Prevalence of exclusive breastfeeding and its determinants in first 6 months of life: A prospective study

Background: Exclusive breastfeeding for first 6 months of life is recommended under Infant and Young Child Feeding practices in India. The objective of present study was to estimate the prevalence of exclusive breastfeeding during first 6 months of life of babies and to identify factors that interfere with the practice in the study area. Methods: A prospective cohort of 462 women who delivered at maternity unit of Government Medical College & Hospital, Rajkot, which is a tertiary care centre for the district, was studied. Data collection was done at hospital as well as during home visits of babies at 1, 3 and 6 months. Factors related to cessation of breastfeeding were analyzed using univariate, bivariate and multivariate analysis. Results: All 462 mothers reported breastfeeding their newborns. Prevalence of exclusive breastfeeding reported at 3 months was 97% which declined to 62% by 6 months of age of infants. Bivariate analysis revealed no significant association between interruption of exclusive breastfeeding before 6 months of age and various demographic, socioeconomic, maternal and infant characteristics. Multivariate analysis by logistic regression demonstrated no association between discontinuation of exclusive breastfeeding and socioeconomic status, maternal education and maternal age, number of antenatal visits, maternal employment and initiation of breastfeeding after delivery. Conclusion: Exclusive breastfeeding prevalence rate found higher than at national level indicating better feeding practices in these part of India. Also, factors classically considered as supportive for breastfeeding had shown no association with breastfeeding pattern in present study

Sickle cell disease status among school adolescents and their tribal community in South Gujarat

Objectives: to create awareness, to screen samples of school adolescents and then to reach their community through them by doing surveillance for sickle cell disease. Design: Field based cross-sectional study. Settings: St Xavier`s high school and Vanraj high school of Umarpada taluka of Surat district. Subjects: School adolescents, their parents and friends. Method: After taking permission from school authority, blood samples of 948 school adolescents were taken for DTT test and then for electrophoresis. Blood samples of motivated parents and friends of those adolescents found positive for DTT was taken in subsequent visit and results were communicated to them. Results: Blood samples of 948 school adolescents, out of 1081 were tested for DTT test. It was positive in 242 samples, giving a prevalence of 25.5% for sickle cell disease. On subjecting the positive blood samples to electrophoresis, the proportion of sickle cell trait and sickle cell disease was found to be 92% and 8% respectively. Then electrophoresis was done in 64 parents and friends, 24 (37.5%) of them were found positive of which, 14 (58%) were having sickle cell trait and 10 (42%) having sickle cell disease. Conclusion: approaching community can be possible through school adolescents for conduction of surveillance of sickle cell anemi

Prevalence of Ocular Morbidity Among School Adolescents of Gandhinagar District, Gujarat

Objective: To study the prevalence of ocular morbidity (abnormal condition) and various factors affecting it among school attending adolescents. Methods: A cross-sectional study was conducted to study abnormal ocular conditions like refractive errors, vitamin A deficiency, conjunctivitis, trachoma, ocular trauma, blephritis, stye, color blindness and pterygium among school adolescents of 10-19 years age in rural and urban areas of Gandhinagar district from January to July, 2009. Systematic sampling was done to select 20 schools having 6th to 12th standard education including 12 schools from rural and 8 from urban areas. Six adolescents from each age year (10-19) were selected randomly to achieve sample size of 60 from each school. In total, 1206 adolescents including 691 boys and 515 girls were selected. Information was collected from selected adolescents by using proforma. Visual acuity was assessed using a Snellen’s chart and all participants underwent an ophthalmic examination carried out by a trained doctor. Results: Prevalence of ocular morbidity among school adolescents was reported 13% (7.8% in boys, 5.6% in girls); with 5.2% have moderate visual impairment. Refractive error was most common ocular morbidity (40%) both among boys and girls. Almost 30% of boys and girls reported vitamin A deficiency in various forms of xerophthalmia. Prevalence of night blindness was 0.91% and of Bitot`s spot 1.74%. Various factors like, illiterate or lower parents’ education, lower socio-economic class and malnutrition were significantly associated with ocular morbidity. Conclusion: Ocular morbidity in adolescents is mainly due to refractive error, moderate visual impairment and xerophthalmia

Characteristics of Fatal Cases of Pandemic Influenza A (H1N1) from September 2009 to January 2010 in Saurashtra Region, India

Background: India reported first case of 2009 pandemic influenza A (H1N1) virus infection in May, 2009 and Saurashtra region in August, 2009. We describe the characteristics of fatal cases of 2009 influenza A (H1N1) infection reported in Saurashtra region. Methods: From September, 2009 to January, 2010, we observed 71 fatal cases that were infected with 2009 influenza A (H1N1) virus and admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features were observed and documented. Results: Median age of the deceased (71) was 29 years, and 57.7% were females. Median time observed was 5 days from onset of illness to diagnosis of influenza A (H1N1), and 57.7% were referred from general practitioner (OR=0.42, CI=0.24-0.74). Median hospital stay reported was 3 days. All admitted patients received oseltamivir, but only 16.9% received it within 2 days of onset of illness. The most common symptoms were cough (97.2%), fever (93%), sore throat and shortness of breath. Co-morbid conditions were present in almost half of the patients who ultimately died, the most common of which was pregnancy (OR=0.15, CI=0.04-0.52). Radiological pneumonia was reported in 98% patients. Conclusion: Residing in urban area, delayed referral from general practitioner, presence of co-existing condition, especially pregnancy was responsible for mortality among influenza A (H1N1) infected positive

Biomedical Waste Management: A study of knowledge, attitude and practice among health care personnel at tertiary care hospital in Rajkot

Background: Bio medical waste (BMW) collection and proper disposal has become a significant concern for both the medical and general community. Effective management of biomedical waste is not only a legal necessity but also a social responsibility. Objective: To know the knowledge, attitude and practice among health care personnels working in tertiary care centre. Methods: The study was conducted from January 2013 to June 2013. It was a descriptive observational hospital based cross sectional study. Study participants included the resident doctors intern doctors, nursing staff, laboratory technicians, ward boys and sweepers working in the institute who are dealing with BMW. The study was conducted by using pretested, semi-structured proforma. The data was tabulated and interpretation was done by using percentages through Epi Info 3.5.1 software. Results: It included 123 resident doctors and interns, 92 nurses, 13 laboratory technicians, and 54 sanitary staff. Majority of study participants belongs to 21-30 years (61%) age group. More than two third of study participants working in hospital from 1 to 5 years. Only 44.3% study participants received training for bio medical waste management. HIV (74.47%) and Hepatitis B (56.03%) were the main infectious diseases transmitted by the bio medical waste. Conclusion: The importance of training regarding bio medical waste management cannnot be overemphasized, lack of proper and complete knowledge about bio medical waste management impacts practices of appropriate waste disposal

OBILJEŽJA POČINITELJA NASILNIČKIH DELIKATA NA PODRUČJU PRIMORSKO-GORANSKE ŽUPANIJE OBZIROM NA POVRAT

Availability of sophisticated statistical modelling for developing robust reference equations has improved interpretation of lung function results. In 2012, the Global Lung function Initiative(GLI) published the first global all-age, multi-ethnic reference equations for spirometry but these lacked equations for those originating from the Indian subcontinent (South-Asians). The aims of this study were to assess the extent to which existing GLI-ethnic adjustments might fit South-Asian paediatric spirometry data, assess any similarities and discrepancies between South-Asian datasets and explore the feasibility of deriving a suitable South-Asian GLI-adjustment. Methods: Spirometry datasets from South-Asian children were collated from four centres in India and five within the UK. Records with transcription errors, missing values for height or spirometry, and implausible values were excluded(n=110). Results: Following exclusions, cross-sectional data were available from 8,124 children (56.3% male; 5-17 years). When compared with GLI-predicted values from White Europeans, forced expired volume in 1s (FEV1) and forced vital capacity (FVC) in South-Asian children were on average 15% lower, ranging from 4-19% between centres. By contrast, proportional reductions in FEV1 and FVC within all but two datasets meant that the FEV1/FVC ratio remained independent of ethnicity. The ‘GLI-Other’ equation fitted data from North India reasonably well while ‘GLI-Black’ equations provided a better approximation for South-Asian data than the ‘GLI-White’ equation. However, marked discrepancies in the mean lung function z-scores between centres especially when examined according to socio-economic conditions precluded derivation of a single South-Asian GLI-adjustment. Conclusion: Until improved and more robust prediction equations can be derived, we recommend the use of ‘GLI-Black’ equations for interpreting most South-Asian data, although ‘GLI-Other’ may be more appropriate for North Indian data. Prospective data collection using standardised protocols to explore potential sources of variation due to socio-economic circumstances, secular changes in growth/predictors of lung function and ethnicities within the South-Asian classification are urgently required

Epidemiological and demographic characteristics of dengue disease at a tertiary care centre in Saurashtra region during the year 2013

Background & objectives: Dengue is one of the most important vector-borne viral infection which may lead to haemorrhage or even shock. The present study was conducted with an objective to study the epidemiological and demographic characteristics of dengue disease during the year 2013 in Saurashtra region of Gujarat state, India. Methods: A longitudinal study was conducted at sentinel surveillance centre for dengue disease at microbiology department of tertiary care hospital in Rajkot, Gujarat from 1 January 2013 to 31 December 2013. A total of 4366 blood samples were collected during study period and serologically tested for dengue NS1 antigen and IgM antibody by capture ELISA testing from various districts of Saurashtra region. Patients with acute onset of illness, high grade fever, severe headache, backache, musculoskeletal pain or retro-bulbar pain with or without rashes were considered as clinically suspected case of dengue virus infection. Patient who presented with fever and found positive for Dengue NS1 Ag and/or IgM Ab was considered as a case. A pre-tested structured proforma was used as a tool for data collection. The data was entered into EpiInfo software and analyzed by using appropriate statistical test (chi-square test). Results: Out of 4366 tested samples, 41.3% samples were found positive for dengue. Majority of samples were tested in age group 16-25 yr (33.9%) and 26-45 yr (31.1%). The ratio of male cases (60.8%) was higher than female cases. Two-third (68.7%) suspected cases were residing in urban areas of Saurashtra region. More than half of the cases (57%) were diagnosed within five days of fever by NS1 antigen test. The reporting of number of cases increased from July 2013, which reached to peak during September 2013 followed by decrease till December 2013. Interpretation & conclusion: Dengue predominately affected males and urban population. A seasonal occurrence was reported mainly during monsoon season. A long term serosurveillance study may help to provide more information about the intensity, seasonal incidence and seasonal effect