High prevalence of type 2 diabetes mellitus and its risk factors among the rural population of Pondicherry, south India

We aimed to assess the prevalence of type-2 diabetes in rural Pondicherry and to study the determinants of Diabetes Mellitus [DM] in the rural population of Pondicherry, south Induia. It was a cross-sectional community-based study conducted from November 2010 to January 2012 in two of the field practice villages affiliated to a Medical College in Pondicherry. Sample size was calculated using open source software, Open Epi Version 2.3.10. The sampling frame comprised individuals aged above 25 years and single stage cluster random sampling was carried out. After obtaining the verbal informed consent each of the study participants were interviewed face-to-face using a pre-tested structured questionnaire. Data were analyzed using the SPSS version 16. The age of the study participants ranged from 25 to 98 years with mean of 42.6 [+/- 13.7] and majority of the study participants 339 [32.5%] from the age-group of 30-39 years. The prevalence of diabetes was 19.8% [60-69 years], 17.1% [40-49 years], 16.8% [50-59 years], and 13.6% [>69 years] among study subjects. In univariate analysis, higher age, being educated, unemployed and poor was associated with higher risk of diabetes mellitus [DM]. Furthermore, a high triglyceride level was significantly associated with increase in the risk of DM [adjusted odds ratio: 3.01; 95% CI: 1.86, 4.86]. Type-2 diabetes mellitus [T2DM] is an important public health problem in the adults of rural Pondicherry. Among non-modifiable factors, higher age, better socio-educational background and positive family history of diabetes was significantly associated with T2DM

Exploring the doctor-patient relationship in clinical practice in hospital settings

The Doctor-Patient Relationship [DPR] is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor's guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants

Assessment of Knowledge and Practices about Menstrual Health among Adolescent Girls of an Urban Slum in Mumbai

Adolescence is a critical period of life marked by biological, social and psychological changes for an individual. The objective of the study was to assess the knowledge and practices of adolescent girls pertaining to menstruation in an urban slum. A cross-sectional descriptive study of three months duration (January 2011 to March 2011) was conducted in an urban slum of Mumbai. All adolescent girls from 10-19 years of age, who had attained menarche, attending general out-patient department and STI clinic, were included. The total sample size of the study was 241. After taking the informed consent of the study respondents, participants were interviewed using a semi-structured questionnaire. The questionnaire comprised of eliciting information pertaining to the socio-demographic profile and reproductive health i.e. hygiene during menstrual periods, awareness about HIV/AIDS of the participants. Special care was taken to maintain privacy and confidentiality. Data entry and statistical analysis were done using SPSS version 17. Frequency distributions were calculated for all the variables and chi-square test was used to study the association between socio-demographic parameters and knowledge and practices about menstruation. It was observed that 79(32.8%) subjects had unsatisfactory menstrual hygienic practices. Even though 66% of adolescent girls were aware about the different modes of transmission of HIV, only 19% knew about safe sexual practices. Education status and late adolescent age group (15-19 years) had a statistically significantly association with adolescent girls knowledge about menstruation. Good/fair knowledge and education status was found to be significantly associated with good practices during menstruation. Study findings have revealed that education status of the adolescent girls was the most important determinant for having good menstrual knowledge. Also significant association was observed between education level and healthy menstrual practices. Thus steps should be taken to improve the literacy status of the adolescent girls for bringing about further improvements in the menstrual hygiene related knowledge and practices.

study of spousal domestic violence in an urban slum of Mumbai

Gender-based violence is recognized as a major issue on international human rights agenda. Domestic violence and abuse can happen to anyone, yet the problem is often overlooked, excused, or denied. This is especially true when abuse is psychological, rather than physical. A community-based cross-sectional study of 6 months duration was undertaken with the objective of studying the proportion and different forms of domestic violence, factors influencing it, and to study treatment-seeking behavior of these women. The study participants were married women in the age group 18-45 years residing in an urban slum area of Malwani, Mumbai. Using stratified random sampling, 274 subjects were selected. House to house visits were paid and they were interviewed face to face using a pretested semi-structured questionnaire after obtaining their informed consent. Rapport was established with the help of a Medical Social Worker. The questionnaire included information pertaining to the sociodemographic parameters and experience of domestic violence in the last 1 year and their treatment-seeking behavior for the same. Utmost care was taken to maintain privacy and confidentiality. Analysis was done using SPSS version 17. The proportion of domestic violence was 36.9%. The most common form of violence was verbal in 87 [86.1%] followed by physical in 64 [63.4%]. A significant association was found between domestic violence and age, education, spousal alcoholism, and duration of marriage

Tuberculosis: active case finding survey in an urban area of India, in 2012

Tuberculosis [TB] continues to pose a major global health problem and thus intensive action is needed to control and ultimately eliminate the disease. An active case finding [ACF] survey was conducted in the urban slum areas of the R-South Municipal Ward of Mumbai City for a period of two months from June to July 2012. Micro planning for survey was done by District Tuberculosis Officer and Medical Officer of Health of R-South ward. The entire health post staffs of R-South ward were trained to perform the survey. TB suspects were identified by trained community health volunteers during their home to home visit. These suspects were referred to the designated microscopy centers [DMCs] for sputum examination and those diagnosed with TB were put on anti-TB treatment. A total of 278 TB suspects were identified on enquiring on the presence of symptoms suggestive of TB. Out of them 221[79.5%] patients got tested for sputum examination. Sputum positive TB was diagnosed in 29 suspects and the sputum positivity rate was 13.1%, which was slightly higher than the passive case finding norms of 10% as prescribed under Revised National TB Control Program. Active case finding for tuberculosis in the general community was discouraged for several decades because of high costs of implementation. However, results of the survey suggest that periodic ACF should be incorporated in populations wherever tuberculosis incidence / prevalence is high as there was a definite improvement in the case detection rate

Breastfeeding Practices and Factors Associated With It: A Cross Sectional Study Among Tribal Women in Khardi Primary Health Centre, Thane, India

India is home to large number of under-five deaths and underweight children in the world which is mainly because of improper breastfeeding practices. Hence the study was conducted to assess the breastfeeding practices in tribal settings so that proper interventions can be planned by the health system staff to reduce infant morbidity and mortality. Cross-sectional study of three months duration from June 2011 to August 2011was conducted in tribal area of Khardi in Thane district amongst women who had delivered within one year of the study. This study was conducted in Khardi Primary Health Centre (PHC) which comprises of eight sub-centres. Five sub-centres among these eight sub-centres were selected randomly using lottery method. All tribal women, with infants between six months to twelve months of age, registered with these five sub-centres during their antenatal period were included as subjects. 153 such women were identified using universal sampling with the help of Auxillary Nurse Midwives (ANM) and Anganwadi Workers (AWW). 21 women were excluded due to non availability. House to house visits were paid to these subjects & they were then interviewed face to face using a questionnaire after taking their informed consent. Dependent variable was breastfeeding practices including exclusive breastfeeding and independent variables were all the socio-demographic factors influencing breastfeeding. Analysis was done with SPSS version 16. More than half (67.4%) infants were exclusively breast fed (EBF) up to six months of age. Pre-lacteal feeds were given to 23.5% infants while colostrum was not given to 15.2% infants. Practice of EBF was found to be significantly associated with advice regarding EBF during antenatal period, education status, parity of mother and sex of child. 67.4% of the infants were exclusively breastfed till six months of age. Religion, education of the mother, number of children of study subjects, sex of the baby and knowledge about EBF was found to be significantly associated with exclusive breastfeeding.