ABSTRACT
Background: Hypertension once considered a problem of adults only in the high income countries, now dramatically is on the rise in low and middle income countries. An established predictor of adult hypertension and organ damage is childhood hypertension. Thus for the control, effective treatment and prevention of its complications, early diagnosis of hypertension in adolescents in an important strategy. The objective was to study the blood pressure profile and its socio-demographic determinants among school going adolescents in urban Agra.Methods: A cross-sectional survey was done among 534 adolescent in age group of 13-18 years studying in various government and private schools in urban Agra. Socio demographic details, anthropometric measurements and family history of hypertension were obtained. Also the dietary habits, physical activity, mode of transport to school were included in the present study. Blood pressure was measured at 0 and 30 minutes and average of two readings was taken as the final reading of that individual.Results: It was found that 49.82% of the study subjects had above normal blood pressure and among them 21.16% were hypertensive and 28.66% had pre-hypertension. Higher blood pressure showed a statistically significant (p<0.05) association with gender, age, dietary habits, physical activity, body mass index, and parental history of hypertension.Conclusions: Hypertension among the adolescent age group was very high. Prevalence of high blood pressure significantly associated with age, gender, family history of hypertension, physical activity, type of school and dietary habits.
ABSTRACT
Background: Timely referral and safe transport form a crucial link for the survival and safety of sick newborn. Thus the study aimed at assessing referral and transport of sick neonates admitted to NICU of a tertiary care government hospital and the factors associated with direct referral and safe final transport. Methods: A hospital based cross-sectional study was carried out in among 450 neonates and was based on face to face interview with caregivers. The data was analyzed using proportions and mean values Chi square test of significance and independent t test were appropriately applied and p<0.05 was taken to be statistically significant. Odds ratios were calculated for dichotomous variables. Results: 72.6% of high risk pregnancies were transferred timely in utero to district hospitals. Around two thirds (65.8%) of neonates were referred by doctors. Treatment during transportation was administered to 29.6% of the neonates. 50.2% of neonates have used the services of an ambulance at some point of time during their travel. Highly significant association of direct referral was observed with earlier age at admission (2.3 days), early development of neonatal symptoms (1.45 days), lesser gestational age (33.1 weeks) and lesser total distance travelled (15.7 km). The odds of final transport of newborns in ambulance was significantly more in males (OR=1.5), rural residents (OR=1.5) and registered pregnancies (OR=4.3). Conclusions: Wide variations remain in neonatal referral and transport with some glaring gaps which need to be adequately addressed.