as a future physician and health intervention programs. Objectives: To estimate the prevalence of stress and identify stressors among medical students. Materials and Methods: A Cross-sectional study was carried out among undergraduate medical students and self administered GHQ-12 and stressor questionnaire were used to collect information regarding stress. Binary logistic regression analysis was performed to calculate odds ratio (OR). Results: Prevalence of stress was 94.52% and more common among females. 33.56% students felt constantly under strain and 25.34% had loss of sleep over worry. Majority of the students of all semesters had stress (P &gt; 0.05) and stressors viz. &apos;competition for marks&apos; (P = 0.005), &apos;frequent examination&apos; (P = 0.001), &apos;difficulty in finding time for recreation&apos; (P = 0.014) and &apos;being away from home&apos; (P = 0.027) were predominantly experienced by the 1 [sup]st year medical students. Multiple logistic regression analysis revealed the causal effect of main parameter on the GHQ caseness and students who found difficulties in following teaching language among the caseness had 81.59% higher chance of developing stress (OR = 8.159, CI = 1.228-54.213). Conclusion: The stress experience was more common due to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life. Introduction The data were analyzed in computer using Microsoft excel 2007 and Epi-info [sup]TM version 6.0. (Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA). The percentage, mean, standard deviations were calculated and Chisquare test, Fisher&apos;s exact test, multiple logistic regression etc. were employed in analysis of data. Results The present study was conducted among 150 medical students where 146 completed the questionnaire. Prevalence of stress was 94.52% and predominantly (97.4%) among 8 [sup]th semester students. Males constituted 56.8% and 43.2% were females. Majority belonged to 20-22 years age group. The age ranged from 18-24 years with a mean (SD) of 20.64 (?1.264) years. The mean (SD) GHQ score for male, female and overall were 6.08 (?2.182), 6.86 (?1.109) and 6.42 (?2.177) respectively. The commonest GHQ score 6 was observed among 22.6% of the participants. Severity of stress was graded on the basis of scoring in the GHQ scale. [sup][9] The mild, moderate and severe stress were 51.4% (GHQ score of 4-6), 32.2% (GHQ score 7-9) and 11.0% (GHQ score 10-12) respectively. No significant association of psychological stress with sex (p-0.071), caste (0.285), year of study (0.406), location of family (0.424) and family income (0.609) [ Discussion The actual cut-off score was chosen depending on the purpose and context of each study, and related to the relative importance of sensitivity and specificity. Despite the variability of cut-offs used to estimate the prevalence of stress reported in our study can be considered as high (94.52%) which was comparable with a study from Malaysia. [ The mean GHQ score found in the present study was lower than the report of Jenny Firth (11.66 [?5.16]), [sup][15] whereas Sherina et al . [sup][10] found it to be 1.03 (?0.178), which was lower than the present study. The difference in the observations made by other authors again pointed that stress was a matter of perception and all were not affected equally. Different individuals had different ways of looking at stressful conditions. Gender, location of family, caste, religion, number of family members, income etc., had no significant relationship with positive GHQ-caseness of medical students and almost similar results were reported from Nepal, [sup] [sup] The common symptoms of psychological stress were comparable to a study from University Putra, Malaysia. [sup][10] Higher percentage of students were found &apos;not feeling reasonably happy&apos; (78.8% vs. 13.70%) and having &apos;problems in sleeping when worried&apos; (71.0% vs. 25.35%) in the present study. [sup][16] The reason for a higher percentage of stress among students could be due to their awareness regarding stress symptoms and ability to adapt quickly. The academic/non-academic stressors were more commonly seen among male medical students ( P &lt; 0.05) and comparable to a study conducted in Perak, Malaysia. [sup][23] Significant association was also observed between semesters and stressors and was comparable to a study from Melaka Manipal Medical College; India [sup][13] except &apos;with difficulty in keeping pace&apos;, &apos;with the amount of information that had to be mastered&apos; and&quot;finding time for recreation&quot;. 41.10% faced difficulties in approaching the teachers. Conclusion The stressors experienced were more common to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life

Determinants of child sex ratio in West and South Districts of Tripura, India

Background: Indian census 2011 has detected declined child sex ratio in the West and South districts of Tripura State. Objectives: To find out the sex ratio at birth and to identify the factors affecting child sex ratio in west and south districts of Tripura. Methods: This community-based cross-sectional study combined with a qualitative component was conducted among 3438 couples chosen by multistage sampling. Quantitative data were collected by a structured interview schedule. Data were analyzed by computer using SPSS version 15.0. Chi-square test was applied for testing the significance of study findings and P < 0.05 was considered statistically significant. Qualitative data were collected by Focus Group Discussions and analyzed by qualitative free listing and pile sorting considering Smith's S value. Results: Sex ratio at birth in West and South Tripura districts during 2013 was found to be 972 and 829 respectively. Son preference was higher among couples irrespective of their literacy, residence, occupation, family type and religion except Christianity. Expenditure at marriage, lesser contribution to parent's family and fears of adverse situations at in law's house after marriage etc. were causes for lesser daughter preference. Very few pregnant women underwent ultrasonography for sex determination of fetus. Girls had differential or delayed medical care and higher death rate. The desire for children was found to be limited after male births. Conclusions: Low daughter preference was mostly due to economic reasons and prolonged contraception following male birth. Literacy, occupation and residence of study subjects did not modify prevalent higher male preference

A study to assess the emotional disorders with special reference to stress of medical students of Agartala government medical college and Govinda ballabh pant hospital

Background: Stress is very common psychological phenomena where medical students faced in day to day activities. Epidemiological studies have asserted that about 70-80% of the diseases may be related to stress. Research related to this stress especially among medical students is essential, considering their learning, role and responsibilities as a future physician and health intervention programs. Objectives: To estimate the prevalence of stress and identify stressors among medical students. Materials and Methods: A Cross-sectional study was carried out among undergraduate medical students and self administered GHQ-12 and stressor questionnaire were used to collect information regarding stress. Binary logistic regression analysis was performed to calculate odds ratio (OR). Results: Prevalence of stress was 94.52% and more common among females. 33.56% students felt constantly under strain and 25.34% had loss of sleep over worry. Majority of the students of all semesters had stress (P > 0.05) and stressors viz. ′competition for marks′ (P = 0.005), ′frequent examination′ (P = 0.001), ′difficulty in finding time for recreation′ (P = 0.014) and ′being away from home′ (P = 0.027) were predominantly experienced by the 1 st year medical students. Multiple logistic regression analysis revealed the causal effect of main parameter on the GHQ caseness and students who found difficulties in following teaching language among the caseness had 81.59% higher chance of developing stress (OR = 8.159, CI = 1.228-54.213). Conclusion: The stress experience was more common due to academics and seen among all year of medical students. Strategy development for eliminating stressors is necessary for promoting healthy life

Prevalence of Pre-diabetes and its associated risk factors: A cross-sectional study in West Tripura district of India

Background: Early detection of Pre-diabetes and controlling the risk factors may delay the development of Diabetes and related complications. Objectives: To estimate the prevalence of Pre-diabetes in West Tripura district of India and to study it’s associations with selected risk factors. Methods: This community based cross-sectional study was conducted in West Tripura district of India, during 1st January 2018 to 31st December 2019 among 320 individuals selected by multistage sampling. Fasting blood sugar was tested for diagnosing Pre-diabetes. Data entry and analysis were performed using SPSS-24. Result: Prevalence of Pre-diabetes in West Tripura district was 19.4%, 28.1% were hypertensive and 32.5% had high BMI. Multivariable logistic regression has identified age ≥40 yr (OR: 20.62, 95% CI: 4.97 – 85.49) higher socioeconomic status (OR: 4.99, 95% CI: 1.95 – 12.72), family history of diabetes (OR: 9.72, 95% CI: 2.51 – 37.61), higher BMI (OR: 2.79, 95% CI: 1.32 – 5.89) and physical inactivity (OR: 3.52, 95% CI: 1.66 – 7.46) as the predictors of Pre-diabetes. Conclusion: West Tripura district of India has higher prevalence of pre-diabetes than the national average. Age ≥40 yr, higher socioeconomic status, family history of diabetes, higher BMI and physical inactivity were identified as significant predictors of Pre-diabetes in this region