Prevalence of mental retardation in urban and rural populations of the goiter zone in Northwest India.

Background: The existence of an endemic goiter belt along the southern slopes of the Himalayas has been known for a long time. Prevalence of neonatal hypothyroidism is high and there has been little work on the prevalence of mental retardation in this part of India. Objective: The study was conducted with the aim to know the prevalence of mental retardation in the urban and rural populations of Himachal Pradesh, India and to generate a hypothesis on the differential distribution (geographical) of mental retardation. Methods: This cross-sectional study was conducted in the rural and urban areas of the district of Kangra, Himachal Pradesh, India among children of 1-10 years of age. In the first phase, the children in the age group of 1-10 years were screened for mental retardation using the Ten Questions Screen, whereas in the second phase the suspects were evaluated clinically. Results: The prevalence of mental retardation was found to be 1.71% in the study population with higher prevalence (3.3%) in the 73-120 months age group. The prevalence was higher among the males in all study populations [rural: 1.9%, urban (nonslum): 1.6%, and urban slum: 7.14%). The prevalence was similar among the urban (nonslum) (1.75%) and rural (1.11%) populations, whereas it was higher (4%) in the urban slum population. A prevalence of 2% was seen in families from the lower middle class and 1.8% among families from the lower class in the rural population, whereas a prevalence of 2% was seen among lower middle class families of urban (nonslum) areas. Conclusion: The prevalence of mental retardation was higher in our study than in other parts of the country. The study concludes with the hypothesis that the prevalence of mental retardation is differentially distributed geographically with socioeconomic factors being important predictors.

A Cross Sectional Assessment of Knowledge, Attitude and Practices towards Hepatitis B among Undergraduate Medical Students of a Medical College in rural area.

Introduction: Hepatitis B virus (HBV) infection is one of the most common blood borne viral infection in the world. It is a major potentially life threatening, global health problem. About 6,00,000 people die every year due to the acute or chronic consequences of hepatitis B. Health care workers including medical students are at risk of acquiring the infection while at work. Objective: To assess the knowledge, attitude and practice of hepatitis B infection among Undergraduate (MBBS) medical students of Dr. Rajendra Prasad Government Medical College, Kangra at Tanda. Materials and Methods: Knowledge, attitude, and practises towards Hepatitis B was assessed by using a pre validated questionnaire in a cross sectional descriptive study. Mean scores for knowledge, attitudes and practices were calculated using the Epilnfo software version 7. Results: Four hundred fifty questionnaires were distributed among the students.387 responded, a response rate of 86%. Mean age of female students was 21.5 ± 1.59 yrs and mean age for male students was 21.9 ± 1.69 yr. Mean scores for Knowledge, Attitude, and Practises were 15.87 ± 1.57 (Maximum score 19) , 2.00 ± 0.63 (Maximum Score 3) and 4.6 ± 0.97 (Maximum Score 6) respectively. This study also demonstrates some important shortcomings in the knowledge, attitude, and practises of medical students. Conclusion: Results of the study suggest good Knowledge, Attitude and Practice of Hepatitis B among the students. Though, overall knowledge and attitude to HBV infection is good, there is a need to develop guidelines to ensure that medical students are not only fully vaccinated against HBV but adequate practice of standard precautions is also adhered to.

Use of social networking sites among medical undergraduates of a medical college in north-west India.

Introduction: Use of Internet for communication has become a very important part of young people's life. Social networking sites are virtual communities that allow users to create a profile and interact with friends. One area of interest in this field is regarding the activities of medical students on social networking sites and how these activities affect their academic performances. Objective: To assess the use of social networking sites and its impact on academic performance among medical undergraduates of a rural medical College. Methodology: It was a cross sectional study conducted over a period of three weeks in December 2013 among undergraduate students of Dr RPGMC Kangra at Tanda. A self-administered questionnaire was used to conduct the study. Data was entered in Microsoft excel sheet and analysed.Result: A total of 150 participants were enrolled of which only 141 agreed to participate. Among these 74 (52%) were males and 68 (48%) females. The mean age of the subjects was 20.2 ± 1.5 years. Majority 123 (87.2 %) used multiple networking sites, 45 % (60/123) had joined communities related to medicine. More than half 52.7 % (65/123) of subjects used these multiple sites to remain connected with their friends.81.7% (49/60) visited medical communities daily and 93.9% (46/49) among them said that these communities has helped increase their knowledge. Average time spent per session was 10-30 minutes among 26.8 % (33/ 123) participants.Conclusion: The results of the study showed that role of social networking sites among undergraduate students pursuing a professional course is important while communicating with friends and people of their own field. It helps them in broadening their knowledge and they feel it has helped them positively in their academic performance.

Understanding pattern and trends in use of tobacco in India.

Tobacco smoking has been in vogue for hundreds of years. With the spread of tobacco to Europe and other parts of the world from the sixteenth century, tobacco smoking soon gained popularity in India. Tobacco consumption is responsible for half of all the cancers in men and a quarter of all cancers in women in India.' This is in addition to being a risk factor for cardiovascular diseases and chronic obstructive pulmonary diseases.2 3 India also has one of the highest rates of oral cancer in the world, partly attributed to high preva lence of tobacco chewing.4-7The World Health Organization predicts that tobacco deaths in India may exceed I .5 million annually by 2020. 8 It has been observed that a signi6cant rural-urban-slum-urban gradient for tobacco use among men as well as women exists in India. There are different, and opposing, trends for use of smoked tobacco (more in rural areas) and smokeless tobacco (more in urban area) among men. However it has been observed that among women, the consumption of smokeless tobacco does not vary significantly.

Epidemiological trends of RF/RHD in school children of Shimla in north India.

Background & objectives: There are no active surveillance studies reported from South East Asian Region to document the impact of change in socio-economic state on the prevalence of rheumatic fever/rheumatic heart disease (RF/RHD) in children. Therefore, we conducted a study to determine the epidemiological trends of RF/RHD in school children of Shimla city and adjoining suburbs in north India and its association with change in socio-economic status. Methods : Active surveillance studies were conducted in 2007-2008 in urban and rural areas of Shimla, and 15145 school children, aged 5-15 yr were included and identical screening methodology as used in earlier similar survey conducted in 1992-1993 was used. The study samples were selected from schools of Shimla city and adjoining rural areas by multistage stratified cluster sampling method in both survey studies. After a relevant history and clinical examination by trained doctor, echocardiographic evaluation of suspected cases was done. An updated Jones (1992) criterion was used to diagnose cases of acute rheumatic fever (ARF) and identical 2D-morphological and Doppler criteria were used to diagnose RHD in both the survey studies. The socio-economic and healthcare transitions of study area were assessed during the study interval period. Results: Time trends of prevalence of RF/RHD revealed about five-fold decline from 2.98/1000 (95% C.I. 2.24-3.72/1000) in 1992-1993 to 0.59/1000 (95% C.I. 0.22-0.96/1000) in 2007-2008. (P<0.0001). While the prevalence of ARF and RHD with recurrence of activity was 0.176/1000 and 0.53/1000, respectively in 1992-1993, no case of RF was recorded in 2007-2008 study. Prevalence of RF/RHD was about two- fold higher in rural school children than urban school children in both the survey studies (4.42/1000 vs. 2.12/1000) and (0.88/1000 vs. 0.41/1000), respectively. The indices of socio-economic development revealed substantial improvement during this interim period. Interpretation & conclusions: The prevalence of RF/RHD has declined by five-fold over last 15 yr and appears to be largely contributed by improvement in socio-economic status and healthcare delivery systems. However, the role of change in the rheumatogenic characteristics of the streptococcal stains in the study area over a period of time in decline of RF/RHD cannot be ruled out. Policy interventions to improve living standards, existing healthcare facilities and awareness can go a long way in reducing the morbidity and mortality burden of RF/RHD in developing countries.