Knowledge, attitude and practices regarding work related hazards among salt workers in Marakkanam, Tamil Nadu

Background: The salt pan workers are exposed to severe health hazards like extreme heat, intense manual labour, direct contact with salt, sunlight glare from salt crystals. This paper describes their knowledge, attitude and practices (KAP) regarding their work related hazards as well as availability and use of personal protective equipments (PPEs).Methods: A community based cross sectional study was conducted in 4 randomly selected villages among the 10 salt worker villages in Marakkanam, Tamil Nadu. A house to house survey of the selected villages enrolled 331 salt workers. The data was collected using a pre designed and pre tested questionnaire.Results: Majority of salt worker (78.5%) reported of being aware of one or more hazards like physical stress (70.7%), direct sunlight (38.7%) and glare from salt crystals (16%) in salt work that resulted in musculoskeletal problems, ophthalmic problems, headache and giddiness. 87% of the salt workers were aware of one or the other personal protective equipments. However, only less than 10% were using the conventional PPEs. The reasons for not using PPE were mainly inconvenience in using and PPE not provided by the employer.Conclusions: Most of the study population is aware of the hazards as well as one or the other methods of protective equipment but actual use of PPE is very low because of non-availability and perception of inconvenience in using them. There is a large gap between awareness and practice regarding PPE usage among these salt workers.

Impact of community based training on medical undergraduates skills upgradation regarding infant and young child feeding practices: A mixed method study

Despite various reforms brought in health care service delivery there is always a gap between community and health care providers. Hence there is a need to explore the successful strategies to reorient the medical students towards public health relevant community needs. Objective: This study aimed to assess the feasibility and impact of community based field training imparted among medical undergraduates to identify problems related to infant and young child feeding practices and design appropriate interventions. Material and Methods: This study is a mixed method study where improvement of knowledge were assessed quantitatively through quasi experimental pre-post study design. Difference in cumulative score obtained after training was compared using student's t test. Perception of students and mentor's views on this approach in terms of benefits and challenges were explored during in-depth interviews. Transcripts of qualitative interviews were analysed using manual content analysis. Results: Total of 781 infant and young children from 30 villages were surveyed by 36 medical undergraduates. There was significant improvement in knowledge on feeding practices from the baseline [baseline mean (SD) score: 3.3 (1.5); post training mean (SD) score: 6.5 (1.1), p<0.001]. Mentors of the opinion that this community based approach had facilitated the students to acquire skills on management, communication, team spirit and professional attitude. Students had opportunity to assess spectrum of illness and the co-existing social conditions in their natural setting. Conclusion: Students as well as other stakeholders were more positive and overwhelmingly supporting this approach. This approach is feasible with better planning, institute cooperation and commitment.

Prevalence of Hypertension Among School Children in a Rural Area of Tamil Nadu.

A cross-sectional study was conducted to measure the prevalence of hypertension among 310 rural school children in Tamil Nadu. The prevalence of hypertension and pre-hypertension was 10% and 14.2%, respectively. Prevalence was significantly higher among and private school students. We recommend that children should be screened for hypertension for early diagnosis and prevention of complications.

Patient and health system delays among adult smear-positive tuberculosis patients diagnosed at medical colleges of Puducherry in south India.

Early diagnosis and prompt initiation of treatment are essential for an effective tuberculosis (TB) control program. This study was done to assess the extent of various delays among TB patients diagnosed at medical colleges of Puducherry. A cross-sectional study involving retrospective medical record review and prospective patient interviews was conducted in and around the union territory of Puducherry during the period 2009-10. Various delays and adjusted odds ratios (ORs) were calculated. Level of significance was determined at 95% confidence interval (CI) (P value <0.05) and all tests were two-sided. Among 216 new sputum smear-positive TB patients, 11.1% and 10.6% were smokers and alcohol users, respectively. The median patient delay, health system delay, and total delay was 37 days, 28 days, and 65 days respectively. Being a resident of Puducherry (OR = 0.39, 95% CI = 0.18-0.87) and family size of ≤5 (OR = 0.45, 95% CI = 0.21-0.97) were found as the determinants of patient delays and total delays, respectively.

Prevalence and determinants of peripheral neuropathy among diabetics in a rural cum costal area of Villupuram district, Tamil Nadu.

Background: Diabetes mellitus is characterised by persistent hyperglycaemia that may be due to absolute or relative insulin deficiency. It was estimated that there would be 285 million diabetics by 2010 in the world. This estimate is projected to increase by 65% to become 438 million in the year 2030. Similarly in India it is estimated to increase by 58% from 51 million people in the year 2010 to 87 million people by the year 2030. Methods: The study was carried out as cross sectional study among 235 diabetic OPD attendants of rural health centre aged 30 years and above. TCSS was used for diagnosis diabetic peripheral neuropathy. Data was entered in MS excel 2007 and analysis was done using SPSS version 17.0. Chi square test was applied to find statistical difference in proportions and a p value of <0.05 was considered statistically significant. Results: The overall prevalence of peripheral neuropathy among the study participants was observed to be 13.2%, while none of the study subjects presented with severe form of the disease. Nearly half of the patient who participated in the study also had co existing systemic hypertension. Also 12.3% of the study subjects had a positive history of foot ulcers. Conclusions: The prevalence of DPN increased with increasing age and it is observed to be associated with duration of diabetes, physical activity, smoking habit and systemic hypertension.

Nutritional status and various morbidities among school children of a coastal area in South India.

Background: Malnutrition and poor health among school children is the common cause of low school enrolment, high absenteeism, early dropout and poor classroom performance. This study was conducted to assess the various morbidities and nutritional status among school children. Methods: This descriptive study was conducted during year 2013 in a higher secondary school located in a coastal area of Puducherry. A total of 714 students were interviewed and examined. A pre-designed and pre-tested questionnaire was used to interview and examine all the participated students. Body weight and height were measured using standardized procedures. WHO criteria for classification of nutritional status was used. Visual acuity and colour vision was assessed using Snellen’s chart and Ishihara’s pseudo isochromatic chart respectively. Mean scores and proportions were calculated and chi-square test was applied. P value of <0.05 was considered as statistically significant. Results: Among 714 student, 369 (51.4%) were males and 345 (48.6%) were females. The mean age of children was 10.2 ± 3.1 years. Among all age groups and both sexes, the observed BMI was lower as compared to the reference values. The prevalence of underweight among children of 5-9 years was (30.7%) and (1.1%) were severely underweight. The prevalence of stunting was 10.4%, including 0.1% of severely stunted children. A total of 30.7% children were thin (low BMI for age). Pallor (39.5%), myopia (34.9%) and dental caries (14.7%) were the common morbidities observed among children. The pallor was observed more commonly among girls and this difference was statistically significant (p value <0.05). Conclusion: Under-nutrition is a prevalent condition among school children. Apart from various nutritional programmes, health education to parents, community and school teachers are quite important to address this problem.

Patient and health system delay among new pulmonary tuberculosis patients diagnosed at medical college hospitals in Puducherry, India.

Background: Early diagnosis of the disease and prompt initiation of treatment are essential for an effective tuberculosis (TB) control program. The delay in the diagnosis and treatment may worsen the disease, increases the risk of death and enhances tuberculosis transmission in the community. This study was done to assess the extent of various delays and their determinants among TB patients. Methods: A cross-sectional study including retrospective medical record review and patient interviews was conducted during the year 2010 in and around union territory of Puducherry in India. A structured questionnaire used in the WHO multi-country study to estimate the diagnostic and treatment delay in TB was used to interview the patients. Average estimates and proportions were calculated for continuous and categorical variables respectively. Unadjusted odds ratios (OR) were calculated. Level of significance was determined at 95% confidence level (P value <0.05) and all tests applied were two-sided. Results: A total of 138 new sputum smear positive TB patients were included in the study. The mean age of participants was 41.8 years ± 17.3 years (range 15-87 years). Majority (67.4%) of the patients were male and married (68.8%). Majority (86%) of the patients were literate. The median patient delay, health system delay and total delay was 36 days, 28.5 days and 81 days respectively. The place of residence (OR = 0.39, 95% CI = 0.18-0.87) and family size (OR = 0.45, 95% CI = 0.21-0.97) were found as the determinants of various delays for TB patients. Conclusion: Patient and health care system delay for TB patients is long. There is need to improve the referral mechanism to ensure an early initiation of treatment for TB patients diagnosed a tertiary care hospitals.

Aging: The triumph of humanity-are we prepared to face the challenge.

Advances in medicine have increased the life expectancy resulting in an increase in the geriatric population all over the world, and their proportion will only continue to rise in the coming years. It is known that the elderly bear a significant burden of morbidity, which is why health systems globally spearheaded by the WHO are waking up to the need for better geriatric health services. This includes India, whose health system continues to grapple with the health challenges of communicable and noncommunicable diseases. This article enumerates the various government policies and programs, constitutional and legal provisions available for the care of the elderly, and concludes that they are grossly inadequate to deal with the various physical, psychological, and emotional needs of the aging population. Mainstreaming of geriatric health to address the health needs of the elderly at all levels of health care, both in the public and the private sectors, giving due importance to multidimensional rehabilitative services and terminal care, involving NGOs and voluntary organizations, and stepping up social security in old age are the recommended measures for improving geriatric health in India.

Profile of animal bite cases in Pune.

A Cross-sectional study was carried out to determine the profile of animal bite cases reporting to the Anti Rabies clinic of Sassoon Hospital, rune. The data was collected using pretested questionnaire. All 250 cases who reported during the period of study were included in the analysis. The male female ratio was 1.98 : 1. Children in the age group 0-14 years were the victims in 132 (52.8%) cases. Dog was the biting animal in 94.4% cases, followed by cat (2.4%), Jackal (1.2%), mongoose (1.2%), monkey (0.4%) and horse (0.4%). Of the 236 dog bite cases 30% of bites were inflicted by pet dogs of which only 38.02% were immunized. The wound was washed with soap and water in only 3.6% of cases. 64.8% of the bites were on the lower extremity and 63.2% of cases reported within 24 hours of the bite. Of the 247 cases administered Beta Propio Lactone (BPL) inactivated vaccine only 18.8% did not have any local reaction and 58.3% had one or more systemic reaction. A three pronged strategy has been recommended to reduce the burden of morbidity and mortality associated with rabies.