Reproductive risk factors and Breast cancer: a case control study from rural India.

Background: Breast cancer is the most common type of cancer in women and is influenced by reproductive factors perceived by women worldwide. Aims: To identify the reproductive risk factors of breast cancer in newly diagnosed cases and to find out the strength of association of the risk factors with the breast cancer. Material and Methods: A hospital based case-control study was conducted in Satara district, India during year 2009 to 2011 among newly diagnosed cases of breast cancer and matched controls. A total of 434 participants including 217 cases and 217 controls were enrolled by purposive sampling technique from selected hospitals of study area. The information was collected by employing pre-tested questionnaire by utilizing interview method. Statistical Analysis used: Descriptive statistics, Odds ratio and Chi-square test was used to find out strength of association and statistical significant difference. Results: Highest proportion [31.80%] breast cancer cases was in age group 40-49 years with lowest age of 25 years at diagnosis of the disease. A very high proportion of both cases [88.02%] and controls [67.28%] were Hindu by religion and were from rural residence. Maximum proportion of breast cancer cases were housewives [63.59%], literate [71.42%] and from upper economic class [56.68%]. The proportions of cases were higher as compared to the controls with respect to risk factors like unmarried status, nulliparity, history of abortion, post menopausal status, absence of breast feeding and the history of exposure to hormonal contraceptives. The risk of getting breast cancer as indicated by Odds ratio was 8 times higher in unmarried women, 2.8 times in nulliparous women, 2.4 times with post menopausal status, 10.4 times with absence of breast feeding, 1.5 times with exposure to hormonal contraceptives and 4.5 times with history of ovarian disease respectively. Conclusion: The reproductive risk factors such as unmarried status of women, nulliparity, menopause, absence of breast feeding, history of ovarian disease and use of contraceptives were strongly associated with breast cancer

Correlates of perceived Stigma and Depression among the women with HIV/AIDS infection.

Background: Depression, a universal problem for individuals with HIV/AIDS because the disease creates uncertainty and disruption in every aspect of their lives. Objectives: To assess the level of perceived stigma and depression among women with HIV/AIDS infection and to determine relationship between perceived stigma and depression. Methodology: A cross-sectional study was carried out in Bel – Air hospital located at Panchgani, state of Maharashtra, India during year 2013 among the women with HIV/AIDS infection. By purposive sampling technique, 50 women were enrolled and interviewed by utilizing Standardized data collection tool i.e. stigma perception scale by Sowell et al and CES-D by Radloff after institutional ethical clearance certificate. Statistics: Descriptive statistics, chi-square test and correlation coefficient was used to analyze the data. Results: The out of a total 50 HIV infected women maximum, 26(52%) were belonged to the age group of 28 – 36 years. All the women were married out of which majority were widows 28(56%). Among the study subjects, maximum, 25(50%) were having secondary education, followed by 46(92%) as housewives. 38(76%) women were aware of HIV status ranging from 1 month to 2.5 years. However, 43(86%) reported that they had acquired HIV infection from their husband. Almost all women perceived stigma at some or other time of which majority, 26(52%) perceived stigma frequently whereas 19(38%) and 5(10%) perceived stigma always and occasionally respectively. Similarly all the women have some sort of depression and majority, 37(74%) experienced depression most of the time whereas 13(26%) experienced depression occasionally. The perceived stigma and depression have a significant positive correlation as indicated by correlation coefficient. Conclusion: Moderate to severe degree of stigma and depression was perceived by women with a status of HIV/AIDS infection. A significant positive relationship is also existed between perceived stigma and depression among the women with HIV/AIDS infection.

Obstetric Profile of Primi Teenage and Non-teenage mothers: A comparative study from Maharashtra, India.

Introduction: Early marriages and teenage pregnancies are important contributing factors for high maternal as well as neo-natal morbidity and mortality. Objectives: To assess the magnitude of obstetric profile of teenage and non-teenage primi mothers and to determine the association among them. Methodology: A cross-sectional study was conducted at OB/Gynac clinic Krishna hospital Karad over a period of first quarter of year 2012. 93 eligible teenage primi mothers and equal number of non-teenage primi mothers admitted to Krishna hospital for delivery were enrolled, interviewed and observed for socio-demographic, obstetric outcome and it’s complications by investigator according to pre- designed structured proforma. Frequency percentage distribution and association was determined by applying tests of significance. Observations: Magnitude of teenage primi pregnancy was 6% during study period and most of them 92.50%, 76.30% and 46.20% were Hindus, housewives and belonged to lower class by religion, occupation and economically with mean age at marriage and delivery was 17.8 yrs and 18.8 yrs respectively. Max. 81.7% teenage primi mothers were anaemic and the percentage of obstetric complications like PIH, Oligohydramnios, PROM, Foetal distress among teenage primi mothers was 24%,8.6%, 1%, and 6.4% which was higher than nonteenage mothers. IUGR, cord prolapse, breech presentation and abruption placenta also reported among teenage primi mothers, however absent among non-teenage mothers. Max 55.9% teenage mothers were delivered before expected date of delivery and proportion of low birth weight baby was also high (39.8%) in teenage mothers than non-teenage mothers. Chance of delivery of male baby also increases as age at marriage increases. Conclusion: Adolescent pregnancy is an issue that calls for more education & support to encourage girls to delay motherhood until they are ready.

Patient satisfaction in national leprosy eradication programme.

Background: Leprosy has been a literal scourge through the history of humanity and to eradicate the disease from high endemic countries need leprosy services to be sustained and they remain of good quality. Objective: The present study aimed for getting a reasonable impression of the client’s views on a range of quality aspects of leprosy services rendered by district leprosy control unit under national leprosy eradication programme(NLEP). Methodology: Cross- sectional study was conducted in Satara district of western Maharashtra, India among registered leprosy patients under district leprosy control unit during April -July2008. A sample of 25 % of registered leprosy cases were selected by random sampling method from primary health centers and urban leprosy control units to assess the patient’s satisfaction under the functioning of NLEP. After verbal consent, participants were interviewed at home site using pre-tested structured proforma include socio -demographic and patient satisfaction variables. Data collected was compiled and analyzed by using statistical software. Results: Patient’s overall level of satisfaction was very good i.e. 88.89% with max, 46.03% cases were from age group 35 to 52 years. Max, 47.61% cases were illiterate with high case detection rate, 52.38% was seen males. The proportion of multi-bacillary (MB) and pauci-bacillary (PB) cases was 65.07 % & 34.92 % respectively. Most of the patients were satisfied with anti-leprosy drugs, health education and no physical deformity due to disease underline. 98.41 % patients were satisfied about follow- up and motivation services. Satisfaction about diagnosis of disease by doctors and starting of treatment was 96.82 % and 95.23 % respectively, however satisfaction with rehabilitative services was 14.28%. Significant statistical association was existed between age of leprosy affected cases and their level of satisfaction under NLEP services (?2=15.92,p <0.05*). Conclusion: Elimination of leprosy and very good patient satisfaction towards leprosy services in Satara district indicates successfulness of NLEP.

Knowledge of breast feeding among primigravida mothers.

Background : Breast feeding, the most natural way of infant feeding to satisfy nutritional, metabolic and psychological needs of the baby. Objectives : To assess the knowledge of breast feeding among primi- gravida mothers attending ante-natal clinic and to determine the association between socio-demographic variables with their knowledge. Materials and Methods : Hospital based cross sectional study was conducted at Ante-natal clinic of Krishna Hospital and Medical Research Center, Karad district Satara. Pre-tested structured proforma used to collect information from 590 married primi gravid mothers attending anti-natal clinic during study period by utilizing personal interview method. Statistical Analysis : socio-demographic frequency percentage distribution, knowledge scoreing and statistical association was analysed by using chi-square test. Results: Out of 590 primi gravida mothers,59.66% showed fair quality of knowledge about breast feeding. knowledge about rooming in, family support for breast feeding & burping after breast feeding was 97.7%, 95.4% , 93.5% however weaning, colostrums feed, hazards of bottle feeding and prelactal food was 84%, 82.7%,75.5% and 54% respectively. Statistical association was existed between age, education, religion, socio-economic status & occupation of respondents with their knowledge about breast feeding (?2=151.52, p < 0.0001*; ?2=211.27,p<0.0001*; ?2=133.91,p < 0.0001*; ?2=35.59,p < 0.0001* and ?2=131.04,p<0.0001*) respectively. Conclusion: knowledge of breast feeding among primi gravida mothers attending ANC clinic was of fair in quality.