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   2017| July-December  | Volume 3 | Issue 2  
    Online since February 7, 2019

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Perception of students on foundation course conducted for first year MBBS students at AIIMS Bhubaneswar
Priyadarshini Mishra, Manisha Kar
July-December 2017, 3(2):16-19
AIIMS Bhubaneswar has introduced its Foundation course for MBBS students at entry level to sensitize them with requisite knowledge and skills so that they can acquire the attributes of a medical student and finally of clinician. A 10-day Foundation course was designed covering 12 topics by Academic Section of AIIMS Bhubaneswar in consultation with the Director. Various teaching-learning methods were followed for its conduction. On the last day, students' feedback was collected using a validated questionnaire which assessed four aspects of each session: content, teachinglearning methods, relevance and involvement of students. Analysis of data showed that barring a few sessions, more than 70% of students were satisfied to a great extent regarding all 4 attributes of the sessions. However, it was 48% in case of History of Medicine. Around 50% of students did not feel that they were involved in session of study skills and time management and computer knowledge and use of online resources in learning. 60-70 % of students did not feel that they were involved in sessions of History of Medicine, National Health Scenario and Ethics and Professionalism. The reason may be History of Medicine, National Health scenario and Computer skills and use of online resources sessions were conducted as a didactic lecture series which had less scope of student interaction. Students' feedback shows that inclusion of role-plays and small activities can help generate interest in a given topic. Overall students were satisfied with the conduct of foundation course and found it to be a very helpful and empowering start to their professional career.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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Awareness of lifestyle, occupational and host factors with respect to reproductive health among students, Western India
Sunil Kumar, Riddhi Aswin Thaker, Dimple Jaiswal, Shruti Patel, Dharati Parmar
July-December 2017, 3(2):23-30
Introduction: Generally, students falsely believe that miscarriage/ preterm birth is uncommon and do not understand its exact causes. Students being the future of the society therefore it is worth to assess their knowledge with respect to fertility. Objectives: This study was conducted to find out the awareness about the host, lifestyle and occupational factors among students with respect to pregnancy, miscarriage and outcome. Material and Methods: Knowledge, Attitude and Practices (KAP) survey was conducted during November 2015 to April 2016 among the students who visited the National Institute of Occupational Health (NIOH) as an observer. A total of 744 students with mean Age of 21.8±0.1 [452 from science and 292 from non-science background (comprising 312 male and 432 female)] were participated. The students were mostly from the state of Gujarat, India. Results: The results indicated that more than 83% students were aware that lifestyle habits such as smoking, tobacco chewing and alcohol consumption have adverse effects upon fertility and pregnancy. Most of the students (male- 81%; female- 86%) were also aware that depression can affect the fertility and its outcomes. Further, 75% students were knowing that stress affects pregnancy. The awareness of most of the variables was more among the female as compare to male students except only 37% female students know thatsexually transmitted diseases (STD) reduces fertility as compared to 55% male students. However, overall 63% students have correct knowledge of reproductive health variables asked. The data with respect to educational background revealed that science graduates had more knowledge regarding fertility than non-science graduates. Conclusion: Awareness about the fertility related aspects were more among female and science students as compared to male and non-science students. More knowledge among science students reflects the role of education system in imparting the knowledge about fertility. However, 37% unaware students can't be ignored and it means that awareness with respect to reproductive health still needed.
[ABSTRACT]   Full text not available  [PDF]
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Evaluating intramural stillbirths in a tertiary care centre of North India - An observational study
Bharti Sharma, Neelam Aggarwal, Ankit Raina, Bharti Joshi, Vanita Suri, Nandita Kakkar
July-December 2017, 3(2):40-45
Introduction: India shares the highest magnitude of stillbirths among all South East Asian Countries in the world. Along with known preventable causes of still births, there are other associated factors which also plays an important role. The main objective of our study was to find out the causes of Still Births and associated logistic issues in all those pregnant women who were admitted with live fetus in a tertiary care centre but had still birth during their stay in a tertiary care hospital. Material and Methods: This study included all pregnant women who had SB during hospital stay over a period of one year. Results: The still birth rate during period of study was 63 per 1000 total births. Out of these 376 women, 66(17.5%) were admitted with live fetuses but had still births during hospital stay. The main causes of still births were hypertensive disorder of pregnancy (21), birth defects (18), antepartum hemorrhage (12) and prematurity (7). There were 17 (25.7%) still births attributed to lack of space in Neonatal intensive care unit or lack of funds due to poor socioeconomic status. Conclusion: The mostcommon preventable causes of still births were hypertensive disorders of pregnancy and iatrogenic prematurity. Other associated factors were limited health facilities, patient related factors, illiteracy, poor socioeconomic status, logistic issues in accessing health care and delayed referral also has a significant role. These could be prevented by improving the premature infant care with strengthening health care facilities and targeting hypertensive disorder of pregnancy at root level.
[ABSTRACT]   Full text not available  [PDF]
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Kiran clinic: Community owned primary health care - A case study from rural Wardha
VA Bhagat, AV Raut, SS Gupta, AM Mehandale, BS Garg
July-December 2017, 3(2):61-64
Background: Primary health care is the right of each and every human being. One of the innovations in making primary health care available to the community is the community owned primary health care clinics (Kiran clinics) functional in the villages of field practice area of Department of Community Medicine at Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. This case study aimed to document the process of formation and evolution of one of such Kiran clinic (KC) with a focus on identifying the facilitating factors for evolution and sustainability of the KC. Material and methods: In this qualitative study, In depth interview (IDI), observations of Kiran clinic day and meetings of management committee meetings were undertaken. All the IDI were tape recorded, transcript prepared and analysis was done manually. Results: Facilitating factors for evolution and sustainability of Kiran clinic in Salod village were voluntary participation, community dialogue, capacity building of committee members, knowledge and ownership of committee members, transparency in work/quality monitoring, and quality services responsive to health need. Conclusions: Kiran clinic is a socially acceptable, feasible and a sustainable model for provision of required health services to villagers.
[ABSTRACT]   Full text not available  [PDF]
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Harnessing the potential of private sector in nutrition: A prerequisite for meeting goal 2 of Sustainable Development Goals (SDG) 2030
Dewesh Kumar, Pankaja Ravi Raghav, Pankaj Bhardwaj, Nitesh Kumar
July-December 2017, 3(2):4-7
Private Public partnership (PPP) in nutrition has got huge potential for multisector assistance where industry, government, academia and NGOs can work in harmonization for achieving sustainable development goal related to nutrition. It is imperative to identify viable ways in which local as well as transnational business stakeholders may be better involved to scale up nutrition at the country and global levels. The PPP model in improving nutrition of masses may prove itself to be a cost-efficient and effective implementation of (1) Direct nutrition interventions and (2) Nutrition related interventions. The potential of private sector involvement is immense and can be harnessed in providing micronutrients through food fortification, promoting good dietary practices and therapeutic feeding for malnourished children. Other nutrition domains where private sector can be of great help are agriculture, health, education, economic development and last but not the least disaster preparedness/mitigation efforts.
[ABSTRACT]   Full text not available  [PDF]
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Client satisfaction regarding health care services provided by Auxiliary Nurse Midwives in North India
Anup Dewanand Salve, Kavita , Amarjeet Singh, Sushma Kumari Saini
July-December 2017, 3(2):20-22
Introduction: In recent years more responsibility have been added to the work of Auxiliary Nurse Midwives (ANMs) affecting the satisfaction of the users. So need was felt to conduct a study on the satisfaction of clients in study area. The objective of the study was to evaluate the performance of ANMs in terms of client satisfaction in selected health care settings of North India. This cross-sectional study was conducted in two selected health care settings of North India. Material and Methods: Convenient sampling technique was used to select 7 ANMs and 100 clients from the study area. Data collection was done by using client satisfaction interview schedule. Descriptive and inferential statistics (χ2 test) was used. Results: Most (87%) clients were satisfied with the services provided by ANMs. The dissatisfaction in rural area was only 2% as compared to 24% in urban area. Lesser proportion of people were satisfied with family planning, provision of health services and other services. Conclusion: Clients in rural area were more satisfied as compared to clients in urban area .More satisfaction was reported in communication, maternal and child health and health education services.
[ABSTRACT]   Full text not available  [PDF]
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Barriers and facilitators to seek treatment for gynecological morbidity among women from urban slums in Pune, India
Geeta S Pardeshi, Murlidhar P Tambe, Ajay S Chandanwale, Radhika S Sharma, Mitali S Wagh
July-December 2017, 3(2):52-60
Background: The high burden of gynecological morbidity along with poor treatment seeking practices indicate the need to identify barriers and facilitators for treatment seeking. Methods: A community based study using mixed methodology was conducted among women in reproductive age group in slums of Pune city. A pretested semi open ended questionnaire was used to record data on sociodemographic variables, symptoms of gynecological morbidity, domestic violence, autonomy and treatment seeking. Data were analysed using logistic regression analysis. Reponses to in-depth interviews were analysed using grounded theory. Results: Out of the 202 women recruited in the study, 116 (57%) reported symptoms of gynecological morbidity of which 64 (55%) reported to have sought treatment. The factors significantly associated with treatment seeking were: discussing symptoms with husband [p=0.001, OR=6.99 (2.11 - 23.12)]; having a role in decision making for major household purchase [p=0.005; OR=4.36 (1.54-12.32)] and reporting four or more symptoms [p=0.015; OR=4.57 (1.34-15.61)]. In-depth interviews identified barriers and facilitators at individual, family, community and health service levels. Conclusion: There was a high prevalence of self-reported gynaecological morbidity amongst women in urban slums and only half of symptomatic women reported to have sought treatment for their symptoms. Women empowerment, health education and initiatives planned under National Urban Health Mission such as linkages with health care set up through ASHAs and community based groups and appointment of lady medical officers and gynecologists at Urban PHCs will facilitate treatment seeking.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
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Antileprotic medication induced psychosis in a patient of tuberous sclerosis: A case report
Udit Kumar Panda, Manas Ranjan Sahoo, Subhankar Swain
July-December 2017, 3(2):65-67
Tuberous sclerosis is a rare multisystem neurocutaneous genetic disorder primarily presented with seizures, mental retardation and hamartomas involving multiple systems. Behavioural and psychiatric manifestation of the illness in form of cognitive disabilities, autistic spectrum disorder, ADHD, learning disabilities etc. are present in a large number of cases. We present a case of tuberous sclerosis who developed psychosis after his skin lesions were misinterpreted as leprosy lesions and he received anti-leprotic medication in primary care setting. Risperidone and sodium valproate were used to successfully manage his behavioural symptoms and seizures.
[ABSTRACT]   Full text not available  [PDF]
  436 71 -
Attitude towards smoking and second hand smoke exposure among school going adolescents in India
Neeti Rustagi, Lobzang Norbu, Anil Kumar, Manoj Kumar Verma
July-December 2017, 3(2):37-39
Exposure to second hand smoke (SHS) among school going adolescents is a public health problem. It is important to understand the possible sources and the attitude among adolescents which increases the risk of such exposure. The objective of present study was to assess exposure and attitude of school going adolescents towards second hand smoke. This cross-sectional survey was conducted among students of a school in India which is supported by funding from para- military forces to ensure quality education to children of para-military personnel's. Students from class VII to XII were included and data was collected using Global Youth Tobacco Scale. Exposure to SHS in past one week inside home was found to be 45% and in public places 76.6%. Though smoking from other people was reported to be harmful (89%) and discussion about harmful effects of smoking is carried out by school authorities (73.2%) and families (75.9%) yet attitude towards SHS among adolescents is favorable and is considered helpful in enhancing socialization and making personality attractive. Second hand smoke exposure among school adolescents is high and strategies designed to reduce smoking among them need to specially target positive image associated with smokers.
[ABSTRACT]   Full text not available  [PDF]
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Elderly depression: A public health dilemma; challenges and opportunities
Soumya Swaroop Sahoo, Udit Kumar Panda, Vikas Bhatia
July-December 2017, 3(2):12-15
India is undergoing a demographic transition that has resulted in rapid growth of the elderly population. This enormous growth has mandated an urgent need for the development of mental health services. Elderly depression is a significant contributor to morbidity and mortality in this age group. The Global Burden of Disease report 2015 outlines depression as the third leading contributor to global disability measured as disability adjusted life years (DALYs). Early identification, diagnosis and initiation of treatment can provide the elderly an opportunity to improve their quality of life and a considerable reduction in the morbidity and mortality. This public health challenge can be addressed by social support and engaging primary health care providers in providing patient centred care. The philosophy of geriatric medicine is not only to add years to life but to help the elderly attain the desired life span with minimal distress and disability.
[ABSTRACT]   Full text not available  [PDF]
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Electronic waste in India: Implications on health
Shreya Jha, Sanjeev Kumar Gupta, Baridalyne Nongkynrih
July-December 2017, 3(2):8-11
Increase in production and consumption of electronic goods has resulted in a rapid rise in generation of electronic waste in India. It is the fifth largest producer of electronic waste in the world. Electronic waste is a mine of precious metals and also a sea of hazardous elements. Exposure to electronic waste has the potential to harm virtually any system of the human body. It can affect thyroid function, increased incidence of cancer, skin and lung diseases, damage to the central nervous system, kidney and bone. This paper provides an evidence-based insight into the status of electronic waste and its management in India, its effect on health, and possible control measures. Timely institution of control measures in this area shall prevent deleterious effects of this waste, and improve health of our people.
[ABSTRACT]   Full text not available  [PDF]
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Estimation of cost of services provided by Urban Health Centre of a medical college in North India
Olivia Marie Jacob, Mahasweta Dubey, Farhad Ahamed, Kapil Yadav
July-December 2017, 3(2):31-36
Introduction & Objective: Rapid urbanization is an emerging problem in India. Urban poor have adverse health indicators when compared to their rural counterparts. There is a need for understanding the allocation of costs for medical services effectively at primary care level. This study was planned to estimate the provider costs of an urban health centre (UHC) of a medical college in North India and was compared with the National Urban Health Mission standards. Methods: Cost analysis was done for the year 2015-16 using a six step process prescribed by World Health Organization. The costs were divided as capital and recurrent costs; fixed and variable costs and expressed in INR. Unit cost of services was estimated as the total annual cost per number of beneficiaries. Results: The total annual costs incurred by the urban health centre was Rs. 1,94,23,363.80 for the year 2015-16. Recurrent costs contributed most of the annual costs (57.3%) and capital costs contributed to 42.7% of the total annual costs. Most of the costs incurred by the centre were due to the salaries, land and building costs. Conclusion: It has been seen that most of the total cost incurred by the centre was not primarily related to health care provision directly. It is necessary to identify the gaps and make the services available by effectively allocating the resources.
[ABSTRACT]   Full text not available  [PDF]
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Factors causing stress among medical students in a private medical college in Puducherry, India
S Rajini, P Alli, V Tamilsevi
July-December 2017, 3(2):46-51
Introduction: Medical education has been reported to be one of the most stressful academic curricula worldwide, negatively affecting the physical and mental health of medical students. This study therefore has been planned to identify the prevalence of psychological stress and possible factors responsible for it among undergraduate medical students so that, appropriate intervention strategy can be proposed to reduce psychological stress. Material and Methods: A cross sectional study was conducted among undergraduate medical students of private medical college, Puducherry using a pre-tested, pre-designed and standard questionnaire to collect data and it is analyzed using suitable statistical methods. Results: Out of total 160 students, 86.87% of students have reported stress. Among them 72.50% had mild to moderate stressor experience and 14.37% had severe stressor experience. IIIrd MBBS students were more stressed 95% followed by IVth MBBS /CRRI students 85% and IInd MBBS students showed stress up to 82.5%. Majority of the students had severe stress because of increased work load towards exams, more self study, required to be more responsible, less time for repeated learning, worried about future & becoming good doctor and habit of postponing work. Conclusion: In our study, more than two third of the medical students have reported to be stressed. Hence, we can motivate the students to involve in extra- curricular and co-curricular activities such as yoga, sports, etc., to cope up stress.
[ABSTRACT]   Full text not available  [PDF]
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Predictive validity of derived clinical adiposity parameters in the assessment of type 2 diabetes mellitus among adults
Swetha Kumar, Saranya Ravi, Vijayaprasad Gopichandran
July-December 2017, 3(2):68-72
Background: Body Mass Index (BMI) is a standard universal method of assessing clinical adiposity risk. Several studies have shown that obesity as defined by BMI criteria is a risk factor for type 2 diabetes. However, among Asian Indians there is an increasing incidence of thin-fat phenotype where BMI fails as a clinical risk predictor for diabetes. So, there is a need for alternate clinical adiposity parameters. Objective: To assess the predictive validity of derived clinical adiposity parameters in the assessment of Type 2 Diabetes Mellitus among adults attending a tertiary hospital. Methods: A cross-sectional comparative study was performed in which 100 diabetic adult men and women attending the diabetic Out Patient Department were enrolled. As a comparison group, 53 non-diabetic adults attending the OPD and other non-diabetic relatives of patients were enrolled. Anthropometric measurements such as height, weight, waist and hip circumference were measured and derived adiposity parameters such as Body Mass Index, Waist-Hip Ratio, Waist-Height Ratio, Body Adiposity Index and Conicity Index were calculated. Receiver Operating Characteristic curves was plotted for each adiposity parameter with diabetes status as a dependent variable to assess predictive validity of the adiposity parameters in assessing diabetes risk. Age and gender-segregated analysis were also performed. Results: Waist-Hip ratio cut-off=1.009 (AUC=0.956; 95%CI 0.927-9-0.985) sensitivity=90%, specificity=81.1% had the best predictive ability for diabetes. Body adiposity index cut-off=30.5285; (AUC=0.568 95%CI 0.470-0.665) sensitivity=52%, specificity=50.9% was the least predictive. Waist-Height Ratio cut-off=0.5889 (AUC=0.708; 95%CI 0.624-0.792) sensitivity=62%, specificity=62.3% and Conicity Index cut-off=1.5393 (AUC= 0.692; 95% CI 0.603- 0.781) sensitivity=61%, specificity=60.4% had moderate predictive ability and finally Body Mass Index (BMI) cutoff= 26.25 (AUC=0.585; 95% CI 0.491-0.679) sensitivity=56%, specificity=54.7% had a poor predictive ability. Gender segregated analysis showed that BMI and Body Adiposity Index were poor predictors of diabetes in women. Conclusion: Waist-Hip Ratio has the best predictive validity in the assessment of risk of type 2 diabetes. This must be confirmed using longitudinal studies.
[ABSTRACT]   Full text not available  [PDF]
  387 62 -
Tribal health care: The unaddressed aspect in Indian health system
Vikas Bhatia, Priyamadhaba Behera
July-December 2017, 3(2):2-3
Full text not available  [PDF]
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