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Introduction: Awareness regarding Gestational Diabetes Mellitus (GDM) among antenatal women is necessary for early diagnosis and management of the disease for ensuring a safe motherhood and a healthy child. Objective: This study envisaged to assess the awareness regarding GDM and its determinants among antenatal women attending healthcare facilities in a rural area of West Bengal and to explore the perspectives of health workers with regard to gaps in proper awareness generation activities among antenatal women. Method: This mixed-method study was conducted from April 2021 to July 2021 at 4 health facilities in Singur, West Bengal. Quantitative data were collected from 195 antenatal women using a pretested questionnaire which were analysed using SPSS software. Qualitative data were collected via in- depth interviews among 6 health workers working in the health facilities and were analysed thematically. Results: Overall, 75.4% of participants were not aware of GDM. Multivariable logistic regression analysis showed that secondary education and below (AOR=3.48, 95% CI=1.63-7.42), no history of GDM among family & relatives (AOR=7.24, 95% CI=2.12-24.66), lesser number of antenatal visits (AOR=3.48, 95% CI=1.63-7.42) and non-receipt of counselling regarding GDM during antenatal visits (AOR= 3.09, 95% CI =1.45–6.58) had a significant association with poor awareness. From health workers' perspectives, lack of reorientation training, shortage of supplies for testing, and overburdening with other responsibilities were the major gaps identified in proper awareness generation activities. Conclusion: Present study revealed majority of study participants possessed poor knowledge regarding GDM. Reorientation training of health workers, organizing awareness campaigns at the community level, and relevant counselling regarding GDM during each antenatal visit should be given utmost priority for improving knowledge about the disease
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Background: Preventable medical emergencies and accidents accounts for a major share of mortality worldwide. First-aid is the provision of initial, on spot management for an illness or injury, meted out by a trained person, who is not an expert, till professional medical assistance is available. School children have often been projected as a potentially promising agent for radically revolutionizing the health scenario of our society, if properly mentored. The aim of study was to assess the changes in knowledge and attitude of adolescent school children towards first-aid management, after appropriate educational intervention.Methods: It was a school based quasi-experimental study conducted among 201 adolescent children. Baseline knowledge and attitude about first-aid management of selected medical emergencies were assessed using pre-designed, pre-tested questionnaire. Then, educational intervention was administered in the form of lectures and demonstrations. Post-interventional evaluation was done using the same questionnaire, after two weeks of intervention. Data was analyzed by SPSS version 16.0.Results: Health professionals (29.2%) and teachers (26.1%) were the primary source of knowledge. Wilcoxon Signed-Rank test was carried out to determine effect of intervention on knowledge and attitude scores of the students. There was a statistically significant increase in knowledge (Z=-10.982, p<0.001) with large effect size (r=0.54) and an increase in attitude, though not statistically significant (Z=-1.949, p=0.05) with small effect size (r=0.09).Conclusions: There is a need for a uniform, interactive module including hands on activities and periodic mock drills to be incorporated as a separate entity to encourage participation.
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Background: Cancer of cervix is the third most common cancer in women in India accounting for 21.7% of cancer deaths among women. Unhealthy cervix, characterized by presence of any abnormal growth, ulcer, or vasculature, is a clinically detectable early stage in the life history of cervical cancer. Very few studies have been conducted to determine risk factors of unhealthy cervix. Methods: A clinic-based cross-sectional study was conducted among currently married women of reproductive age group attending Urban Health Unit and Training Centre, Chetla, Kolkata. A total of 189 women attending the clinic was selected using systematic random sampling method was who were interviewed and examined using pre-designed pre-tested schedule. Analysis was done using (SPSS version 16). Results: Among 189 women, 45.5% were diagnosed with unhealthy cervix. Hierarchical logistic regression showed that educational status, PCI, frequency of cleaning external genitalia and extramarital relationship of the spouse were significantly associated with unhealthy cervical condition. Conclusions: Most of the risk factors of unhealthy cervix are behavioral and modifiable. Health education and behaviour change communication of women of reproductive age group would help in reducing their morbidity as well as mortality from cervix related conditions that includes cervical cancer.
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Background: Menstruation, a phenomenon unique to the females, is the cyclical shedding of the inner lining of uterus. It is associated with myths and misconceptions and poor knowledge of the normal physiology. Above all, poor menstrual hygiene is a precursor of various morbidities related to the reproductive tract. This study was conducted among women of reproductive age (WRA) group with the aim to assess their socio demographic characteristics, to elicit the knowledge, attitude and practices regarding menstruation and to find the factors associated with the menstrual hygiene practice.Methods: This community based cross-sectional study was conducted among 152 women aged (15-49 years) during December 2017 to January 2018 in Lockgate area of Chetla, Kolkata, West Bengal, India. Data on socio-demographic characteristics, knowledge, attitude and practices towards menstruation were obtained from structured questionnaire. Outcome variable was menstrual hygiene practice. Descriptive statistics and logistic regression were performed to analyze the data by using SPSS 16.0 version.Results: The mean ages of the participants were 27±8 years. Inadequate knowledge, negative attitude and unsatisfactory practice towards menstruation were 73.7%, 65.1% and 62.5% respectively. Significant correlates were Lower level of education [AOR=1.6 (1.3, 2.1)] and less per capita income [AOR=4.7(1.4, 15.5)] for inadequate knowledge. Less per capita income [AOR=4.7(1.9, 11.1)] for negative attitude. Increasing age [AOR=1.1 (1, 1.2)] and lower level of education [AOR=1.3 (1.2, 1.6)] for unsatisfactory menstrual hygiene practice when adjusted with other variables in the multivariate analysis.Conclusions: Women need to be educated about the significance of menstruation, importance of high quality menstrual hygiene management, use of satisfactory absorbent material, proper and hygienic disposal of menstrual absorbent so as to enable them to lead a healthy reproductive life.
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Background: Tobacco is the single most preventable cause of death and disability. Quitting tobacco use at any age will help in improving the quality of health. Objective: To find out the intention to quit tobacco smoking and its predictors among adult male smokers. Methodology: A cross–sectional clinic based study was conducted for 2 months (July–august 2017) among 123 adult male current smokers. Nicotine dependence was assessed using Fagerstrom test for nicotine dependence (FTND) questionnaire and intention to quit tobacco smoking and its various predictors were assessed using structured schedule. Logistic regression was done to establish association. Results: Intention to quit tobacco smoking significantly associated with higher educational status (AOR=3.04. CI=1.32–6.98),low nicotine dependence(AOR=3.85, CI=1.52–9.73),less duration of tobacco smoking( AOR=2.33, CI=1.02–5.31),previous H/O quit attempts (AOR=2.73, CI=1.17–6.32) Conclusion: The low rate of quitting intention among adult smokers underscore the need for comprehensive policy initiatives that would encourage smokers to think about quitting. Keywords: Tobacco smoking, Nicotine dependence, Intention to quit smoking
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Child , Communicable Diseases , Primary Health Care , Public Health , Quality of Life , Vaccination CoverageABSTRACT
Background: Iron deficiency anemia during pregnancy as it is associated with increased maternal and perinatal mortality and morbidity. Objective: To study the knowledge and practices of pregnant women regarding IFA supplementation during pregnancy. Methodology :A cross–sectional study was conducted for 2 months (May –July 2017) among 108 pregnant women in their third trimester attending the antenatal at Singur. Knowledge and practice assessed using structured schedule. Logistic regression was done to establish association. Results : Poor knowledge significantly associated with lower age(AOR= 0.80,CI=0.67–0.95), lower educational status( AOR= 3.75, CI= 1.5–9.34),lower per capita income ( AOR= 3.09, CI= 1.24–7.72). Poor practice associated lower educational status(AOR=3.30, CI=1.45–7.53) and improper guidance from health–care worker(AOR=3.15, CI=1.29–7.72) Conclusions : The present study indicated poor knowledge and practice regarding IFA supplementation. So intensive counselling, motivation and implementing this into practice would help in reducing the incidence of anemia during pregnancy.
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Evidence based practice deals with current best medical evidence in conjunction with clinical expertise and patient values to guide health care decisions. This paper intends to draw attention of the readers to the brief history of Evidence Based Medicine and the different methods of evidence appraisal in quantitative research like “hierarchy of evidence” which lists a range of study designs ranked in order of decreasing internal validity and may vary according to research question. There are other methods like integrative methods, network meta-analysis, quantitative modeling and infectious disease modeling that are also used for evidence appraisal. There are various approaches of quality assessment of research evidence amongst which GRADE approach (Grading of Recommendations Assessment, Development and Evaluation) is discussed in a nutshell to outline the roadmap from evidence generation in research to guideline formulation. Fundamentally the GRADE approach provides guidance for rating quality of evidence and grading strength of recommendations in order to aid in evidence based health care decisions.
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Japanese Encephalitis (JE) is a mosquito borne disease with epidemic potential. There is no specific treatment available till date and apart from vector control, vaccination of individuals is considered as a safe and effective measure for prevention. Vaccination campaign among 1-15 years is being carried out with full vigour from 2015 onwards in West Bengal. This study was conducted to assess the knowledge of the care givers of 1-15 years old children about JE and its prevention and to find out the factors associated with vaccination status of the children. A cross sectional, community based study was conducted from May-June 2016 in a slum of Chetla, Kolkata, which is within the service area of Urban Health Unit and Training Centre (UHU&TC), Chetla of All India Institute of Hygiene and Public Health, Kolkata, where the campaign prior to the study was completed in March 2016. Care givers of 90 children of aged 1-15 years were interviewed with a pre-designed, pre-tested, structured schedule. Mean age of the surveyed children was 6.34 years (SD 3.76) and 88% of them were vaccinated during the campaign. 56.7% of the caregivers had poor knowledge about JE and 84.95% were sensitized about the campaign by relatives/friends followed by health workers (33.7%). Low socio-economic status and good knowledge of JE had significant association with vaccination of the child after adjusting with other factors (age and sex of the child, education and occupation of parents, type of family). Enhancement of knowledge and awareness about JE with appropriate health education programmes and special emphasis on sensitization campaigns for JE vaccination at both mass and individual level would prevent emergence of JE epidemics in future.
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Radiofrequency waves generated from mobile phones cause potential public health problems. Short-term effects like changes in sleep, heart rate, and blood pressure, and long-term effects like carcinoma are well documented. The Government of India’s efforts in laying down regulations regarding the safety limits, manufacture, marketing, and mobile use are still in nascent stage. The need for stringent enforcement of laws for prevention of phone usage while driving and guidelines of medical regulatory bodies regarding rules and regulations of phone usage while at class or attending patients is of utmost importance. This should be supplemented by mass media to raise awareness among people regarding the possible health effects of radiofrequency emissions from mobile phones and the guidelines to minimize its exposure. It is the need of the hour to teach young people to be structured, to know when to have the cell phone on, and to avoid becoming the slave of technology instead of its mastery.
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A community based cross-sectional study was undertaken among 1081 adolescents to assess the relationship of adolescent blood pressure with weight, height and BMI in Chetla, Kolkata; data collection was done with a predesigned schedule along with recording of anthropometric measurements and blood pressure. Mean, correlation coefficient was used for statistical analysis. Systolic and diastolic blood pressure of both sexes increased with increase in weight, height and BMI with a significant positive linear correlation. Life style modification should be stressed upon from childhood.