Does the Mode of Delivery Affect the Health-Related Quality of Life? A Comparative Analysis

Background: Health?related quality of life (HRQoL) of postpartum mothers is a multidimensional concept and is relatively neglected in both researches and in practice as most postpartum researches have focused on the physical complications. In line with the global trends, India has witnessed a sharp rise in cesarean section (CS) deliveries and has become a global concern for the health of the mother as well as her quality of life. Objectives: This study was conducted to analyze and compare the HRQoL after normal vaginal delivery and CS in the postpartum women. Methods: It was a community-based cross-sectional study and a predesigned, pretested interview schedule was used in the form of a questionnaire including the Medical Outcomes Study Short Form 36 Health Survey for HRQoL. The study was conducted in a resettlement colony, Kalyanpuri located in Delhi, India with a total population of 25,754 with 4596 eligible couples in 4302 households from November 2018 to March 2020. The study participants comprised of a sample size of 330 post?partum women and the data were collected in the 6th week of post-partum period. Results: In our study, there were statistically significant (P < 0.05) differences with mode of delivery as one of the predictors of HRQoL of postpartum mothers. The study subjects with vaginal delivery had higher mean HRQoL score under all the domains. Conclusion: In CS, reduced physical activity, body pain not only affected the mental health domain score but also significantly impacted the emotional domain. Promoting the use of family planning services is also significant in improving maternal health and should be made a provision of quality of care and strengthening of quality improvement and sustainable quality assurance mechanisms are major problem-solving steps in improving access to healthcare.

Depression, Anxiety and Stress among Undergraduate Medical Students during the COVID-19 Pandemic

Introduction: Depression, anxiety, and stress among medical undergraduate students are often under- recognized and undertreated. Prolonged online classes in the backdrop of COVID-19 pandemic have resulted in tremendous psychological stress among students. Objective: To assess the prevalence of stress, anxiety and depression among medical students during the COVID pandemic and the associated factors. Method: A cross-sectional study was conducted among undergraduate students in a medical college in Delhi. A self-administrated questionnaire, containing general information (on-screen time, death or hospitalization in family due to COVID) and the DASS-21 version, was circulated to students enrolled before 2020. Data collected was tabulated in Microsoft Excel and analysed using SPSS version 23. Results: Out of 550 students, 345 (62.7%) participated in the study, of which 341 gave consent. High frequencies of depression 214 (62.8%), anxiety 199 (58.3%) and stress 150 (43.7%) were reported. Significant association was found between the determinants like hectic online classes and curbs on travelling and socializing. Conclusion: The high burden of depression, anxiety and stress detected among the students is a pointer towards a negative impact of online classes that can negatively impact academic performance, professionalism and empathy towards patients

A study of clinical and treatment profile of tuberculosis patients attending DOTS centre at Primary Health Centre

Introduction: Tuberculosis (TB) is an age-old disease killing significant number of humans over history and one of the major cause of morbidity and mortality, especially in developing and underdeveloped countries. It killed 1.4 million people annually worldwide in the year 2019. India had 2.69 million cases in 2019, according to TB report 2020. Despite the presence of the programme for it's control, TB continues to threaten the population due to emergence of more and more resistance cases challenging it's elimination. This study reflects the annual burden of tuberculosis in an area served by a Primary Health Centre in Urban Delhi and the treatment outcomes. The records of the patients attendingMethods: the DOTS centre was obtained from the treatment register at Primary Health Centre, Palam, Delhi. The records of patients visiting between April 2020 to March 2021 were included. Data analysis was done on Statistical Package for the Social Sciences (SPSS) version 22 and appropriate statistical tests were applied. The total number ofResults & Conclusion: tuberculosis patients registered from April 2020 to March 2021 were 260. Out of these 260 patients, 155 (59.6%) were pulmonary and 105 (40.4%) were extra-pulmonary. A total of 175 (67.3%) were microscopically confirmed and 85 (32.7%) were clinically/radiologically diagnosed.

Myths and unhealthy wound practices regarding animal bite among subjects attending anti rabies clinic in a South Delhi municipal corporation polyclinic in Mehrauli, Delhi

Background: Rabies is one of the highly fatal diseases, with nearly fifty nine thousand deaths annually globally and almost one third of these are in India. Higher rates of dog bites are common in our country, due to large stray dog population. Despite a preventable disease, unhealthy wound practices are still prevailing in the community due to lot of myths related to the disease. The objectives of the study were to assess the magnitude of unhealthy wound practices and to assess the knowledge regarding health seeking behaviour following animal bite.Methods: The present study was a cross sectional study conducted at SDMC Polyclinic, Mehrauli, Delhi from January to December 2015. A total of 160 cases of animal bite that attended OPD and consented were analysed for knowledge, practices and health seeking behaviour towards animal bite.Results: Out of total 160 respondents almost all were bitten by dogs of which 2/3rd was stray dogs and most common site of bite was lower limb. 55% of the subjects did not wash or clean the wounds after bite. 27% of subjects applied chilli powder or its paste with oil and 2.5% used oil and turmeric paste and 1.9% oil on the wound. Only 41.9% of the subjects believed that vaccination is the treatment of the choice following animal bite.Conclusions: Intensive health education through mass media and mid media can be used to create awareness about the disease transmission and preventive measures like wound management and post-exposure prophylaxis. Also, pet vaccination should be made mandatory for all those who keep pets.

A study on disability in terms of activities of daily living among elderly in Palam village of west Delhi

Background: Aging, an integral part of living, typically is accompanied by gradual but progressive physiological changes and an increased prevalence of acute and chronic illness. Although neither a disease nor disability per se, aging nonetheless is associated with a high incidence of physical impairment as well.The objective of the present study was to assess the prevalence of activities of daily living (ADL) disability in elderly living in Palam village of Delhi.Methods: A community based cross-sectional study was carried out to assess the prevalence of ADL disability in elderly living in Palam village of Delhi using Barthel ADL index. It uses ten variables describing ADL and mobility. The sample size was estimated to be 350 and systematic random sampling was used to choose the study subjects.Results: The prevalence of ADL disability was found to be 20.3% in the study population. This was found to be 16.3% in males and 23.9% in females.Conclusions: After obtaining adequate data on elderly having difficulty in performing their routine activities of daily living, appropriate steps needs to be taken to mitigate its ill effects which should also address their health care needs and help them to live a healthy and good quality life.

An epidemiological study on home injuries among children of 0� years in South Delhi

Background: Injuries are an important public health problem worldwide, accounting for 5 million deaths, of which unintentional injuries account for 0.8 million deaths in children. Though there are many factors responsible for injury in the home, the environment plays an important role. Objectives: The objectives were to study the magnitude and pattern of home injuries in children aged 0� years and to assess the environmental risk associated with home injuries. Methods: A community-based, cross-sectional study was conducted in 2015 in a ward of Mehrauli containing 20,800 households, and the total sample of children was selected from 400 households by systematic random sampling, with sampling interval being 52. Information was taken using a predesigned, semi-structured, pretested proforma from both the parents and children. The data collected were analyzed using SPSS version 12. Results: The prevalence of home injury was found to be 39.7% in the last 1 year, significantly higher in the age group of 1�years (54.3%) followed by 5� years (45.1%) (P = 0.000). The total number of injuries and the average number of injuries in girls were significantly higher than those of boys. The most common type of home injury was falls (59.5%) followed by injury with sharps and burn injury. The environmental risk was assessed using standard and working definitions and found unsafe electrical points (95.3%), unsafe stairs (100%), unsafe kitchen with access to sharps (29.3%), access to active fire (19.3%), and unsafe furniture and objects (22.8%). Conclusion: Though home injury did not occur in 60% of the children during the study period, the risk of injury in the future is high. Educating the parents and the children at schools and environmental modification are important strategies for prevention of home injury.

Post exposure management of animal bite cases attending a primary health center of Delhi.

Rabies is an ancient disease of mankind. Every year 4 million people are exposed worldwide after animal bite and around 60000 fell victim to the rabies of which more than 95% of cases are bitten by the dogs. Rabies is a disease associated with many myths. The present study was conducted to find out the clinical profile of the animal bite cases including the common practices, precautions adopted by them after animal bite and lastly the extent and completion of post exposure treatment. Total 147 cases of animal bites attended the OPD during the study. In present study, 123 (83.7%) cases were bitten by dogs, followed by monkey (8.2%) and cat (8.2%). Majority (54.4%) suffered class II bites followed by class I (31.3%) and class III bite (14.3%). Of the total 147 cases, 116 cases (78.9%) completed post exposure prophylaxis which was observed higher among male and in younger age group.

A study of malnutrition among children aged 6 months to 2 years from a resettlement colony of Delhi.

Nutritional status of 1661 children aged 6 months to 2 years who attended the Well Baby Clinic of UHC Gokulpuri, Delhi during the year 2000 was studied. 60.7% of them were malnourished. Undesirable practices of discarding the colostrum, not exclusively breast feeding the child till at least 4 months of age, delayed weaning, dilution of top milk, use of bottle and nipple for feeding the children are still widely prevalent.

Awareness and practices regarding malaria of catchment population of a primary health centre in Delhi.

Malaria is a major public health problem in India. IEC activities have been an important activity of National Anti Malaria Programme. The present study was undertaken with the objective to assess awareness and practices regarding malaria among patients attending malaria clinic. Literacy status was low among the respondents. About 57% of respondents were aware of the cause of malaria as parasite or mosquito and awareness increased with the literacy status (49.4% in illiterate to 85.4% in high school and above literate). More than half (51.0%) of the respondents attributed high fever with chills and rigor as the most important symptom of malaria, but some of the respondents also mentioned only high fever (18.9%) or high fever with diarrhea (21.2%) as main symptom of malaria. Majority of the respondents knew that mosquito bred in water (62.9%) and mosquito breeding could be prevented (56.6%), knowledge significantly better among literate than illiterates. The present study showed that the awareness and practices about the cause and prevention of malaria were just fair among the patients attending the Malaria Clinic of a Primary Health Centre of Delhi and were dependent upon the literacy status of the study population. Poor response towards practising preventive measures against mosquito bites as approx. one third were not practising any method could be due to poor awareness about malaria preventive measures.

Pulse polio programme: an overview of parent's perception.

India is contributing large number of total world's polio cases. The present study was carried out with the objective to assess the knowledge of the parents regarding pulse polio and their perception towards pulse polio and other immunization. The study revealed that children of all age groups participated in PPI though the coverage was low in 37-48 and 49-60 month age group. In all 30.5% children of respondents could not get OPV in the previous year and they came for the first time to the PPI centre. A significant finding of the study was the status of children regarding other immunization, as 59.5% of the respondents were not immunizing their children for other vaccines. In the present study, 73.2% of the respondents could tell correctly about pulse polio. Predominant source of information about pulse polio was found to be electronic media (55.8%) followed by health workers (20.9%). Only 8.4% respondents opined that distance of PPI centre was far away from their residence.

An epidemiological profile of gastro-enteritis deaths in Delhi state.

This paper describes epidemiological features of 75 gastro-enteritis deaths that occured in 22 major hospitals of Delhi during 1990-92. Three fourth's of deaths were in under five years of age group and more than half were infants. In 84 per cent, diarrhoea was of an acute watery type. Dehydration was the commonest immediate cause of death, while malnutrition was the commonest associated cause. No ORS/SSS/HAF was given to one fourth of the patients. Close relatives of two third's of deceased were either not aware at all about ORS/SSS or had incorrect information. In 87 per cent, food intake was either stopped or had been restricted. The study emphasizes the need for an intensive IEC campaign for prevention, and for better case management in the hospitals coupled with appropriate reorientation training of private practitioners.