National Journal of Community Medicine
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Executive Editor: Dr. Prakash Patel
ISSN: 0976-3325(Print)
Frequency: 4 issues a year
Language: English
Open Access Peer-reviewed journal
Web site: https://www.njcmindia.org/home/
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Item Adolescent Obesity � Emerging Public Health Problem of 21st Century(Medsci Publications, 2022-01) Grace, G A; Edward, S; S, G.Many Countries struggle to tackle the consequences of under nutrition and infectious diseases. At the same time, they are also now showing a rapid increase in non-communicable diseases and their risk factors like obesity and overweight, especially in urban areas. In the present era, it is quite common to find co-existence of under nutrition and obesity within a country, within a community and even within a household. Children living in developing and under-developed countries are more susceptible to poor nutrition during antenatal period, infancy and childhood. On the contrary, children also have easy access to food products with increased salt and fat percentage, decreased levels of micro nutrients and more junk calories. The synergistic effects of high calorie intake and low physical activity lead to increase in prevalence of childhood overweight and obesity. This article discusses about the aetiology, epidemiology and determinants of adolescent obesity.Item An Analysis of The Trend of Incidences and Fatality of Pulmonary Tuberculosis in East Java from 2015-2020: A Lesson From COVID-19(Medsci Publications, 2023-05) Setyawan, MF; Mertaniasih, NM; Utomo, B; Soedarsono, S; Adnyana, IMDM; Eljatin, DS; Sumah, LHM; Al, Karina C; Nuha, Z.Background: Pulmonary tuberculosis is still a public health problem, and surveillance data analysis has not been done much. Recently a global pandemic of COVID-19 has the potential in disturbing TB elimination pro-grams and treatment. This study aims to comprehensively analyse the incidence rate (IR) and Case Fatality Rate (CFR) of pulmonary tuberculosis in East Java from 2015–2020 and during COVID-19 and the strategies for optimizing tuberculosis disease control. Methodology: The study analyzed annual surveillance data using an analytical descriptive design. The Varia-bles were analyzed with Spearman correlation with a level of evidence of 95% (p<0.05). Results: The prevalence of pulmonary tuberculosis in East Java fluctuated from 2015–2020. In 2020 and dur-ing the COVID-19 pandemic, the number of cases and morbidity rates increased. Statistic results confirm the presence of a significant correlation between the values of Incidence rate (IR) and Case Fatality rate (CFR) (p = 0.032), IR and Treatment Success Rate (TSR) (p = 0.020), and CFR and TSR (p = 0.002). Population density is not correlated with the number of new cases (p = 0.667). Treatment rates have increased to 51%; cure and treatment rates have decreased to 76% and 89%, respectively, and there was a 4% increase in mortality dur-ing COVID-19. Conclusions: COVID-19 has tremendously affected the treatment of pulmonary TB cases in East Java, Indone-sia by increasing the incidence rate and decreasing the fatality rate. The pandemic promotes fear in the com-munity to check their medical status and improve the quality of their health in East Java.Item Arcane Language of Human Emotions: Envy and Jealousy in Academia(Medsci Publications, 2022-09) Kumar, M; Kumari, A; Sharma, K.Jealousy and Envy are essential part of human emotions and behavior. In today’s fast-moving world where everyone is in rush to cut-throat competition, it is more important to discuss these emotions than ever before. Jealousy and envy somewhere connected. Jealousy is a practice to defend something that is owned and threatened whereas envy is a tendency to obtain something that does not own by one. Jeal-ousy and envy develop naturally and also test their character by the response they give due to emotional burnout. Sometimes these situations broke and turn healthy competition into a rivalry at cost of long-standing personal relationships. Jealousy and envy include compound emotional experiences during the exercises to acquire or not lose something desirable. The impact of envy and jealousy is not assessed in academia and research area moreover it is important to understand that envy is often hidden in the classroom context, but it must still be discussed.Item Are Parents Willing to Vaccinate Their 6- To 11-Year-Old Children Against COVID-19? A Community Based Study in Murshidabad, India(Medsci Publications, 2023-03) Bandyopadhyay, P; Mahmud, SS; Bhattacharyya, A; Ghosh, R; Das, M.Context/Background: The future of Corona virus disease is still uncertain due to viral mutations. Immuniza-tion against COVID-19 has not yet been introduced for children aged 6-11 years. Parents are instrumental for the success of any immunization programme, being the chief decision makers for their wards. The study aims to assess the perceptions of parents regarding COVID 19 vaccination among children aged 6-11 years in an urban slum of Murshidabad and identify the factors influencing such perceptions among them. Methodology: A cross sectional study was conducted among 106 parents in a slum area of Murshidabad, West Bengal. Participants were interviewed using a validated WHO Vaccine Hesitancy Scale (VHS). Bivariate and multivariable analysis were done using Chi square test and binary logistic regression respectively. Results: Majority of the study subjects instead of parents were unlikely to vaccinate their children against COVID-19. The major concern centered around the safety (73.5%) of the vaccine. Higher level of education (p=0.003), previous history of COVID-19 infection in the family (p=0.004) and having a children aged between 6-8 years (p=0.006), influenced such perceptions, with the latter being the single most important predictor (AOR 4.126, P=0.007). Conclusions: The likelihood of parents to vaccinate their child was found to be low. This underscores the im-portance of an effective communication strategy when such programme will be rolled out.Item Are Patients Satisfied with Government Health Care? A Study on Patient’s Level of Satisfaction and Their Perception of Violence Against Doctors at A Government Hospital in North Karnataka, India(Medsci Publications, 2023-02) J, Rudramma; Iti, J.Background: The level of patient satisfaction must be evaluated periodically to assess the quality of health care provided by the government and to improve health care delivery in developing nations. The purpose of the study is to determine the level of patient satisfaction and their perception of violence against doctors among in-patients attending government teaching hospital. Methodology: It was a cross-sectional study among in-patients of government teaching hospital in North Karnataka. A predesigned structured Patient Satisfaction Questionnaire –18 (PSQ–18), along with self-framed violence questionnaire was used as study tools. Descriptive Statistics, ANOVA & Kruskal - Wallis tests were done using SPSS version 16. Results: The mean score for overall satisfaction was 3.72± 0.387. The mean patient satisfaction was highest for interpersonal manner (4.00 ±0.72) & the least was accessibility and convenience (3.52±0.58). Among the study subjects47.5% had heard about the violence against the doctors, 33.5% said violence against doctors is on rise. Violence against doctors was unethical according to 57.5% and 60% said it must summon punish-ment. Conclusions: The overall patient satisfaction was good; accessibility and convenience need to be improved. The study helps in understanding patient’s needs in various dimensions of health care.Item Assess and Evaluation the Quality Of Life (Qol) Among Cancer Patients Undergoing Treatment by Using EORTC QLQ-30 Scale(Medsci Publications, 2022-02) Agarwal, AK; Yadav, A; Yadav, CS; Mahore, R; Dixit, P.Background: Cancer is a challenge for majority of population抯 health-related quality of life (HRQoL), compromising their physical health and emotional well-being. QoL is equally distributed among different social groups. The aim of this study to analyze the impact of clinical characteristics and social determinants of health on the QoL of a cohort of persons diagnosed and/or treated for cancer. Methods: We performed a cross-sectional study in a cohort of 155 with various stages of cancer at different stages of their disease. Data were obtained using questionnaires QLQ-C30 from the European Organization for Research and Treatment of Cancer (EORTC), which include a set of functional and symptomatic scales. We conducted descriptive and bivariate analysis using the Chi-Square test, Anova Test and adjusted for relevant variables using logistic regression. The dependent variables were the functional scales of QoL and the independent variables were socio-demographic and clinical variables. Results: Among the participants, 80(51.6%) were male and 75(48.4%) were female and majority 66(42.6%) in between the age of 40-60 years. Large proportion of patients were diagnosed with Oral cancer 67(43.2%), and Breast cancer 23(14.8%), and the clinical stages during the beginning of therapy were maximum at stage II a 104(67.1%). The mean of global health status/QoL was 52.34 (SD= 23.34). Quality of life was found to be significantly associated with some functional scales as role functioning (P?0.001), social function, (P=0.00), and symptom scales as pain (P=0.00), loss of appetite (P=0.004) and financial impact (P=0.02) as well as associations were noted in relation to socio demographic characteristics. Women from the most disadvantaged class, and showed the poorest results for most of the function scales. In contrast, age, education, occupation and social status had differential effects depending on the function studied. The highest functional status was cognitive functioning (54.58�.68). Conclusions: The cancer diagnosis has become more prevalent and carries significant changes to the method of living with physical and emotional changes in term of quality of life (QoL) because of inconvenience, torment, disfigurement, reliance and loss of confidence. In addition, addressing the unmet needs of these patients and ensuring higher satisfaction rate are recommended to maintain adequate HRQoL.Item Assessment of Epidemiological Factors in a Cholera Outbreak in an Urban Area of Western India(Medsci Publications, 2022-04) Patel, DN; Patel, MR; Modi, BP; Vidja, J.Background: Cholera is a preventable disease, still it remains a major public health problem among developing countries like India. Access to safe water and a sanitary environment can easily control many gastrointestinal infections including Cholera. In the last week of June 2021 large number of acute diarrhoeal cases were reported which was higher than expected subsequently confirmed as an outbreak of Cholera. Objective: To verify the diagnosis, identify risk factors and institute appropriate control measures to control the outbreak. Materials and Methods: A cross-sectional study was undertaken to identify the time, place and personal distribution of the disease. Based on the findings of the descriptive study, sanitary survey and environmental examination a hypothesis was formulated. A case-control study was carried out to test a hypothesis Results: A total of 158 cholera cases were reported with one death. Male and females were affected equally. All age groups affected, 18.35% of the cases were reported among children aged 0-5 years old. It was a common source epidemic and water was source of infection. The water sample reported faecal contamination. Those households not using water purification methods were 1.454 times more affected (OR=1.454) than those using water purification methods. Conclusion: The Vibrio Cholerae bacterium caused the cholera outbreak in Nadiad. Infection was caused by contaminated drinking water.Item Assessment of Nutritional Status and Its Determinants among Fewer than 5 Children in a Rural Area of Southern India(Medsci Publications, 2022-05) Nirmalson, SP; Vijayakarthikeyan, M.Background: Globally malnutrition possesses a double burden in the forms of undernutrition and obesity. The most adverse form of human deprivation is undernutrition among under five children. A child who is underweight may be stunted, wasted or both. Objectives: To assess the nutritional status of under-five children and to identify the determinants of nutritional status among under-five children. Materials and Methods: This is a community based cross-sectional, analytical study conducted on 330 under-five children from a rural area of Salem district of Tamilnadu. Simple random sampling was used to select the study participants. Data was collected using a pre tested semi-structured questionnaire containing socio-demographic particulars, details pertaining to the mother, details pertaining to the child and anthropometric measurements. Data was entered in MS Excel and analysed using SPSS version 20. Results: In this study, majority 60% of them were males. Around 16.4%, 26.4% and 32% of Under 5 children were underweight, wasted and stunted respectively. During the last 1 year about 33.6% and 73.6% had history of acute diarrhoeal infection and acute respiratory tract infection. Variables significantly associated with underweight, stunting and wasting were female gender, nourishment of mother, exclusive breastfeeding (p value < 0.05). Underweight was significantly associated (p value < 0.05) with wasting and stunting. Conclusion: Stunting and wasting rates were higher compared to the National and regional rates given inNFHS-5 data. Proper care of the girl child, frequent sensitization of the mothers regarding the nutrition of their children by community health workers and early diagnosis and treatment of infection are some measures that can be adopted to combat the problem of undernutrition in the locality.Item Assessment Of Quality of Life Among PLHIV Attending the FIART Clinic of Bankura Sammilani Medical College, West Bengal(Medsci Publications, 2022-11) Dey, SP; Bhattacharya, T; Sarkar, AP.Introduction: People Living with HIV (PLHIV) are facing increasing challenges pertaining to the disease as life expectancy is gradually rising. This study was conducted to assess the quality of life (QOL) in vari-ous domains among PLHIV and to find out its’ associated factors. Methods: A descriptive, cross-sectional study was conducted in Facility Integrated Antiretroviral Thera-py (FIART) clinic of Bankura Sammilani Medical College & Hospital (BSMCH) among 99 PLHIV from 01/07/2019 to 30/06/2020. Data were collected by interviewing PLHIV aged within 18-60 years using pre-designed, pre-tested, and semi-structured questionnaire incorporating WHO Quality of Life for HIV (WHOQOL-HIV) - BREF version to assess the QOL of the study subjects in various domains.Results: 44% participants rated their QOL as good, 79% satisfied with their health. Among all other do-mains, QOL score (median- 17.0, IQR- 4) was found highest in physical domain, while it was lowest (me-dian- 14.0, IQR- 2) in spiritual domain. Overall QOL was significantly higher in males, rural residents, joint family and higher socio-economic class. Multiple linear regression revealed statistically significant relation of overall QOL with residence, family type and socio-economic status. Conclusion: Psychological and spiritual well-being of PLHIVs is an area of concern and requires clinical attention.Item Association of Congenital Anomalies in Newborns with Maternal and Fetal Factors in North Gujarat Region, India: A Cross-Sectional Analytical Study(Medsci Publications, 2022-09) Thakor, N; Nimbalkar, D; Nimbalkar, P.Background: Approximately 8 to 15% of perinatal deaths and 13 to 16% of neonatal deaths in India are a result of congenital anomalies. The objective of the research was to studyincidence of clinically detect-able congenital malformations in newborns delivered at secondary and tertiary hospitals and their asso-ciation with maternal and fetal factors. Material and methods: This study include all new-borns delivered at secondary and tertiary care hospi-tals in the Mehsana districts of Gujarat, India from January 1st, 2021 to December 31st, 2021. A total of 6900 consecutive births were examined for visible structural anomalies to determine the overall inci-dence and distribution of congenital malformations and their association with feto-maternal factors. Results: Total numbers of malformed babies were 90 with incidence of 1.30%. Incidence of malformed babies was 1.54% among mother in the age group of 21-35 years, 3.57% among mother with consan-guineous marriage, and 6.67.% among mothers with severe anemia. The incidence was 0.97% in babies <1500 birth weight, 0.97% among live births and 12.5% among preterm babies. Conclusion: Congenital anomalies in newborns are significantly associated with maternal factors like maternal age, consanguinity, previous child with malformation, history of previous abortion and severe anemia and fetal factors such as stillbirth, premature babies, and low birth weight.Item Association Of Socio-Demographic Determinants with Economic Burden Among Road Traffic Accident Victims: A Longitudinal Study(Medsci Publications, 2023-01) Chellamuthu, L; Kittu, D; Bahurupi, YA; Vasudevan, K.Background: RTA are the sixth leading cause of death in India with a greater share of hospitalization, disabili-ties, deaths and socio-economic losses. The study was conducted to assess the socio-demographic determi-nants associated with households’ economic burden among RTA victims. Methods: A longitudinal study was conducted for 2 years in Puducherry employing simple random sampling to include 169 accident victims. Baseline data was collected with a semi-structured questionnaire on socio-demographic details, direct and indirect costs towards road traffic injuries. Follow up was at 6th and 12thmonth from the day of accident. Data entry and analysis were performed using Epi-data. Written informed consent from each participant was sought. Ethical clearance received. Results: Mean age of the accident victims was 36.2 (11.4) years. The median (IQR) for direct, indirect and to-tal expenses were INR 1500 (1000-22100), 18000 (2400-46500) and 3000 (1037-47125) respectively. Asso-ciation between the median (IQR) indirect expenses and marital status as well as socio-economic status of vic-tims were found to be statistically significant. Conclusion: Accident victims and their family faced financial burden, as a large proportion of victims were from productive age group belonging to lower- and middle-class income groupItem Association Of the Methylene Tetrahydrofolate Reductase (MTHFR) Gene Polymorphism with Susceptibility to Recurrence of Cardiovascular Outcomes Among Ischemic Stroke- A Randomized Controlled Trial(Medsci Publications, 2022-10) Kataria, N; Kalyani, VC; Mirza, AA; S, V; Kumar, M; Bharupi, Y; Ranjan, S; Kumar, N; Kumar, NBackground: Hyperhomocystenemia and genetic variants are factors for causing young age stroke glob-ally. This study aims to identify homocysteine related-MTHFR gene polymorphism that associated with recurrent cardiovascular outcomes. Methodology: A randomized controlled trial conducted upon 90 hyperhomocysteinemic ischemic stroke patients were taken from the neurology wards of a tertiary care hospital were randomly selected into vitamin B therapy group and control groups (n=45 in each group). Baseline subject details were col-lected venous blood sample for MTHFR genetic testing via PCR-RFLP technique along with blood homo-cysteine levels, vitamin B12, folic acid levels. Results: The results showed that the frequency of CT genotype polymorphism was 15.5% vs 13.3% for the MTHFR C677T gene without any significant difference between vitamin group and control group re-spectively (p-value >0.05). The reduction in mean homocysteine up to -6.77±4.50 versus -2.08±0.71 μmol/L in the vitamin group as compared to control group respectively, p value 0.001. Conclusion: Considerable amount of MTHFR gene polymorphism found among hyperhomocysteinemic ischemic stroke of sub-Himalayan region. Nutritional deficiencies including vitamin B 12 & folic acid, and some hidden reasons found, which could lead to the primary cause of hyperhomocysteinemia. Vitamin B therapy is an effective for reducing homocysteine.Item Autism Spectrum Disorders-A Review on The Preventive Aspects(Medsci Publications, 2023-06) Barik, S; Patnaik, L; Pattanaik, S.Autism Spectrum disorder (ASD) is a neurodevelopmental disorder presenting with defects in social commu-nication skills and repetitive sensory motor behaviour. There has been increasing concern regarding this dis-order due to its increase in incidence and prevalence in recent years. Since it stays for lifelong and has no spe-cific pharmacological treatment, many studies are being conducted to find ways of preventing this disorder. Better understanding of the causative factors will lead to better development of prevention strategies. This review aims at highlighting the methods of prevention of ASD which are mostly focussed on the environmen-tal factors causing ASD as well as the ongoing researches on development of drugs and genetic modification using animal models. Some studies have shown preventive effects of factors such as nutrition supplements such as Vitamin D and folate, breastfeeding and avoiding exposure to harmful chemicals and drugs. The aim is to prevent the occurrence of the disorder and preventing the severity of symptoms wherever possible. Still more studies are needed to establish the exact association between the possible causative factors and ASD so that clinical trials can be done to establish the preventive effects in future.Item Barriers to Early Diagnosis and Treatment among Breast Cancer Survivors: Qualitative Study in Tertiary Care Hospital, North Karnataka(Medsci Publications, 2022-03) Nandini, C; Roopakala, N; Andanigoudar, KB.Introduction: Around the World, Breast cancer has become one of the common cancers among women. Prevalence and mortality of Breast cancer in India are 18 lakh & 12.7 per lakh cases respectively. One of the important reasons behind late presentation & high death rate is the lack of breast cancer awareness. Objectives: To assess the barriers in diagnosis and treatment among breast cancer patients and to explore the perception about cancer prevention among them. Methods: A qualitative study was done among women with confirmed breast cancer who were admitted to KIMS, Hubballi, and Cancer hospital, Navanagar in April 2019. Data collection was done by the In-depth interview method and analyzed as per qualitative study protocol standards. Results: The data was collected among 14 participants. Themes were generated accordingly. The findings showed lack of awareness, myths, financial constraints, negligence were the major barriers to the early presentation of breast cancer. Conclusion: This study showed barriers such as lack of awareness, negligence, fear, financial constraints, myths and misconceptions, social stigma, lack of family support. Measures taken to reduce mortality by early diagnosis and treatment.Item Behavioral And Psychosocial Risk Factors for Hypertension Among Bus Drivers and Conductors in Karnataka(Medsci Publications, 2022-05) Sulgante, S; Kirte, RC.Background: Hypertension being a disease of occupational origin, its prevalence is found to be high among those who work in a few selected occupational groups. Road transport professionals are one such group and due to their work needs, they tend to adapt to the lifestyle which makes them more vulnerable to developing such diseases in long run. Objective: To identify behavioural and psychosocial risk factors for hypertension among bus drivers and conductors of NEKRTC, Raichur division. Methods: A community based cross sectional study was carried out in two NEKRTC depots of Raichur division, Raichur. A total of 360 bus drivers and 338 conductors were interviewed. Data collection was done by interviewing bus drivers and conductors and by physical examination and analyzed using percentages and chi square test. Results: The risk factors found to be significantly associated with hypertension in bus drivers and conductors were tobacco smoking, use of smokeless tobacco, alcohol consumption, duration of service, Body Mass Index and Waist Hip Ratio. Conclusion and recommendations: Considering the association of hypertension with various risk factors in bus drivers and conductors, preventive measures like lifestyle modifications and regular high-risk screening program for early diagnosis needs to be promoted in them.Item A Bibliometric Analysis of Literature on Covid-19 And Mental Health(Medsci Publications, 2022-09) Rani, P; Yadav, A; Kumar, D; Pandey, J; Gull, M; Ansari, MA; Ghosh, S; Sahni, B.Purpose: The present study analyzed the existing literature related to COVID 19 and Mental Health by using the technique of bibliometric analysis which may serve as guide-map for future researchers and policy makers. Method: Bibliometric analysis is conducted in the present study by using various techniques like cita-tion analysis, co-citation analysis, co-occurrence of keywords, thematic mapping by using visualization of similarities (VOS) viewer open-source software and R-based bibliometrix. Results: The study highlighted the most significant journals, authors, co-cited authors, institutions, key-words co-occurrence, and most cited articles in the area of COVID-19 and Mental Health on the basis of bibliometric analysis of 149 studies taken from the database of Scopus for the past three years (2020–first quarter of 2022). Also, authors identified few relevant themes such as Economic Effects of COVID-19, COVID-19 and its Impact on Healthcare workers, COVID-19 and its Impact on Patients and General Population as important emerging key areas for further research. Conclusion: We have highlighted significant citations, co-citations and keywords co-occurrence to summarize the literature. The present bibliometric study convincingly confirms the effect of COVID 19 pandemic on mental health and provides enough evidence to advocate formulation of strategies to tackle mental health issues.Item Birth Preparedness and Complication Readiness Among Pregnant Women Attending an Urban Health Centre in Surat, India(Medsci Publications, 2022-11) Patel, G; Patel, H; Modi, A; Mukherjee, A; Kosambiya, JK.Background: Birth preparedness is an important strategy to reduce MMR. It includes knowledge of key danger signs; identification of: birth place; birth attendant, fund, transport and compatible blood donor for emergency use beforehand. Objective: This study aims to explore birth preparedness in Surat and determine factors associated with it. Methods: Study conducted facility based cross-sectional study among 310 antenatal women at Urban Health Training Centre attached to Government Medical College, Surat, Gujarat. Predesigned, semi- structured, pretested questionnaire was used for data collection after acquiring informed written con-sent. Result: A total of 310 women participated in the study. Mean age of participants was 22.9 + 3.6 years. Almost one-third (30.3%) of participants were illiterate. Almost six-tenth (61.9%) of participants were involved in unskilled or semi-skilled work and two-fifth (38.1%) of participants were homemakers. Ma-jority of participants (96.7%) were registered in first trimester. Most known factor during pregnancy as danger sign was bleeding (81.9%). BPACR index was calculated as ∑Indicator/7 which was observed to be 62.3%. There was statistically significant association between awareness about health problems dur-ing pregnancy and type of family. Conclusion: Raising awareness regarding components of BPACR among antenatal women will help to reduce morbidity and mortality in antenatal women and achieve sustainable development goalItem Breast Cancer Is Significantly Associated with Cancers in The First- and Second-Degree Relatives in Ethnic Mizo-Mongoloid Population, Northeast India(Medsci Publications, 2022-09) Zodinpuii, D; Pautu, JL; Zothankima, B; Khenglawt, L; Lallawmzuali, D; Lalmuanpuii, R; zuali, L; Ralte, L; Muthukumaran, RB; Varma, AK; Zothanzama, J; Senthil, Kumar, N.Background: High incidence of breast cancer among the endogamous Mizo-Mongoloid tribe stresses the need to explore the disease pertaining to the family history as well as other risk factors. This study in-vestigates the association of risk factors and inherited diseases with breast cancer.Methodology: The study includes 426 unrelated breast cancer cases and 810 healthy controls of female Mizo ethnicity. Association between reproductive history, lifestyle/ dietary habits, tobacco and alcohol exposures, family history in relation to cancer and inheritable diseases was assessed by univariate lo-gistic regression using Chi-square tests and multivariate analyses using Cox regression. Results: Age at diagnosis was highest between 41 to 50 years. Consumption of fermented pork fat, smoked food and Smoke-less tobacco, lower intake of vegetables/ water, having a first/ or second de-gree relative with cancers and inheritable diseases were found to be the major risk factors. Certain known factors were also acting as confounding factors. Conclusions: The present study reveals that Mizo women with first- and second-degree relatives of breast cancer, various other cancers and inheritable diseases have increased risk of breast cancer. This study also highlights the importance of analysing genetic factors which can aid in early detection of in-herited risk factors.Item Burden Of Care and Depression in Caregivers of Patients with Schizophrenia(Medsci Publications, 2022-10) Taj, M; Poguri, M; Mariyana, G; Jebarose, S; Paul, christina M.Background: Schizophrenia, a chronic psychiatric disorder affecting all major domains of a patient’s life, leads to significant disability. Since the deinstitutionalization policy, the onus of care is on families espe-cially the primary caregiver who experiences physical and emotional burden. Depression among care-givers has been estimated to be higher than the general population. This cross-sectional study aimed to assess burden of care and depression in primary caregivers and associated caregiver variables. Methods: 75 consenting primary caregivers of patients with ICD-10 diagnosis of schizophrenia were as-sessed for burden of care and depression using the Burden Assessment Schedule and the Patient Health Questionnaire - 9 after collecting socio-demographic and caregiving details. Results: All the caregivers, 49 females and 26 males, had moderate to high levels of burden with a ma-jority having moderate to severe levels of depression. Spouses (p=0.0038), older caregivers (p=0.01) and those with lower educational levels (p=0.01) experienced more burden. There was a significant positive correlation between burden of care and depression (p=0.000). Conclusion: In one of India’s largest metropolitan cities, though psychiatric services are easily available, caregivers continue to feel burdened and depressed. This can impact not just the caregiver but also care being provided to the patient and illness outcome.Item Caesarean Section Delivery in India: A Comparative Assessment of Geographical Variability Using Nationally Representative Survey Factsheet Data(Medsci Publications, 2023-04) Tripathy, B; jena, A; Pandey, AK; Mishra, SS; Mishra, C.Background: In line with global trends, India has witnessed a sharp rise in C-section (CS) deliveries, especial-ly in the private sector. Methodology: Study attempts to explore change in CS delivery in India at national, regional and State/UT lev-els. We have used factsheet data from the most recent nationally representative survey data i.e., NFHS to ex-amine changes in private and public healthcare facilities, and to determine a difference in rural and urban in CS deliveries. Results: The CS rate has increased from 17.2% to 21.5% in 2019-21. CS was more than twice (40.9%) amongst the private healthcare facilities during the fourth round of NFHS which has shown a considerable in-crease during the fifth round of NFHS (47.4%). There is equal distribution (12.8% during 2015-16 to 17.6% in 2019-21 in rural areas v/s 28.2% during 2015-16 to 32.3% in 2019-21in urban areas) of CS deliveries amongst the rural and urban areas to the total deliveries. Conclusion: Study found that with every one in five deliveries being caesarean, the figure is significantly high as per the recommended cut off by WHO. Thus, it is essential to explore factors regarding emergency or elec-tive caesarean section and to understand if the health facilities are following the recommended protocols for performing CS deliveries.