Antenatal service utilization among women in South India: a community based cross sectional study

Background: Antenatal period is important for identifying pregnancy related threats and antenatal care (ANC) is one of the most effective health interventions during this period. It provides a unique opportunity for screening and diagnosis, health promotion and disease prevention. This study assessed the antenatal service utilization pattern and its determinants among women.Methods: A community based cross sectional study was conducted in the field practice area of a teaching hospital in Mangalore. Study included 142 women who had delivered in the last one year in the study area, selected using snowball sampling method. A pretested semi-structured validated questionnaire was used to collect the data. Predictors of full ANC were identified using univariate analysis and explanatory variables were entered into multivariate regression model to obtain the adjusted odds ratios to find the association between full ANC coverage and its determinants.Results: Among the participants, 99.3% registered their pregnancy and 78.9% had early registration. Majority, 91.5% had minimum antenatal visits, 83.1% consumed iron and folic acid supplements for more than three months and tetanus toxoid (TT) coverage was 98.6%. Full ANC coverage was found to be 81% and unadjusted analysis showed higher odds of full ANC coverage among housewives, primiparous, women in joint family and among literates. However, multi variable analysis revealed literacy as the major determinant of full ANC.Conclusions: In the present study, majority of the women had adequate antenatal care utilization. Full antenatal coverage was found to be statistically significant among literate women

Awareness of consequences of obesity on reproductive health problems among women in an urban area in South India

Background: Obesity is a well-known risk factor for number of non-communicable diseases. There is paucity of data however with regard to awareness of its consequences on reproductive health hazards.Methods: Data was collected from 208 women aged ≥18 years from households chosen by systematic random sampling in an urban area.Results: The mean age of participants was 41.4±14.2 years. Majority of them completed their graduation [109(52.4%)] and were housewives [80(38.5%)]. Most of them were married [167(80.3%)]. Out of 208 study participants, 166(79.8%) knew that obesity adversely affects reproductive health causing problems like PIH [156(75.0%)], GDM [150(72.1%)], menstrual irregularities [130(62.5%)], infertility [117(56.2%)], decreased efficacy of hormonal contraception [84(40.4%)], premature delivery [67(32.2%)], miscarriages [66(31.7%)] and fetal malformations [55(26.4%)] during pregnancy. Difficulties during delivery [137(65.9%)], higher chances of caesarean section [130(62.4%)], infections [36(17.3%)] and PPH [33(15.9%)] in the intra and post natal period were also known to participants. Majority of women [158(76%)] had average awareness level regarding consequences of obesity on their reproductive health. Only 21(10.1%) had good awareness. Source of information among majority of participants was media [116(55.8%)]. Good awareness level was significantly more among those aged ≤ 25 years (p=0.03), with higher level of education (p=0.038), nulligravida (p=0.037) and professionals (p=0.02).Conclusions: Awareness generation on consequences of obesity on reproductive health is required to bring about behavioral change regarding obesity prevention among women in the setting.

Prevalence, severity and risk factors of allergic disorders among people in south India

Background: Allergic disorders are not usually life-threatening conditions but they impair the person’s ability to function. It thus adversely affects the psychological wellbeing and quality of life. These implications of allergic disorders can be minimized if strategies are planned for its early identification followed by appropriate interventions.Objectives: To find out the prevalence and risk factors of allergic disorders. Methods: Data was collected by house to house survey among participants aged 18 years and above using a standardized allergy assessment questionnaire.Results: Mean age of the 400 participants was 42.8±14.7 years. Majority 105(26.2%) were in the age group 36 to 45 years. Majority were females 287(71.7%) and were house wives 217(54.2%). Majority of participants were of upper socio economic class 98(44.7%) out of 219 and majority were from urban areas 326(81.5%). The prevalence of allergy among participants was found to be 115(28.7%). Out of these 115, 37(32.2%) had possibility of allergy, 60(52.2%) had probability of allergy and the rest 18(15.6%) had very high likelihood for allergy. People residing in semi urban areas had increased risk of allergy (p=0.024) than those from urban areas. The prevalence of asthma was 30(7.5%) and skin allergy was 23(5.8%). Most common precipitating factors for allergy were dust exposure 103(25.8%) followed by seasonal changes 71(17.8%). Family history of allergy was associated with allergy among participants (p<0.001). Usage of firewood was associated with symptoms of respiratory allergy among participants (p=0.01).Conclusion: The study revealed some important determinants of allergic disorders which have important implications to frame appropriate prevention and health educational strategies.Keywords: Allergy, prevalence, risk factors, semi-urban areas, urban area

Prevalence, severity and risk factors of allergic disorders among people in south India.

Background: Allergic disorders are not usually life-threatening conditions but they impair the person\u2019s ability to function. It thus adversely affects the psychological wellbeing and quality of life. These implications of allergic disorders can be minimized if strategies are planned for its early identification followed by appropriate interventions. Objectives: To find out the prevalence and risk factors of allergic disorders. Methods: Data was collected by house to house survey among participants aged 18 years and above using a standardized allergy assessment questionnaire. Results: Mean age of the 400 participants was 42.8\ub114.7 years. Majority 105(26.2%) were in the age group 36 to 45 years. Majority were females 287(71.7%) and were house wives 217(54.2%). Majority of participants were of upper socio economic class 98(44.7%) out of 219 and majority were from urban areas 326(81.5%). The prevalence of allergy among participants was found to be 115(28.7%). Out of these 115, 37(32.2%) had possibility of allergy, 60(52.2%) had probability of allergy and the rest 18(15.6%) had very high likelihood for allergy. People residing in semi urban areas had increased risk of allergy (p=0.024) than those from urban areas. The prevalence of asthma was 30(7.5%) and skin allergy was 23(5.8%). Most common precipitating factors for allergy were dust exposure 103(25.8%) followed by seasonal changes 71(17.8%). Family history of allergy was associated with allergy among participants (p<0.001). Usage of firewood was associated with symptoms of respiratory allergy among participants (p=0.01). Conclusion: The study revealed some important determinants of allergic disorders which have important implications to frame appropriate prevention and health educational strategies

Pattern of seizure cases in tertiary care hospitals in Karnataka state of India

Background: The prevalence and incidence of epilepsy is higher in developing countries than in developed countries. Understanding pattern and risk factors of seizure cases will help in suggesting appropriate preventive measures. Objectives: This study was carried out to assess the pattern of seizure, its management and compliance with treatment. Materials and Methods: Data from medical records of seizure cases in three tertiary care hospitals of Mangalore city in south India admitted from January 2006 to December 2011 were collected and analyzed. Results: Nearly half (44.4%) of the 196 cases belonged to productive age group (15-45 years) and 2/3 rd (60.7%) were males. Majority (>80% cases) were unskilled workers and of low socio-economic status groups. Family history of seizures was present in 8.4% cases. Mean age of onset of seizure was found to be 19.9 years. Proportion of generalized tonic clonic seizure cases was 78.1%. Secondary seizures were seen in 66 (33.7%) cases with the most common cause being trauma to the head (24.2%). Refractory seizures were present in 2.7% cases. Monotherapy was the most commonly followed treatment regimen and phenytoin was the most popular anti-epileptic drug (AED) used. Non-compliance with AEDs was seen in 18.1% cases and was more among patients on polytherapy (P = 0.032). Conclusion: Seizure manifestations and treatment compliance vary widely in the studied population. In depth analysis of each seizure type will give more information about the factors associated with it

Patients Admitted with H1N1

BackgroundDuring the spring of 2009, a pandemic of novel flu, popularly called swine flu, emerged in Mexico and spread globally. We describe the profile of the patients who were hospitalised with the flu in two large government hospitals in Bangalore. After warnings of flu outbreak, these two hospitals were identified initially for screening and treatment for novel flu.Method A retrospective review of clinical records is reported. Data including the common clinical features, underlying medical condition and treatment outcome of 112 patients admitted with novel flu to two government hospitals in Bangalore from June to November 15, was collected.Results61 (54.4%) of the patients were in the age group 16–35 years, 69 (61.6%) were males, 41 (36%) presented within two days of symptoms, 93 (83%) presented with fever, 81 (72.3%) presented with cough and 37 (33%) with breathlessness. The data suggests that 17% of the patients had history of travel to novel flu affected areas, 6.2% both travel and contact. For majority of patients, the duration of stay in the hospital was 4–6 days (51.7%), 12 (10.7%) had history of underlying co morbid conditions. In the study, 19 (16.9%) were treated with steroids, 31 (27.6%) were admitted to an ICU (intensive care unit) and 26 (23.2%) died all aged 16–35 years.ConclusionIn our study, majority of the patients were 16–35 years old, presented to the hospital within two days with fever, cough and breathlessness as the predominant symptoms and less than half of them had history of travel or contact. Most of the patients recovered, and death was reported in 23.2% of the patients

Skin diseases and conditions among students of a medical college in southern India

Introduction: Skin diseases are a common problem among young adults. There is paucity of data about it among medical students. This study aimed to find out the pattern of skin disorders and to describe their association with various socio-demographic factors among medical students. Materials and Methods: This cross-sectional study was conducted in June 2011 in a medical college in Mangalore, Karnataka. Two-hundred and seventy eight medical students were chosen from the 4 th , 6 th and 8 th semester through convenient sampling method. Data on hair and skin morbidities suffered over past 1 year and its associated factors were collected using a self-administered questionnaire. Results: Most of the participants 171 (61.5%) were of the age group 20-21 years and majority were females 148 (53.2%). The most common hair/skin morbidities suffered in the past one year were acne 185 (66.6%), hair loss 165 (59.3%), and sun tan 147 (52.9%). Fungal infection (P = 0.051) and severe type of acne (P = 0.041) were seen significantly more among males while hair morbidities like hair loss (P = 0.003), split ends of hairs (P < 0.0001) and dandruff (P =0.006) were seen significantly more among female students. Patterned baldness (P = 0.018) and sun tan (P < 0.0001) were significantly more among non-Mangalorean students than native Mangaloreans. Presence of dandruff was significantly associated with hair loss (P = 0.039) and usage of sunscreen was found to protect from developing sun tans (P = 0.049). Conclusion: Skin disorders, particularly the cosmetic problems are very common among medical students. Gender and place of origin were found to significantly influence the development of certain morbidities

Proportion of depression and its determinants among type 2 diabetes mellitus patients in various tertiary care hospitals in Mangalore city of South India

Background: Depression is found to be common among patients with diabetes and it is associated with poor outcomes in disease control. This study was carried out to find out the proportion and determinants associated with depression among patients with established type 2 diabetes mellitus (T2DM) in various tertiary care hospitals in Mangalore city of south India. Materials and Methods: This study was conducted in one government and three private tertiary care hospitals in Mangalore in December 2010. All consenting patients with confirmed diagnosis of T2DM were interviewed and screened for depression by administering the 9-item PRIME-MD Patient Health Questionnaire (PHQ-9). Results: Of the 230 T2DM patients, 119 (51.7%) were males. The mean age of all participants was 53.61 ± 10.7 years. The median duration of T2DM was found to be 12.1 ± 7.35 years. Among the participants, 71 (30.9%) met the criteria for moderate depression, 33 (14.3%) for severe depression, and the remaining 126 (54.8%) had no clinically significant depression. Only 26 (11.3%) patients were already aware that they were depressed, of whom just 3 had taken medical consultation. Among the risk factors, depression was found to be significantly associated with older age, female gender, low socioeconomic status, unskilled and retired employment status, having complications due to T2DM or comorbidities like hypertension and coronary artery disease, being overweight and being on insulin syringe injections. Conclusion: This study found a high proportion of depression among patients with T2DM. Therefore the care of individuals with diabetes mellitus (DM) should include the screening and possible treatment of depression in order to achieve and sustain treatment goals