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Chief Minister's Comprehensive Health Insurance Scheme Tamil Nadu (CMCHISTN) tool towards Universal Health Coverage (UHC) in Tamil Nadu, India
TS Selvavinayagam
January-June 2017, 3(1):26-31
Background: The state of Tamil Nadu in India is one of the states with better health indicators in the country. With an ambition to provide still better health care to the residents of the state, the possibilities of the journey towards UHC are analyzed. Objectives: To explore the possibilities of using the existing Chief Minister's Comprehensive Health Insurance Scheme (CMCHISTN) as base to reach Universal Health Coverage (UHC) in Tamil Nadu. Methods: The various dimensions of UHC namely people, benefit, and financial protection are analyzed considering the present status in the state particularly the Chief Minister's Comprehensive Health Insurance Scheme and matched with future needs to reach UHC in Tamil Nadu. This provides the vital indications in success towards UHC. Results and conclusion: The gap between the existing modalities under CMCHSITN and requirements for UHC are within the reachable level. With additional resources and effort, it is possible to reach UHC in Tamil Nadu in the near future. CMCHISTN is one of the best available options for reaching UHC in Tamil Nadu.
[ABSTRACT]   Full text not available  [PDF]
  9,852 167 -
Public health legislations in India (Part-I)
Durgesh Prasad Sahoo, Vikas Bhatia
January-June 2018, 4(1):10-15
  6,820 497 -
Nutritional assessment among children (1–5 years of age) using various anthropometric indices in a rural area of Haryana, India
Vikas Gupta, Suraj Chawla, Debjyoti Mohapatra
January-June 2019, 5(1):39-43
Background: Global Nutrition Targets 2025 specified a set of six global nutrition targets, and one aim is to achieve a 40% reduction in the number of children under 5 years of age who are stunted. National data on underweight provided under National Family Health Survey-4 (NFHS-4) (2015–2016) revealed an underweight prevalence rate around 35.7% as compared to NFHS-3 where it was 42.5%, which reflects only 6.8% reduction in underweight over a decade. Methods: This cross-sectional study was conducted in the rural area of Rohtak district during October 2014 to September 2015 among children who were 1–5 years of age. The anthropometric measurement and nutritional status categorization among children were done using the WHO guidelines. Results: A total of 600 children participated in the study. Around 41.3% of the study participants had stunting as their nutritional status, while taking composite index of anthropometric failure (CIAF) for nutritional status into consideration, nearly 54.4% of the participants were undernourished. Stunting and underweight were more prevalent among girls. Conclusions: Composite anthropometric index provides the actual prevalence or proportion of undernourished children in a community, so the policies should be based on the basis of CIAF so to reduce the prevalence of undernutrition in the community more effectively.
  5,801 434 1
Oral leukoplakia: Management protocol for primary health-care providers and family physicians
Ashok Kumar Jena, Jitendra Sharan, Swapnil Ghodke, V Anusuya, Uday Hemant Barhate
January-June 2019, 5(1):19-23
Oral cancer is very common in India. Most of the oral cancers develop on a potentially malignant (precancerous) lesion. Leukoplakia is the most common precancerous lesion in the oral cavity. The malignant transformation rate of oral leukoplakia is very high. There is no marker to distinguish those lesions that may transform to frank cancer from those that may not. Thus, early identification of oral leukoplakia and its proper treatment is important for best prognosis. This article highlights on the diagnosis and treatment protocol for oral leukoplakia.
  5,765 299 -
Vaccine hesitancy and attitude towards vaccination among parents of children between 1-5 years of age attending a tertiary care hospital in Chennai, India
Sahana Sankara Narayanan, Aparna Jayaraman, Vijayaprasad Gopichandran
July-December 2018, 4(2):31-36
Introduction: Vaccination is an effective public health intervention; however, coverage of vaccination is declining in states like Tamil Nadu which have good health indicators. Objective: To evaluate the presence of vaccine hesitancy among parents of children between 1 and 5 years of age attending the paediatric out patient department of a tertiary care hospital in Chennai and to assess its relationship with attitudes towards vaccines. Material & Methods: A cross sectional questionnaire-based survey was conducted among 100 consecutively sampled parents of children between 1 and 5 years of age attending a tertiary care paediatric out-patient department. The Parental Attitude towards Childhood Vaccines scale of vaccine hesitancy and the Beliefs and Attitudes towards Childhood Vaccines scale were used to measure vaccine hesitancy and beliefs and attitudes towards vaccination respectively. The data were analysed descriptively and statistical correlation between vaccination attitudes and vaccination hesitancy were studied. Results: In the predominantly urban, educated, working class population, the prevalence of vaccine hesitancy was 21%. But all the children had received complete vaccination appropriate for age. The major drivers for vaccine hesitancy were suspicions about newer vaccines, concerns about adverse effects of vaccines and the perception that there is no need for vaccines against uncommon diseases. The vaccine hesitancy scores were negatively correlated with the vaccine attitude scores (R = -0.266; p = 0.007). Conclusion: Vaccine hesitancy is present among the sampled mothers and is influenced mainly by concerns regarding safety of newer vaccines. Vaccine hesitancy needs to be clearly addressed for strengthening the Universal Immunization Program.
  5,002 428 2
Adapting the stepped care approach for providing comprehensive mental health services in rural India: Tapping the untapped potential
Priyamadhaba Behera, R Senthil Amudhan, Rishab Gupta, Anindo Majumdar, Arun M Kokane, Mohan Bairwa
July-December 2018, 4(2):5-10
Recent National Mental Health Survey (2015-16) reported a prevalence of 13.7% for any mental disorders excluding tobacco use disorders in India. Translating it into real numbers, nearly 150 million people need active mental health interventions, disproportionately more in rural areas. Major challenges in delivering comprehensive mental health services in rural India are: a) lack of a well-defined strategy; and b) lack of trained mental health manpower. To fill this gap, the global mental health community has increasingly realized the importance of Community Health Workers (CHWs) and role of stepped care approach in mental health service delivery. We propose a model of stepped care approach to fulfil the need of rural India, utilizing the existing health system components for improving mental health knowledge, reducing social stigma for mental disorders, screening for priority mental disorders at community level, ensuring compliance to treatment, timely follow-up, and community-based rehabilitation by mobilising community support for diagnosed cases. This stepped care approach will integrate mental health into Ayushman Bharat’s Health and Wellness Centres (HWCs) for the provision of comprehensive primary health care. Integration of new age technologies such as telepsychiatry, e-health, and mHealth into the proposed model will make it feasible and cost-efficient for inaccessible parts of the country.
  3,563 738 1
Epidemiology of ovarian tumours in Northern India - A tertiary hospital based study
Sonia Puri, Veenal Chadha, AK Pandey
July-December 2018, 4(2):37-41
Introduction: Ovarian cancer is the leading cause of mortality of female gynaecological cancers and ranks seventh as the most common cancer worldwide. The increasing life expectancy has led to increase in its burden exponentially now even in developing countries but limited knowledge is there about the pattern of ovarian tumours. Objective: To determine the burden and describe the pattern of ovarian tumours in patients visiting GMCH. Material and methods: This epidemiological study is retrospective, descriptive hospital based study over five years. The data so collected was analysed using SPSS software. Results: Maximum number i.e 74(24.4%) of cases were in the age group of 50 to 59 years followed by 40 to 49 years. It is also seen that maximum number of cases i.e total of 65 registries were in the year 2013. Maximum number of cases were from the state of Haryana contributing to nearly 41% of total cases. Most of the cases could not be classified into four stages i.e they were categorized as unknown. Chemotherapy is the most commonly used treatment modality. Epithelial adenocarcinoma was the commonest histology subtype. Conclusion: Research should be aimed to find tools for screening and early diagnosis so that better therapeutic approaches can be designed to decrease the burden.
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COVID-19 pandemic: Saving lives and livelihoods and human existence
Vikas Bhatia, Raviraj Uttamrao Kamble
January-June 2020, 6(1):1-3
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Prevalence of polypharmacy: Comparing the status of Indian states
Priya Sharma, NL Gupta, HS Chauhan
January-June 2019, 5(1):4-9
Introduction: The word “poly” is Greek and means many or much. However, the term polypharmacy has been given definitions connected both to the use of more than a certain number of drugs concomitantly and to the clinical appropriateness of drug use. Polypharmacy is the use of multiple medications by a patient, generally older adults (those aged 60 or over 65 years). More specifically, it is often defined as the use of 5 or more regular medications. It sometimes alternatively refers to purportedly excessive or unnecessary prescriptions. The term polypharmacy lacks a universally consistent definition with an increasing share of population in this age group, it is natural to expect an increase in the problems associated with them as well. Health problems are supposed to be the major concern of this section of the society, and it is reported that use of medications has increased significantly among the elderly in the last decade. Objective: The objective of this study is to assess the prevalence of polypharmacy among elderly patients in different Indian states, to make a comparison, and also to study the patterns of polypharmacy and its associated aspects. Materials and Methods: Literature review comprising of original articles, reviews, and case studies was studied to identify articles which correspond to research done on polypharmacy in various different ways published between the years 2010 and 2018. As the review focuses on the geriatric population, so considerable data were searched and collected for the use of medication in geriatrics to assess what makes them prone to polypharmacy, what pattern of polypharmacy they follow, and how they are affected by the consequences. Results: Uttaranchal, Karnataka, and Telangana reported a higher level of polypharmacy with 93.14%, 84.6%, and 82.8%, respectively, whereas Andaman and Nicobar Islands (2%) and West Bengal (5.82%) showed the lowest polypharmacy. Conclusion: Overall comparisons made show that there are more studies needed to assess the level of polypharmacy and ways and measures should be incorporated by the government in states showing high polypharmacy.
  3,711 314 1
Role of artificial intelligence (AI) in public health
Prem Sagar Panda, Vikas Bhatia
July-December 2018, 4(2):60-62
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Operational issues and lessons learned during National Iron Plus Initiative documentation in Eastern India
Vikas Bhatia, Swayam P Parida, Preetam B Mahajan, Sasmita Pradhan
January-June 2019, 5(1):10-15
Anaemia is a condition in which red blood cells have fewer haemoglobin molecules than normal, or fewer red blood cells overall, and thus less ability to carry oxygen to tissues in the body. Nutritional anaemia is a major public health problem in India and is primarily due to iron deficiency. Symptoms of iron deficiency anaemia are primarily non specific and become apparent when there is severe anaemia. The National Iron Plus Initiative (NIPI) is the most ambitious and comprehensive anaemia control programme in the world. The process documentation team conducted 170 interviews in March, April and May 2016 among officials and frontline workers at state, district, block, sector/cluster and field levels and among NIPI beneficiaries in Odisha. To achieve variation in responses and to get full set of information on how NIPI was being implemented, process documentation and survey data were collected in four districts of Odisha– Keonjhar, Jagatsinghpur, Bhadrak and Kalahandi. This review will give an overview about the operational issues encountered during the National Iron Plus Initiative documentation in Odisha.
  3,046 256 -
Anemia among pregnant women attending antenatal clinic at a secondary health care facility in district Faridabad, Haryana
Shashi Kant, Sumit Malhotra, Partha Haldar, Ravneet Kaur, Rakesh Kumar
January-June 2019, 5(1):51-55
Background: India confronts a high burden of anemia among pregnant women, that contributes to significant morbidity and mortality for mother and child. Anemia Mukt Bharat strategy launched by Government of India envisages provision of variety of facility-based interventions for management of anemia in pregnancy. Secondary care hospitals prescribe injectable iron treatment for moderate anemia and blood transfusion services for severe anemia. Objective: To estimate the magnitude and severity of anemia among pregnant women when they presented themselves for the first time at the antenatal care clinic of a secondary care hospital so as to forecast adequate supplies of medicines for managing anemia. Materials and Methods: This was a descriptive study using routinely maintained hospital clinical records during the years 2013–2015. It was conducted in a subdistrict hospital, Ballabhgarh in Faridabad district of Haryana state. Hemoglobin (Hb) level was routinely measured at first visit for all pregnant women using BC-3000 plus autohematology analyzer. Anemia in pregnancy was considered when Hb concentration was <11.0 g/dL. Results: The Hb level at first visit was available for 13,467 women during the study period. The mean Hb level (standard deviation) was 9.3 g/dL (1.3). The proportion of anemic pregnant women was 91.3% (95% confidence interval [CI]: 90.8, 91.7). The most common category of anemia was moderate anemia 62.5% (95% CI: 61.6, 63.2). Conclusion: We found a very high prevalence of anemia in pregnant women presenting to a secondary care setting of a North Indian hospital during their first visit to the facility during the antenatal period.
  3,032 203 -
Sickle cell anemia: An update on diagnosis, management and prevention strategies
Shruti Mishra, Gaurav Chhabra
July-December 2018, 4(2):67-71
Sickle cell anemia is the most common disease entity of all the monogenic disorders. This is an autosomal recessive disorder. HbS polymerization, vaso-occlusion, and hemolytic anemia are central to the pathophysiology of sickle cell disease, they precipitate a cascade of pathologic events, which in turn lead to a wide range of complications. The disease is particularly more prevalent in certain regions of the country like Odisha, Madhya Pradesh, Tamilnadu and has a significant impact on morbidity. Community based approach by providing availability of screening tests, & pre-marital and pre-pregnancy counselling should be initiated to reduce the disease burden in the society.
  2,940 261 -
Socioeconomic status: A theoretical framework for the development and use of assessment tools
Pradeep R Deshmukh, Sujiv Akkilagunta
January-June 2020, 6(1):4-8
Decades of research have established the relationship between socioeconomic status (SES) and health. The tools for the assessment of SES have evolved ever since, growing in complexity over time. The purpose of measuring SES in health research is twofold – to causally link the exposure to poor SES with health state and to find out the causal mechanisms to devise programmatic interventions. In health research, SES should be viewed as a determinant of unequal distribution of health resources that further leads to health disparities. We refer to socioeconomic position as an umbrella term for social stratification that defines individuals/households based on the present circumstances. Socioeconomic position can be measured in three distinctly varied ways – socioeconomic disadvantage, social class, and SES (or position). Tools for the measurement of SES can be classified as indices based on income and expenditure, indices bases on occupation and education, wealth index combining education, and asset-based wealth index. Each tool has its own theoretical assumptions – Weberian, Marxist, or Functionalist perspectives. The choice of tool should depend on theoretical assumptions. The tool should be comprehensive, including all three dimensions – education, occupation, and income. Life-course perspective, linking the timing of exposure to poor SES over the life course is useful in the development of interventions. Study tools incorporating a life course perspective in the measurement of SES are the need of the hour.
  2,864 211 -
Climate change: A global emergency, let's save our planet
Vikas Bhatia, Raviraj Uttamrao Kamble
January-June 2019, 5(1):1-3
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Acute osteomyelitis
RB Kalia
July-December 2018, 4(2):11-18
Acute osteomyelitis requires careful clinical evaluation, a high index of suspicion as it is an uncommon but devastating disease that affects largely previously healthy children. Management of osteomyelitis is a formidable challenge as success of antibiotics in soft tissues has not been replicated in bony tissue due to peculiar anatomy and physiology of the bone. Illness, malnutrition and decreased immunity predispose children to develop acute osteomyelitis. Absence of phagocytic cells in the metaphysis may explain predilection in children. Recently the trend in treatment strategy includes a rapid transition from intravenous to oral antimicrobial therapy and a shortened overall course of therapy. Many new therapeutic options are on the horizon that will likely impact the management of this and other childhood bacterial infections. This review will focus on recent advances in the management of acute hematogenous osteomyelitis in children.
  2,803 221 -
Changing world, changing trusts and health providers' sufferings
Shakunatala Chhabra
July-December 2019, 5(2):86-91
Workplace violence (WPV) is a serious problem anywhere, but is one of the most complex issues in health settings. Many factors contribute to WPV is health setting, health workers functioning in stressful environment, 24-h access to many, presence of drugs, and human sufferings with limitations in care. Violence may take a variety of forms, verbal aggression to physical assault, use of deadly weapons against physicians, others, and even patients. It is, therefore, associated with a variety of risks to workers safety, as well as organizational liability. The objective was to know happenings and challenges in the prevention of violence against health providers. This simple review of available studies and opinions was done by using Uptodate, ERMED CONSORTIUM, Cochrane Library, Delnet, and MedIND, and self-experiences were added. Physical violence (PV) against doctors and other health personnel is increasingly being reported. It is believed that more than 75% of doctors face violence during their practice. Almost half of the violent incidents occur in critical care units. WPV has been categorized into physical and mental, but all types of violence are destructive, in one or other way. There is evidence that female health workers are exposed to PV more often than others. It is essential to identify risk factors in order to prevent and manage WPV against health providers. Reasons for violent outbursts include inadequate workforce, infrastructure to treat patient load, and long waiting times. Many health personnel never report exposure of violence to anyone because of various reasons including perception that reporting was useless. Though it is difficult to completely eliminate violence in health-care settings, and although there is no “one-size-fits-all” approach for prevention, there are many ways to reduce the potential for violent occurrences and to minimize the impact if violence does occur.
  2,769 195 -
They do not just drive when they are driving: Distracted driving practices among professional vehicle drivers in South India
Rizwan Suliankatchi Abdulkader, Chittibabu Madhan, Kathiresan Jeyashree
January-June 2019, 5(1):34-38
Background: Driving is a complex task, requiring coordination between multiple mental and physical faculties. Distractions lead to delayed recognition of information needed to drive safely. It is essential to understand distracted driving practices to regulate them and reduce crash risk. This study aims to identify common distractors among professional vehicle drivers in South India. Methodology: A questionnaire-based cross-sectional study was conducted on professional drivers of three-and four-wheeled vehicles. Epicollect 5, a mobile-based data collection tool, was used for data collection and entry. Results: Among 82 male professional drivers (57.3% car, 35.4% bus/lorry), with a mean (standard deviation) age of 38.4 (10.6) years, all reported being distracted by at least one of the listed distractors. Mobile phone usage and cognitive distractions were reported by 75.6% and 79.3%, respectively. Younger drivers (P = 0.005) and those with less than a decade of driving experience (P = 0.038) were more likely to use mobiles while driving. Drivers reporting cognitive distractions were more likely to have met with an accident than those who did not (44.6% vs. 23.5%). Conclusions: Distracted driving is common among professional drivers. Cognitive distractions are as common as distractions due to mobile phones. Sensitization of drivers and strict enforcement of legislation are recommended.
  2,777 164 -
Understanding the patterns of technology and internet use for academics by undergraduate medical students in a teaching hospital of North India
Sneha Mohan, Sumit Malhotra
January-June 2019, 5(1):24-27
Background: E-learning or computer-based learning has been incorporated into medical education in many countries. Readiness to utilize this medium merits exploration in the Indian context. Therefore, we aimed at assessing the current patterns of technology and internet use by undergraduate medical students in a tertiary care teaching hospital, focusing on their use for academics and their views on e-learning. Materials and Methods: This cross-sectional study was conducted using a self-administered questionnaire among undergraduate medical students in the first 4 years of the study. The data generated were entered into Microsoft Excel and analyzed using SPSS version 22. Descriptive analysis and comparison of proportions were done using Chi-square test. Results: A total of 212 students responded, with a mean (±standard deviation) age of 20 years (±1.54) and 70.3% of males. There was universal access to technological devices with complete internet access. Internet was used primarily for entertainment (99.1%) and WhatsApp (97.2%), with 86.8% use in academics. Most students accessed the internet multiple times each day. Majority of the students (90.6%) used social networking sites and were open to using it for academics. Reliability of the material found online was a concern (83.5%), and most (63.2%) were interested in further training. Only a quarter of the students had utilized medical e-learning material online, and a majority (77.4%) were willing to incorporate it into the curriculum feeling that it would benefit them (64.6%). Conclusions: Incorporating e-learning tools into the medical curriculum needs to be considered for undergraduate medical studies, owing to its availability and readiness for utilization.
  2,798 127 -
A community-based study on awareness of cancer and anticipated barriers in seeking help
Deepak Sharma, Naveen Krishan Goel, Munish Kumar Sharma, Dinesh Kumar Walia, Sonia Puri
January-June 2019, 5(1):61-65
Introduction: Cancer is a leading public health problem worldwide. Contributing factors include lack of awareness regarding cancer and improper help seeking behavior. Objective: To assess the awareness regarding early warning signs of cancer, its risk factors and anticipated barriers in seeking help. Methodology: A community-based cross-sectional study was conducted among 470 study participants. Trained workers administered a standardized tool to respondents after obtaining their informed consent. Epi Info software for windows version 7.2 was used for the analysis. Results: Overall, merely 7.7% (36/470) of the study respondents were aware of all the nine warning signs of cancer. The most commonly known early warning sign of cancer was “unexplained swelling” (58.3%). Further, although majority knew that cigarette smoking is a risk factor for cancer (90.4%), very few were aware about the role of inadequate physical activity (9.3%) and diet devoid of adequate amounts of fruits and vegetables (11.9%). There were few anticipated barriers in seeking help such as embarrassment (13.2%) and difficult to interact with a doctor (7.9%). Conclusion: There was inadequate awareness about cancer but a favorable help-seeking behavior. It is, therefore, recommended that health-care professionals should scale up efforts for disseminating information regarding cancer among the people.
  2,702 200 1
Decoding mystery disease “litchi as idiopathic triggering cause of hypoglycemia-induced (LITCHI) encephalitic syndrome” – Are the evidence of association adequate?
Vineet Kumar Pathak, Kapil Yadav, Jitendra Majhi
January-June 2019, 5(1):16-18
There has been an increase in reports of outbreak of encephalopathy in children presenting with a syndrome of sudden onset of high fever and altered sensorium in and around the peak of Indian summer months in geographical regions that flourish in Litchi plantation. In the light of the increased mortality and morbidity due to the mystery disease and the speculations surrounding litchi consumptions, a study was conducted in the litchi production hub of Muzaffarpur district Bihar in India by the NCDC in technical collaboration with US CDC. The variables that were significantly associated were litchi consumption (OR: 9.6 [3.8-24.1]), visiting a fruit orchard (OR: 6 [2.7-13.4]), and absence of an evening meal (OR: 2.2 [1.2-4.3]) in the 24-h preceding illness onset. The recommendations that have been advocated are to avoid eating unripe litchi or its seed and always preferring fresh and ripe ones, children should not to go to sleep without a proper dinner meal during the litchi season and cases of altered sensorium should be always be checked for blood glucose levels and prompt correction should be done if levels suggest hypoglycemia in hospitals.
  2,605 203 -
Effect of information, education, and communication activity on health literacy of smoking and alcohol among school-going adolescents in Delhi
Srishti Yadav, Anita Khokhar
January-June 2019, 5(1):28-33
Background: Noncommunicable diseases (NCDs)/lifestyle diseases account for a major cause of deaths every year. Risk factors such as smoking and alcohol consumption contributing to the development of lifestyle diseases were more prevalent in the developed countries decades back, but millions of productive years of life are lost due to NCDs in India too. Objective: This study was conducted to assess the health literacy of school-going adolescents regarding harmful effects of smoking and alcohol consumption and assess the improvement in their knowledge after different information, education, and communication (IEC) activities. Methods: It was a school-based interventional study conducted among students of class 6, 7, and 8. Assessment of health literacy of risk factors – smoking and alcohol use in lifestyle diseases was done by self-administered questionnaire among school-going adolescents. Intervention in the form of IEC was done three times, and the postintervention data were collected 2 weeks after the first and 3 months after the last intervention. Responses were scored and categorized as satisfactory and unsatisfactory. Results: There were a higher proportion of students with satisfactory level of knowledge of smoking and alcohol use effects in both the schools after 3 months of educational intervention, although the result was statistically significant for School 2 only where intervention was given by didactic lectures (P < 0.05). Conclusions: There was an improvement in scores of students in both the schools after 2 weeks and 3 months of educational intervention, though the results were statistically significant for 3 months only (P < 0.05).
  2,511 170 -
Mental health, functional ability, and health-related quality of life in elderly patients attending a tertiary hospital of Patna
Sudeep Kumar, Pragya Kumar, Shamshad Ahmad, Anup Kumar
January-June 2019, 5(1):44-50
Background: With changing socioeconomic, demographic, and development scenario, there is a cultural shift in looking after the elderly population which may lead to depression in this age group. Materials and Methods: The study was a hospital-based cross-sectional study conducted in the orthopedic department of a tertiary care setting on 157 elderly individuals. This study was conducted with objectives to estimate the proportion of depression using the Geriatric Depression Scale Short Form (GDS-SF) questionnaire along with its associated factors in geriatric population coming to the orthopedic department of the institute. The study tools were GDS-SF, Katz Index of Independence in activities of daily living (ADL), the Lawton instrumental ADL, and health-related quality of life by the Centers for Disease Control. Results: The proportion of depressed individuals was 70/157 (44.6%) using GDS as a tool. The maximum number was in the age group of 60–74 years. Women outnumbered men (51.3% vs. 38.31%) for depression. The depression using GDS score was more prevalent in rural elderly, illiterate, and elderly who were economically dependent on their children and who belonged to lower middle socioeconomic status. Approximately 98% of the study participants were found to be independent using ADL. Approximately 60% males and 68% females were dependent for the instrumental ADL using Lawton score. Most of the study participants had arthritis as a major impairment sharing almost equal proportion among males and females. Conclusion: The current study concludes that there is a very high proportion of elderly subjects who are experiencing depression using the GDS-SF tool. There should be regular screening for this disease in this age group even in a tertiary care setting.
  2,507 167 -
Effectiveness of daily directly observed treatment, short-course regimen among patients registered for treatment at an urban primary health center in Bengaluru
Huluvadi Shivalingaiah Anwith, Sreerama Reddy Kaushik, Ramanathan Thenambigai, M Madhusudan, Dandiganahalli Shivaram Priyanka, Nagaraj Deepthi, PS Karishma
January-June 2019, 5(1):56-60
Background: Tuberculosis (TB) is a major public health problem in India with high morbidity and mortality. As per the World Health Organization guidelines, the Revised National Tuberculosis Control Program introduced daily directly observed treatment, short-course (DOTS) regimen with a fixed-dose combination with weight bands. This study was undertaken to compare the effectiveness of daily DOTS regimen with intermittent regimen and to assess the proportion of adverse drug reactions in both groups. Materials and Methods: A descriptive study was conducted at a peripheral health institute under one of the TB Units in South Bengaluru. Participants registered for treatment during the third and fourth quarter of 2017 were selected using continuous sampling. Data were collected by case record analysis, structured interviews, and telephonic follow-up. Results: The study included 81 participants, with the mean age of 40 ± 16.1 years. Majority of the study participants 55 (67.9%) were male, and majority (38 [46.9%]) belonged to the upper-lower class. Forty-two (51.8%) of the study participants were on intermittent regimen, and 39 (48.1%) were on daily DOTS regimen. There was 100% sputum conversion at the end of treatment under both treatment regimens. A total of 36 (85.7%) participants under intermittent regimen and nine (23%) under daily regimen developed one or the other adverse drug reactions. The treatment success for participants under intermittent regimen was 38 (90.47%) and that for daily regimen was 35 (89.74%). However, there was no statistically significant difference between the two groups. Conclusion: Both daily and intermittent DOTS regimens are equally effective in TB treatment, but adverse drug reactions were more common with the intermittent regimen.
  2,451 180 -
Developing the underdeveloped: Aspirational districts program from public health point of view
Vikas Bhatia, Rama Shankar Rath, Arvind Kumar Singh
July-December 2018, 4(2):2-4
  2,295 258 -