Knowledge, attitude and treatment seeking behaviour among postmenopausal women in an urban slum area of Bhubaneswar, Odisha

Background: In every women life this unique physiological phase that is menopause take place. In developing countries like in India most of women neglected their basic health care which poses the major public health challenges. The objectives of the study were to assess the knowledge, attitude towards menopause and its associated factors among postmenopausal women of urban slum; to explore the treatment seeking behaviour and the barriers for not seeking health care among these post-menopausal women.Methods: This cross sectional study was conducted using multistage cluster sampling and house to house visit in randomly selected slums under the UHTC area of KIMS, Bhubaneswar. A pretested and predesigned questionnaire was used among 220 postmenopausal women.Results: The results of the study show that 60.9% of women have a heard about menopause before attaining menopause but 33.1% women attitude towards menopause is negative. Only 10% of study population were aware of HRT that it treats menopausal symptoms. We found that the awareness of cancer cervix was 19.1% but the screening was done only by 2.7% of study population.Conclusions: There is considerably lack of knowledge and awareness about the effects and the treatment of menopausal symptoms especially in rural and slum women in India. So, such studies help in creating awareness since disseminating health education for postmenopausal women is of prime importance.

Community Knowledge, Attitude, Awareness and Protective Practices Regarding Malaria in Mewat and Rohtak Districts of Haryana, India.

Aim: Mosquito borne diseases especially malaria is a serious public health problem in the tropical and sub-tropical regions of the world especially the developing countries including India. Besides available key interventions to control the spread of vectors and vector borne diseases, there is a felt need for involving a suitable community approach based on knowledge, attitude, awareness, behaviour and protective practices to get the best results. Hence, the present study is an attempt to provide some inputs in this direction. Methodology: A community based cross-sectional survey was carried out in a highly malaria endemic cluster of six selected villages of Rohtak and Mewat region of Haryana to know the respondent knowledge about malaria and other mosquito-borne diseases, as much as their attitude, awareness and practices regarding the malaria and its control. The results obtained were processed and analyzed statistically by using STATA version 10 software. Results: The study revealed that about 52% of the respondents in Rohtak region and 42.68% in Mewat region committed that malaria is transmitted by mosquito bite which was directly correlated with the level of education. It was observed that high fever, chills and body pain were considered as the major signs/symptoms of malaria. Television followed by friends and relatives and health care provider’s acts as the major source of information about malaria and other mosquito borne diseases. Overall (76.2%) individuals from both study areas mentioned that malaria is a serious problem in their area but only 46.3% knew about various Government measures for the protection and treatment of malaria. Mosquito nets, mosquito coil and repellents were commonly used as protective practices by the respondents but the difference was not found significant except for mosquito net (P <0.05) in both the study areas. Conclusion: Promoting active community participation by improving current intervention strategies through information, education and communication regarding malaria and other mosquito-borne diseases may yield better results.

Estimating the Economic Burden of Malaria and Assessing Its Relationship with Socio-Economic Condition in Rohtak and Mewat Districts of Haryana, India.

Aim: Malaria continues to remain a serious public health problem and causes significant economic burden especially among the poor tribal and marginalised communities in the tropical and subtropical countries of the World. In view of the lack of information in respect of malaria and economic losses in Haryana, an attempt was made to assess the relationship between the occurrence of malaria and socio-economic conditions as well as to estimate the direct and indirect costs incurred due to malaria in Rohtak and Mewat districts of Haryana. Methodology: A community based cross-sectional survey was carried out in a highly malaria endemic cluster of six selected villages of Rohtak and Mewat region of Haryana, to estimate the economic burden in terms of direct and indirect costs of malaria. Results: The study revealed that on an average a household incurred a total cost of Rs.1835 (29.77 US$) in Rohtak district and Rs 2027 (32.91 US$) in Mewat district as direct and indirect cost per patient. It was estimated that direct costs due to malaria consumed 36-40% of annual income of poor households and 3-4% of high income households suggesting that the burden of malaria is significantly higher among poor households. Conclusion: The study revealed that malaria posses a significant economic burden on poor households both through out-of-pocket expenditure and man-days lost. To reduce the economic burden of malaria implementation of suitable intervention measures with focus on poor and marginalised along with better allocation of resources and health care facilities at the Government hospitals must be taken into consideration. It is also needed the intensification of IEC (Information, Education and Communication) campaigns regarding malaria to enhance awareness and solicit community participation.

A Pilot Study to Calculate the sample size for the Prevalence of Aggression in Psychiatric Outpatient Setting.

Background: There is a rise in the number of invisible mental health problems like aggression in a developing country like India. There is scarce data available on the prevalence of aggression in psychiatric patients which has been collected in a systematic manner. Objective: A pilot study to calculate the sample size for the prevalence of aggression in psychiatric outpatient setting in a General Hospital Psychiatric Unit using Modified Overt Aggression Scale in twenty patients. Results: The prevalence of aggression was 20% in the pilot study. Conclusions: This pilot study enabled us to calculate the sample size accurately. This also facilitated the investigator to handle the shortcomings and modify the research protocol accordingly.

Antibodies raised against hemolymph of Anopheles culicifacies reduce the fecundity and malaria parasite development.

Background & objectives: Several studies have been made to study the effect of antisera raised against different tissues (hemolymh, ovary, midgut and salivary glands) on the fecundity and malaria parasite development in the different species of mosquitoes but there are no reports on the antisera raised against the hemolymph of Anopheles culicifacies, the principal malaria vector in India accounting for 65% of malaria cases. Hence, an attempt was made to study the same and evaluate its impact on malaria parasite development. Methods: Polyclonal and multifactorial antibodies were produced in rabbits against heterogenous mixture of hemolymph proteins. Antibodies against hemolymph proteins were screened for their potential to influence reproductive performance of mosquitoes. Antibody titer in rabbit serum was determined by ELISA and putative candidate antigens were identified in the hemolymph of An. culicifacies by western blotting. Cross reactivity amongst various tissues vis-a-vis hemolymph protein was also identified. In addition, a significant reduction in oocyst development was also observed in An. culicifacies mosquitoes that ingested antihemolymph antibodies along with Plasmodium vivax. Results: The maximum reduction in fecundity (57%) was observed during fourth week, after the last booster and number of oocyts per infected mosquito reduced by 73.35% in the group of mosquitoes that ingested antihemolymph antibodies along with the infected blood meal respectively. However, the ingestion of antibodies against hemolymph proteins did not have significant influence on hatchability. Antisera raised against hemolymph proteins of An. culicifacies recognized 11 polypeptides by western blotting. Interpretation & conclusion: During the present study, 11 putative candidate antigens were identified in the hemolymph of An. culicifacies, against which antibodies produced significantly reduced the fecundity by 57%. In addition, a significant reduction in oocyst development was also observed in An. culicifacies that ingested antihemolymph antibodies along with P.vivax.

Occupational noise in rice mills.

BACKGROUND: A major occupational hazard for the workers in rice mills is the noise during the operation of various machines. A noise survey was conducted in the workrooms of eight renowned rice mills of the north-eastern region of India established during the period between 1980 and 1985. The rice mills were selected on the basis of the outcome of a walk-through noise survey involving several rice mills of the region. A noise survey map of each rice mill was drawn to identify the predominant noise sources and the causes of high noise in the workrooms of the rice mill. The sound-pressure level (SPL) in the workrooms of the rice mill varied from 78 to 92 dBA. The paddy cleaner, rubber roll sheller, compartment separator, rice cleaner, auxiliary sieve shaker and an electric motor without enclosure were found to be the predominant noise sources in the workrooms of the mill. The causes of high noise in the rice mills may be attributed to the use of a long flat belt drive, crank-and-pitman mechanism, absence of an electric motor enclosure, poor machine maintenance and inadequate acoustic design of the workroom of the rice mill. About 26% of the total labourers were found to be exposed to higher levels of noise than 85 dBA. Subjective response indicated that about 26% of the total labourers felt noise interferes in their work and about 49% labourers were of opinion that noise interferes with their conversation. CONTEXT: Noise from machines in the rice mills was found to be the major occupational hazard for the rice mill workers. The predominant noise sources need to be identified and the causes of high noise need to be studied to undertake the appropriate measures to reduce the noise level. AIMS: To identify the predominant noise sources and their distributions in rice mills, to study the causes of high levels of noise in rice mills and to examine the response of the workers towards noise. SETTINGS AND DESIGN: A noise survey was conducted in eight renowned rice mills of the north-eastern region of India. The mills were selected based on a walk-through survey conducted for the identification of rice mills with high noise. A noise survey map of each rice mill was collected by following the guidelines of Canadian Centre for Occupational Health and Safety (CCOHS). The distribution of high noise in rice mills was studied and the causes of high noise were identified. The subjective response to noise in rice mills was assessed by conducting personal interview with all the workers of the rice mills using a structured form. METHODS AND MATERIAL: The guidelines of CCOHS were followed during the noise survey. A sound level meter (SLM; Model-824) was used to record the noise level at each grid point marked at 1 m x 1 m. SPL in weighting scale "A" and the noise spectrum were recorded at each grid point for 30 s and data were stored in SLM. A noise survey map of equivalent SPL was drawn for each rice mill by drawing contour lines on the sketch of the rice mill between the points of equal SPL. The floor area in the rice mill where SPL exceeded 85 dBA was identified from the noise survey map of each rice mill to determine the causes of high levels of noise. In order to study the variation in SPL in the workroom of the rice mill throughout the shift, equivalent SPL was measured at six locations in each rice mill. The subjective response to noise in rice mills was assessed by conducting personal interview with all the workers of the rice mills using a structured form. Demographic information, nature of work, working hours, rest period, experience of working in mill, degree of noise annoyance, activity interference, and psychological and physiological effects of machine noise on the worker were asked during the interview. STATISTICAL ANALYSIS USED: Nil. RESULTS: The noise survey in eight select rice mills of the major paddy-growing regions of India revealed that the workrooms of five rice mills had SPL more than 85 dBA in the locations where workers were engaged for most of the time. The predominant noise sources in the rice mills were paddy cleaner, rubber roll sheller, compartment separator, rice cleaner, sieve shaker and an electric motor without enclosure. The causes of high noise in the rice mills may be due to the use of a long flat belt drive, crank-and-pitman mechanism, absence of an electric motor enclosure, poor machine maintenance and inadequate acoustic design of the workroom in the rice mill. In general, a well-maintained rice mill with each machine being run individually using an electric motor produced less noise than that being run using a single electric motor along with flat belt drives. The normal working period in the rice mill was 48 h/week and it was 56 h/week during the peak season of rice milling. About 26% of the total workers were exposed to noise of more than 85 dBA. Subjective response indicated that about 26% of the total workers felt noise interferes in their work and about 49% workers were of opinion that noise interferes with their conversation. CONCLUSIONS: The workers in the rice mills are exposed to high noise, which will have detrimental effect on their health. Apart from undertaking appropriate noise control measures, preventive maintenance of machines needs to be given due importance in all the rice mills.