ABSTRACT
The Doctor-Patient Relationship [DPR] is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor's guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants
ABSTRACT
Adolescence is a critical period of life marked by biological, social and psychological changes for an individual. The objective of the study was to assess the knowledge and practices of adolescent girls pertaining to menstruation in an urban slum. A cross-sectional descriptive study of three months duration (January 2011 to March 2011) was conducted in an urban slum of Mumbai. All adolescent girls from 10-19 years of age, who had attained menarche, attending general out-patient department and STI clinic, were included. The total sample size of the study was 241. After taking the informed consent of the study respondents, participants were interviewed using a semi-structured questionnaire. The questionnaire comprised of eliciting information pertaining to the socio-demographic profile and reproductive health i.e. hygiene during menstrual periods, awareness about HIV/AIDS of the participants. Special care was taken to maintain privacy and confidentiality. Data entry and statistical analysis were done using SPSS version 17. Frequency distributions were calculated for all the variables and chi-square test was used to study the association between socio-demographic parameters and knowledge and practices about menstruation. It was observed that 79(32.8%) subjects had unsatisfactory menstrual hygienic practices. Even though 66% of adolescent girls were aware about the different modes of transmission of HIV, only 19% knew about safe sexual practices. Education status and late adolescent age group (15-19 years) had a statistically significantly association with adolescent girls knowledge about menstruation. Good/fair knowledge and education status was found to be significantly associated with good practices during menstruation. Study findings have revealed that education status of the adolescent girls was the most important determinant for having good menstrual knowledge. Also significant association was observed between education level and healthy menstrual practices. Thus steps should be taken to improve the literacy status of the adolescent girls for bringing about further improvements in the menstrual hygiene related knowledge and practices.
Subject(s)
Adolescent , Menstruation , Hygiene , Reproductive Health , Poverty Areas , IndiaABSTRACT
Tuberculosis [TB] continues to pose a major global health problem and thus intensive action is needed to control and ultimately eliminate the disease. An active case finding [ACF] survey was conducted in the urban slum areas of the R-South Municipal Ward of Mumbai City for a period of two months from June to July 2012. Micro planning for survey was done by District Tuberculosis Officer and Medical Officer of Health of R-South ward. The entire health post staffs of R-South ward were trained to perform the survey. TB suspects were identified by trained community health volunteers during their home to home visit. These suspects were referred to the designated microscopy centers [DMCs] for sputum examination and those diagnosed with TB were put on anti-TB treatment. A total of 278 TB suspects were identified on enquiring on the presence of symptoms suggestive of TB. Out of them 221[79.5%] patients got tested for sputum examination. Sputum positive TB was diagnosed in 29 suspects and the sputum positivity rate was 13.1%, which was slightly higher than the passive case finding norms of 10% as prescribed under Revised National TB Control Program. Active case finding for tuberculosis in the general community was discouraged for several decades because of high costs of implementation. However, results of the survey suggest that periodic ACF should be incorporated in populations wherever tuberculosis incidence / prevalence is high as there was a definite improvement in the case detection rate