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Volume-18 (2019);
No. 3 (July-September)
Published on Oct 30, 2019
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2019;3:1
Original Article |
Kodali PB.
Out of Pocket Costs of Institutional Delivery in Four Empowered Action Group States of India: An Analysis of NFHS 4 Data. |
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Abstract: Background: Maternal and child health is one of the priority areas in Indian context, particularly in Empowered Action Group (EAG) states of the country. Institutional deliveries are prioritized as one of the important means to reduce MMR and IMR. The current study aims to estimate and compare the out of pocket expenditure associated with institutional deliveries in EAG states of Bihar, Uttar Pradesh, Madhya Pradesh and Chhattisgarh in India. Methodology: The study was conducted through secondary analysis of NFHS 4 data. The study adheres to the approach of ecological study design and aims at comparing the OOPE and its variations at the state level. The data was analysed using SPSS version 20. Statistics of mean, standard deviation and 95% confidence levels for OOPE were computed and compared. Results: Uttar Pradesh had the highest OOPE with mean OOPE for institutional delivery of INR 7616.77, 95% CI (7310.26 – 7923.28), Chhattisgarh had the least OOPE with mean OOPE per institutional delivery being INR 3917.80, 95% CI (3513.40 - 4294.25). Presence/absence of health insurance had profound impact on the OOPE. Institutional deliveries in UP which were not covered under any Insurance had mean OOPE of INR 11596.54, 95% CI (8832.62 – 14360.45), on contrary institutional deliveries in Chhattisgarh which were covered under insurance schemes had OOPE of INR 3964.84, 95% CI (3220.70 – 4709.00) Conclusion: While OOPE fluctuated with insurance and other socio-demographic factors, existence of inter-state differences reflects on the importance of health service availability in reducing OOPE. Interventions focussing on reducing OOPE should also focus on health system strengthening by improving availability and accessibility of health services.
Key words: Out of Pocket Expenditure, Institutional deliveries, Maternal and Child health care, Health Expenditure |
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2019;3:2
Original Article |
Malakar B, Mallick A, Roy SK, Santra A.
Hearing Threshold and its Concomitants Among Santal Stone Mine Workers of Birbhum District, West Bengal, India. |
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Abstract: Background: Hearing impairment is one of the major health problems under the paradigm of occupational health. Mine workers are vulnerable to hearing impairment due to the nature of work, inadequate knowledge of sound hazards and limited access to protective devices. However, the cause of such health problems in India have rarely been explored. Present study aimed to find out hearing threshold of the study population, the level of noise in the mine areas and the relationship of different concomitants on hearing thresholds of the workers. Methods: Cross-sectional data on audiometric measurements, age and work duration in stone mining work were collected from 189 adult Santal stone mine workers (i.e. Group I= working and residing in stone mines and Group II = working in stone mines but residing outside stone mines) of Birbhum district, West Bengal. Data on noise pollution level were also collected. All the data were collected following standard techniques and instruments. Descriptive statistics, cross-tabulation and multivariate logistic regression analysis were performed. Results: Hearing thresholds was higher in Group I than Group II; in aged workers than younger workers and working for long duration than short duration in mines. The level of noise pollution inside the stone mine area was above the recommended limit. The most important concomitants of hearing threshold were residence and work in stone mines. Conclusion: The workers engaged in stone mine work and residing inside mine area were more susceptible to hearing impairment. The intensity of the risk further increases with the advancement of age.
Key words: Hearing loss, Multivariate logistic regression, Noise pollution, Occupational Health, Santals |
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2019;3:3
Original Article |
Oluboyo OB, Musa HS, Akinseye JF, Akele RY, Oluboyo AO, Adewumi FA.
Risky Sexual Behaviors and Prevalence of Chlamydia trachomatis Antibodies among Students in a Tertiary Institution. |
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Abstract: Chlamydia infection is a common sexually transmitted infection in humans caused by Chlamydia trachomatis. This infection occurs frequently in sexually active adolescent and young adults. This study determined the prevalence of Chlamydia trachomatis antibodies among students involved in risky sexual behavior in a tertiary institution. A total of 92 students consisting of 46 males and 46 females between ages 16 and 25 years who were involved in risky sexual behaviors were investigated. Gamma immunoglobulin (IgG) and Mu immunoglobulin (IgM) antibodies to Chlamydia trachomatis were assayed in the serum of the students using enzyme linked immunosorbent assay. Of the total students, 71.9% had multiple sex partners while 28.3% had single sex partners. The overall prevalence of Chlamydia trachomatis IgG and IgM antibodies were 56.5% and 40.2% respectively. Prevalence of Chlamydia trachomatis IgG and IgM, though more in ages 16-20 is not statistically significant (p>0.05) over higher ages. No significant difference was recorded in the prevalence of Chlamydia trachomatis antibodies among gender. A very significant difference (p<0.05) was recorded among students involved in multiple sex partnership in relation to those having single sex partners. Risk of Chlamydia trachomatis was high among sexually active students especially among students involved in multiple sex partnership behavior. In view of the subtle nature of Chlamydia trachomatis infection and the long term deleterious effects it may produce, it is pertinent to campaign against risky sexual activities, especially among students in higher institutions to reduce the rate of infection and safeguard their future.
Key words: Risky sexual behavior, Chlamydia trachomatis, Antibodies, Tertiary institution |
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2019;3:4
Original Article |
Esan DT, Fasoro AA, Olaiya FM, Bello CB.
Awareness and Utilization of Cervical Cancer Screening among Women in an Urban Area in Southwestern Nigeria. |
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Abstract: Introduction: Cancer of the cervix is the commonest cause of cancer death in women worldwide. This study assessed the awareness level and pattern of utilization of cervical cancer screening test among women of different professions in Ado-Ekiti, Nigeria. Methods: A descriptive cross-sectional design was used and respondents were selected from four different professions. Results: About 40% of respondents had heard of cervical cancer prior to the survey and only 40.5% were aware of cervical screening tests. Among those who were aware of the screening tests, 16% had ever utilized cervical cancer screening tests. Conclusion: This study established low cervical cancer awareness level and low utilization rate of cervical cancer screening among respondents. Therefore, there is need for sustained and concerted community health awareness most importantly at the grassroots in order to increase awareness and utilization rate of cervical cancer screening among the sampled populace.
Key words: Cervical cancer, Awareness, Utilization, Screening |
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2019;3:5
Original Article |
Pappachan BC, D'Silva F, Safeekh AT.
Psycho-Social Interventions for Psychological Distress and Quality of Life among Women with Breast Cancer – A Systematic Review and Meta-Analysis. |
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Abstract: Objective: To systematically review the effect of various psycho-social interventions on psychological distress and Quality of life among women with breast cancer. Methods: We have conducted a systematic review of RCTs on psycho-social interventions for women with breast cancer that are published from 2005 to 2016. Databases such as PubMed, Cochrane Library, CTRI, IndMED and Google scholar were searched. Inclusion criteria were women diagnosed with breast cancer (Grade I-III) aged between 18-65 years and studies which addressed any kind of psychosocial interventions for breast cancer cases. Results: six studies out of 233 studies were included for qualitative analysis with a total of 1404 participants and only four were included for meta-analysis. Mode of delivery of the intervention was varied across studies such as face to face education intervention, direct face to face interaction with telephonic interaction, direct individual as well as group sessions and direct session along with Audio-visual methods. Conclusion: The review suggests tentatively that nurse-led interventions delivered in person or by telephone could provide valuable improvements in illness-specific QoL and mood, as part of a package of cancer care.
Key words: Psycho-social interventions, Breast cancer, Women, Quality of Life, Psychological distress, Systematic review, Meta-analysis |
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2019;3:6
Original Article |
Yeravdekar R, Chandak A, Shukla S.
Perception and Practices of Voluntary Blood Donation Amongst Students of Higher Educational Institutes in India. |
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Abstract: Objective: This study was carried out to assess the knowledge, attitude, practice, and behavior (KAPB) regarding blood donation amongst students of higher educational institutes (HEIs) Method & Results: 7281 students from Higher Educational Institute in India were interviewed. Of these, 4667 (64.1%) had adequate (average and above average) knowledge of blood donation. Overall knowledge was better among male participants. From the sample, 2592 (35.6%) students had donated blood at least once while 4689 (64.4%) participants had never done so. From those who had not donated blood, 1841 (39.3%) did not do so due to lack of opportunity whereas 1630 (34.7%) did not have information regarding the same. Conclusion: The current study used the largest number of participants as sample, which also included international students. This study will help stakeholders in designing strategies to encourage non-donors to donate blood and the donors to donate on a regular basis.
Key words: Voluntary blood donation (VDB), Motivators for blood donation, Attitude, Students, Higher educational institutes |
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2019;3:7
Original Article |
Pathak P, Kukreti V, Bisht AT.
Parental Perceptions, Depression and BMI: A Road to Understand the Occurrence of Vulnerability to Anorexia in Adolescent Girls. |
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Abstract: Adolescence tagged as period of stress and storm needs to be comprehended and handled with utmost care. Eating disorder one of the complex problems encountered during adolescence has an impact on the psycho-physiological health. The present study was conducted to assess the vulnerability towards anorexia by adolescent girls and also to compare parental perception, depression and Body Mass Index (BMI) between anorexia vulnerable and non anorexic girls residing in the rural area of Uttarakhand state. It was seen that 40% of girls showed symptoms of anorexia. Data on parental perception, depression and BMI revealed that anorexic vulnerable girls scored low for parental care and high for parental protection, depression and BMI as compared to their non-anorexic counterparts. It may be concluded that anorexia, once considered as disorder of western and urban culture, is now creeping into the rural setup too. Therefore, there is a current need for identifying and perceptively intervening in the problem at the parental level for better management of the problem.
Key words: Anorexia, Parental perception, Depression, BMI |
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This Article |
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2019;3:8
Original Article |
Talwar P, Matheiken S, Cheng JLA, Sabil S.
Reliability and Factor Structure of the Westside Test Anxiety Scale among University Students. |
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Abstract: The Westside Test Anxiety Scale (WTAS) is a widely-used screening instrument for assessing test anxiety impairments in educational settings. However, psychometric properties of this measure have not been established adequately. Therefore, the main objective of this study was to evaluate the factor structure and measurement invariance of the WTAS. Data for the cross-sectional study was collected from a convenience sample of 218 undergraduate students enrolled in a public university in Malaysia. Construct validity was investigated by Exploratory Factor Analysis (EFA). Confirmatory Factor Analysis (CFA) was used to test two models (original structure and EFA structure). Also, multiple-group invariance was analyzed in order to determine the extent to which the factor structure was comparable across gender. Results of CFA indicated that both models met all the pre-established fit criteria. There was however, more support for the re-organized two-factor EFA model, with high reliability values. Multi-group CFA demonstrated measurement invariance across gender. Findings from the present study indicate that the WTAS could serve as a screening tool to detect test anxiety among students.
Key words: Test anxiety, Factor structure, Gender invariance |
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This Article |
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2019;3:9
Original Article |
Adesegun O, Ojuola O, Osonuga A, Idowu AO.
Effects of Music on Health: The Plight of the Piper. |
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Abstract: Music, an important tool of social and cultural value, has found relevance in healthcare and is being harnessed for therapeutic purposes. However, the art of producing music with musical instruments, has potential health benefits and hazards, which are often ignored. In this article, we review literature, and expound on the effects of playing wind instruments on the health of the player. Some authors have documented superior lung function and a lower risk of obstructive sleep apnea amongst wind instrumentalists. However, the list of health hazards associated with playing wind instruments exceed the potential benefits, with myriad cases of adverse events documented following wind instrument playing. Many of these adverse events are as a result of increased pressures (intra-thoracic, intra-abdominal, intra-ocular, intra-cranial etc.), especially with high resistance instruments, when delivering high pitches and volumes. It is recommended that wind instrument players be aware of the potential health benefits and risks associated with playing their instruments, avoid prolonged playing, ensure adequate rest intervals between playing, and avail themselves of regular (at least annual) medical fitness checks, with special attention paid to their otolaryngologic, cardiovascular, respiratory and ocular health.
Key words: Music, Health, Wind instrumentalists, Wind instruments |
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2019;3:10
Original Article |
Yusof MZ, Hod R, Aizuddin AN, Samsuddin N.
Health Effects of Hevea Brasiliensis Wood Dust Exposure Among Furniture Factory Workers. |
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Abstract: Background: Potential health impacts resulting from wood dust exposure among workers in the furniture factories have been reported in many studies. However, most of the studies focused on pine, beech, teak, oak and red western cedar. Studies on the health effects due to rubber wood (Hevea brasiliensis) dust are still lacking, thus there is a need to explore this public health issue further. This study assessed the respiratory and skin health effects among workers exposed to rubber wood dust in the furniture factory. Method: A cross-sectional study was conducted among 241 workers in a furniture factory located in Peninsular Malaysia. The data was collected through face-to-face interview by using questionnaire and spirometry. Result: The level measured in the material supply and machinery area showed the concentration level of rubber wood dust exceeded the permissible exposure limit of 1 mg/m3. Workers exposed to rubber wood dust showed the highest prevalence of eye symptoms (n=125, 51.9%) and nasal symptoms (n=122, 50.6%). High exposed group was more likely to complain on eye symptoms (adjusted OR=3.89, 95% CI=2.03 to 7.49) and nasal symptoms (adjusted OR=2.63, 95% CI=1.41-4.91). Workers worked for ten years or greater were higher risk to have phlegm (adjusted OR=4.59, 95% CI=1.25 to 16.86) chest tightness (adjusted OR=6.33, 95% CI=2.16 to 18.53), breathlessness (adjusted OR=9.84, 95% CI=2.75 to 35.26), and eyes symptoms (adjusted OR=3.67, 95% CI=1.24 to 10.89). The high exposed group and workers who worked for ten years or greater showed decreased lung function but only high exposed group showed statistically significant findings. Conclusion: Appropriate preventive and control measures should be implemented to protect workers in the rubber wood furniture factory.
Key words: Hevea brasiliensis, Wood dust, Furniture factory, Health effects, Lung function |
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2019;3:11
Original Article |
Latha T, Bhat AK, Hande M, Mukhopadhyay C, Devi ES, Nayak BS, George A.
Compliance Towards Infection Prevention and Control Practices in Orthopedic Department of a Tertiary Care Hospital. |
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Abstract: The aim of was to analyzing the infection control practices in the Orthopedic department of a tertiary care hospital of South India. Methods: A total of 535 events were observed using structured observation checklist through participatory observation in this descriptive cross sectional study. The events were observed by the researchers during the patient care activities. Ethical clearance and consent was obtained. Results: Hand disinfection before the procedure was 54.4% and 75.5% after the procedure. Performing hand washing techniques was better with soap and water than using a sanitizer. Use of personal protective equipment, personal factors and removal of jewelley were good (above 80.8%). The compliance towards infection control practices during the various procedures ranged from 74.6% to 97.7%. Conclusion: Compliance towards infection control practices was good except for hand disinfection. The hand wash is key element in infection control. Therefore, behavioral change intervention may be useful in improving the compliance to hand washing.
Key words: Hand disinfection, Hand hygiene, Hand sanitizer, Orthopedic, Soap and water, Infection control, Compliance |
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2019;3:12
Original Article |
Nayak PP, Nayak SS, Vikneshan M, Sathiyabalan D.
Smartphone Apps - The Powerful E-learning Tools for Dental Professionals and Students. |
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Abstract: Introduction: M-learning is used to supplement traditional learning methods by dental professionals and students. There is a lack of information on quality of dental educational apps. Hence the present study was conducted. Material and Methods: A total of 210 apps were included in the study. Various features of app including, the type, cost, ratings, number of downloads, involvement of dental professional in its development, target group, applicability and, user feedback was recorded. Results: Among the apps reviewed, 165 and 45 apps were general and specialty related respectively. Most of the apps reviewed were free, developed by dentist and targeted towards students. Around 81.9% android apps had less than 1000 downloads. Around 60% of the applications were updated within last fifteen months. Discussion and Implications: Most of the apps contained only text matter with few pictures. Very few apps used high definition animation to show various intercellular interactions; and augmented and virtual reality techniques to demonstrate and allow students to practice dental procedures in the virtual model. Such apps could go a long way in improving the understanding, especially of abstract concepts. Dental educational apps are relatively less, particularly the specialty related apps.
Key words: Dental Education, Information Technology, Mobile Applications |
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2019;3:13
Original Article |
Lincy S, Maheswari E, Saina AK, Greeshma M, Grace JR.
Drug Utilization Pattern of Proton Pump Inhibitors in the Department of General Medicine. |
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Abstract: Objectives: In current clinical practice, utilization of Proton Pump Inhibitors (PPIs) has increased enormously as OTC drug as well as the commonly prescribed drug in majority of the prescriptions. PPIs are predominantly indicated in prescriptions for the purpose of prophylaxis of antibiotics and analgesics. The study aimed to assess the prescribing pattern of PPIs in the Department of General Medicine of a tertiary care hospital. Methods: This is a prospective observational study conducted in the Department of General Medicine for a period of 1 year from August 2017 to July 2018 to analyse the prescribing pattern of PPIs. The medication charts of both inpatients and outpatients of General Medicine department was reviewed. Core information such as demographic characteristics, diagnosis, and current medications were recorded. The patients were regularly monitored for drug – drug interactions. Results: Of 1019 prescriptions, 908 (89%) prescriptions were found to have PPIs. Pantoprazole 749 (82.49%) was the most commonly prescribed PPI followed by esomeprazole 124 (13.66%). The indications for PPI therapy were acute gastroenteritis 103 (11.34%), ulcers 7 (0.77%), gastro esophageal reflux disease 5 (0.55%), gastrointestinal bleed 3 (0.33%), ulcerative colitis 2 (0.22%), inflammatory bowel disease 1(0.11%), esophageal and gastric injury 1(0.11%) and gastric erosion 1 (0.11%). PPIs were found to be prescribed with antibiotics 681 (75%) followed by non-steroidal anti-inflammatory drugs 179 (19.7%). Conclusions: The study showed inappropriateness in prescribing patterns of PPIs leading to increased therapeutic burden and treatment cost. This necessitates formulation of standard therapeutic guidelines for rationalizing the utilization of PPIs.
Key words: Acute gastritis, Drug-drug interactions, Polypharmacy, Proton pump inhibitors, Pantoprazole |
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2019;3:14
Original Article |
Prasanna LC, Andrade LS.
Variable Occipital Sulci: A Useful Guide to Identify the Focal Lesions on the Occipital Lobe. |
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Abstract: Objectives: The position and extent of human occipital cortical areas defined either architectonically or functionally have characteristic relationships to the occipital sulci, their banks and fundi or to points of sulcal intersections. The aim of our study was to define the variability of the human occipital sulci with particular regard to the sulcal: (1) presence, (2) position, (3) extent, (4) intersections and (5) length. Materials and method: Investigation was performed on 40 human formalin-fixed cerebral hemispheres used for undergraduate teaching in Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India. Main occipital sulci were observed extensively along the superolateral surface of the occipital lobe. Results: Six types of occipital sulci on the superolateral surface were compared with the previous authors. Conclusion: Well established and constant occipital sulci, or the points of their intersections, may be used as useful anatomical landmarks during less invasive neurosurgical procedures.
Key words: Calcarine sulcus, Lunate sulcus, Occipital lobe, Parieto-occipital sulcus, Superolateral surface |
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2019;3:15
Short Report |
Kamath JBN, Madegowda A, Jain M, Sujir P, Pai M.
An Innovative Nerve Repair Simulation Model with a Technique to Assess Fasicular Coaptation. |
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Abstract: Traumatic nerve injuries and its repair are an integral part of hand surgery speciality. Along with suitable tension at the anastomotic site, another important factor that determines favourable outcome during repair is to obtain a proper coaptation of the nerve fascicles. Practice in microsurgical skill labs on simulation models helps residents and young surgeons to develop these key steps. An ideal simulation exercise should not only mimic the technical challenges involved in the procedure but should also allow the trainees to evaluate their own technique & methods. As there is lack of description of simulation exercises with provision for evaluation of extent of repair in the literature, we propose a simple model of nerve repair simulation emphasizing on evaluation of fascicular coaptation.
Key words: Nerve repair simulation, Evaluation, Fascicular coaptation |
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