Arecanut and Tobacco use Among School Children

BackgroundAreca nut is the fourth most commonly used psychoactive substance in the world after caffeine, alcohol and nicotine. Its use is considered a benign and socially acceptable habit among most Indians. Like tobacco, chewing areca nut also leads to oral and oropharyngeal cancers. Chewing of these substances usually starts early in life leading to a multitude of problems in adulthood. This study was conducted among high school students to determine the prevalence and explore the awareness of health hazards associated with these substances.Method  This cross sectional study was carried out in Vantamuri village, South India. All consenting school children of 7th, 8th and 9th class were interviewed individually using a pretested questionnaire about their chewing habits. This was followed by a thorough oral cavity examination for all.ResultsOut of 392 participants 62.5% were boys. Mean age of all participants was 14.8 ± 1.13 years.  The prevalence of areca nut usage among boys and girls was 27.3% and 6.1% while it was 2.4% for gutka (contains tobacco) amongst boys.  Majority of students started chewing between 13 and 14 years. About 49% of users were chewing these substances regularly for more than a year. Addictive tendencies were seen in two users. 43% of users chewed the same product used by their family members (

Diagnosis of Pulmonary Tuberculosis

BackgroundIn India majority of patients with respiratory symptoms initially consult private doctor. Few studies have been performed on the role of private practitioners in TB control. The present study was planned to assess the private practitioners approach in the diagnosis of pulmonary tuberculosis.Method  A Cross Sectional study was conducted between September 2008 and October 2009 in rural and urban area of Udupi taluk. The study population included all modern medicine general practitioners and all the specialists practicing Internal Medicine, Chest Medicine, and Paediatrics. The non response rate was 8%. About 15 practitioners who were not in the list were interviewed during field visits. So, the total number of practitioners interviewed was 116.                                                              ResultsThe majority (67.4%) of general practitioners and physicians opted for sputum examination as the investigation of choice to diagnose pulmonary Tuberculosis. About 26.1% of general practitioners and physicians used both sputum and chest x-ray to diagnose pulmonary tuberculosis. About 6.5% used chest x-ray alone. However, about 58.3% of paediatricians preferred both sputum and chest x-ray to diagnose pulmonary tuberculosis. ConclusionRelying only on chest x-ray to diagnose pulmonary tuberculosis may lead to over-diagnosis, over-medication and unnecessary utilization of resources. There is a need to improve the awareness among private practitioners regarding the importance of sputum smear examination to diagnose pulmonary tuberculosis

REASONS FOR PATIENT DELAYS & HEALTH SYSTEM DELAYS FOR TUBERCULOSIS IN SOUTH INDIA

Background: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of tuberculosis treatment is essential for an effective tuberculosis control programme. Objectives: To study the self reported reasons for patient and health system (diagnosis & treatment) delays in Tuberculosis patients. Methods: A community based cross sectional study was conducted among 98 new sputum positive TB cases aged > 15 years registered under RNTCP from Oct 2006 to June 2007 & receiving treatment under DOTS in Udupi taluk by interviewing them. Results: Total 98 patients were recruited and 68% were males. Out of 17 patients with patient delays, 82% felt that their symptoms were not severe, 71% felt that patient delay was due to lack of awareness and 71% did not take it seriously. Out of 86 patients with health system delays, 82.6% of patients mentioned that doctor has not advised for sputum examination, 76.7% of patients told that they first consulted a private doctor, 21% of them mentioned that doctor was unaware to diagnose TB. Conclusion: Symptoms not severe is the main reason for the patient delay and doctor didn’t advise for sputum examination is the main reason for health system delays

Impact of low birth weight and breastfeeding practices on the nutritional status of children aged 2 to 5 years in the slums

Malnutrition among children in developing countries is a major public health problem, especially in India. Inappropriate feeding practices, in combination with other causes such as infection and food shortage, may be responsible for 1/3rd of malnutrition. Moreover, the risk of mortality is inversely related to children's height-for-age and weight-for-height. The aim: To assess the nutritional status of children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati and to determine the impact of low birth weight, breastfeeding practices and other related factors on the nutritional status of the above study population. Materials and methods: This is a community-based observational cross-sectional study conducted among 282 children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati. Socio-demographic data, Birth history, breastfeeding practices and anthropometric measurements were noted in the study questionnaire. Nutritional status was determined using HAZ, WHZ and WAZ scores of WHO child growth standards. Data was entered and analyzed using IBM SPSS Statistics 26 version to test for association between categorical variables, and a p-value < 0.05 was considered statistically significant. Results: A total of 282 school children with mean age of 39.9 (+10.4) months participated in the study, of which 132 (46.8 %) were boys and 150 (53.2 %) were girls. This study observed exclusive breastfeeding in 193 (68.4 %) children. Prevalence of stunting, wasting and being underweight were 22 %, 12.4 % and 23.8 %, respectively. A statistically significant association was found between stunting (p=0.006) and underweight (p=0.001) with low birth weight children. Conclusions: The present study revealed a high prevalence of malnutrition, especially stunting, a common outcome of long-term malnutrition among young children. Low birth weight and inappropriate breastfeeding practices result in long-term adverse consequences on the nutrition of preschool children, which should be prevented through appropriate strategies

Lymphatic Filariasis and Mass Drug Administration

BackgroundA third of world’s filariasis cases occur in India. As a result Mass Drug Administration (MDA) was commenced in 1997 with the aim of eliminating this disease by 2015. However the coverage of MDA was not satisfactory. The underlying reasons for the poor coverage need to be identified. This study was conducted to assess the awareness of health personnel of lymphatic filariasis and the MDA programme.Method  This cross-sectional study was conducted in Kundapura taluk of Karnataka state in India during the 6th round of the MDA which was held between December 11 to 13, 2009. 78 health personnel who were posted for drug distribution were selected by convenience sampling. After obtaining informed consent health personnel were interviewed individually using a semi-structured questionnaire. Performance of health personnel was assessed according to points scored for their responses.ResultsThe mean age of all participants were 22.7± 8.9 years, 74(94.1%) were females and 58(74.4%) were nursing students. Only 17 (21.8%) participants had prior experience before taking part in this round of MDA. Only 4 (5.1%) participants achieved good scores while 45 (57.7%) got average scores. Performance scores were significantly better among paramedical workers (

A study of quality of life among the elderly in urban areas of Tirupati

Background: The objectives of the study are to evaluate quality of life (QoL) among the elderly and to determine the association between socio-demographic factors and QoL. Methods: A community-based cross-sectional study was conducted in elderly subjects (aged 60 years and above) (n = 120) in the urban field practice areas of our tertiary care teaching institute in southern India. QoL was assessed using World Health Organization-QoL BREF Questionnaire. Results: Most of the study population were aged 60–69 years (65.8%), males (51.7%), from nuclear families (78.3%), Hindus (67.5%) and were literates (78.3%). Majority of families belong to the upper lower socio-economic group (45%). Most of them belonged to the backward caste communities (30%). The mean total QoL score was high among ≥80 years, males, illiterates and upper class. All these differences were statistically non-significant. However, the mean total QoL score showed significant relation with socio-economic class. The domain correlation ranged between 0.238 and 0.690 and was statistically significant. Conclusions: Most of the study population were leading moderate QoL, followed by good QoL. Based on total domain QoL scores, it is concluded from this study that overall QoL is good among elderly ≥80 years, males, illiterates and the population in the upper socio-economic class. The mean total QoL score showed a significant relation with socio-economic class

REASONS FOR PATIENT DELAYS & HEALTH SYSTEM DELAYS FOR TUBERCULOSIS IN SOUTH INDIA

Background: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of tuberculosis treatment is essential for an effective tuberculosis control programme. Objectives: To study the self reported reasons for patient and health system (diagnosis & treatment) delays in Tuberculosis patients. Methods: A community based cross sectional study was conducted among 98 new sputum positive TB cases aged > 15 years registered under RNTCP from Oct 2006 to June 2007 & receiving treatment under DOTS in Udupi taluk by interviewing them. Results: Total 98 patients were recruited and 68% were males. Out of 17 patients with patient delays, 82% felt that their symptoms were not severe, 71% felt that patient delay was due to lack of awareness and 71% did not take it seriously. Out of 86 patients with health system delays, 82.6% of patients mentioned that doctor has not advised for sputum examination, 76.7% of patients told that they first consulted a private doctor, 21% of them mentioned that doctor was unaware to diagnose TB. Conclusion: Symptoms not severe is the main reason for the patient delay and doctor didn’t advise for sputum examination is the main reason for health system delays