Knowledge and parity: Perspectives of usage of emergency contraceptive pills among women of a rural area of Delhi

Context: Correct use of emergency contraceptive pills (ECPs) may prevent up to 95% of unwanted pregnancies which may significantly decrease unsafe abortions and maternal mortality. Aims: Assessment of knowledge and use of ECPs among women and to explore factors associated with them. Materials and Methods: This was a facility-based cross-sectional study. Data were collected using a prestructured, pretested questionnaire from 381 reproductive age women (15­49 years) selected by systematic random sampling. Statistical Package for the Social Sciences version 16 and Epi info (version 7.0.) were used for all statistical analyses. Descriptive analysis was performed, and results were expressed in terms of frequencies and percentages. The Chi-square and Fisher's exact test were used as tests of significance in univariate analysis. Determinants of use of ECPs were identified using logistic regression. Results: Of 381 women interviewed, awareness level of ECPs (ever heard about ECPs) was found to be 34% (n = 128). Ever use of emergency contraception was reported by 38 (9.7%). Age (odds ratio [OR] = 3.02, 95% confidence interval [CI] [1.88­4.87]), education (OR = 0.086, 95% CI [0.047­0.158]), husband's education (OR = 0.11, 95% CI [0.067­0.187]), socioeconomic status (OR = 6.14, 95% CI [3.28­11.51]), and family status (OR = 2.6, 95% CI [1.59­4.24]) were found to be significantly associated with the use of emergency contraceptives. Conclusions: The study identified that most respondents lack adequate knowledge about ECPs, and ever use of ECPs was very low. Factors that were associated with the use of ECPs were age, literacy, socioeconomic status, and knowledge about the method. Creating a sustainable awareness on ECPs and their use may serve them with power to control their parity

Evaluation of quality of multivariable logistic regression in Indian medical journals using multilevel modeling approach.

Background: Availability of user-friendly statistical software has increased the application of multivariable logistic regression (MLR) in the medical journal many fold. The reporting quality in terms of checking assumptions, model building strategies, proper coding, and report format need proper care and attention to communicate correct and reliable model results. Objective: The objective of this article is to evaluate the quality of MLR article based on 10-point well establish criteria and to study the factors that may influence the quality. Methods: Study included PubMed indexed Indian medical journals as on March 2010 and published at least ten original articles that applied MLR during 10 years was included in the study. Multilevel modeling was applied to assess the role of journal and article attributes on MLR quality. Results: Twelve out of 39 Indian PubMed indexed journals fulfilled the inclusion criterion. Of a total 5599 original articles in these journals, 262 (4.68%) applied MLR in their study. Conformity of linear gradient assumption for continuous covariate was the least fulfilled criterion. One-third of the MLR articles involved statistician or epidemiologist as co-author, and almost same number of MLR articles' first author was from outside India. The trend of 10-point criteria remained consistent although the number of MLR articles increased over the period. The average quality score was 3.78 (95% confidence interval: 2.97-4.60) out of a possible 10. Larger sample size, involvement of statistician as co-author, non-Indian as the first author, and use of SAS/STATA software increased the quality of MLR articles. Conclusions: The quality of MLR articles in Indian medical journals is lagging behind as compared to the quality of MLR articles published from the United States and Europe medical journals. Joint effort of editors, reviewers, and authors are required to improve the quality of MLR in Indian journals so that the reader gets the correct results.

Neonatal Care Practices in Urban Villages.

Neonatal health is the key to child survival. Care practices during delivery and neonatal period contribute to risk of mortality and morbidity. The present study was conducted in two urban villages of east Delhi to study practices during delivery and neonatal period amongst mothers. A total of 100 neonate- mother pairs were studied. About two-third (64%) births took place at home, 48(75%) of the home deliveries were conducted by a traditional birth attendant. The traditional birth attendant did not wash her hands in 24 (37.5%) and did not wear gloves in 46(72%) of the deliveries conducted at home. Breast feeding was initiated within one hour in only 12% of the newborns. Early initiation of breast feeding was more likely in newborns with parents with higher education and higher income and those belonging to joint families. About one- third of newborns were bathed immediately after birth. Application to the cord was practiced by 86% of the mothers. The practice was not related to education of mother or income; it was more common in newborns whose fathers were more educated and those belonging to joint families. Thus unsafe traditional newborn practices are common in the area emphasizing the need for education in clean delivery practices and newborn care.

Distribution and determinants of body mass index of non-smoking adults in Delhi, India.

Data on height and weight of 3,428 non-smoking healthy adult subjects, obtained during an earlier community-based study in Delhi, India, on chronic respiratory morbidity due to ambient air pollution was analyzed to study the distribution of body mass index (BMI) and its determinants among adults in Delhi. The sample was drawn by systematic sampling from rural and urban areas of Delhi. In urban areas, the sampling frame was restricted to areas around air quality-monitoring stations. However, the areas were spread across the city and reflected wide economic spectrum. Subjects were classified as underweight, normal, overweight, and obese as per the criteria of the World Health Organization for BMI. The mean BMI of the entire sample was 22.14 +/- 4.61. It was higher among females, urban residents, and the higher-income group. Overall, 49.7% of the 3,428 subjects had a normal nutritional status, 24.8% were underweight, 19.4% overweight, and 6.1% obese. The prevalence of underweight was higher in rural areas (38.5%) and among the lower-income group (39.9%), while overweight and obesity were more common in urban residents (22.7% and 7.5% respectively), among females (21.7% and 7.7%), and the higher-income group (31.8% and 11%) (p < 0.05). The adjusted odds for underweight were 2.02 for rural subjects and 4.00 for the lower-income group. For overweight or obesity, odds were 5.6 for the higher-income group, 3.62 for urban residents, and 2.5 for females. It was concluded that problems of both underweight and overweight and obesity exist among the adults of Delhi. While females, residents of urban areas, and economically-better-off were more likely to be overweight or obese, residents of rural areas and those from lower-income groups were more likely to be underweight.

Immunization in urbanized villages of Delhi.

OBJECTIVE: To assess the immunization coverage of BCG, DPT, OPV, Measles, MMR and Hepatitis B vaccines in two urbanized villages of East Delhi and study the factors affecting the coverage. METHODS: Children of age 24-47 months were selected using systematic random sampling. Information on socio-demographic factors and immunization status was obtained by house-to- house visit. Immunization coverage of all vaccines was computed and analysis of association between immunization coverage and socio-demographic factors was done. RESULTS: The coverage levels were 82.7% for BCG, 81.5% for DPT/OPV 1, 76.8% for DPT/OPV 2, 70.7% for DPT/OPV 3 and 65.3% for measles vaccine. It was 41.4% and 41.6% for DPT booster and MMR vaccine. Higher education of mother (OR=1.96) and father (OR=1.80), father's occupation (OR=1.86), residential status (OR=1.76), place of birth (OR=2.64) and presence of immunization card (OR=5.8) were significant determinants for complete immunization on univariate analysis. On regression analysis mother's education (OR=1.43), presence of immunization card OR=2.05 and place of birth (OR=3.80) remained significant. CONCLUSION: Immunization evaluation surveys have shown a wide variation across regions, states and different strata of the society.

Do our medical students have enough knowledge of Hepatitis B ? A Delhi based study.

Hepatitis B virus is the world's most common blood borne viral infection. Occupational risk of Hepatitis B infection is well known in medical and dental workers especially during the professional training period. The present study was conducted among medical students of a Medical College in Delhi to assess their knowledge regarding Hepatitis B. A questionnaire was administered to the first, third and final year medical students regarding Hepatitis B vaccine, disease, and mode of spread, sequel and prevention. The knowledge regarding all aspects was maximum amongst the final year students as compared to first and third years. Knowledge regarding the booster dose of vaccine, transmission through formites, universal precautions for prevention was not good. There is need for strengthening in these areas and training in these should be started at the earliest.

Knowledge, attitudes, beliefs and practices regarding measles in a rural area of Delhi.

387 mothers in Mehrauli block of Delhi were interviewed regarding their knowledge, attitudes, beliefs and practices regarding measles. 98.4% enumerated one or the other symptoms, fever being the commonest. 77.5% were aware of the infectious nature and 97% had favourable attitude regarding feeding the child during measles. The commonest foodstuff given was cowmilk and khichdi. 95.1% of the respondents intended to apply local herbs on eruptions. There was a variety of local medicines for home treatment and Laung, Tulsi leaves and Kishmish being the practice in descending order of preference. 98.4% respondents favoured giving special nutritional care during the attack of measles to their children.