Assessment of need of effective health education programme for improvement of personal hygiene among adolescent girl students in a slum area of Kolkata: a school based intervention study

Background: Personal hygiene aims at healthy living by maintaining cleanliness of the body. Adolescent girls being in the period of active growth and development are the ideal candidates to impart proper knowledge which in turn create a correct attitude followed by practice and it would be carried to next generation. The study aimed to assess the effectiveness of a health education programme in improving the knowledge, attitude and practice of personal hygiene among the adolescent girls in a slum area of Kolkata, West Bengal, India.Methods: A quasi-experimental study was conducted in two government Bengali medium secondary schools located in a slum area of Kolkata, West Bengal, India. First a baseline survey with the help of a predesigned pretested questionnaire and checklist was done to find out the socio-demographic information and existing K.A.P of personal hygiene of the students. This was followed by an intervention phase of 6 months during which weekly lecture and demonstration classes were taken in the study school. Impact of intervention was assessed by application of post-test questionnaire. Both the schools were followed for another 3 months to establish the sustainability of the programme.Results: There was statistically significant improvement in the mean scores of K.A.P of personal hygiene from the pre-test level to post-test level among the students of study school as compared to control school, though there was a significant decline in the mean scores at 9 months than 6 months revealing want of sustainability of the programme.Conclusions: Regular revision and reinforcement should be done to increase the effectiveness of a health education programme to improve personal hygiene and thereby resulting in a healthy living

Assessment of quality of life and its determinants among caregivers of lung cancer patients: a cross sectional study in a tertiary care centre of Kolkata, West Bengal, India

Background: Lung cancer is the commonest cancer worldwide considering its incidence and mortality. It not only affects the life of the patient, but also has significant impact on the life of the primary caregivers too. The study aimed to assess the Quality of Life (QOL) among caregivers of lung cancer patients and to find out its determinants.Methods: It was an institution based cross-sectional study conducted in a tertiary care center of Kolkata with the help of a predesigned, pretested, structured, standardized questionnaire where 210 patient-caregiver dyads were included by complete enumeration method to assess quality of life of the caregivers and its possible predictors.Results: Half of the caregivers experienced poor quality of life (overall QOL score ≤ median score) as assessed by QOLLTI-F (Quality of Life in Life-Threatening Illness-Family Carer Version). Multivariate analyses suggested that gender, religion, area of residence, financial burden, stage and type of lung carcinoma, disability and depression among the patients were important determinants of quality of life of the caregivers.Conclusions: Comprehensive care covering different domains like financial risk protection, psycho-social assistance through governmental and also different non-governmental initiatives, self-help groups are the needs of the hour to address this important public health issue as caregiver’s life is equally important as that of the patient and they are highly interdependent

Disability among lung cancer patients and its predictors: a cross-sectional study in a tertiary care centre at Kolkata, India

Background: Lung cancer is one of the commonest cancer worldwide and also in India. Being a chronic disease, it is expected to result in disability during the course of the illness. Disability in turn results in deterioration of mental health and leads to poor quality of life. The present study intended to assess the degree of disability among lung cancer patients and to find out the covariates of the same.Methods: An institution based cross-sectional study had been conducted over a period of six months among lung cancer patients attending a tertiary care centre. Exit interview had been conducted with a pretested schedule after taking informed consent. Disability had been assessed by WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Data were entered and analysed in SPSS 20.0 version.Results: A total of 210 patients were recruited in this study. Half of the study population were suffering from higher level of disability. Multivariate analysis revealed degree of disability was higher among the patients who were financially dependent to others, had advanced stage of the disease and when time since diagnosis was more than one month.Conclusions: Holistic approach needs to be taken up to address this alarming issue of disability and its consequences among lung cancer patients. The approach should include various rehabilitative measures, social security schemes by the government and active involvement of non-governmental organisations

Impact of health education regarding menstrual hygiene on genitourinary tract morbidities: an intervention study among adolescent girl students in an urban slum

Background: Menstruation and menstrual hygiene are still issues which are insufficiently recognized in Indian society and influenced by misconceptions and socio‐cultural restrictions. Adolescent girls become vulnerable to reproductive tract infections resulted from lack of knowledge and faulty practices regarding menstrual hygiene. The study aimed to assess the impact of health education programme regarding knowledge, attitude and practice of menstrual hygiene on genitourinary tract morbidities among adolescent girl students in a slum area of Kolkata.Methods: A quasi experimental study was conducted in two Government secondary schools located in a slum area under Kolkata Municipal Corporation. The study consisted of three steps. First a baseline survey with the help of a pre designed pretested questionnaire was done to find out the socio-demographic information, existing knowledge, attitude and practice of menstrual hygiene of the students and presence of any genito-urinary tract morbidities was documented. This was followed by an intervention phase of 6 months during which weekly lecture and interactive classes were taken in the study school. Second step was reassessment of K.A.P of menstrual hygiene and documentation of related morbidities at post intervention. Third step was to follow them for another 3 months for final reassessment of the same.Results: There was statistically significant decrease in the genito-urinary tract morbidities with improvement of mean K.A.P score of menstrual hygiene in study school from the pre-test level to post-test level as compared to the control school. But there was a significant decline of mean menstrual hygiene score at follow up of 9 months in the study school depicting lack of sustainability of the heath educational programme.Conclusions: Sustained health education programme with regular reinforcement and active involvement of the mothers regarding menstrual hygiene can lead to better reproductive health of adolescents

Contraception-still miles to go: a study among married women in a rural area of West Bengal

Background: Unregulated growth of population is the most important problem that is hindering the socio-economic growth of a developing country like India since its independence. Multiple socio-economic factors are responsible for non-acceptance of contraception. To meet the unmet need these factors are needed to be explored. The current study aimed to assess the rate of acceptance of different contraceptive methods, various socio-demographic factors affecting acceptance and to find out the reasons for non-acceptance among married women of reproductive age group in a rural area of West Bengal.Methods: An institution based cross sectional study was conducted among 224 married women of reproductive age group with the help of a predesigned, pretested schedule.Results: Almost entire study population (98.2%) had the knowledge of any modern accepted method of contraception; health personnel (91.1%) being the most common source of knowledge. In majority of cases (69.6%) the decision of contraceptive use was taken by the husband and wife jointly. The overall prevalence of current use of contraception was 33.9% of which most common method adopted was found to be tubectomy (42.1%). The total unmet need was 50%. Multivariate analyses revealed that women aged more than 27 years, belonging to Hindu religion, nuclear family of higher per capita income with education of self and husband being up to or above middle level, having at least two leaving issue and one male child had higher odds of ever use of contraception.Conclusions: To bridge the gap of knowledge and practice intense awareness generating programmes focusing on the local barriers of contractive practice were the need of the hour to address this alarming public health problem

Factors associated with removal of postpartum intrauterine contraceptive device among acceptors in rural areas of Nadia district, West Bengal: a case-control study

Background: The unmet need for contraception remains high in the postpartum period. Postpartum intrauterine contraceptive device (PPIUCD), despite being an effective and well-suited contraceptive method for this period, many women discontinue its use due to various reasons just after a few days or weeks. The study aimed to identify the factors associated with the removal of the same.Methods: A community-based case-control study had been conducted in Nadia district of West Bengal. A multi-stage sampling technique had been applied to identify and interview the cases and controls with the help of a predesigned pretested semi-structured schedule.Results: The overall removal and expulsion rates were found to be quite high (21.5% and 16.3% respectively). Multivariate analysis revealed that acceptors belonging to joint family, educated only up to middle level, if place of delivery and insertion of PPIUCD was BPHC, the same had been inserted by nursing staff, experienced pain after insertion,  not given consent before insertion, not counselled ever on PPIUCD, not decided to accept PPIUCD before delivery, not satisfied with its use and undergone no follow up visit after its insertion, were having higher odds of removal of the same.Conclusions: Rigorous counselling during the antenatal period should be focused to achieve a declining trend regarding PPIUCD removal

Assessment of knowledge and practices of ASHA workers related to maternal-child health and their performance affecting factors: a mixed method study in Deganga block, North 24 parganas district, West Bengal, India

Background: ASHA acts as a ‘bridge’ between the rural people and health service outlets and plays a central role in achieving national health and population policy goal. ASHAs form the backbone of the NRHM. They need to provide preventive, promotive and curative health facilities in the rural community. Maternal and child health is an important public health issue which indicates level of socio-economic development in each and every country. ASHA workers are the main front-line workers in primary health care delivery system who are expected to work in this domain to bring out betterment in RCH indicators.Method: It was a mixed method study. Quantitative portion was descriptive, cross-sectional and qualitative part was focus group discussion (FGD). The study had been conducted in one block (Deganga block) of North 24 parganas district of West Bengal which was previous to selected purposively for the study. All ASHAs of Deganga block and one beneficiary mother (mother who had a baby of less than 1 year) for each ASHA from her area of work had been included as study population. ASHA- Beneficiary dyad had been interviewed with a predesigned pretested questionnaire after taking informed consent.Result: More than half of the study population (64.7% and 50.5 %) had overall good knowledge and practice score related to maternal-child health and family planning respectively, though they had poor knowledge in updated dosage schedule of iron folic acid tablets, proper attachment techniques for successful breast feeding, missed doses of OCP, ECP, IUCD and safe period. They performed less efficiently in areas like counselling about harmful effects of addiction during pregnancy, birth preparedness and complication readiness, colostrum feeding, weaning, ECP and MTP. Mainly inadequate remuneration and lack of job satisfaction were the factors hindering their performance.Conclusion: Frequent refresher courses, regular monitoring and supportive supervisions by respective higher authority, administrative steps for combating their dissatisfaction are of utmost importance to improve their performance

A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum haemorrhage in a tertiary care hospital in Bankura district of West Bengal, India

Background: PPH is the prime cause of maternal mortality worldwide. The incidence of PPH can be drastically combatted by application of uterotonic in active management of third stage labour. Timing of its administration is a matter of concern. This study aimed to assess whether timing of administration of oxytocin would have any impact on incidence or mean blood loss of PPH.Methods: It was a single blinded randomized controlled trial conducted in the department of Obstetrics and Gynecology, Bankura Sammilani Medical College for 6 months where 100 antenatal mothers admitted for normal delivery in labour room were allocated randomly in study and control group considering inclusion and exclusion criteria. Incidence of PPH and mean blood loss had been identified clinically by following them for 24 hours.Results: Only 9% of study population had experienced PPH. There was no statistically significant difference in incidence of PPH with difference in timing of administration of oxytocin (p >0.05). But there was statistically significant decrease in mean blood loss if oxytocin was administered before the placental delivery. The mean blood loss with oxytocin administered before placental delivery was 296.8 ml (102.45) and after placental delivery was 452.0 (128.87) ml respectively.Conclusions: Policy makers should keep in mind not only the incidence of PPH, but the mean blood loss amount too in a setting where anaemia in pregnancy is quite prevalent

Use of genetic algorithm to determine the kinetic model of solid-state reactions

Solid-state reactions take place by different rate-controlling heterogeneous processes. To find the appropriate kinetic model for a particular solid-state reaction, a genetic algorithm-based simulation technique was carried out using DTA data with a fitness function, and a computer program was developed for the same. The process was applied to the decomposition reactions of limestone and magnesite samples. It was observed that both the decomposition reactions mostly followed the Avrami-Erofeev kinetics model

Self-affine multiplicity fluctuation of grey tracks in π⁻-AgBr interactions at 350 GeV/c

93-99Fluctuation characteristics of protons produced in π⁻-AgBr interactions at 350 GeV/c have been investigated in cosθ,φ and Xcosθ–Xφ phase spaces. Xcosθ and Xφ Factorial moment methodology has been used for the analysis. In two-dimensional analysis, fluctuation characteristics have been studied both in self-similar and self-affine space. No scaling behaviour is observed in the full bin-range. For in-depth study, full bin range is divided into different sub-bins. Fluctuation analysis into different sub-bins confirms the scaling law in a particular bin only. The analysis provides an indication of self-affine fluctuation pattern in this bin. Xcosθ and X