An assessment of utilization of postnatal care services in urban area Jabalpur district

Background: Postnatal period is a vulnerable time, because most maternal and new born deaths occur during this period, especially immediately after childbirth. Postnatal care in the first hours and days after childbirth could prevent the great majority of these deaths. The objective of study was to assess the utilization of post-natal care and associated factors for low utilization in urban area of Jabalpur district.Methods: A community based cross-sectional study was carried 360 mothers who delivered in last one year in urban area of Jabalpur district. Sampling method was multistage sampling method. A total 36 wards with 10 mothers from each ward was selected. The questionnaire included information related to mode of delivery, post-natal checkups and visits of health care providers.Results: Among 360 mothers, 93.9% mothers received first postnatal check-up within 24 hrs. 1.11% of mothers between 2-3 days and 1.67% of mothers received first postnatal check-up between 4-7 days while 3.33% of mothers didn’t receive any postnatal check-up. Regarding number of post-natal visits, 58.33% mothers received 3 or more postnatal visits, 35% of mother received 2 PNC visits, while 3.3% did not receive a single postnatal visit. The education of mothers, joint type of family, high socioeconomic status, early registration of pregnancy, minimum 4 ANC visits and institutional deliveries were found significantly associated with utilization of postnatal check-up.Conclusions: Utilization of postnatal services is still poor in the urban areas even though the physical accessibility was adequate. In the present study, it was concluded that the role of education, especially of female education, is important contributing factor associated with utilization of postnatal care.

Utilization of antenatal care services in tribal area of Madhya Pradesh: a community based cross sectional study

Background: As part of the Sustainable Development Goal 3, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births globally by 2030. Antenatal care (ANC) is an important determinant of maternal mortality and ANC visit is an important component of maternal health care. This study was carried out to assess the utilization of antenatal care services and to understand the factors associated with utilization of antenatal care services in tribal area of Madhya Pradesh.Methods: Community based cross-sectional study carried in tribal dominated district of Madhya Pradesh. A total of 210 mothers who delivered in last one year were selected for study by cluster sampling technique and mothers were interviewed using structured questionnaire after obtaining informed consent.Results: Present study 94.8% antenatal mothers registered and received at least one antenatal check-up and 51.4% mother were registered during first trimester while only 43.4% mothers received four or more ANC visits. Completely utilization of ANC services was found in 39.5% mother. Education of the mother, occupation of mother, income, education of the husband, knowledge of mother about the needs of antenatal care and early ANC registration were found to be significant factors associated with full utilization of ANC services.Conclusions: This study revealed that education of mother and knowledge of mother about the needs of ANC were important contributing factors associated with full utilization of ANC services in tribal area. The education is related with the economic status, awareness of mother about utilization health services, empowerment and decisions making capacity of mothers.

Assessment of Quality of Life among Parents of Children with Atopic Dermatitis

Atopic Dermatitis is a chronic disease that improves and remits with time. It may affect parental life style and parent-child relationship. Psychologically, individuals suffering from atopic dermatitis either children or adults have been shown to suffer a higher level of anxiety and lower quality of life. Objectives: To assess the Severity of AD in the children and quality of life in parents of children with AD. To analyse the relationship of severity and treatment of the disease on the quality of life in parents. Methods: The study comprised50 children diagnosed with AD ranging in age from 6 months to 12 years as well as parents of these patients attending Paediatric Dermatology Clinic at Dermatology department, GGS Medical College,Faridkot from February 2017 to February 2018. The quality of life was quantified by the Dermatitis Family Impact (DFI) Questionnaire. Eczema Severity was assessed using SCORAD Index. These two parameters were evaluated on two occasions 12 weeks apart, meanwhile the patients were managed accordingly. Results & Conclusion: The mean SCORAD and mean DFI Score at the baseline was 32.016 ± 10.78 and 15.14 ± 4.0 respectively. These values decreased to 16.494 ± 6.62 and 12.08 ± 3.34 respectively, at the end of 12 weeks. SCORAD and DFI scores, showed positive correlation which was statistically significant (p=0.04 at both visits), implying that quality of parental life is significantly correlated to severity of AD in the child. Hence, proper management of dermatological illnesses often requires combined evaluation and management of emotional factors as well.

Population genetic structure of malaria vector Anopheles stephensi using mitochondrial Cytochrome oxidase II gene in Indian populations.

The genetic differentiation in A. stephensi based on haplotype diversity using Restriction Fragment Length Polymorphism and by sequencing of CO II gene across different localities in India has been analyzed. The presence of only one DraI restriction site in CO II gene conferred to haplotype B indicating that the gene is very much conserved and the gene flow is not affected even by a major geographical distance barrier. The sequencing and analysisof various population parameters revealed seven haplotypes in all populations. The West Bengal population was found to be more genetically diverse than others. The geographic distance between populations was found to be contributing to the genetic differentiation. The sign of demographic expansion were found in three of the five populations. The local geographic barriers were found to be ineffective in prevention of gene flow.

Population genetic structure of malaria vector Anopheles stephensi Liston (Diptera: Culicidae).

Malaria is a complex disease that afflicts human today. Malaria epidemiology is associated with drug resistance in parasite and differential distribution and insecticide resistance in vector. Efforts are being made to eradicate malaria but burden of malaria is still increasing. Vector control is essential for malaria prevention strategies. Knowledge of population genetic structure is pre-requisite for determining prevention strategies, particularly using transgenic mosquitoes. Population genetic study can predict level of gene flow between different populations. Anopheles stephensi Liston is urban vector of malaria in Indo-Pakistan subcontinent. About 12% of malaria cases of malaria in India are contributed by A. stephensi. Studies conducted on population genetics of A. stephensi using various markers in different parts of the world are discussed in this communication.

A Study to find out the Dental and Associated Psychosocial Factors in Patients of Halitosis.

Background: Halitosis is unpleasant breath, regardless of its sources. Oral malodor can actually be an indication of more serious health concerns. Some studies have estimated the prevalence of halitosis to be between 22% and 50%, others between 6% and 23%. Poor oral hygiene, periodontal diseases, nasal problems, and various systemic illnesses can be various reasons behind halitosis. Psychiatric problems and halitosis contributes to each other’s pathology significantly. Method: 250 patients were enrolled for study. Sociodemographic profile was noted for all. Complete dental check up was performed to rule out dental factors for halitosis. Organoleptic scale was used to detect the intensity of halitosis. SCL-80 was used to find out psychological component of halitosis. Data was statistically analyzed. Results: Males significantly outnumbered females (p<0.0001) in being post graduates. Significantly more (P=0.0024) females were unemployed and household workers, 40 % were professional and 32% were students. Significantly higher number (p<0.0001) of subjects with halitosis had associated medical problems. Significantly higher (p=0.0101) difference was observed overall and among Males and females regarding dental problems. 34.47% had periodontitis, gingivitis (39.20%), missing tooth (22.80%), calculus (18.80%), tooth sensitivity (49.31%), caries tooth (53.29%), abscess (15.20%) and history of trauma (34.06%). Significantly higher results in somatization (p=0.0003; chi square=19.099), depression (p=0.0019; chi square=14.956), IP sensitivity (p<0.0001; chi square=27.506), phobia (p=0.018; chi square=10.063), OCD (p=0.0312; chi square=8.862) and anger hostility (p=0.0016; chi square=15.308) subscales of SCL 80. Conclusion: Present study concludes significant correlation between dental and psychological factors in halitosis. Halitosis itself produces psychiatric symptoms which could affect the social and personal interaction. Further research into these aspects of halitosis is strongly recommended in developing countries like india.

A Descriptive Study to Assess the Psychiatric Morbidity among Patients with Coronary Artery Disease.

Background: Symptoms of depression and anxiety are known to be associated with cardiac events. Anxiety is an independent predictor of both cardiac events and increased health care consumption and accounts for the relationship between depressive symptoms and prognosis. Psychological Symptoms need to be considered in the risk stratification and treatment of coronary artery disease (CAD) patients. Materials and Method: A non experimental research design was utilized to assess the psychiatric morbidity in a sample of 60 patients with CAD, attending the outpatient clinic of the Department of Cardiology of a tertiary hospital in Punjab. Symptom checklist -80 was used to assess the psychological deficits. Analysis and interpretation of the data was done using descriptive and inferential statistics. Results: Out of 60 patients, 39.9% of patients had symptoms of moderate depression and 7.70% had severe depressive symptoms. 12.5 % patients had severe anxiety and 39.41% had moderate anxiety symptoms. Anger hostility in both moderate and severe range was observed in 10.14 % of the subjects. Moderately severe depression and anxiety was higher in males as compared to females and the difference was statistically significant. (p=0.024 & p=0.0424). Females had significantly higher anger hostility than males (p=0.0176). Mean score on additional symptoms was 2.71± 4.14 and 5.21± 4.52 among male and female patients respectively. On an average, depression and anger hostility were significantly more in patients with co morbid medical illnesses (p=0.0066), recent invasive procedure undertaken (p=0.03) and who were living alone (p=0.039). Conclusions: Our study concludes that CAD can lead to various psychiatric disorders, which further can complicate the course and outcome of the primary disease itself. Moreover the cost of treatment of CAD and its complication can further worsen the psychiatric disorder. Psychiatric disorders also lead to poor compliance and follow up in CAD patients.

A Descriptive Study to Assess the Neuro-psychological Deficits among Epileptic Children.

Background: Neuropsychological deficits are common among epileptic children and these deficits of epileptic children may be influenced by factors like age, gender, frequency of seizures, duration of seizures, age at onset of seizures, type of seizures and family history. Material and Method: A non experimental research design was utilized to assess the Neuropsychological Deficits among Sample of 60 children with epilepsy, with age group of 8-16 years, attending outpatient neurology unit of Christian Medical College & Hospital, Ludhiana, Punjab. Symptom checklist -90 was used to assess the psychological deficits and Performance of intelligence to assess neurological deficits was assessed with the help of Bhatia’s Battery. Analysis and interpretation of data was done by using descriptive and inferential statistics. Results: Out of 60 patients, 60% of epileptic children were free of psychological deficits, 36.7% had mild and 3.3% had moderate level of psychological deficits. Children had maximum psychological deficits score (50.08%) in anger hostility related symptoms and least (12.75%) in phobic anxiety symptoms. 43% of epileptic children had borderline and dull normal IQ level which indirectly represented neurological deficits, maximum in cognition i.e. 43.33% and lowest in loss of coordination or loss of fine motor control. Epileptic children had more mean percentage neurological deficits score but with little difference in both Koh’s block design test (68.6%) and in ‘Pattern Drawing Test’ (68.1%) i.e. they had more problems related to the analytical- synthetics ability and the lowest mean percentage neurological deficits score (19.2%) were in “Immediate Memory Test”. Conclusion: Epileptic patients suffers from various degrees of neuropsychological problems, which if could be recognized early and intervened in time can further reduce the disability among these children’s and will lower the psychosocial impact of epilepsy at large.

Safety and Efficacy of Add on Modafinil to Selective Serotonin Reuptake Inhibitors in Major Depressive Disorder.

Aim: Despite the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depression, a significant number of patients show partial or no remission of symptoms. Although antidepressant medications are effective, they have a delayed onset of therapeutic effect. Modafinil is a novel psychostimulant that may be helpful in treating patients with residual symptoms of depression. The efficacy of modafinil as add-on therapy to SSRIs in depressed patients in Indian population is lacking; hence this study was designed to study the efficacy and safety of Modafinil as add-on therapy to SSRI in depressed patient in Indian Population.Methods: In an open, randomized study, 50 patients diagnosed with major depressive disorder (MDD) were divided into two groups. In Group A (n = 25) patients received conventional SSRIs with low dose Modafinil for 8 weeks. In Group B (n = 25) patients received conventional SSRIs for 8 weeks. Patients were evaluated at baseline and then at the end of 2, 4, 6, and 8 weeks. Results: There was significant improvement in Hamilton depression rating scale (HDRS), Epworth Sleepiness Scale (ESS), Fatigue severity Scale (FSS) and Clinical Global Improvement – severity (CGI-S) Scale (p < 0.05) in both groups. Modafinil in low dose as add on therapy showed more decrease in scores, had earlier onset of action, as compared to conventional treatment (p < 0.05). No serious adverse event was reported in either of the groups. Conclusion: Low dose Modafinil as add-on therapy had shown better efficacy, earlier onset of action as compared to conventional treatment in MDD in Indian patients.

A Case Control Study to Assess the Comorbidity of Depression and Migraine.

Background — Migraine is a common neurological disorder affecting around 18% of females and 6% of males. The present study was undertaken to identify and assess the impact of coexisting depression in diagnosed cases of migraine. Material and Methods — A hospital based case control study was conducted on 450 patients suffering from migraine of all ages and both sexes attending psychiatry OPD at civil hospital, Gurdaspur in Punjab. International headache society criteria for the diagnosis of migraine and 21- item Hamilton rating scale for depression was used. Migraine with depression (MWD) cases were compared with migraine without depression as controls (MC). Duration and frequency of migraine, comorbidity with depression was measured. Results — Out of 450 patients, 200 were MWD and 200 were MC patients. Among MWD and MC, females were common: 73% (146) and 75% (150) respectively. Of the females having MWD, 50% (73) belonged to age group 31-40 years as compared to females with MC where 58% (87) were from age group 21-30 years. Among the males, maximum number of patients belonged to age group 20-30 years for MWD and MC i.e 48% ( 26 ) and 57% (29) respectively. 50% of MWD reported having migraine attacks for five years or more years, whereas only 16% of MC had the similar duration (P value<0.01). 80% of (n=160) of MWD reported maximum disability during the headache as compared to 64% (n=128) of MC. 70% (140) of MWD had an average frequency of 4 or more attacks per month compared to 45% (90) of MC having one episode per month or less. Conclusion — Patients suffering from migraine with long history and high frequency might benefit from psychiatric evaluation and addition of antidepressants for their treatment.