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Volume-19 (2020);
No. 2 (April-June)
Published on September 20, 2020
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2020;2:1
Original Article |
Das S.
Under-five Mortality Rate in Odisha: An Assessment of Trends and District Level Variations. |
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Abstract: The under-five mortality rate (U5MR) is one of the key indicators of development. The Millennium development goals envisaged a reduction of U5MR by half of the 1990 level between 1990 to 2015. The Sustainable Development Goals (SDGs) proposed in 2015 aims to reduce U5MR to at least as low as 25 deaths per 1,000 live births. However, a high level of diversity has been observed in the rate of decline in U5MR between and within regions. The broad objective of this paper is to assess the changing pattern of U5MR in Odisha in time and space. The analysis is based on primarily three sources of data: the Sample Registration System (SRS), the National Family Health Survey (NFHS) and the Census of India. The examination of data reveals a declining trend of U5MR in Odisha, yet the current level is substantially high. Geographic (spatial) variation in U5MR is notable. Further, the study observes sharp variations in U5MR by socioeconomic characteristics. The findings of this paper suggest for addressing the social determinants of health and mortality in disadvantaged spaces and population groups for a faster rate of decline in the U5MR and narrowing the differences across space and socioeconomic groups in Odisha.
Key words: Under-five mortality rate, SDGs, National Family Health Survey, Sample Registration System, Spatial patterns, Socioeconomic groups |
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2020;2:2
Original Article |
Singh MS, Chhetri DD.
Maternal Socioeconomic Conditions and Health of the Children of Lingmoo Village, South Sikkim. |
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Abstract: Background: The health of children is reflective of the overall health of the nation. Health in early life may have substantial effects on health and wellbeing throughout the entire life course. Health of the children depends on several factors like mother`s health and behaviour, numbers of children in the household, place of birth and socio economic characteristics. Objective: The present study was conducted to observe the health of children and its association with mothers’ socio-economic conditions. Methods: Data on health of the children was collected from 251 married Nepali women aged between 18 to 60 years from Lingmoo village of South Sikkim. Data on overall health of the children, health check up, vaccination, polio drop, infant mortality and overall health care was collected from each mother through interview. Results: The higher frequencies of children are provided with polio drops (88.4%) and immunization (91.2%). The frequency of infant mortality was higher among women who belong to middle income group (3.7%). The overall good health of the children was higher among children belongs to higher income group (89.4%), mothers who attained higher secondary education (85.2%) and government employees (100.0%). Conclusions: Socioeconomic conditions of the mothers show positive association with overall health of the children. Better socioeconomic status mothers can relatively afford and provide better nutrition, medical facility as well as more awareness for health and hygiene.
Key words: Children, Health, Vaccination, Socioeconomic conditions |
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2020;2:3
Original Article |
Singh V, Murry B.
Maternal Health Situation in North-East India: A Case Study of the Khasis. |
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Abstract: This paper is focused on few trajectories of mother and child health in the northeastern India taking Khasis as a case. Data on reproductive performance of mother and child healthcare practices were collected from 399 women in their reproductive ages; ANC and PNC practices, child immunization and breastfeeding behavior were obtained along with awareness level of HIV-AIDS and RTIs; 239 women were also screened for iron-deficiency. Anemia is found to be one the factors affecting maternal health. The age is found to be non-significant with respect to perceptions on pregnancy and child care. Common fertility and mortality indicators such as crude birth rate (CBR) and infant mortality rate (IMR) are lower than the average figures of Indian and rest of Northeastern states. There is clear indication for lack of awareness particularly with respect to reproductive tract infections. Socio-economic status and cultural barriers might have played crucial role in accessing available healthcare utilities.
Key words: Maternal health, Khasi, Anemia, Demographic rates, Child health |
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2020;2:4
Original Article |
Kadiyala P, Smitha MC, Narayana Murthy MR.
Determinants of Adolescents Attitude Towards Gender Equality in Urban, Rural, and Tribal Areas of the Southern Part of India. |
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Abstract: Background: Gender stereotyping and assumptions about men and women shape everyday personal interactions and attitudes on gender norms. Adolescents forming the future society would be playing an essential role in practising gender equality norms and inculcating it in future generations. Hence the study was undertaken to know the adolescent's attitude towards gender equality norms and to explore its determinants. Objectives: To assess the attitude of adolescents towards gender equality in Urban, Rural, and Tribal areas of Mysuru district. To determine the association of socio-demographic variables, interpersonal influences of family, friends, and experiences of gender bias with adolescent’s attitude towards gender equality. Methods: A cross-sectional study was conducted in the urban, rural, and tribal areas of Mysuru district using multistage sampling. Data was collected from 500 adolescents by a pre-structured and pre-tested, validated questionnaire and analysis was done using SPSS V.24. Results: 50.5% of adolescents had negative attitude scores towards gender equality, and 79.3 % of adolescent girls had reported the personal experience of gender bias. Age, Sex, Residence, interpersonal influence of family and friends and personal experience of gender bias among adolescent girls showed significant association with their attitude towards gender equality. Conclusion: Nearly, half of the adolescents have a negative attitude towards gender equality, and more than three fourth of adolescent girls had personally experienced gender bias. The influence of family and friends was significant in determining the attitude of adolescents towards gender equality norms.
Key words: Adolescents, Gender equality, Urban, Rural, Tribal |
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2020;2:5
Original Article |
Salimath G, Raddi SA.
Correlation Between Physical Abuse and Depression Among School Going Adolescents (10-16 years of age) - A School Based Study. |
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Abstract: Introduction: Every child had all the rights to a safe childhood and a life free from violence. The experience of child abuse and neglect infringe upon that right. An estimated 10–20% of adolescents globally experience mental health conditions, yet these remain underdiagnosed and undertreated. The experience of child abuse and neglect infringe upon that right. Childhood ill-treatment will cause severe mental health disorders in adolescents. Objectives: To find out correlation between physical abuse and anxiety among school going adolescents. Method: The study was conducted in eight schools in Belagavi using descriptive cross sectional research design with stratified cluster sampling. It included Primary and secondary schools of Belagavi. The study samples were consisted of 785 students. Self-structured physical abuse and Modified Kutcher Adolescent Depression Scale was used to find out prevalence & correlation between physical abuse and depression among the adolescents. Results: The results of the study showed that Out of total 785 study subjects 444(56.56%) had exposed to moderate physical abuse, 196 (24.97%) had exposed to low physical abuse, and 145(18.47%) had exposed to high level of physical abuse. The study findings showed that there is significant relationship between physical abuse and depression among adolescents, with r-value =0.1256 (p<0.0326) Conclusion: The study concluded that there is a significant positive relationship between physical abuse and depression among adolescents.
Key words: Physical abuse, Depression, Adolescents |
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2020;2:6
Original Article |
Mohan R, Ganapathy K, Vinayagamoorthy V.
Lost to Follow – Up During Diagnosis (LTFU) of Tuberculosis Patients: A Mixed Method Study on Determinant’s and Potential Solutions. |
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Abstract: Background: Loss to follow up of tuberculosis patient during diagnosis is an important barrier to achieve elimination of TB by 2025 in India. This study estimated the burden and trend of loss to follow up of TB patient during diagnosis, explored tuberculosis patient’s perspective for becoming Loss To Follow Up during diagnostic period (LTFU) and stakeholders’ initiatives and suggested solutions for the same. Methods: Mixed Method study was used - Quantitative (Record based cohort study) and Qualitative (In – depth interview with LTFU patients on their challenges faced and barriers for not giving 2nd sputum sample and free list with stakeholders). Data were extracted from RNTCP Laboratory Register for the cohort of patients registered between January 2014 and December 2018 in a DMC of tertiary care teaching hospital. Qualitative interviews were carried out using interview guide. Results: Of the total 1678 positive cases, 90 (5.3%) were LTFU. On adjusted analysis distance >75km from medical college (Relative risk 2.3; 95%CI: 1.2-4.3) and year of diagnosis were identified as significant risk factors. In Manual content analysis showed five categories of challenges faced by LTFU cases namely 1) lack of awareness; 2) addictions; 3) stigma; 4) Employment related barriers and 5) perception on drug side effects. Free listing conducted between staffs of hospital and from stakeholders the main suggested solutions identified were 1) context-based counselling; 2) friendly patient tracking; and 3) proactive in-service. Conclusion: There was significantly decreasing trend in LTFU patients over the years (in 2014 – 6% to 0.5% in 2018). Co-ordinated context-specific pro-active interventions are required to achieve End TB strategy of the nation
Key words: LTFU, Mixed methods research, Suggested solutions, Stakeholder’s perspective |
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2020;2:7
Original Article |
Rahimi BA, Hemat MD, Rahimy N, Rafiqi N, Kakar MAZ.
Determinants of Uncontrolled Hypertension Among Hypertensive Patients in Kandahar, Afghanistan. |
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Abstract: Background: Globally, hypertension is a major public health issue as well as one of the leading causes of cardiovascular diseases and deaths. To determine the risk factors of uncontrolled hypertension among adult hypertensive patients in Kandahar, Afghanistan.
Methods: This was a cross-sectional study, conducted in Kandahar City, Afghanistan. Data of 12 months (May, 2018–April, 2019) was collected from outpatients who visited Mirwais Regional Hospital and Sidal Hospital in Kandahar City. Results: Among 1050 hypertensive patients, 651/1050 (62.0%) were females, 636/1050 (60.6%) living in rural areas, 816/234 (77.7%) married, 723/1050 (68.9%) uneducated, 918/1050 (87.4%) overweight or obese, 459/1050 (43.7%) having family history of hypertension, and 786/1050 (74.9%) of the patients with uncontrolled hypertension. Mean age of the patients was 51 years. Binary logistic regression revealed that living in rural areas (AOR [Adjusted Odds Ratio] 3.0, p-value 0.004), sedentary lifestyle (AOR 3.7, p-value 0.002), and poor adherence to antihypertensive medications (AOR 4.4, p-value 0.003) were the statistically significant risk factors for the uncontrolled hypertension in these patients.
Conclusion: Uncontrolled hypertension is a major threat for the hypertensive patients in Afghanistan. Better strategies for the control of hypertension are required in Afghanistan to reduce the burden of disease as a result of complications of uncontrolled hypertension.
Key words: Hypertension, Blood Pressure, Determinant, Kandahar, Afghanistan |
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2020;2:8
Original Article |
Gada V, Battalwar R.
A Study on Relationship of Prevalence of Pre Menstrual Dysphoric Disorder (PMDD) with Diet and Lifestyle Pattern of Women in Mumbai City. |
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Abstract: OBJECTIVES: Since PMDD affects the life of women significantly by reducing their efficiency and worsening the quality of life, the objectives of the study are to understand the prevalence and its association with diet, lifestyle pattern, physical activity and quality of life among the women suffering from PMDD. METHODOLOGY: A random sampling method was used for a co relational study with sample size of 200 from Mumbai City. Interview cum questionnaire method was used to collect the data. Premenstrual Symptom Screening Tool (PSST) was used to assess prevalence of PMDD in participants. The analysis was done using Statistical Package of Social Software for Windows (SPSS, version 20). The analysis of data included t-tests and Chi-Square tests. RESULTS: The prevalence of PMDD was 53.5%. 53.5% of participants had high mean values of weight, BMI, Waist Circumference, Waist to hip ratio, Waist to height ratio and were found to be highly significant with the prevalence of PMDD (p < .005). 76.6% had poor physical activity status, thus representing high significance between lack of physical activity and presence of PMDD (p < 0.05). In 24 Hours 3 days diet recall the mean values of Energy (in kcal), Carbohydrates (in gms), Protein (in gms) and fats (in gms) were 1439.55± 310.101, 217.46±67.381, 39.47±12.184 and 47.77± 14.511 respectively. There was no significant difference in Energy, Carbohydrates, protein and fats intake when classified according to presence of PMDD (p > 0.05). However, the prevalence of PMDD was higher among 41.1% of participants who skipped the breakfast and meals frequently (p < 0.05). CONCLUSION: There is a significant co relationship between the presence of PMDD with poor physical activity, poor lifestyle patterns and food habits.
Key words: Pre Menstrual Dysphoric Disorder, Physical activity, Diet, Lifestyle pattern |
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2020;2:9
Original Article |
Kanjilal M, Kumar U, Gupta GK, Agrawal D, Arya RK, Dhakar JS.
Musculoskeletal Pain and its Risk Factors Among School-Going Adolescents in Delhi, India. |
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Abstract: Often ignored musculoskeletal pain among adolescent school students can result in the development of musculoskeletal disorders in adulthood. To determine the prevalence of musculoskeletal pain and its risk factors, a cross-sectional study was conducted on 1600 students (855 males and 745 females) registered in 10 co-educational government schools of Delhi. Demographic details along with Nordic Musculoskeletal, Depression, Anxiety Stress Scale-21, Youth physical activity and modified Sedentary Behaviour Questionnaires (duration of using smartphones and watching television) were administered. The prevalence of musculoskeletal pain was 63% (55-70) at 95% CI. The female gender (p=0.008), moderate to vigorous level physical activity more or less than 60-90 minutes per day (p=0.017), smartphone use ≥ 5 days a week and ≥ 2 hours per day (p=0.02) were the risk factors for developing musculoskeletal pain. The stress (p=0.037), anxiety (p=0.032), and depression (p=0.056) were associated with musculoskeletal pain in Chi-square (Χ2) analysis.
Key words: Musculoskeletal pain, Adolescent, Physical activity, Smartphone |
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2020;2:10
Original Article |
Uchenwoke CI, Odoh EP, Ilo IJ, Okemuo AJ, Ojukwu CP, Chukwu SC.
Hand Grip Strength, Dexterity and Hand function and its Relationship with Cardiorespiratory Fitness and Functional Decline in a Selected Geriatric Population. |
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Abstract: Background/Objectives: Age associated skeletal muscle changes may impact on cardiorespiratory function. The study is aimed at investigating hand grip strength, dexterity and hand function and its relationship with selected cardiorespiratory fitness parameters and functional decline in a selected geriatric population. Materials and Methods: The study utilized a cross-sectional survey design. A total of 115 (46 males and 69 females), geriatrics who met the inclusion criteria participated in the study. Their Hand grip strength (HGS), Dexterity using Coin Rotation Task (CRT), Hand function using Michigan hand outcome Questionnaire (MHQ), selected cardiorespiratory fitness parameters (FEV1, FVC, PEFR, FEV1/FVC,VO2max), functional decline using Groningen Activity Restriction Scale (GARS) and Demographic variables were assessed. Data was analyzed using Descriptive statistics, Pearson moment correlation and multiple regression analysis. Significance level was set at 0.05. Results: There was a statistically significant positive correlation between HGS and FEV1 (r=0.326, p=0.001), FVC (r=0.295, p=0.001), PEFR (r=0.479, p=0.001), a statistically significant negative correlation between CRT and FEV1 (r=-0.318, p=0.001), FVC (r=-0.295, p=0.001), PEFR (r=-0.448, p=0.001) and a positive correlation for GARS (r=0.514, p=0.001); a statistically significant negative correlation between MHQ, FEV1 (r=-0.185, p=0.048), PEFR (r=-0.227, p=0.015). HGS statistically predicted FEV1 (p=0.001), PEFR (p=0.001) and GARS (p=0.001), Dexterity statistically predicted FEV1 (P=0.045), PEFR (P=0.002), GARS (p=0.001), while MHQ statistically predicted GARS (p=0.001). Conclusion: HGS, dexterity and hand function correlates and predicts some cardiorespiratory fitness parameters and functional decline in the elderly and thus, assessment of these parameters may be used clinically to determine individuals with elevated risk of cardiorespiratory impairment.
Key words: Aging, Hand function, Handgrip strength, Dexterity, Cardiorespiratory fitness, Geriatric. |
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2020;2:11
Original Article |
Radha K, Srinivasan KR.
Characterization of Facial Anthropometrics and Correlation with Sexual Dimorphism in 18-25 Years South Indian Adult Population. |
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Abstract: Background: The Facial anthropometrics have wide implications in determining the age, sex for identification in forensics and cosmetic pre-surgical assessments. The studies on comparisons of face indices with north and south Indian population were cited routinely but not within the south Indian population.Thus, the current study had attempted to characterise facial anthropometrics and correlate with sexual dimorphism.
Aims/Objectives: To characterise the facial anthropometrics and correlate with sexual dimorphism in south Indian population.
Methodology: An observational study was conducted on 200 subjects, recruited by convenient sampling after meeting the inclusion and exclusion criteria. The “Facial index”(FI) was calculated after measurement of face height (FH), Upper face height(UFH), Lower face height (LFH), Face width (FW)using digital vernier calliper. The facial anthropometrics and face types were evaluated for differences in male and females. The state of origin from south India was also evaluated for similar significant implications. The t-test and ANOVA or chi-square tests were used for statistical analysis as needed.
Results: The study population of 200 subjects, 45%(n= 90) were males and 55% (n=110) were females. The FH (p<0.0001), FI (p<0.0001) and LFH (p<0.0001) were significantly different in males and females. The majority of the participants i.e 51.3% (n= 102) were hyperleptoprosopic followed by 19% (n=38) of leptoprosopic and mesoprosopic variants. There is a statistically significant difference (p<0.0001) between both genders, upper facial height (p<0.0001) and lower facial height (p<0.004) considering the face type.
Conclusion: The facial anthropometrics and face form had significantly correlated with sexual dimorphism in the study. The FH, FI and LFH along with facial form can be used as reference for future studies in south Indian adult population in age range of 18-25 years.
Key words: Facial indices, Anthropometry, Population, Facial height |
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2020;2:12
Short Report |
Singh VK, Mathew M, Kudva R, Pai K, Bishnu A.
Sinonasal Metastasis: A Clinico-pathological Series of Seven Cases. |
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Abstract: Introduction: Metastases to the sinonasal region is rare and presents with features overlapping with various regional neoplastic/non-neoplastic lesions. This series aims to highlight the clinical presentations and diagnostic difficulties of sinonasal metastases. Material and Method: A review of pertinent demographic and laboratory data for patients diagnosed with metastases to the sinonasal region, over a period of 6 years (2012- 2017) was done. Results and Discussion: Seven cases (males- 6, females-1) of sinonasal metastases were identified. The age ranged from 41-72 years. The common clinical presentation was nasal obstruction, epistaxis, and pain. Grossly tumors were irregular masses (mean size – 4.1cm) with maxillary sinus as the most common site. The histologic types included Squamous cell carcinoma (3 cases), clear cell renal cell carcinoma (2 cases), and one case each of infiltrating ductal carcinoma, and eccrine spiradenocarcinoma. The site of the primary tumor was larynx (2/7), kidney (2/7), breast (1/7), lung (1/7), and neck (1/7). The mean time interval between the primary tumor and metastasis was 4.5 months. All cases were managed with resection of the metastatic tumor. Metastatic breast and renal tumors comprise the bulk of reported cases in English literature. Metastasis from a lung carcinoma are rare and here we report the first case of an eccrine spiradenocarcinoma to maxillary sinus. Conclusions: Owing to the overlapping clinical presentations, a high degree of suspicion is needed in patients with previous history of malignancy for early diagnosis. The current course of therapy is palliative for such patients and carries a grim prognosis.
Key words: Metastasis, nasal obstruction, Renal cell carcinoma, Lung carcinoma, Eccrine spiradenocarcinoma |
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2020;2:13
Case Report |
Vimal M, Satchidanandam A, Aishwarya R.
Sunrays and Granules: Rare Presentation of a Great Mimicker. |
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Abstract: Actinomycosis is a chronic granulomatous infectious disease caused by gram positive bacteria Actinomyces. It is characterised by variable presentation that mimics malignancy, tuberculosis, nocardia and other fungal organisms. We present a rare case of primary cutaneous actinomycosis in a 36 years old female in left upper extremity which was clinically suspected as lipoma. May Grunwald Giemsa stained fine needle aspiration smears revealed the classic colonies of Actinomyces with basophilic radiating filaments, confirming the diagnosis of actinomycosis. A high degree of clinical suspicion is needed for early diagnosis of Actinomycosis which is readily treatable and curable if appropriately managed.
Key words: Actinomycosis, Swelling, Lipoma, FNAC |
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2020;2:14
Case Report |
Harrison A, Khanna R, Ranjoalkar A, Hebbar A.
Basophilia with Blasts – A Diagnostic Dilemma. |
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Abstract: Basophilia is commonly seen in inflammatory and autoimmune conditions. Primary malignancies of basophils are rare, however basophilia is seen in few haematological malignancies. It is most commonly seen in myeloproliferative neoplasms. Presence of basophilia helps to differentiate chronic myeloid leukemia (CML) from acute myeloid leukemia (AML). The association of basophilia with AML is rare.
We present a case of 68 year old male with complaints of fever and worsening of itching, pain and swelling in right lower limb and left upper limb. On physical examination he had mild hepatosplenomegaly and no lymphadenopathy.
Complete blood count showed leucocytosis. Increase in blasts and basophils was noted on peripheral smear and bone marrow examination. Flow cytometry on bone marrow aspirate showed blasts to be of myeloid origin. A distinct population of mature basophils was also noted. After exclusion of all morphological mimickers, a final diagnosis of AML with basophilia was made.
The presence of basophilia in AML may warrant a search for an underlying chromosomal abnormality to assess the prognosis of the patient. Only few cases of AML with basophilia have been reported so far and it remains a diagnostic challenge.
Key words: Acute myeloid leukemia, Basophils, Flow cytometry |
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2020;2:15
Case Report |
Ahmed T, Shenoy J, Mohammed A, Ayaz SM, Malaikal BJ, Rajput MS.
Extra
Nodal (Cutaneous) Rosai Dorfman Disease. |
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Abstract: Rosai-Dorfman disease is an extremely rare disorder characterized by proliferation and accumulation of histiocytes in lymph nodes, usually in the cervical region. In approximately 43% cases, this accumulation occurs in extra nodal sites such as the skin, nasal sinuses, central nervous system, kidney and gastrointestinal tract. We report such a case of extra nodal (cutaneous) Rosai Dorfman disease in a young female patient.
Key words: Rosai-Dorfman disease, histiocytes, lymph nodes, extra nodal, skin |
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2020;2:16
Case Report |
Singh A, Varshney S, Tyagi AK, Kumar A, Kalonia T.
Adenoid Cystic Carcinoma Nose Masquerading as Basal Cell Adenoma. |
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Abstract: Basal cell adenoma is a benign basaloid cell tumor involving salivary glands. It requires biopsy and histopathology to distinguish from pleomorphic adenoma, adenoid cystic carcinoma and basal cell adenocarcinoma. Present manuscript reports a case of an adult female with nasal mass, which was clinically and cytologically mimicking benign lesion and adenoid cystic carcinoma was confirmed only on surgical biopsy. The possible clinical dilemma between Basal cell adenoma and Adenoid cystic carcinoma is discussed in this case report.
Key words: Adenoid cystic carcinoma, Basal cell adenoma, Basal cell adenocarcinoma |
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2020;2:17
Case Report |
Ahmed T, Shenoy J, Mohammed A, Fahad S, Malaikal BJ, Rajput MS.
Trichilemmal Carcinoma of the
Scalp. |
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Abstract: Trichilemmal carcinoma is a rare hair follicle tumour which develops from the outer root sheath of the hair follicle. It is thought to occur from a malignant transformation of a benign Trichilemmoma and is usually found on sun-exposed areas such face, ears, scalp of elderly women. It is a low-grade tumour with low metastatic potential. We present the case of an elderly female patient with low grade Trichilemmal carcinoma of the scalp with cervical lymph node which was clinically and histopathologically proven to be insignificant.
Key words: Trichilemmal carcinoma,
Hair follicle, Scalp, Elderly women |
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