Can personal hygiene act as a proxy indicator of morbidity profile? A study on orphans of Uttarakhand region

Background: A healthy childhood is essential for future growth and development. It is greatly influenced by parent, family, society and environment which formulate attitude, behavior, manner and emotions. Millions of children across the world are deprived of this crucial phase of life; those are the orphans and abandoned children.Methods: This institution-based cross sectional study was carried out with the help of pre-designed semi-structured questionnaire amongst 193 orphans aged 5-14 years to assess the personal hygienic practices and morbidities among orphans and to find out the association between the morbidity with personal hygiene and other risk factors.Results: The leading morbidities observed were poor oral hygiene (57.51%) as a morbidity followed by dental caries (50.58%) and pallor (30.57%). The average morbidity per child was found to be 2. There was significant association between ages, education, personal hygienic practices with the presence of morbidity in the orphans.Conclusions: Practices related to personal hygiene was not satisfactory. There was a significant association between morbidity and personal hygiene. Despite of the fact that these children are highly vulnerable; their health needs are poorly understood and ill served.

Prevalence and correlates of psychological distress among cancer patients in a tertiary care hospital in northern India

Background: Patients diagnosed with cancer are usually exposed to high level of mental stress and hence invariably lend in psychological distress. This study aimed to estimate the prevalence of psychological distress amongst cancer patients and determine its association with socio-demographic factors. Methods: This hospital based cross-sectional study was conducted at a cancer research institute of district Dehradun. Purposive sampling was used to select the hospital and recruiting patients. All eligible patients, giving written consent for the study were interviewed and distress related information was gathered using the Hospital Anxiety and Depression Scale (HADS). The data were collected for two months and sample size of 208 was achieved. Data was entered in SPSS 22.0 and association of different variables with psychological distress was determined by chi-square test.. Results: The mean age of the surveyed cancer patients was 51.05±15.68 years and the male female ratio was 1.7. Prevalence of psychological distress was found to be 38.5% and significantly more female patients than male patients (47.4% and 33.3% respectively) had distress. The association between psychological distress and increasing age, sex, literacy and employment status was found to be significant. Conclusions: Approximately 39% of cancer patients had psychological distress (anxiety/ depression/ both). The prevalence of psychological distress was found to be significantly higher in female patients, older age, patients with no formal education, unemployment and lower socio-economic status. Appropriate psychiatric interventions/ counselling following diagnosis and during therapy may be effective in reducing distress and improving quality of life in cancer patients.

Diabetes mellitus as a risk factor for ischemic stroke: a case control study

Background: In developed countries, stroke is the third most common cause of mortality, following cancer and coronary heart disease. The increase risk is often seen in individuals with diabetes and is associated with poorer clinical outcomes (including higher mortality). That’s why assessment of risk factors for stroke are important.Methods: This age and sex matched hospital based case control study assessed the risk factors of ischemic stroke in tertiary care hospital for a period of one year. Sample size was calculated for matched case control (1:1 ratio) by n-master software and came out to be 189 pairs. All patients under WHO case definition were enrolled as cases for study purpose, controls were selected from the same hospital with disease other than stroke. Analysis was conducted through calculation of odd ratio (OR) and confidence internal (CI) by using SPSS 22.0 program. Odds ratio (OR) of risk factor was calculated using bivariate analysis.Results: Results revealed that male: female ratio among the case and control was 2.1:1, mean age of case and control were 58.86±13.03 and 58.21±12.67. Out of 189 Case, 59 (31.2%) were suffering from diabetes, while only 39 (20.6%) controls were having diabetes mellitus. P value was 0.02, which is significant.Conclusions: In the present hospital based case control study, it was found that diabetes mellitus was a significant risk factor among the ischemic stroke patients.

Prevalence And Bio- Social Predictors Of Hypertension In Rural Dehradun.

Abstract: Background and Objectives: Cardiovascular diseases account for a large proportion of all deaths and disability worldwide. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Studies have shown a high prevalence of hypertension in both urban and rural areas. Although there is generally a lower prevalence of hypertension in rural Indian population, there has been a steady increase over time in this rural population as well. Methodology: This observational cross sectional study was conducted in a randomly chosen block in district Dehradun. Overall 457 people were interviewed and measurements were taken to know the prevalence of hypertension and related risk factors. The collected data was entered and analysed in SPSS software (21.0 version ). Results: The prevalence of hypertension was 23.9% and male subjects had higher prevalence than females (26.2% and 21.5%respectively). With increasing age, prevalence of hypertension increased significantly. Age, sex, marital status, family type and occupation were found as important bio-social predictors of hypertension. Conclusion: Increasing prevalence of hypertension in rural areas and in younger age groups is of concern to the public health. In developing countries like India, preventive strategies should be directed towards masses with focus on behaviour change communication.

A study on rural & urban differences in tobacco use and its socio-demographic determinants in district Dehradun.

Background: Today, tobacco use causes 1 in 10 deaths among adults worldwide – more than five million people a year. By 2030, unless urgent action is taken, tobacco’s annual death toll will rise to more than eight million. Material & method: A community based cross sectional study was undertaken in district Dehradun. Multistage stratified random sampling was done for selection of study area. A sample of 632 was taken for study purpose. Kish method was used for selection of respondents in selected household. Statistical analysis: Chi-square test, Mantel Haenszel Odds Ratio and Multi Variate Logistic Regression Analysis was done to develop results. Significant level was assumed at p<0.05. Results: The overall prevalence of ever use of tobacco was 24.4%. It was more (32.9%) in rural area as compare to urban area (15.8%). Tobacco use was directly proportional to age, more prevalent in Muslims and was indirectly proportional to education & socioeconomic status. Conclusion: Legislation pertaining to tobacco and alcohol sale and use does exist. However its strict enforcement is required in order to reduce the menace.

Screening for Hypertension and Morbidity Profile of Patients - A Primary Care "High Risk Approach".

Background: The world is ageing fast. Increased longevity is not only a triumph for society but a huge challenge for health systems which need to be prepared to address the needs of older people at the community level. Most preventative health care and early disease screening takes place in primary health centres within health systems. These centres play a critical role in the health of older people worldwide at the local level by increasing quality of life. Menace of rising burden of non-communicable diseases can be controlled by developing a model of screening at primary health care level. A study has been planned, to identify one of the major iceberg disease i.e. hypertension which acts as precursor of many other morbidities Methodology: Study was conducted at Rural Health Training Centre, Rajeev Nagar. Sample size included all the patients above 40 years of age attending (for any ailment ) OPD during one year period i.e. 1 January – 31 December 2011. Screening for hypertension was done and morbidity profile along with demographic indicators were also recorded during data entry. Results: Study subjects included females (58.2 %) and males (41.8). About one fourth (22.7 %) of the patient screened were in Pre-Hypertensive category while 12.3 % and 3.6 % were in hypertensive Stage I and II respectively. 38.6 % persons were diagnosed with high blood pressure. Most of the patients with high blood pressure were in age group of 60-69 years, followed by 50-59 years. Higher blood pressure was slightly more among males (39.6 %) as compared to females (37.9%). Locomotor (17.6%), GIT (16.0 %), respiratory (13.5 %) and skin diseases (10.1%) were the principal morbidities. Conclusion: A community based hypertension screening programme targeting older adults above 40 years of age can help in early detection of new cases of 'iceberg diseases' to initiate primary and secondary level prevention. Utilising basic health facility to screen for hypertension suggested here is promising to identify and cater vulnerable population.

ICDS — is it the entitlement of every Indian child.

Objectives: To assess the extent of utilization of services by underthree & their mothers at AWC’s & to study the gender differences in availing the services . Methods : A cross- sectional study regarding the utilization of services by children (0-3 years) & their mothers among 11 Anganwadis in 8 villages registered under RHTC,HIHT Dehradun. The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 17.0 for Windows. Results : Study findings showed that majority of underthree children i.e. 89.2% were enrolled in the AWCs whereas only 29.20 % went to AWCs to avail the combined benefits of vaccination, supplementary nutrition, healthcheckups followed by Immunization services(23.2%).63.55% children in the age group 0-3 years were attending the AWC to receive SN whereas only 22% of children were availing it regularly. Conclusion: The problems encountered at AWCs were under utilization of services due to lack of awareness of parents & insufficient motivation of AWW. There is a need to improve awareness about the services especially in the underthree age group so that eligible beneficiaries can avail them.

Morbidity Profile of Elderly Persons

This cross-sectional study was conducted to know about the morbidity status of the geriatric population reporting at RHTC. A total of 285 elderly persons (>=60 yrs.) had reported at RHTC during the study period. All the subjects underwent personal interview and clinical examination. Hypertension was the commonest morbidity (41.4%) followed by musculoskeletal problems (36.8%) and respiratory problems (36.1%). The prevalence of psychosocial problems among patients was found to be 28.8 % (males-16.9%, females-48.1%). With the changing pattern of family, migration and other socio-demographic factors; there is a continuous rise in the health problems of elderly in developing countries. It makes a greater demand on the health services of a community.