Pattern of ocular morbidity in school children and its association with academic achievement

Background: Ocular morbidity describes any eye disease regardless of resultant visual loss. India is plagued by ocular morbidities in school going children. Refractive error is considered to be the major cause of visual impairment. The objectives of the present study were to compare the pattern of ocular morbidity in urban and rural school children, to study the association of academic achievement with ocular morbidity in study population and to suggest appropriate recommendations for addressing the problem of ocular morbidity in school children.Methods: A cross sectional study was conducted in the 9 primary and 5 junior high schools of field practice areas of Rural Health Training Centre and Urban Health Training Centre respectively, under Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh from September 2005 to August 2006.Results: Prevalence of ocular morbidity in the present study was 23.3%. Maximum prevalence of 28.7% of ocular morbidity was seen in the age group of 14-16 years. Prevalence of ocular morbidity was found to be 100 (51.6%) in males and 64 (40.1%) in females. 29.3% of the 164 school children having ocular morbidity showed poor academic achievement compared to 18.7% of the 541 children not having ocular morbidity and the association was found to be statistically significant.Conclusions: Refractive error was one of the major causes of ocular morbidity among school going children but most of them were of mild degree. Ocular morbidity was found to affect the academic achievement of school going children.

Domestic accidents among under-5 year children: a study on the modern day epidemic

Background: Domestic accidents are a priority problem, and urgent attention is required to prevent considerable morbidity and mortality in children of the under-five age group.Methods: Community based cross-section study done in the peri-urban areas of Aligarh, India. Mothers/care-givers were interviewed about any domestic accident faced by children under 5 year age, in the last 1 year, through a semi-structured, pilot tested questionnaire. Multivariable logistic regression was performed using SPSS 24.0 software.Results: Majority of respondents were in the age group 20-35 years, majority of the children affected were male (35.6%), and in the age group of 3 to <4 years (22.3%). Most accidents occurred inside home, most commonly due to falls, followed by sharp injury and burn. Mother’s education level had a significant association with the occurrence of domestic accidents (odd’s ratio: 2.34, CI: 1.08-5.07).Conclusions: Domestic accidents among children are prevalent in the study area. Dissemination of injury prevention information with special focus on household modification and increased parental supervision are effective strategies to prevent unintentional injury.

Assessment of Knowledge of Janani Suraksha Yojna among RDWs of Aligarh: A community based cross Sectional study.

Background: Janani Suraksha Yojana (JSY), launched on 12th April, 2005 under the umbrella of NRHM is a safe motherhood intervention. It is a conditional cash transfer scheme aimed to increase the number of institutional deliveries and decrease the maternal and neonatal mortality rates but still the awareness about the scheme is low in women from rural areas and urban slums, especially in low performing states. Aims: To assess the awareness of recently delivered women from rural areas and urban slums regarding JSY and to study the knowledge level of various components of JSY. Methods: A cross-sectional study was carried out in the rural areas and urban slums of field practice areas of Jawaharlal Nehru Medical College, AMU, Aligarh for a period of one year. The prevalence of institutional delivery in UP as found in a study by UNFPA 2008 (50.2%) was used for calculation of sample size. (95% confidence level, 12% relative precision and 8% non response) The yielded sample size was 278, which was rounded off to 300 and selected proportionately. After taking informed consent from the head of the families and targets, the study subjects were interviewed by a pre-designed and pre-tested questionnaire. Statistical analysis used: SPSS 20 and Epi Info software (with Yate’s correction).Results: The awareness of JSY was found to be high (85%) but knowledge regarding benefits covered under the scheme was only limited to cash incentive for institutional deliveries. Knowledge of 108 ambulance was also low(26.6%). Conclusion: There is an urgent need to strengthen IEC campaigns and monitoring strategies.

Health Problem Pattern Among Geriatrics In Aligarh- A Cross Sectional Study.

Background & Objectives: Old age is associated with decline in physical, physiological & cognitive function affecting the quality of life of the elderly population. The robust increase in proportion of elderly has resulted in demographic burden in a developing country like India. To cope up with this burden appropriate & timely intervention is required based on the situational analysis of the health problems faced by the aged population. Objective is to determine the pattern of health problems among geriatric population and to find out the rural- urban difference in health problems, if any. Methodology: The cross- sectional study was done among 450 individuals aged 60 years & above residing at field practice area of Urban Health Training Centre & Rural Health Training Centre, JN Medical College, AMU, Aligarh. The data was obtained through pretested & predesigned questionnaire by selecting individuals using systematic random sampling with PPS. Data was entered & analyzed by SPSS 20. Tests of proportion & Chi square test were applied. P value <0.05 was considered significant. Results: The present study revealed that the most prevalent problem was cataract (79.6%), followed by depression (36.2%), refractive error (31.3%), locomotor problems (23.6%) and hearing loss (16%). No significant rural- urban difference was found among the prevalence of health problems. Conclusion: The study concluded that the magnitude of health problems faced by elderly ranges from low (hearing loss) to high (cataract) that warrants strengthening of the available health care services to tackle the burden of health problems.

Study of menstrual problems among the adolescence girls of rural area of Aligarh.

Introduction: Menstrual practices are still bounded by social restrictions and taboos. This may result in ignorance of hygienic practices during menstruation. So there should be proper knowledge given to the girls since childhood. The present study was conducted in rural areas of Aligarh. It was conducted in 70 adolescent girls before taking verbal consent from them. The aim of the study was to find menstrual pattern among the rural adolescent girls, the various menstrual problems among them and the effect of this problem on their daily routine. Material and Methods: A cross sectional study was conducted among girls of age group 13 to 19 years attending the rural health training centre of Department of Community Medicine, J.N. Medical College, Aligarh. Seventy girls who had given verbal consent were interviewed. Data was collected by personal interview and semi structure questionnaires. Data was analyzed using SPSS software. 35.7% were in 13-15 years age group, 21.4% were in 15- 17 years age group and 42.9% were in 17-19 years age group. Regarding problems related to menstrual cycle, dysmenorrhea (71.4%) was the commonest problem. Other then this, girls had pre-menstrual syndrome (57.14%), backache (50%), fatigue (42.8%), breast heaviness ( 28.5%), joint pain (21.4%), increased weight (28.5%), headache( 28.5%) and abdominal bloating (50%). The menstrual problems affected their daily routine. Around 71.4% of the subject were forced to have prolonged bed rest, 64.28% had missed social activities. 50% of them had disturbed sleep, 35.7% had decreased appetite, 42.8% had missed classes, 50% who were employed had to abstain from their work. Conclusion: Menstruation problems usually cause interruption of daily routine of adolescent girls. School health programme should include provision for screening of adolescent girl for menstruation related problem and providing them with relevant information. Clearing up the misconception relating to menstruation and offering possible treatment options should be done. This may help in improving school and academic performance of students.

Impact of Behaviour Change Communication among Pregnant Women Regarding Knowledge of Low Birth Weight Infants’ Susceptibility to Certain Morbidities.

Objective: To assess the impact of Behaviour Change Communication (BCC) Package among pregnant women regarding correct knowledge of susceptibility of the low birth weight neonate to certain morbidities. Study Design: A community based intervention study. Place and Duration of Study: Field practices areas of Urban Health Training Center Department of Community Medicine, JNMCH, AMU Aligarh (UP) India, between September 2008 to August 2009. Participants: 200 pregnant women (100 pregnant women from each intervention and nonintervention groups) were enrolled. Sampling: Purposive sampling method. Statistical Analyses: Data analysed with Epi Info version 3.5.1. Significant difference was determined using Chi- square test. The impact of Behaviour Change Communication was assessed using relative risk and difference was accepted significant at more than 95% (p value <0.05). Intervention and non-intervention were also compared after 7th and 28th of delivery days. Results: Before BCC package intervention, there was no significant difference (pvalue> 0.05) between two groups regarding correct knowledge about susceptibility of low birth weight infants to different conditions. Due to impact of BCC Intervention, knowledge regarding susceptibility of LBW baby to infection was increased to two times. Knowledge regarding susceptibility of LBW baby to yellow palm and sole was increased to four and half times. Knowledge regarding susceptibility of LBW baby to feeding difficulty was increased to seven times and knowledge regarding susceptibility of LBW baby to hypoglycemia was increased to 4.75 times. Knowledge of mother regarding susceptibility of LBW baby to infection, yellow palm and sole, feeding difficulty and hypoglycemia were increased significantly (p-value <0.05) in the intervention group due to impact of the BCC package on 7th day of follow up and was maintained on the 28th day after delivery. Conclusion: There was significant improvement in pregnant women regarding correct knowledge about susceptibility of the low birth weight neonate to different conditions.

Good and harmful neonatal practices among pregnant women in peri-urban area of Aligarh.

Background: Neonatal mortality in developing countries is one of the most important problems that need immediate attention in order to achieve Millennium Development Goals. Aims & Objective: To assess the knowledge and practices of pregnant women regarding good and harmful neonatal practices. Material and Methods: Study Design: A community based study. Setting: Field practice areas of Urban Health Training Center Department of Community Medicine, JNMCH, AMU Aligarh. Participants: 200 pregnant women. Sampling: Purposive sampling. Study Period: one year. Statistical Analysis: Data analysed with Epi Info version 3.5.1. Percentages, and Chi Square Test used. Results: Initiation of breastfeeding within 1 hour was done only in 16% of babies. Colostrum was given by 41% mothers. 20% babies were exclusively breastfed. Witch craft in neonatal illness was noticed in 70% babies. Majority of babies (97%) were applied kajal in the eyes. Prelacteal feeds were given in 80% and pacifiers in 72.5% babies. All the home deliveries except one were conducted by untrained dais. Untrained Dai did not wash their hands with soap and water in 64.5% of home deliveries. Dark and ill-ventilated room for conducting the delivery was used in 82% deliveries. The cord was cut with a used blade, or any unsterile scissors, knife, or sickle, broken cup in 68.8% of deliveries. Application of ghee/ cow dung on the cord was done in 93.5% deliveries. 100% newborns were given bath soon after birth. Delivery room was not warm in 54.6% of deliveries. Conclusion: It was concluded that harmful newborn care practices were common. This can be attributed largely to dais because most of deliveries were conducted at home. Some good practices were prevalent in the community like new blade, delivery in a warm room, practice of rooming-in.

Impact of behaviour change communication among pregnant women regarding good and harmful traditional practices.

Background: Neonatal survival is influenced much by care provided by the family before, during and after delivery, which in turn is influenced by mother’s beliefs, and perceptions of her immediate family. Objective: To assess the behaviour of pregnant women regarding good and harmful neonatal care practices. 2. Implementation and assessing impact of Behaviour Change Communication (BCC) Package among pregnant women regarding good and harmful neonatal care practices. Methods: A community based intervention study was conducted in the field practice area of the Urban Health Training Centre, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. 200 pregnant women were enrolled purposively. Data were analyzed with Epi Info version 3.5.1. Percentages, and Chi Square Test used. Results: Due to implementation of BCC Package in intervention, good practices like giving colostrum were increased two times. Initiation of breastfeeding within 1 hour was increased 4.7 times, exclusive breastfeeding was gone up 3.8 times and induction of burping was increased 6 times. There was significant difference (P–value <0.05) between the two groups on 7th and 28th days of delivery. Harmful practices like not washing hand were decreased 3.83 times, use of dark and ill-ventilated room was decreased 2.54 times, and practice of cutting the cord with a used blade, or any unsterile scissors, knife, or sickle, broken cup was decreased 3 folds. Application of ghee/ cow dung on the cord was decrease significantly. Practices of prelacteals and use of pacifier, application of kajal, and witch craft for neonatal illnesses were reduced significantly. Conclusion: There was significant improvement in pregnant women regarding traditional neonatal practices. Some practices had not changed due to some strong cultural beliefs and influence of mother in-law and elderly females of the family.

Distribution Pattern of the Psychosocial Problems according to the Academic Assessment of Adolescent Male Students.

Background: Many studies have reported psychosocial problems among adolescents. Methodology: A study of distribution pattern of psychosocial problems was conducted according to academic assessment among the adolescent males aged 10 – 19 years students selected from all rural and urban schools situated within 1 KM of urban and rural health training centers of the department of Community Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh. The study population comprised of 2347 students out of which 410 students were selected for study out which 390 students cooperated in the study. Semi-structured schedule for the record of psychosocial history, 35 items pediatric symptoms check list (YPSC) to screen psychosocial problems where applied and class teacher was requested for academic assessment of the student to grade according to 4 – points Likert scale that graded each student as (1) Excellent (2) Very Good (3) Average (4) Poor. Diagnosis was made as per criteria of ICD-10 (1999). Results: 17.9% students showed psychosocial problems. The problems were mere in students graded as poor in studies.

Determinants of Vitamin A Deficiency amongst Children in Aligarh District, Uttar Pradesh.

Objectives: To determine the prevalence and determinants of xerophthalmia among children aged 0-60 months . Methods: This cross-sectional study included 3571 children under 5 years of age from six villages and four periurban areas. Children with xerophthalmia were identified and severity graded using the WHO classification. The main outcome measures were sociodemographic, nutritional and comorbidity related risk factors of xerophthalmia. A pretested questionnaire carrying information on the above factors was administered to the caregivers. Univariate and multivariate binary logistic regression analyses were performed to examine the association of each of these factors with xerophthalmia. Results: The overall prevalence of xerophthalmia was of serious public health importance at 9.1%. Prevalence of both mild (night blindness, and Bitot’s spots) and severe forms (corneal changes) of xerophthalmia increased with age. Bitot’s spots and night blindness were the commonest manifestations. Rural dwelling, lower social class, maternal illiteracy and occupation outside home were significant antecedent socio-demographic risk factors on univariate analysis. Multivariate analysis revealed low intake of proteins and vitamin A containing foods as well as predominant maize diet to be significant dietary factors. Nutritional wasting and a preceding history of measles were significant comorbid determinants (P<0.05). None of the socio-demographic variables emerged significant on multivariate analysis. Conclusions: Vitamin A deficiency remains a significant public health problem in Aligarh district.The proximal factors in a child’s mileu viz nutrition and comorbidities were more significantly associated with xerophthalmia than the distal socio-demographic factors, thereby making a case for their cost effective prevention.The high magnitude of the problem calls for intensification of existing prophylactic measures in these areas.

Pattern of Sexual Development and Anthropometry in Adolescent Males.

Background : The significance of staging the sexual development becomes apparent on observing a group of adolescents of similar age but with great variability in size, shape and level of pubertal maturation. Objectives: To study the pattern of sexual maturation and anthropometry in adolescent males. Methods: The cross-sectional study was done in school having a total of 2347 male adolescents, out of which 390 students cooperated in the study. Probability proportionate to size sampling was used. Sexual Maturity Rating (SMR) was done by showing pictorial representation to the adolescents. The data obtained were tested statistically by percentages and Chi-square Test using SPSS version 10.0 for windows. Results: SMR-1 ranged from age 10 – 13 yrs, SMR-2 ranged from 10-16yrs, SMR-3 started from age 11yrs and ended gradually at 18yrs. Similarly SMR-4 started from 13 yrs and SMR-5 at 14 yrs. The mean weight and height increased from lower age groups to higher age groups within the same stage of sexual development. Within the same age group the mean weight as well as height also increased according to the current stage of sexual development. Conclusion: There is great variability in the timings of onset of puberty and the progression of the sexual maturity among the adolescents. The anthropometry indices for somatic growth in adolescent are influenced by both the chronological age and the sexual maturity of the adolescents. Thus calculating the anthropometric indices in adolescent according to the age alone will not be of much use as the somatic growth also depends on the sexual maturity of the adolescents.

Global developmental delay and its determinants among urban infants and toddlers: A cross sectional study.

Objective To estimate the prevalence of global developmental delay among children under 3 years of age and study the determinant factors. Methods Cross sectional descriptive study was conducted in field practice areas of the Department of Community Medicine, JN Medical College, Aligarh, India. A total of 468 (243 boys and 225 girls) children aged 0–3 years were included. Developmental screening was performed for each child. A multitude of biological and environmental factors were analysed. Results As many as 7.1% of the children screened positive for global developmental delay. Maximum delay was observed in the 0–12 months age group (7.0%). Undernutrition and prematurity were the two most prevalent etiological diagnoses (21% each). Stunting and maternal illiteracy were the microenvironmental predictors on stepwise binary logistic regression while prematurity and a history of seizures emerged significant biological predictors. Conclusions Developmental delay can be predicted by specific biological and environmental factors which would help in initiating appropriate interventions.