RESUMO
Background: Stress in medical students is increasing nowadays & leading to untoward incidences. It is necessary to identify the stress levels & its causes at earliest so that early interventional measures can be adopted. This study aimed to find out prevalence of stress in medical students & to compare level of stress in males and females. Methodology: Total 338 medical students were evaluated for the presence of stress and its levels (mild/moderate/severe) using the Kessler Psychological Distress Scale (K10).Gender difference for stress levels was compared using student’s ‘t’ test. Reasons for stress were evaluated by a questionnaire. Results: The total prevalence of stress was 57.9% and the prevalence of severe stress was 10.6%. It was found that level of stress was significantly higher (p<0.05) among females (mean=22.60±7.11) as compared to males (mean=20.86±8.05). The main reason for stress in males was found to be academic problems and in females, problems related to hostel. Conclusion: Overall stress prevalence was 57.9%, which is high and thus needs to be addressed. Females have higher stress than males. The main source of stress in females being hostel problems and in males academic problems. Thus, various programs need to be arranged along with counselling to combat this stress.
RESUMO
CONTEXT: Cervical cancer is the second most common malignancy among women in India. There is thus a need to identify unexplored risk factors such as occupational exposure to tobacco dust to justify its increasing trend so as to recommend suitable preventive measures. AIMS: The aim was to study the association between occupational exposure to tobacco dust with development of carcinoma cervix. SETTINGS AND DESIGN: Case‑control study done in two tertiary care hospitals in Mangalore. METHODOLOGY: 239 histologically confirmed new cases of cervical cancer and the equivalent number of age‑matched controls from 2011 to 2012 were interviewed about occupational history of beedi rolling and related factors. STATISTICAL ANALYSIS: Chi‑square test, unpaired t‑test, logistic regression. RESULTS: Exposure rate to tobacco dust following beedi rolling was 63 (26.4%) among cases and 38 (15.9%) among controls (P = 0.005, odds ratio [OR] =1.893). The latent period from occupational exposure of tobacco dust subsequent to beedi rolling and development of cervical cancer was found to be 26.5 ± 8.5 years. Adjusted OR of beedi rolling with development of cervical cancer was found to be 1.913 (P = 0.005) after controlling the confounding effect of tobacco usage and was 1.618 (P = 0.225) after controlling the effects of all confounders. Three‑quarters of beedi rollers were working in conditions of inadequate ventilation and hardy anybody used face mask during work. About a quarter of participants underwent voluntary screening for cervical cancer. CONCLUSION: Occupational exposure to tobacco dust was found to be associated with risk of developing cervical cancer. Measures to promote awareness, timely screening of this disease along with the improvement in working conditions is required for improving the health status of beedi rollers and to minimize the incidence of carcinoma cervix in the community.
RESUMO
Disability prevention in cases with lymphatic filarial disease has been a research priority in view of the current programme on global elimination of lymphatic filariasis. This is also important for estimation of disease burden, impact evaluation, developing strategy for morbidity management and rehabilitation for lymphoedema patients in the endemic countries. In this communication, we are presenting the results of quantification of functional limitations of lower extremities with lymphoedema caused due to bancroftian filariasis by objective assessment of movement of joints and power of muscles in the affected legs. A total of 81 consecutive lymphoedema patients attending a filariasis clinic in Pondicherry urban locality were recruited for the study. Assessment for restriction of movement of joints and loss of power of muscles was carried out as in Manual for doctors to evaluate permanent physical impairment, prescribed by an expert group of WHO and Ministry of Health, Govt. of India on evaluation for permanent disability. Of the cases assessed, 40% in grade-I, 55% in grade-II, 77.3% in grade-III and 94.7% in grade-IV lymphoedema cases had functional limitations either in joint movements or power of muscles or both. The effective loss of locomotor/function (combined loss of joint movement and power of muscles in %) increased with stage of lymphoedema (grade-I-4.3+7.4, grade-II-7.0+8.4, grade-III-15.4+14.8 and grade IV- 33.2+22.8). The degree of loss varied significantly between the grades (P< 0.0001). The methodology used in this study can be adapted to evaluate the impact of the morbidity management component of strategy for Elimination of Lymphatic Flariasis (ELF) programme. This study will also enable researchers for fine-tuning the method for estimating disease burden and, to develop and evaluate strategies for morbidity management/rehabilitation of filarial lymphoedema patients.