A cross-sectional study on iodine status among pregnant and non-pregnant women of Tripura: a North-Eastern state of India

Background: Due to excess metabolic demand of iodine in pregnancy, pregnant women and lactating mother and their neonates are most vulnerable of iodine deficiency disorder. Urinary iodine excretion is a good marker of recent dietary iodine intake. Thus, present study was conducted to assess the iodine status and median urinary iodine excretion (UIE μg/lit) among pregnant and non-pregnant women of Tripura.Methods: Tribal and Bengali pregnant and non-pregnant women from Bokafa and Jolaibari Block of South Tripura district were included in the study. Urinary iodine excretion was done using simple micro plate method. Salt iodine was estimated using iodometric titration. All the tests were performed at CNRT Lab, ICMR, India.Results: Total number of subjects included in this study was 1071. Total number of urine samples collected from pregnant and non-pregnant women was 538 and 533 respectively. Median value of UIE in pregnant and non-pregnant women of Tripura was 155.0µg/L and 130.0µg/L. In pregnant women percentage prevalence of severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-149µg/L) was found in 4.1%, 15.1% and 29.6% subjects. In case of non-pregnant women severe (<20µg/L), moderate (20-49µg/L) and mild iodine deficiency (50-99µg/L) was found in 0.6%, 9.6%, 27.8% subjects respectively. The overall prevalence of iodine deficiency was found in 48.8% pregnant women, compared to 38.0% non-pregnant subjects.Conclusions: Efforts towards universal salt iodization need to be stepped-up in Sub-Himalayan region (NE part of India) and pregnant and lactating mothers may be targeted with alternate iodine supplements (Colloidal Iodine)

A cross-sectional study on morbidity pattern of elderly population residing in a rural area of Tripura

Background: The elderly is one of the most vulnerable and high-risk groups in terms of health and their health seeking behaviour is crucial in any society. A major component of the burden of illness for the elderly derives from prevalent chronic disease. The objective of study aims to find out morbidity pattern of elderly population aged 60 years and above.Methods: A community based cross-sectional study was done in rural areas of Madhupur, Sepahijala district, Tripura from August 2015-January 2016. A total of 260 (elderly aged 60 years and above) study participants were selected by simple random sampling.Results: Majority (52.7%) were between 60-70 years of age, least (1.5%) was in 90-100 years age group. Most of the study population (84.6%) were Hindu and female were more than male (51.9 % vs 48.1%). Majority (38.8%) of them were suffering from two (2) morbidities and 8.1% of study population had 4 and more morbidities. Non-specific generalized weakness was the most common (62.7%) morbidity, followed by gastrointestinal problems (56%) found in geriatric population. Musculoskeletal problems (low back pain, joint pain, osteoarthritis) were 45% followed by anaemia (42%) and impaired vision (36%). Increasing age group and non-smoke tobacco habit among the elderly population was associated with number of morbidities (≥ 3 morbidities/ person) per person (p <0.05).Conclusions: The study showed high prevalence of morbidities among elderly population. Non-specific generalized weakness was one of the most important problems in this age group. We have to find out the underlying cause of this non-specific generalized weakness by further clinical examination and laboratory investigations in future research

Self-medication practices among medical and nursing students in Tripura, India: a mixed-method study

Background: In developing countries like India, self-medication is a common practice because of costly clinical services and easy availability of medicine from pharmacies. There is an increase trend of self-medication among different health professional students apart from general people. This study aims to assess self-medication practice among medical and nursing students in Tripura, India.Methods: This cross-sectional study was conducted among undergraduate medical and nursing students of Tripura Medical College and Tripura College of Nursing, of Tripura for two months (January- February 2018). A pre-tested, semi-structured schedule was used to collect the required information. The collected data was entered in SPSS version 16.0, represented in proportions and p <0.05 was considered as statistically significant.Results: Overall 353 (88.3%) students of both courses practiced self-medication; prevalence was more among medical (91.5%) than nursing students (85%). Main source of information among medical students were books (90.2%) while 56.5% nursing students replied friends and/or seniors as primary source. Majority (53%) respondents took self-medication for headache (79.2% medical vs 72.4% nursing students) followed by fever (77.6% medical vs 52.4% nursing). Less than half of the respondents (48.5% medical vs 46.5% nursing students) believed that self-medication was harmful; maximum nursing students (71.5%) believed that self-medication is self-care as compare to medical students (56.5%).Conclusions: The study found wide practice of self-medication among students, inappropriate use of which may cause serious health hazards. Promoting education regarding self-medication and making healthcare system available can reduce self-medication practices substantially

A study to assess the feasibility of Text Messaging Service in delivering maternal and child healthcare messages in a rural area of Tamil Nadu, India

BackgroundMobile text messaging is a potentially powerful tool for behaviour change because it is widely available, inexpensive, and instant. AimsTo evaluate whether mobile Text Messaging Service is a feasible mode of raising knowledge regarding maternal and child health (MCH) and to explore issues related to mobile text messages as a mode of health education. MethodA community-based intervention study was conducted from January to June 2013 in six randomly selected villages of Vellore district, Tamil Nadu. A multi-stage sampling technique was followed: 120 individuals from 120 households (30 clusters in 6 villages) were contacted. Data were collected using a pretested questionnaire by house-to-house visits in 3 phases: 1) baseline assessment of aptitude towards text messages; 2) intervention: sending MCH-related text messages; and 3) end-line assessment to evaluate the increase in knowledge level. Qualitative data regarding mobile text messages as a mode of health education were explored. Quantitative data were analysed using SPSS version 17.0 and qualitative data by Anthropac software.  ResultsOf the individuals surveyed, 69.17 per cent and 52.5 per cent were “able to read” and “type and send” text messages, respectively. Seventy per cent of individuals were willing to receive health information via text messages, and 98.33 per cent believed text messages could effectively spread health messages. A significant increase in knowledge was observed following text messages. Male gender and subjects’ ability to read text messages were significantly associated. Factors related to mobile phone use include minimum economic burden, easy availability, portability, and ease of use. Factors related to mobile text messages as a mode of health message delivery include direct receipt of information, mass reach, the absence of regional language font in many handsets, and illiterate individuals being unable to read messages. ConclusionIn rural areas, mobile text messages have the potential to deliver health messages regarding MCH.

Knowledge, attitude, and practice regarding household consumption of iodized salt among rural women of Tripura, India: A mixed-methods study

INTRODUCTION: Iodine is an essential element for thyroid function; it is necessary in minute amounts for normal growth, development, and well-being of all humans. There is gap in the utilization of adequately iodized salt in the rural areas due to nonavailability, poverty, poor knowledge of iodine deficiency diseases, and faulty storage practices. OBJECTIVE: The objective was to find out knowledge, attitude, and practices (KAP) regarding iodized salt consumption and association of sociodemographic factors, if any, among rural women of Tripura. MATERIALS AND METHODS: This community-based study was conducted among 270 rural women residing at Madhupur village, Tripura. A self-made pretested schedule (Cronbach's alpha = 0.7) was used as the study tool to collect information on KAP regarding iodized salt consumption. RESULTS: Majority of the participants belonged to 31–40 years (30.4%), with a mean age of 38.6 (±13.8) years; all were predominantly Hindus (90.4%). Knowledge and attitude regarding iodized salt consumption were significantly associated with age groups ≤36 years, literacy, and general caste (P 0.05). Good knowledge and attitude regarding use of iodized packed salt were less than half (46.7% and 41.1%, respectively), but higher level (83.3%) of correct practice was found (P > 0.05). CONCLUSION: The existing knowledge and attitude of participants toward iodized salt usage were less, but majority were consuming iodized salt without knowing its benefits. Hence, there is a need to educate rural people through nutrition education or knowledge, with active participation of grassroot level workers in generating awareness about the health benefits of consuming adequately iodized salt

HOW MEDICAL UNDERGRADUATES PREPARE FOR UNIVERSITY EXAMINATION: LESSON FROM A TEACHING MEDICAL INSTITUTION IN SOUTH INDIA

Background: Medical colleges in India conventionally follow a curriculum overfed with large volume of information expecting students will imbibe such curriculum unquestionably overlooking what and how they progress. There have been many attempts to improve the learning process of medical students, neglecting the process which students adopt towards such learning and prepare for their exams aiming better performance. Objective: To explore qualitatively the way medical undergraduates prepare for their university examination. Methods: Present qualitative research was undertaken among medical interns during Nov-2011 to March-2012. FGDs were conducted by trained moderator using semi-structured guidelines and note taker recorded each FGD. Content analysis of FGDs was primarily oriented towards behaviour of medical undergraduates during preparatory phase before their university examinations like study pattern, study material, eating behaviour, level of stress, addiction etc. Qualitative content analysis of textual level of data was undertaken using Atlas.ti.5.0 software package. Results: Students are serious about studies just before examinations and refer to notes prepared by seniors, small books with important topics, and self-made notes. Girls depend predominantly on self-made notes. Students primarily focus on important topics in each subject. Time-in-hand decides what they study and try to remember before exams. They become casual about their diet, clothing and self-care. Stress, fear and high academic expectation often drive them towards addictive substances. They often suffer from loneliness and seek empathy from opposite sex batch mates, seniors, teachers and family members and start believing in their fortune and examiners' will rather than actual preparation. Conclusion: Students' psychology and culture should be addressed in harmony with curriculum reform for better learning by medical undergraduates

Combating the COVID-19 pandemic in a resource-constrained setting: insights from initial response in India

The low-and-middle-income country (LMIC) context is volatile, uncertain and resource-constrained. India, an LMIC, has put up a complex response to the COVID-19 pandemic. Using an analytic approach, we have described India’s response to combat the pandemic during the initial months (from 17 January to 20 April 2020). India issued travel advisories and implemented graded international border controls between January and March 2020. By early March, cases started to surge. States scaled up movement restrictions. On 25 March, India went into a nationwide lockdown to ramp up preparedness. The lockdown uncovered contextual vulnerabilities and stimulated countermeasures. India leveraged existing legal frameworks, institutional mechanisms and administrative provisions to respond to the pandemic. Nevertheless, the cross-sectoral impact of the initial combat was intense and is potentially long-lasting. The country could have further benefited from evidence-based policy and planning attuned to local needs and vulnerabilities. Experience from India offers insights to nations, especially LMICs, on the need to have contextualised pandemic response plans