Annals of Community Health

Editor: Dr Umesh Y Ramadurg , Dr Raghuram Venugopal
ISSN(Print): 2347-5455 Online:2347-5714

Frequency: Yearly

Language: English

Open Access Peer-reviewed journal

Web site: https://www.annalsofcommunityhealth.in/ojs/index.php/AoCH/index

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Now showing 1 - 20 of 74
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    World Environment Day
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jul) Ramadurg, Umesh Y.
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    Depressive Disorders among People with Chronic Illness in an Urban Area of South India
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jul) Raghuram, V.; Murthy, N. S. Narasimha
    Over the past decades, twin demographic and epidemiological transitions have been reflected an increase in the burden of chronic diseases. Although public health practitioners have recognized the increasing burden, the socioeconomic and overall health impact is to be adequately researched. Depressive disorders are considered an important correlate, for appropriate management of chronic disease but have been given relatively less importance. Hence, this study was taken up in an urban slum of Bengaluru city to explore the associations between depressive disorders and chronic diseases.Methodology: The cross-sectional community-based study was conducted in an urban slum of Bengaluru city using a modified cluster sampling technique. All persons who were ill or on long-term medication or were hospitalized for a period more than 3 weeks in the past 1 year were interviewed. A semi-structured pre-tested questionnaire incorporating Hamilton Depression Rating Scale was used. Results: He overall prevalence of chronic illness was 10% among the study population with 10.9% having mild depression, and 1.2% having mild-moderate depression, and none severe depression. None of them were taking any treatment for their depression. The mean age of those with mild depression was 53.9 years and was greater among females (males 5.0% and females 16.7%). The latter was highly statistically significant. Of the 91 persons with symptoms of mild depression, nearly two-thirds (58.2%) belonged to Class IV of Modified B G. Prasad’s classification. Factor analysis showed that HAM-D scores to have a significant relation with chronic illness. Discussion: Depressive disorders among those with chronic disorders are hitherto unrecognized in routine clinical practice. Middle ages, females and those lower down in the socioeconomic hierarchy are at greater risk. There is a need to establish a mechanism for appropriate management of these disorders.
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    A Study of Causes of Neonatal Mortality in Tertiary Care Hospital, Bagalkot
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jul) Ramadurg, Umesh Y.; Ghattargi, C. H.; S., Gagan; R., Manjula; Mayappanavar, Ramesh Y.; Bhadja, Dip; Nair, Sandhya S.
    Neonatal deaths account for a major proportion of child deaths globally. Major causes of neonatal deaths are preterm birth, asphyxia, sepsis, pneumonia, congenital anomalies, diarrheal diseases, and tetanus. Without a sound knowledge about the changing trends in morbidity and mortality, it will be difficult to formulate appropriate strategies in management, prevention, and review. The present study was aimed at providing statistical data related to mortality pattern seen in hospitalized neonates. Methodology: A descriptive case series study was conducted with records of the patients who were admitted in the Paediatric Department of HSK Hospital and Research Centre over a 12-month period. The collected data were analyzed using Microsoft Excel and appropriate statistical test was used to interpret the data. Results: A total of 101 infants died in our hospital, among them maximum 87 (86.14%) mortality was observed in early neonatal period. Causes of mortality were classified as direct and antecedent causes. The most common direct cause was found to be birth asphyxia 35 (34.66%) followed by respiratory distress syndrome 15 (14.85%) and meconium aspiration syndrome 15 (14.85%). Congenital cardiomyopathy (n = 3) was the most common congenital anomaly. 79.35% of the neonates had low birth weight and 20.65% were small for gestational age. Conclusion: With birth asphyxia being the most common cause, education and training regarding neonatal resuscitation will play a major role in decreasing the neonatal mortality.
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    Study of Risk Factors Influencing Low Birth Weight of Babies among Institutional Deliveries at RIMS Teaching Hospital, Raichur
    (Akash Institute of Medical Sciences and Research Centre, 2018 Apr) Mudaraddi, Roshan
    The birth weight of an infant is one of the most important determinants of its chances of survival, healthy growth, and development. One of the principal causes for infant mortality in India is low birth weight (LBW). The infant mortality rate is about 20 times greater for LBW babies than for normal birth weight babies. The prevalence of LBW continues to be high despite the adoption of National Health Policy in 1983. The magnitude of LBW infants in developing countries is enormous. There are about 22 million LBW infants in the world, out of which India has about 7–10 million. LBW constitutes about 30% of live births in India. Now according to the revised National Health Policy - 2002, the goal is to reduce proportion of LBW babies from 30% to 10% by 2010. This study is undertaken to find out the proportion of LBW babies in institutional deliveries and to study sociodemographic and maternal factors influencing the birth weight of baby. Materials and Methods: A hospital-based cross-sectional study was undertaken in the postnatal care wards of Raichur Institute of Medical Sciences and Teaching Hospital, Raichur. The study subject constitutes 714 postnatal mothers with singleton live-born babies delivered during the study period. Data were collected by interviewing mothers with the help of pre-tested semi-structured questionnaire and data were analyzed. Results: Proportion of LBW was found 25.1%. A significant association was found between birth weight and various factors such as mother’s education, socioeconomic status, age at first conception, interpregnancy interval, antenatal care visits, anemia, tobacco consumption, and obstetric complications. Interpretation and Conclusion: The proportion of LBW was found to be 25.1% compared to national average of 28%. LBW can be prevented through good prenatal care and intervention programs.
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    Psychological Stress among Grassroot Level Workers in a PHC of Bagalkot District
    (Akash Institute of Medical Sciences and Research Centre, 2018 Oct) Mannapur, B. S.; Dorle, A. S.; Ghattargi, C. H.; Ramadurg, Umesh; Kulkarni, K. R.; Selvan, Vetri
    It is important to study the problems of the grassroot level workers and the levels of stress that they encounter. The stressed Anganwadi and ASHA workers are likely to be unhealthy, poorly motivated, less productive, and less efficient in implementing the various national programs. Objective: The objective was to study the level of stress among the grassroot level workers and the various factors related. Materials and Methods: Study design: This was a cross-sectional study. Setting: This was conducted at PHC of Bagalkot district. Study subjects: Grassroot level workers (Anganwadi [n = 46] and ASHA [n = 29] workers) were selected. Sample size: The sample size was 75. Data collection: Date were collected through self-reporting questionnaire schedule consisting of two schedules: (i) Sociodemographic characteristics and (ii) presumptive stressful life events scale questionnaire. Scores used in the study: Fifty-one life events were found to be experienced by the normal Indian population in the past 1 year. For each life event, a mean stress score was given. The total score was obtained for each by adding all the applicable life events scores. Accordingly, they were categorized into no stress, less/moderate stress, and severe stress. Statistical test used: Analysis was performed using Chi-square test. Results: About 61.33% were Anganwadi and 38.67% were ASHA workers. 70.67% had mental stress in the past 1 year. 8% of the subjects had a family history of mental illness and 25.33% of them were practicing yoga/meditation. 66.67% of the study subjects had experienced severe stress and 26.67% has mild/moderate stress. The factors such as past history of mental illness, socioeconomic status of the participants, house construction, unfulfilled commitments, unemployment of family member, loan, beginning of school, and marital conflict are significantly associated with level of stress. Conclusion and Recommendations: Psychological stress was found to be more among Anganwadi and ASHA workers. They are suggested to practice healthy lifestyles such as yoga and meditation to relieve stress.
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    A Cross-sectional Study on Quality of Life among Diabetic Patients Attending Tertiary Care Hospital in Bagalkot City, Karnataka
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jan) Mhetri, Jayaraj R.; Dorle, A. S.
    India has the large number of diabetic patients, and the number is expected to raise to 69.9 million by 2025. “Quality of life (QOL)” evaluation has emerged as an important outcome measure for chronic disease management. In diabetes, psychosocial factors have an important impact on self-care, acceptance of therapeutic regimens, treatment success, and QOL. Aims and Objectives: The aim of the study was to find out the QOL among the diabetic patients attending the outpatient department of tertiary care hospital in Bagalkot city. Methodology: It is a cross-sectional descriptive study, which was undertaken at a tertiary care hospital in Bagalkot city. The duration of the study was from August 10, 2016 to October 25, 2016. A sample size of 180 was obtained after considering the prevalence of diabetes in Karnataka as 10.22%. Patients attending the hospital for outpatient services were interviewed in their own language after obtaining the consent. QOL instrument for Indian Diabetes Patients questionnaire was used it is a reliable, valid, and sensitive tool for the assessment of diabetes-specific QOL in Indian subjects. Statistical analysis was done using Microsoft Excel 2010 and SPSS 20.1 trial version. Chi-square and Fisher’s exact test was used. Results: The mean age of study participants was 58.14 ± 13.46 years. 31.8% of the study participants were on insulin therapy. 52.3% of the males in the study had good QOL. The patients who were obese had poorer QOL than the patients with overweight and normal body mass index; this was statistically significant. Married participants had better QOL. In participants with comorbidities, QOL was poorer when compared to those without comorbidities; this difference was statistically significant.
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    Morbidities of Employees in a Biscuit Factory of Bengaluru City
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jan) Narayan, Kaushik K.; Raghuram, V.; Kumar, Jayanth
    The employees working in biscuit factories are exposed to various factors such as noise, heat, odor, flour dust, sugar dust, biscuit dust. At the individual level, flour induced rhinitis and asthma are frequently severe enough to cause considerable inconvenience, discomfort, and even abandonment of the trade. Methods: A cross-sectional study involving all the employees working at a biscuit manufacturing factory of Bengaluru city, was conducted from January to March 2015 after obtaining informed consent from each one of them. Medical pro forma form 16 as per factories act was used to assess the health status of the study population. The data were entered and compiled in Microsoft Excel sheet. Analysis was done using SPSS software version 20.0. Results: It was observed that 6.7% of the study population had hypertension, 5.7% of them were found to have skin problems , 6.5% had decreased visual acuity and 4% of the workers showed symptoms of respiratory morbidity. Discussion: A strong health surveillance system has to be devised for regular monitoring of the employees’ health and facilitate early detection of various morbidities.
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    Zika Virus in India – Do We Have the Answers?
    (Akash Institute of Medical Sciences and Research Centre, 2018 Oct) Raghuram, V.
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    A Study of Factors Associated with Low Birth Weight in a Tertiary Care Centre in Rural South India
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jan) Shashikiran, M.; Raghavendra, S. K.; Pukale, Ravindra S.
    Low birth weight (LBW) is a significant indicator of child survival and future morbidity in any community all over the world. It has reduced considerably in developing countries due to improved living conditions and better care of women and adolescent girls. However, in developing countries, it is still an important cause of child mortality and morbidity. LBW is typically multifactorial at different levels such as maternal, fetal, and environmental factors. Objectives: The objectives are as follows: (1) To assess the prevalence of LBW in a tertiary care setting in a rural area and (2) to determine various sociodemographic factors associated with LBW and degree of association of each. Materials and Methods: A record based study was conducted at Adichunchanagiri Hospital and Research Centre, wherein all singleton live births data for 1 year (January 1, 2016–December 31, 2016) were accessed from the MRD section of AH and RC. All available data were analyzed using percentages, odds ratio, and Multivariate analysis. Results: Overall, the prevalence of LBW was 15.89% (194 LBW out of 1221 live births). Female babies (17.12%), Teenage mothers (19.37%), Rural residence (15.94%), Maternal Hypertension (21%), and Shorter spacing between pregnancies (17.47%), and Preterm (62%) were some associated factors with LBW. Of all the above risk factors, teenage mothers, spacing, and gestational age were found to be statistically significantly associated with LBW. Conclusions: Although declining in most communities, LBW still remains unacceptably high in many undeveloped regions. It requires a multi-pronged approach by a team of dedicated professionals to reduce this problem afflicting mankind.
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    Leadership in Public Health Practice
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jan) Ramadurg, Umesh Y.
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    Sleep Quality, its determinants and its Association with Academic Performance among the Students of a Medical College in Kerala
    (Akash Institute of Medical Sciences and Research Centre, 2019 Jan) M., Madhusudan; Anaswara, D. U.; Aiswarya, E.; Jose, Anupriya; Nayana, Dileep; Paul, Kukku M.; Hussain, Rasana; Thomas, Tessy
    Sleep deprivation may have grave health consequences; resulting in increased disease morbidity and mortality. Prevalence of poor sleep quality is higher among medical compared to non-medical students and the general population. Poor sleep quality affects the academic performance of medical students and also their work performance in the future when they become practitioners. Hence, in this background, the present study was conducted. Objectives: The objectives of the study were to find out the prevalence of poor sleep quality among medical students, its determinants and also its association with academic performance. Materials and Methods: This was a cross-sectional study conducted at a Medical College, Wayanad District, Kerala, between May and November 2018. All the undergraduate medical students of the college were the study subjects. Data were collected using a predesigned and pretested self-administered questionnaire, i.e., the Pittsburgh Sleep Quality Index. Completed responses were obtained from a total of 684 students. Results: 62.4% were found to have good sleep quality and 37.6% poor sleep quality. The prevalence of poor sleep quality was more among 17–19 years age group, males, married, Phase I MBBS students, NRI quota students, subjects belonging to religion “others,” urban origin students and day scholars. However, only phase of MBBS and place of origin were found to have a statistically significant association (P=<0.01 for both). The prevalence of poor sleep quality was more among those who had failed in the previous university exam/internal assessment or who had passed in pass class when compared to those who had secured distinction/I/II class. However, the association was not found to be statistically significant (P = 0.39). Conclusions: The prevalence of poor sleep quality among the study subjects was lower. There was a significant association of male sex and Phase I, MBBS with poor sleep quality. There was no significant association between sleep quality and academic performance.
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    Internet Addiction and its determinants among the Students of a Medical College in Kerala
    (Akash Institute of Medical Sciences and Research Centre, 2018 Jul) M, Madhusudan; Fernandes, Sunny D A; Thomas, Tessy; Unnikrishnan, Alaka; Malakkaran, Sharath S; H, Arjun Krishnan; K P, Hasna
    Internet has literally percolated every aspect of human life today including social communication, education, research, health seeking, banking, business, shopping, administration, and entertainment, so much so that we cannot imagine our lives without internet. However, internet can be misused and excess internet use can be pathological and addictive. Younger population and especially college students are more vulnerable to this addiction because of their psychosocial and environmental characteristics. This internet addiction can lead to various psychological, physical, as well as social problems. Hence, in this background, the present study was conducted to find out the prevalence of internet addiction among medical students and also its determinants. Methodology: This was a cross-sectional study done at DM Wayanad Institute of Medical Sciences, Wayanad District, Kerala, between January and June 2018. All the undergraduate medical students of the college were the study subjects. Data were collected using a predesigned and pretested self-administered questionnaire (Young’s internet addiction test). Completed responses were obtained from a total of 729 students. Results: 5.5% were found to have no internet addiction and 94.5% were found to have internet addiction. 60.8%, 31.3%, and 2.5% were found to have mild, moderate and severe internet addiction, respectively. The prevalence of internet addiction was more among males compared to females, Part II, final phase students compared to other phase students, management quota students compared to other quota students, Christians compared to other religions, urban origin students compared to rural origin, and day scholars compared to hostellites. However, only sex, phase of MBBS, and place of origin were found to have a statistically significant association (P= <0.01, 0.026 and 0.049 respectively). There was a weak negative correlation (r = −0.117) between the percentage of marks obtained in previous university examination and IA scores, and the correlation was found to be statistically significant (P= <0.01). Conclusions: The prevalence of internet addiction among the study subjects was significantly more compared to other studies. Sex, phase of MBBS, and place of origin were found to have a statistically significant association with internet addiction. There was a negative correlation between the degree of internet addiction and academic performance.
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    Health and Economic Security of Migrants in Rural Areas of Trichy, Tamil Nadu – A Cross-sectional Study
    (Akash Institute of Medical Sciences and Research Centre, 2019 Jan) Deodatt, S.; Duraisamy, Shanmugapriya; Rajeev, Rahul
    Migration of labor is a universal phenomenon. The most common reason for migration are the economic stability for better livelihood. However, the various demographic and social patterns along with the lack of awareness about the health-care facilities in the migrated place and poor economic security make them highly vulnerable to various diseases. Health and economic security of the migrants play crucial role not only in safeguarding the health of migrants but also in overall development of the country by increasing the productivity. With this, the study was conducted to assess the economic and health security of the migrants. Materials and Methods: A descriptive cross-sectional study was conducted over a period of 2 months from November to December 2018 in urban and rural field practice area of a tertiary care hospital in Trichy among 51 migrant population using semi-structured questionnaire. Results: The median monthly wages were found to be Rs. 10,000/month. With respect to the health and economic security, only about 13.7% of the study participants received medical allowances from their employers. 5.9% had job security and 27.5% excise travel allowances for their travel to native place. Conclusion: Although the average monthly income is good, the number of dependents is more and job security is poor. Since majority are not registered with L27district authorities and working in unorganized sector, the social and economic security is very uncertain increasing their risk for poor utilization of services.
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    A Comparative Study on Health Expenditure among Individuals with Diabetes and Hypertension in Rural Tamil Nadu
    (Akash Institute of Medical Sciences and Research Centre, 2019 Apr) Deodatt, S; Elango, S; Charumathi, N; Dheekshana, S; Cynthia, S
    Introduction: Recent data reveal the diabetic prevalence in adult population to be around 8.8% and prevalence of hypertension 25–29%. Out-of-pocket (OOP) expenditure on the treatment of chronic diseases continues to be the major impediment and a burden on the people. 78% of Indian population spend out of their pockets financing for health in India. Aim and Objectives: The aim of the study is to compare OOP expenditure of diabetes and hypertension. Materials and Methods: A descriptive cross-sectional study was carried out in the rural field practice area of tertiary medical college in Trichy district of India. Mean cumulative expenditures on diabetes hypertension in medications and investigations were compared. Results: Mean cumulative OOP expenditure was Indian rupee (INR) 1435/month (approximately INR 17,200 annually) for diabetes and INR 313 (approximately INR 3756 annually) for hypertension. Comparative cumulative OOP expenditure per month between the two groups was found to be highly significant (0.009). Conclusion and Recommendations: Out of Pocket Expenditure on diabetes treatment in the present setting was 4 times the treatment of hypertension. Policymakers should consider subsidizing the cost of diabetes expenditure.
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    Socioeconomic Burden of Multidrug-Resistant Tuberculosis Patients at Ballari District – A Cross-sectional Study
    (Akash Institute of Medical Sciences and Research Centre, 2019 Apr) Padmashali, B. S. Bharath; Sameena, A. R. B.; Basavaraj, S.
    Tuberculosis (TB) is one of the main causes of deaths related to antimicrobial resistance and the leading killer of people with HIV. The emergence of strains with multidrug-resistant TB (MDR-TB) has led to a resurgence of TB as a major public health menace worldwide, and MDR-TB has been an area of growing concern in recent years and is posing threat to global efforts for TB control. It has been seen that apart from physical symptoms, TB patients face various problems that are social, economic, and psychological in nature. Therefore, for the assessment of patients’ health status, it is necessary to consider the overall effect of TB on health and patients’ perception of well-being, besides routine clinical, radiological, and bacteriological assessments, so this present cross-sectional study was conducted to explore the burden of MDR-TB on the social, economic, and psychological well-being of the patients residing at Ballari. Methods: There are 79 MDR-TB cases registered at DR-TB center and residing in Ballari district. The data were collected from individual patients by home visits according to TB units, using a pre-designed pre-tested semi-structured questionnaire to measure the social, economic, and psychological burden of MDR-TB using standard tools. The data were entered into Microsoft Excel 2007 spreadsheet. Final analysis was done using SPSS for Windows 20.0 version. Social, economic, and psychological burden was analyzed with 95% confidence interval. Results: 68.3% patients became unemployed because of disease, 62 (78.5%) patients have to depend on others/family member for their daily routine work, and 69 (87.3%) patients are worried or had mental anguish about their disease status. The mean total cost incurred per patient is ₹58,061.99 (approximately US$ 855). The mean total direct cost incurred per patient is ₹21,318.8 (US$ 314). The mean total indirect cost incurred per patient is ₹36,743 (US$ 514). The mean pre-diagnosis and diagnosis cost per patient is ₹11,628 (US$ 171). The mean guardian cost per patient is ₹3,991.3 (US$ 59). The mean direct hospitalization cost incurred per patient is ₹6,315.44 (US$ 93). 14 (35%) patients from upper and middle class (Classes 1, 2, and 3) are shifted to lower socioeconomic classes (Classes 4 and 5). 60 (75.9%) patients have stopped working/doing household work for more than equal to 6 months because of disease. Conclusions: Study finding indicates that there is a significant social, economic, and psychological impact of MDR-TB that has a direct impact on the quality of life of MDR-TB patients and their families. There is a need for psychosocial intervention model (strategies) for MDR-TB patients and their caregivers to mitigate the negative effects of disease.Key words: Burden, multidrug-resistant tuberculosis, socioeconomic burden, tuberculosis
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    World Breastfeeding Week - Genesis and Progress
    (Akash Institute of Medical Sciences and Research Centre, 2018 Apr) Raghuram, V.
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    Cross-sectional study of Sociodemographic Factors Affecting Persistent Sputum Positivity among Adult Pulmonary Tuberculosis Patients under Treatment in a Tuberculosis Unit, Bagalkot, Karnataka
    (Akash Institute of Medical Sciences and Research Centre, 2018 Oct) Dorle, Ashok S.; Thippeswamy
    Tuberculosis (TB) treatment not only cures the patient but also helps in prevention, as it stops transmission of infection by rendering the patient’s sputum non-infectious. Sputum conversion is an important milestone during treatment and is to be achieved as soon as possible. When there is non-conversion, patient sputum persists to be positive for tubercle bacilli and patient continues to be infective. There are multiple factors responsible for this persistence of sputum positivity which have explored by various studies. There are variations in the association of these predisposing factors with persistent sputum positivity. Objectives: The current study was conducted to know the prevalence and the sociodemographic factors responsible for persistent sputum positivity in Bagalkot Taluk TB unit. Materials and Methods: A total of 170 adult pulmonary TB (Category – I) patients of Bagalkot Taluk TB Unit were selected. A community-based survey with the pre-tested questionnaire was administered to collect relevant sociodemographic data regarding factors that influence persistent sputum positivity. Laboratory data were collected through concerned health facilities. Data were tabulated in MS-EXCEL 2013 and analyzed in Openepi version 3.01 and SPSS version 20. Results: Among 170 patients, pulmonary TB was seen more frequently among males (63.5%), middle-aged (31.7%), urban residents (55.3%), lower socioeconomic status (95.4%), and illiterates (28.8%). Prevalence of persistent sputum positivity was 10.59%. Among the persistent sputum positive patients, a higher prevalence was seen in males (66.67%) and lower socioeconomic class (88.33%). Age, literacy, and occupation were associated, whereas gender, place of residence, type of family, smoking, and alcoholism were not associated with persistent sputum positivity.
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    A Cross-sectional Study on Binge Drinking among Health Institutional Students in Bagalkot.
    (2015-01) Selvan, T Vetri; Sumalatha, N; Dorle, Ashok S; Ghattargi, C H; Jambaiah, B
    Background: Alcohol consumption is a major public health problem worldwide. In 2012, about 3.3million deaths were attributed to alcohol consumption. DALY attributed to alcohol consumption is 139 million. Ad-olescence is the critical period when the first initiation of alcohol intake takes place. Sixteen percent of drink-ers of age more than 15yrs engage in heavy episodic drinking. Due to change in lifestyle a considerable num-ber of social drinking have shifted to binge drinking. Objectives: To know the prevalence of binge drinking among health institution students in Bagalkot. Material and Methods: A cross sectional study was conducted among 380 health institution students. Five different cadre of health institutions were taken, one medical, one dental, one Ayurveda, one nursing and one Pharmacy College. A pre designed, semi structured ques-tionnaires were used. The results were analysed by chi square test. Results: Among total 380 participants, 68% were girls and 32% were boys. Majority of the respondents were staying away from home (83%). More than one fifth (20.53%) of respondents had tasted alcohol at least once, of which more than one third (37.18%) were female. Prevalence of binge drinking was 3.16%. Among binge drinkers, 58.33% had at least one of their family members who consumed alcohol. Conclusion: Existence of risk behaviour like binge drinking among students were seen and it demands integrated approach. Increased awareness among parents and also the respondents is needed to prevent adolescent behaviours from becoming a risk to their health and community.
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    Perceived Socio-Cultural and Economic Factors Influencing Maternal and Child Health: Qualitative Insights from Mwingi District, Kenya.
    (2015-01) Nzioki, Japheth M; Ombaka, James H; Onyango, Rosebella O
    Background: Reducing child mortality rates and improving maternal health are Millennium Develop-ment Goals (MDGs) that Kenya is striving to realize by next year, 2015. One way of achieving the MDGs is through identifying and addressing the factors influencing Maternal and Child Health (MCH). The aim of this study was to explore expert opinions on social –cultural and economic factors influencing MCH in Mwingi District, Kitui County in Kenya. Methods: This was a qualitative study which was conducted as part of a larger mixed method study. Data was conducted using Focus Group Discussions (FGDs) and in-depth interviews. Three FGDs were conducted with each having 8 respondents (N=24) and nine in-depth interviews were conducted with 9 key informants (N=9). Purposive sampling was used to sample participants in the FGDs while maximum variation sampling was used to select key informants for the in-depth interviews. Framework analysis and quasi statistics were used in data analysis. NVivo software was used in data man-agement and analysis. Results: Social-cultural and economic factors influencing MCH in the district include; 1.Various cultural and religious factors, 2. Various deficiencies in health care service provision, 3. Unreliable transport infrastructure, 4. Poverty, 5. Illiteracy, and 7. Food insecurity. Conclusion and recommendations: Efforts to improve MCH in the district should: address cultural and religious influence on MCH, address deficiencies in health care service delivery, alleviate poverty, improve transport infrastructure, reduce illit-eracy, and improve food security.
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    Students’ Perception of Educational Environment in an Indian Medical School Using DREEM Inventory.
    (2015-01) Shah, Chinmay; Parmar, Dhaval; Parmar, Rasmika
    Introduction: Students’ perception of the environment within which they study has been shown to have a significant impact on their behaviour, academic progress and sense of well-being. The study, by way of student perceptions recorded on the Dundee Ready Educational Environment Measure (DREEM) inventory, reveals the strength & weakness of educational environment at our institute. This understanding can be aided for refining the learning environment. Method: Perceptions of students recorded by DREEM inventory anon-ymously and mean global scores and domain scores were expressed as mean + standard deviation (SD). Result was recorded gender wise and the difference in the result of male and female compared using rank sum test to see if the difference between the perception is significant or not. Result: Students’ Perceptions of Learning: The mean domain score was 31.40/48 (SD 4.63) Students’ Perceptions of Teachers: The grouped mean SPT score was 28.24 /44 (SD 4.63) Students’ academic self-Perceptions: The grouped mean score was 22.05 /32 (SD 4.9) Students’ Perceptions of Atmosphere: The grouped mean score was 31.30/48 (SD 5.5) Students’ Social Self-Perceptions: The grouped mean SSP score was 17.70/28 (SD 3.9). Female students indicated a more pos-itive perception of their environment than did males on almost all aspects. Conclusion: Study using DREEM inventory revealed problematic areas of learning environment in our medical school, which help us in de-ciding priority areas for reform of educational environment.