Healthline Journal of Indian Association of Preventive and Social Medicine, Gujarat Chapter

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https://imsear.searo.who.int/handle/123456789/151627

Editor-in-Chief: Dr. Girija Kartha
ISSN: 2229-337X (Print), 2320-1525 (Online)

Frequency: Half yearly

Language: English

Open Access Peer-reviewed journal

Web site: https://iapsmgc.org/index.php

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Evidence to Guidelines
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Paul, Bobby; Saha, Indranil
Evidence based practice deals with current best medical evidence in conjunction with clinical expertise and patient values to guide health care decisions. This paper intends to draw attention of the readers to the brief history of Evidence Based Medicine and the different methods of evidence appraisal in quantitative research like “hierarchy of evidence” which lists a range of study designs ranked in order of decreasing internal validity and may vary according to research question. There are other methods like integrative methods, network meta-analysis, quantitative modeling and infectious disease modeling that are also used for evidence appraisal. There are various approaches of quality assessment of research evidence amongst which GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) is discussed in a nutshell to outline the roadmap from evidence generation in research to guideline formulation. Fundamentally the GRADE approach provides guidance for rating quality of evidence and grading strength of recommendations in order to aid in evidence based health care decisions.
Respiratory Morbidities among Workers Employed in Cotton Industries in Surendranagar City
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Nagar, Shashwat; Patel, Hiren; Nagar, Noopur
Introduction :According to a publication in 1986by the World Health Organization (WHO) on Pneumoconiosis and Smoking, workers in cotton processing industries have the risk of developing obstructive respiratory conditions such as Bysinosis and Occupational Asthma, due to prolonged exposure to inhalable cotton dust particles, bracts and pericarps as well as to bacteria and fungi that may grow on cotton products. Objectives:To identify the presence of Respiratory symptoms among those exposed to cotton dust and To associate the findings with the duration of exposure of cotton dust. Methods :The study carried out was cross sectional and in 3 cotton industries in Surendranagar city. A total of 144 workers who consented for the study were selected and were interviewed and examined for respiratory signs. Results :Nearly 78% of the subjects had respiratory complaints. Most of the workers had had a more than 10 year exposure to cotton dust. Majority of symptoms were dyspnoea and expectorations. Nearly 95% of the subjects had the habit of consumption of smokeless tobacco. Conclusion:It can be concluded from the study, that the risk factors for Respiratory diseases are highly prevalent among workers employed in industrial set ups involving respirable dusts. More than 80% of the workers had 10 yrs or more years of exposure to cotton dust and the association of the exposure with the respiratory problems was proved statistically significant.
A Study on Quality check on Multiple Choice Questions (MCQs) Using Item Analysis for Differentiating Good and Poor Performing Students
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Chhaya, Jatin; Bhabhor, Hitesh; Devalia, Jayna; Machhar, Ullas; Kavishvar, Abhay
Introduction :Single best answer MCQs (Multiple Choice Questions) are becoming a popular form of formative as well as summative assessment in educational institutes, not only but including medical field. Formation of MCQs with appropriate level of difficulty and excellent level of discrimination power is a huge task and failing in it, results in failure of test and by that we end up with poor discrimination among high and low performing students. Difficulty index (p-value) and Discrimination Indices (DI) are tools that enable us to choose appropriate MCQs while planning the assessment of students. Method :The cross-sectional study was conducted in the department of Community Medicine of Government Medical College, Surat in June-July 2016, with 103 medical students of third year. As a routine practice formative assessment was planned with 40 MCQs, each have 4 options with one single best response as a key answer. The MCQs were analyzedfor difficulty index, discrimination index. Result :Analyzed item with p-value and DI showed half of the items were at appropriate difficulty level (p-value between 30% - 70%), with excellent discrimination power (>0.24) and substantial proportion of item had poor discrimination ability. Two items found to have negative discrimination value while another two had zero discrimination power. Conclusion :Item analysis is an excellent tool that help us in formation of proper MCQs that have average Difficulty Index (DIF) with excellent Discrimination Index (DI). Poorly formed MCQs should be revised or discarded for future assessment.
Spirituality in Health and Disease
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Bala, D. V.
Use of WHO Anthro Software for Assessing under Nutrition (Wasting, Stunting & Underweight) amongst Under-Five Children of District Ahmedabad, Gujarat
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Rastogi, Swarna; Maheshwari, Chaitanya; Santosh, Kr. Raghav; Lala, M. K.
A Cross Sectional Study on Health Profile of Post-Menopausal Women of Urban Area of Gujarat
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Patel, Divyangkumar N; Chhaya, Jatin; Dobaria, Hiral; Jha, Pooja; Chaudhary, Pinkal
Introduction :Menopause is the inevitable stage of women's reproductive cycle. Indian women spend around a third of their life in post-menopausal period. The common climacteric symptoms experienced by women are vasomotor, physical and psychological symptoms. There is no specific health care programme for post-menopausal women. Objective:The objectives are to determine the average age at attaining menopause and the prevalence of various menopausal symptoms among postmenopausal women. Method:The present cross sectional study was carried out in four different urban sites of Gujarat. Two stage sampling methods adopted to select participants. Data was collected by personnel interview using a pre-tested structured questionnaire. Results:Median age of menopause was 45 years with a range from 35 to 56 years. The most common symptoms present among participants were fatigue (73%), irritability (72%), weight gain (61%), headache (59%), anxiety (52%), joint pain (51%), insomnia (51%). The Vasomotor symptoms like hot flushes, night sweat and urinary incontinence were present respectively in 41%, 35% and 23% of study participants. Conclusion:The study shows that postmenopausal women in Gujarat suffer from various vasomotor, physical and psychiatric problems with varied frequencies. This study reveals that Indian urban women attain a menopause at early age. Frequency of the post menopausal symptoms increased when women attain menopause at early age.
A Study on Non-Adherence to Medication, Self-care Practices and Health Related Quality of Life of Type-2 Diabetic Patients in Field Practice Areas of B.J. Medical College, Ahmedabad
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Norma, Bhanat; Mall, Anjali; Dixit, Grishma
Introduction :Glycemic control plays the main role in diabetes management which mainly depends upon patient adherence to the treatment plan. Accurate assessment, adherence to medications, diet care, foot care and exercise is necessary for effective management of diabetes, as non-adherence leads to development of short-term risks as well as long-term complications which declines the quality of life of diabetic patients. Objective :The present study was conducted to study socio-demographic profile of diabetic patients, to find out prevalence rates of non-adherence to medications, diet care, foot care, exercise among type-2 diabetic patients and to find out association between non-adherence to medication, self-care practices and health related quality of life based on five domains among type-2 diabetic patients. Method :A cross sectional study was conducted from October to November 2016 infield practice areas of B. J. Medical College, Ahmedabad to find out prevalence rates of non-adherence to medications, diet care, foot care, exercise among type-2 diabetic patients. Total 130 diabetic patients diagnosed since at least 1 year and age >25 years were interviewed using a predesigned schedule adapted from EQ-5D questionnaire. Results :High non-adherence rate was found for exercise (76.8%) followed by foot care (70.7%), medication (56.1%), blood glucose monitoring (46.9%) and diet care (25.3%). There is significant association between mobility problem and poor foot care practices (p<0.05); between discomfort/pain and poor foot care practices (p<0.05); between anxiety/depression problem and medication non-adherence (p<0.05). Conclusion :In the present study high rate of non-adherence was found and it also reflected that non-adherence patient had poor quality of life.
Internal Assessment
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Raval, Devang; Talsania, N J
A Study on Impact of Radiotherapy on Functional and Radiological Changes on Irradiated Lung in Breast cancer Patients
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Javia, Abhay; Pithadia, Pradeep; Paliwal, R.; Paliwal, Dipesh V.
Introduction :The invention of therapeutic use of radiation in various carcinomatous lesions lead to injuries of adjacent normal tissues, especially radiation induced fibrosis after administration of radiotherapy in patients of carcinoma breast. Objectives :The present study aims to find out prevalence of radiation induced fibrosis and evaluate impact of radiation therapy on functional and radiological parameters of pulmonary tissues in patients of carcinoma breast using spirometry and HR CT scan. Method : A total of 38 patients of carcinoma breast were evaluated with subsequent follow-up visits after administration of radiotherapy to assess changes in physiological function, type of radiological reaction etc. Results :The prevalence of radiation induced fibrosis in carcinoma breast patients was 13.16% with majority (80%) of cases with apical lateral involvement of lung tissue. Moreover, frequency of radiation induced fibrosis is directly proportional to mean lung dose and percent irradiated lung volume.
Assessment of Knowledge and Skill of Counseling among Counselors of SexuallyTransmitted Disease (STD) Urban Project
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Chawada, Bansari; Kosambiya, Jayendra kumar; Chaudhari, Vipul
Introduction :Counselors in STI clinic have roles of educating and counseling for clients of STI clinic. They can help in prevention of STI by their counseling services among attendees of STI clinic. Current study was done to assess pre defined micro- macro counseling skills and knowledge practice gap among counselors working with STI project of city. Method: Total 25 counselors working at STI clinics of Urban Health Centers were observed and interviewed for their skill assessment. To assess counseling skills, counselors were observed in a session of counseling with real STI patient. Counseling was rated based on the performance of skill ranges from Worst, Very Poor, Poor, Average, Good and Excellent. Counselor then interviewed to assess their knowledge. Result:Majority of the counselors had average and good rate for micro and macro component of counseling. Wide gap of knowledge and practice was noted for use of Information Education and Communication tool and risk assessment. All counselors could mention risk group population for STI/HIV, but only 60% practiced risk assessment in a new diagnosed case of STI. All counselors were able to describe condom as component of STI prevention but 76% actually talked regarding condom in counseling session. Around 92 % of the counselors could introduce investigator's presence during the session to the client. Conclusion:There is definite knowledge practice gap among counselors of the urban project. Counselors were having satisfactory micro – macro skills for counseling, but core component of STI like risk assessment and condom promotion were lacking in practice
Prevalence of Hypertension among Reproductive Age Group Women in Study District of West Gujarat : A Community Based Cross Sectional Study
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Rathod, Mittal; Parmar, Dipesh; Kaliya, Mehul; Unadakat, Sumit; Sarkar, Amrita; Kansagra, Trusha
Introduction :Non-communicable Disease, are on rise in our country and mean age of incidence is comparative-10 to 20 years lower in India as against western countries. Same holds true for Hypertension. Despite decades of public health education, hypertension awareness remains problematic, with only about two-thirds of adults and the elderly aware of their hypertension status and known differences between men and women. Aims & objectives :To assess prevalence of Hypertension and associated factors. Method :A community based cross-sectional study was conducted among 450 women of reproductive age group women of Jamnagar district. Results :There was even distribution in almost all Age groups of reproductive age group women except for 15-19 years and 40-44 years. Mean systolic Blood pressure was 124.84±13.616 mm of Hg with range of 98- 162 mm of Hg. On diastolic blood pressure measurements, mean value was 77.14±9.574 mm of hg with range of 52- 98 mm of Hg. Conclusion : The prevalence of HT in present study was 20.44%. 55.33% fallen on in pre hypertensive stage. There was significant association between various risk factors & occurrence of HT
Association between Blood Pressure and Cognition among Old Age People
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-01) Jadav, Pranay; Bavarva, Neha
Introduction :High Blood pressure may lead to memory impairment in old age. Present study had been conducted to know relation between cognition and blood pressure in geriatric people. Method :A cross sectional study was conducted among 600 study participants aged of 60 years or more in villages of Vadodara district. Blood pressure was measured by sphygmomanometer and cognition was screened through Mini Mental State Examination (MMSE). Results:The overall prevalence of high blood pressure among study participants was 42.7%. Cognitive impairment (MMSE score < 22) was prevalent in 23.5% of study participants. High SBP was significantly associated with low MMSE score even after adjusting potential confounders in multiple linear regression models. Conclusion:-SBP is related to poorer performance on Mini-Mental State Exam in the geriatric population aged 60 years and above in absence of any apparent neurological deficit. Diastolic blood pressure does not find any significant relation between MMSE score.
Innovative Methods to Overcome Barriers and Improve Immunization Coverage: A Comparative Study in Two Wards of Ahmedabad City
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Patel, Shraddha; Vyas, Sheetal
Introduction: Immunization is one of the most cost effective public health interventions since it provides direct and effective protection against preventable morbidity and mortality. Objectives : To identify the challenges and barriers associated with immunization coverage. Also to implement innovative strategies to overcome these challenges before session of Intensified Mission Indradhanush (IMI) and compare the coverage levels in areas with versus without use of innovative Mathod: Two slum areas were selected from the South zone of Ahmedabad Municipal Corporation (AMC) and out of those one was from UHTC of AMC MET Medical College which was the intervention area in this study. Families with incomplete immunization of children <2 years were included in the study. In intervention area, personal visit by investigator, one to one health education, mobile reminders and support of local influencers was taken to increase the coverage. Data of both the areas were collected in a pre-designed and pre-tested proforma and analysed. Qualitative analysis of reasons for not accepting immunization services was also carried out Result: Coverage of BCG, fIPV 1, OPV1 and Pentavalent-1 was 100% in both the areas. Coverage of OPV2 and Pentavalent-2 was 100% and 57% in intervention and non-intervention areas respectively. Overall coverage of all other vaccines was more in the UHC Isanpur which was the intervention area. Further even in the non-intervention area, more experience of ASHA was significantly associated with better coverage. Qualitative analysis revealed not informed about IMI round, fears and religious beliefs etc. as reasons for not accepting immunization services. Conclusion: Personal visits, Involvement of community leader, Motivation and mobile reminders about the round of IMI was highly effective in improving coverage of IMI from due list
Severe Acute Malnutrition in Children: Management in Community
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Nayak, Sunil; Gharat, Vaibhav
Profile of Patients of Ocular Trauma Visiting Municipal Eye Hospital Ahmedabad in the Months of August and September 2016
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Prajapati, Bhavesh; Shukla, Aparajita
Introduction: Globally, more than 55 million eye injuries occur per year, while there are approximately 1.6 million people with blindness from ocular trauma. The prevalence of ocular trauma in India was reported as 2.4%. Measures to create awareness about ocular trauma and preventive measures would result in a great decrease in ocular morbidity and mortality due to trauma Objectives: To assess the proportion of different types of ocular injuries among the patients. To correlate the different causative factors and conditions leading to Ocular Trauma. To make recommendations for public health and clinical strategies for the prevention, management, and research of ocular trauma in the future Method: The study design was crosssectional, done in Municipal Eye Hospital Ahmedabad with help of semi-structured pilot tested questionnaire from August 2016 to September 2016. The type of sampling is non-random with sample size of 141 Results: Out of 141 cases, maximum injuries were observed in male patients and in the 15-29 years age group (34%). Extra ocular foreign body injury (max. in 15-29 age groups) was seen maximum followed by blunt trauma (max. in children). Patients with extra ocular foreign body injuries reported the earliest. Only 15% of patient reported with complication (max. in Open Globe injuries). Vision was affected in 9.9% patients with maximum in wooden stick injuries and 19% eyes required surgical intervention. Conclusion: Eye should be protected while driving to prevent exposure of foreign body. Patients who reported within 24 hours had the least complications. So, Awareness should be created by the authorities through mass media regarding ocular trauma and benefits of early reporting.
Patient Satisfaction Survey: To Improve Quality of Care at Tertiary Care Center, South Gujarat
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Chauhan, Naresh; Patel, Hiteshree; Patel, Harsad; Kosambiya, J. K.
Introduction: Mismatch between patient expectation and the service received is related to decreased satisfaction Aims and Objectives: To measure level of satisfaction and identify the obstacles in availing services among the patient at Tertiary Care Center, South Gujarat. Method: It was a cross sectional study, included 800 respondents, 400 each from indoor and outdoor facilities. Respondents from all the department have been taken by proportion to their OPD and IPD load (PPS) after informing and taking their consent. Data has been collected by using android smart phones Results: General perception of the clients for the OPD services were 60% believed that the time to get services is appropriate, 98% respondents satisfied with staff behavior, 60% satisfied with the cleanliness OPD at the same time few dissatisfied with public utilities (16%), 70% patient satisfied with available water and other amenities in, around the hospital and 77% felt that the space in OPDs was crowded. All the patient whom examination required reported that the privacy has been maintain. As many as 92% wish to return every time for the treatment from our hospital. General perception regarding the IPD services shows that more than 95% patients were satisfied with various services like quality of medical care, nursing care, diagnostic and referral service, admission process, discharge process and physician services. As far as the staying is concerned at people ranked lowest to the availability of drinking water and cleanliness of toilet and bathroom Conclusion: The findings of the present study can be utilized to improve the services
Assessment of Infrastructure and Logistics at Various Facilities ProvidingSterilization Services in Rajkot District
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Nimavat, Nirav K.; Jahangirporia, Dhara N.; Patel, Umed V.
Introduction :The National Population Policy 2000 and the Reproductive and Child Health (RCH) Programme Phase II emphasize the importance of achieving population stabilization and attaining the goal of replacement-level fertility. Sterilization services are largely being provided through a network of public and private sector facilities Objective:To assess the infrastructure and logistics at various health facilities of Rajkot District where Sterilization services provided Method:A cross-sectional study was conducted by Community Medicine department, PDU Government Medical College, Rajkot, during February-March 2015. All health facilities of Rajkot district where Laparoscopic Tubal Ligation (Lap TL) camps were organized including 4 Community Health Centers (CHCs), 5 Sub-District Hospital (SDHs) 1 district hospital, and 1 medical college and hospital were selected for the study. A standard checklist was used for infrastructure and logistics available at various facilities. The data entry was done in Microsoft Office Excel 2007 and analysis was done using the same software Results:Majority of places; infrastructure and facilities are available as well as clean.Storage facility for contraceptives was adequate at all the 11 facilities. All the 11(100.0%) facilities have vehicle/ambulance in running condition. At 3(27.27%) facilities there were no boards displaying service timings. Availability of staff as per sanctioned posts was at 3(27.27%) places and various categories of staff for the activities were present at 6(54.55%) facilities Conclusion:Improvement isrequired in displaying of IEC materials and sitting arrangement for beneficiaries.
A Study on Knowledge and Practices Regarding Hand Hygiene and Factors Affecting its Adherence among Healthcare Providers of a Tertiary Care Hospital of South Gujarat
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Baria, Hinal; Patel, Ravikant; Nayak, Sunil
Introduction: About 1.4 million people around the world become seriously ill from Health Care Associated Infections at any given time The risk of infection in developing countries is 2 to 20 times higher than in developed countries and its incidence in India ranges from 5-30%. Aims and objectives:To study knowledge and practices regarding hand hygiene among Health Care Providers and to study the factors affecting the hand hygiene adherence Method:Cross sectional study conducted in tertiary care of hospital of Valsad. Prior oral informed consent was taken from the participants before the start of the study. An anonymous questionnaire formed as per WHO guidelines on hand hygiene was used as data collection tool. Results 64% medical and 72% paramedical staff has taken training in hand hygiene in last three years. 19.37% medical and 26.02% paramedical staff reported less time and more work load as barriers in implementing routine hand hygiene practices respectively. 20.93% medical and 6.97% paramedical staff reported training as an important factor for improved hand hygiene practices in the hospital. 66% staff of both groups correctly knows about required time needed for hand washing practice as per WHO guidelines whereas 26% medical and 44% paramedical staff doesn't have correct knowledge of hand hygiene practices when hands are visibly soiled Conclusion Lack of correct knowledge regarding hand hygiene practices among health care providers.
Clinico-Epidemiological Study of Patients Suffering from Sickle Cell Anaemia In a District Level Private Hospital of a Tribal District in South Gujarat
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Nagar, Shashwat; Patel, Hiren
Introduction: Sickle cell disorder is an autosomal recessive condition, in which inheritance of an affected gene from both parents results in a disorder. According to hospital based epidemiological survey, the prevalence of sickle cell gene is observed among tribal population, which accounts for 15 % of the total population of Gujarat and are distributed in various districts. Objectives: To study clinical profile, epidemiological characteristics and socio-demographic features of persons having sickle cell disease and sickle cell trait and establish relationships if any of the epidemiological profile with the clinical and sociodemographic features of the study subject Method: The study was carried out in Janak Smarak hospital in Vyara Town, Tapi District. It was a descriptive cross-sectional study for a period of one year and minimum of 75 persons with sickle cell disease and 150 persons with sickle cell trait was taken for the study Results: Proportion of females affected were more than that of the male. Majority of the participants belonged to Gamit caste and most of them were Hindus. Majority of the participants were married and it was significantly associated with Sickle cell status of the individuals. Majority of sickle cell disease patients had clinical manifestations of sickle cell crisis like pain in both upper and lower limbs; weakness, fever and body ache and sign of pallor. Nearly half of the sickle cell disease patients had a history of blood transfusion Conclusion: Family history and predisposition happens to remain one of the most important predictors of the Sickle cell status among the population. Nearly more than half of the Sickle Cell Disease patients needed regular transfusion with Blood or any of its components. This points out the necessity of establishing these units in higher numbers in tribal areas
Factors Affecting Exclusive Breastfeeding and Complementary Feeding Practices among the Mothers of Children between Age Group of 12 to 23 Months in Udaipur, Rajasthan
(Indian Association of Preventive and Social Medicine Gujarat Chapter, 2018-02) Tundia, Mohnish N.; Thakrar, Dhara V.; Bhawarlal, L. Vyas
Introduction Poor feeding practices are a major threat to social and economic development. Not breastfeeding significantly increases risk for a large number of acute and chronic diseases including lower respiratory infection, ear infections, bacteraemia, bacterial meningitis, urinary tract infection, and necrotizing enterocolitis. This study will provide evidence about factors affecting exclusive breastfeeding and complementary feeding practices and will highlight level of problem in community Objective: To find out various factors affecting Exclusive Breast Feeding (EBF) & complementary feeding practices among the mothers of Udaipur city Method: A total of 210 mothers were interviewed who were randomly selected from the outpatient department over a period of 6 months in this cross sectional study. An oral consent was taken from the participating mothers Results: Out of total, 69.05% mothers gave prelacteal feeds to their babies. 54.76% of mothers had initiated breast feeding within 1-4 hour of birth. Only 33.81% babies were given exclusive breast feeding for six months. 17.14%, 13.81% and 22.38% mothers were counselled about breastfeeding by local health worker, doctor and relatives respectively, while 46.67% were not counselled at all Conclusion: Prelacteal feeds was given in nearly two third of babies. Only one third mothers gave colostrum to their babies.Exclusive breastfeeding was received by only one third babies. Less than 10% of babies were breastfed for 2 years. The association was statistically significant between exclusive breastfeeding and factors like place of delivery, numbers of Antenatal visits, education and occupation of mother

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