Contraceptive use and unmet need for family planning among HIV-positive women: A hospital-based study

Background: For women living with HIV who do not want to become pregnant or who wish to delay pregnancy, contraception has the added public health benefit of reducing the number of infants who might acquire HIV. The unmet need for contraception must be addressed to prevent unintended pregnancies among HIV-positive women and consequently mother-to-child transmission of HIV. Objectives: The objectives of this study were to assess the contraceptive usage and its various determinants and to find out the unmet need for family planning among HIV-positive women. Methods: This was a cross-sectional descriptive hospital-based study conducted among 235 HIV-positive women attending the ART center of a medical college. Data were collected using a questionnaire-containing sociodemographic details, obstetric history, treatment information, contraceptive usage, and their fertility desires. Data analysis was performed using MS Excel and the SPSS version 20.0 using frequencies, Chi-squared test, and multiple logistic regression. Results: The mean (standard deviation) age of the study participants was 28.8 (5.5) years. Majority (96.6%) of them were married and were illiterate (34.4%). The prevalence of unmet need for family planning was found to be 17%, and the prevalence of consistent contraceptive use was 74.5%. The most common family planning method used by women was male condom. Not having HIV-positive children, HIV-negative partner, and discussing contraceptive with partner were observed to be significant predictor of consistent contraceptive use on multiple logistic regression. Conclusion: There is a need to boost family planning counseling and address the unmet need and contraceptive use among HIV-infected women.

Menopausal symptoms and quality of life in women above 40 years in an urban resettlement colony of East Delhi

Background: Awareness of menopausal symptoms and their effects on the quality of life is extremely important for better management of symptoms. Objectives: The objectives of this study was to assess the prevalence of menopausal symptoms and its effect on the quality of life in women >40 years and determine the association of sociodemographic, obstetric, and other factors with menopause. Materials and Methods: A cross-sectional study was conducted in 105 women aged 40 years and above residing in an urban resettlement colony of Delhi. An interviewer-administered questionnaire was used to obtain information about sociodemographic and menstrual history. Quality of life related to menopause and its symptoms were measured using the menopause-specific quality of life questionnaire. Statistical analysis was done using SPSS 20.0. Results: Majority of the participants were married (70%), literate (50.5%), unemployed (92.4%), and belonged to upper-lower socioeconomic class (65.7%). The most prevalent symptom was decrease in physical strength in 85.7% of women. The prevalence (89%) and mean score of botheration (3.05 ± 0.917) for physical domain of symptoms was highest and it was significantly associated with the age of subjects and attainment of menopause (P < 0.05). Psychosocial domain was also significantly affected by the age of participants. Sexual domain of symptoms was least prevalent (11%) and had the least mean score of botheration (1.38 ± 1.134). Mean age of menopause was 44.6 years. Awareness regarding menopause was poor (1.9%). Conclusions: Physical symptoms are the most prevalent. Both physical and psychosocial symptoms are associated with age of participants, while only physical symptoms are associated with menopause attainment. The awareness of menopausal symptoms was very poor in the participants.

Family caregivers’ burden: A hospital based study in 2010 among cancer patients from Delhi.

BACKGROUND: A large number of patients with chronic diseases like, cancer are cared for in homes by the family members in India. The vital role that these family members play as “caregivers” is well recognized, however, the burden on them is poorly understood. AIMS: To assess burden and to determine the predictors of burden on family caregivers of cancer patients. SETTING AND DESIGN: A cross‑sectional, hospital based study conducted in National Capital Territory of Delhi. MATERIALS AND METHODS: 200 family caregivers of cancer patients were selected by systematic random sampling and interviewed using standard, validated Hindi version of Zarit Burden Interview. STATISTICAL ANALYSIS: Univariate analysis and multivariable logistic regression were carried out using Statistical Package for the Social Sciences software (version 17.0). RESULTS: The study population consisted of 90 (45%) males and 110 (55%) female caregivers aged 18‑65 years. 113 (56.5%) caregivers reported no or minimal burden while 75 (37.5%) caregivers reported mild to moderate burden. Using logistic regression marital status, education and type of family of caregivers, occupation of cancer patients and type of treatment facility were found to be the predictors of burden on caregivers. CONCLUSION: In view of the substantial burden on family caregivers coupled with lack of adequate number of cancer hospitals, there is a public‑health imperative to recognize this important group. All levels of health‑staff in cancer hospitals in developing countries should be sensitized to the various burdens faced by family caregivers.

Breast feeding patterns in an urban resettlement colony of Delhi.

Studies on duration and patterns of breast feeding based on recall may lead to a bias about the exact feeding status. The present study was designed to overcome this bias using the 'current status analysis method'. Mothers of 650 infants from 0 to 12 months of age attending a Health Centre were interviewed about the current feeding patterns of the infants and other socioeconomic variables. Month-wise prevalence of feeding patterns was determined. It was observed that breast feeding was maintained at a high level (more than 90%) throughout infancy while exclusive breast feeding showed a rapid decline. At 1 month, 74% and at 4 months, 46% of infants were exclusively breast-fed. The median duration of exclusive breast feeding was 3.83 months. Mothers with lesser education and lower family income were more likely to exclusively breast feed (p < 0.05). The time interval between birth and first breast feed was 24-48 hours in most (48.9%) of the infants. Majority (76.9%) of the infants received pre-lacteal feeds. Hospital-born infants received their first feed earlier and were less likely to receive pre-lacteal feeds as compared to those born at home (p < 0.001). Thus, the practice of exclusive breast feeding has to be promoted amongst pregnant and lactating mothers by health personnel. Also knowledge regarding infant feeding has to be imparted in schools and colleges.

Process evaluation of pulse polio immunisation in Delhi.

The aim of the study was to assess the functional aspects and the staffing at Pulse Polio immunisations posts. Interns and medical students conducted the survey in eighty seven pulse polio immunisation posts scattered all over National Capital Territory of Delhi on 18th January 1997. A pre-tested structured format containing information pertaining to dose utilisation and staffing was filled. Number of children given pulse polio was on an average 459.2 per immunisation post (474.7 rural, 516.35 slums and 435.0 urban). Average number of neonates (below one month) per immunisation post given polio drops was 5.1 (1.1%). The break-up for rural area, slums and urban area was 3.0 (0.63%), 6.7 (1.30%) and 4.9 (1.13%) respectively. By 12 pm, 67.8% and by 2 pm 88.7% of the doses had been administered. Staffing at most of the immunisation posts was adequate for all categories of staff except doctors (0.48 per booth).

Health and nutritional status of boys aged 6 to 12 years in a children observation home.

One hundred and ninety two boys in the age group 6 to 12 years, living in a Children Observation Home in Delhi were studied for their nutritional status and morbidity profile. Body Mass Index (BMI), an age-independent index was used to grade the nutritional status according to which, 36.7% of the boys were found to be malnourished. Signs of specific nutritional deficiencies were observed in 13.5% of the boys. Morbidity in some form or the other was present in 148 (60%) boys. Skin disease was the commonest morbidity (31.7%), followed by diseases of the oral cavity (16.1%), acute respiratory infections (8.6%) and diseases of the ear (9.9%). Need for health promotional activities is stressed to reduce the morbidity and improve the health status of these children.

Magnitude of acute respiratory infections in under five.

A community-based study was carried out in a rural area of Delhi to measure the prevalence and incidence of acute respiratory infections among children below the age of 5 years. The prevalence of 12.1%, was similar in boys and girls and was seen to decline with age. The incidence of acute respiratory infections was 2.5 episodes per child per year; it was not different in boys and girls. There was a statistically significant decline in the incidence with age. Upper respiratory tract infections comprised 87.5% of total acute respiratory infection morbidity while lower respiratory tract infections were 12.5%. Both upper and lower respiratory tract infections declined with increasing age; while the former was similar among boys and girls, the incidence of latter was significantly greater in boys (0.4 episodes per year) as compared to girls (0.2 episodes per year). A total of 87.5% episodes were mild, 10.4% moderate and only 2.1% were severe. The results suggest that acute respiratory infections are a major community health problem and an acute respiratory infection control programme needs to be implemented urgently.

Experimental studies on the treatment of frostbite in rats.

The effect of treatment by high dose of vitamin C, rapid rewarming by 37 degrees C water alone and with vitamin C, rapid rewarming by 37 degrees C decoction of Indian black tea alone and with vitamin C for experimentally produced frostbite was evaluated in 6 groups (25 each) of rats. Frostbite was produced experimentally in the hind limbs by exposing the animals at -15 degrees C for 1h using the harness technique. The degree of injury was assessed and classified on the basis of tissue necrosis at the end of 15 days. Administration of high dose of vitamin C for prolonged period and rapid rewarming at 37 degrees C water bath immediately after cold exposure apparently reduced the tissue damage. High dose of vitamin C therapy preceded by rapid rewarming in plain water showed additional benefit. Rapid rewarming in decoction of Indian tea resulted in identical beneficial effect. The degree of tissue preservation was highest with rapid rewarming in tea decoction followed by high dose of vitamin C.