General practitioners' knowledge, attitude, and practices regarding optional immunization in urban area of Sangli District: A cross sectional study.

Introduction: Immunization is one of the most effective, safest, and efficient public health interventions. Thousands of children are still dying from vaccine-preventable diseases every year. Administration of optional vaccines such as Hib, Inactivated polio vaccine (IPV), typhoid, hepatitis A, chickenpox, and rotavirus at appropriate age helps them in protecting from various diseases in under 18 population. Also, the attitude and practices of general practitioners have an important role in preventing modern diseases in children. Objective: This study was undertaken to assess the level of knowledge, attitude, and practices regarding optional vaccines among the general practitioners. Material and Methods: Study type: Cross-sectional. Study setting: Sangli-Miraj-Kupwad corporation area. Study subject: Practicing General Practitioners willing to participate. Study period: July 2018-Sep 2019. Study tools: predesigned, pretested questionnaire. Statistical analysis: by using Microsoft Excel and SPSS 22.0 version software. Results: Out of 162 general practitioners, 105 were males and 57 were females. A total of 83 (51.23%) general practitioners had good knowledge about optional vaccines in their practice. Good knowledge was found to be highest among MBBS practitioners 38 (55.9%). A total of 118 (72.84%) general practitioners were counseling the parents regarding optional vaccines. Conclusion: There is a need to create training programs and continuing medical education (CMEs) for general practitioners (GPs) on optional vaccination practices to improve knowledge.

Barriers for Early Detection of Cancer Amongst Urban Indian Women: A Cross Sectional Study.

BACKGROUND: Cancer is a leading cause of death globally. Every year, millions of cancer patients could be saved from premature death and and suffering if they had timely access to early detection and treatment. There are two main components of early detection: early diagnosis and screening. In India, cancers of cervix, breast, mouth/oropharynx are the most frequent cancers in women. These cancers are amenable to early detection. More than two third of the cancer patients are already in an advanced and incurable stage at the time of diagnosis. OBJECTIVES: This study was designed with the aim to know the reasons for non availment of cancer screening procedures and early diagnostic facilities. MATERIALS AND METHODS: This cross-sectional study was planned in Sangli, Miraj and Kupwad Corporation area during October 2013 - March 2014 by a pretested questionnaire. Women of 25 years and above were study subjects selected randomly from a cluster sample of ward with estimated sample size of 559 women. Statistical analysis was done with the help of IBM SPSS 22. RESULTS: Nearly 74% of women said that cancer is curable. For awareness about signs and symptoms, risk factors and screening test 82.3% women scored less than 50% of total score. Only 17.7% women had awareness score more than 50%. But their attitude score was > 50% in 85.2% of women. For practice score, 24.4% women scored > 50%. Significant association was found between awareness, attitude and practice scores and education, occupation and history of cancer in family, friends and neighborhood of respondents. CONCLUSIONS: Low awareness is the main barrier for undergoing cancer screening and early detection. There is a need of effective health education programme.

Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study.

BACKGROUND: There is considerable variation in BCG scar failure rate on available data and correlation between BCG scar and tuberculin conversion remains controversial. Through this study we aimed to determine the scar failure rate and tuberculin conversion in term infants vaccinated with BCG within the first month. MATERIALS AND METHODS: A prospective cohort study was conducted among 85 consecutive infants weighing >2 kg attending the immunization clinic of a medical college hospital. Fifteen subjects who could not complete the follow up were excluded. Total of 70 cases were analyzed. All babies were administered 0.1 ml of BCG and examined at 3 months (+1 week) for scar. Tuberculin test was done with 5TU PPD. An induration of >5 mm was considered positive. Statistical analysis was done using Microsoft Excel and SPSS-22. RESULTS: Out of the 70 infants, 41 (58.6%) were males. Although majority (72.9%) of infants were vaccinated within 7 days, only 18 (25.7%) received BCG within 48 hours of birth. Sixty-four (91.4%) had a visible scar at 12 weeks post vaccination representing a scar failure rate of 8.6%. Tuberculin test was positive in 50 (71.4%). The mean ± s.d. for scar and tuberculin skin test (TST) reaction size was 4.93 ± 2.01 mm and 6.01 ± 3.22 mm, respectively. The association between scar formation and tuberculin positivity was highly significant (P < 0.001). There was significant correlation between scar size and TST size (r = 0.401, P = 0.001). CONCLUSIONS: Less than 10% of infants fail to develop a scar following BCG vaccination. There is good correlation between scar positivity and tuberculin conversion.

Knowledge about diabetes and relationship between compliance to the management among the diabetic patients from Rural Area of Sangli District, Maharashtra, India.

INTRODUCTION: Diabetes is an important public health problem of India. Studies have shown that increase in patients' knowledge regarding the disease results in better compliance to treatment and decrease in complications. This study was planned to assess the knowledge about diabetes and its correlation with pharmacological and non-pharmacological compliance, among the diabetic patients attending rural health center from Sangli District, Maharashtra (India). MATERIALS AND METHODS: The study was conducted during September to November 2014. The study subjects were all willing adult patients with type II diabetes mellitus attending a selected rural hospital. The study tool was pretested and self-administered questionnaire. Analysis was done using Microsoft Excel and SPSS-22. RESULTS: Total study participants were 307 in number, with the mean age of 55.6 years. The mean morbidity with diabetes was 10.7 years. Only 23.8% had good knowledge regarding diabetes, while 19.2% participants had poor knowledge. Knowledge was significantly associated with the compliance to the pharmacological and non-pharmacological management. CONCLUSION: Although most of the patients were suffering with diabetes for many years there is lack of knowledge regarding the disease and self care. The compliance to the management of diabetes was better in patients with good knowledge. Seminars, counseling sessions and workshop should be arranged periodically for diabetic patients to increase their awareness.

A retrospective study of use of polyvalent anti-snake venom and risk factors for mortality from snake bite in a tertiary care setting.

AIMS: Envenomation with poisonous snakes is associated with considerable morbidity and mortality. The present study was undertaken with the objectives of assessing anti-snake venom (ASV) use, early adverse reactions to ASV, premedication and clinical outcomes in snake bite patients. Association of various risk factors (age, gender, dose of ASV, time gap between snake bite and ASV administration, use of mechanical ventilation and type of snake bite) with mortality was also assessed. SETTINGS AND DESIGN: This retrospective study was conducted at two Tertiary Care Teaching Hospitals. SUBJECTS AND METHODS: The medical records of 176 patients of snake bite with documented use of ASV were retrospectively analyzed to retrieve relevant data. STATISTICAL ANALYSIS: Descriptive statistics was used to express results about ASV use, early adverse reactions to ASV, premedication and clinical outcomes. Univariate and multivariate analysis was performed to find out significant risk factors associated with mortality. RESULTS: The main indication for ASV was vasculotoxic snake bite (75%) followed by neurotoxic snake bite (16%). Mean dose of ASV was 18.63 ± 14.52 vials. Prophylactic premedication with corticosteroids alone or in combination with antihistaminic was used in more than 70% patients. Early adverse reactions to ASV were seen in 4% patients. Neurotoxic snake bite was a significant risk factor associated with mortality in multivariate analysis. CONCLUSIONS: Neurotoxic snake bite is an independent predictor of mortality in snake bite patients. Currently used polyvalent ASV may be less effective in treating neurotoxic snake bite.

Barriers for early detection of cancer amongst Indian rural women.

CONTEXT: Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. Healthcare providers in developing countries regularly see women with advanced, incurable cancers. Health of a rural Indian women and her access to health facility is compromised due to sociocultural, economical, and environmental factors. AIMS: To know the problems associated with early detection of cancers in rural women. SETTINGS AND DESIGN: Rural area and cross-sectional. SUBJECTS AND METHODS: STUDY SUBJECT: Women of 35 years and above. EXCLUSION CRITERIA: Not willing to participate. SAMPLE SIZE: All eligible women of selected villages. SAMPLING TECHNIQUE: Random selection of villages. Study duration: 2 months. Study tools: Pretested questionnaire. STATISTICAL ANALYSIS USED: Percentages, χ(2) test, analysis of variance (ANOVA), multivariate analysis. RESULTS: Awareness about symptoms, possibility of early detection, available tests, possibility of cure of disease was low. Main barrier for screening was cognitive, that is, 'don't know' answer by 83.99% women for cancer cervix, 84.93%, for cancer breast, and 67.26% for oral cancer. Awareness score was significantly associated with age (χ(2) = 17.77, P = 0.001), education (χ(2) = 34.62, P = 0.000), and income (χ(2) = 16.72, P = 0.002); while attitude score with age (χ(2) = 16.27, P = 0.012) and education (χ(2) = 25.16, P = 0.003). Practice score was significantly associated with age (χ(2) = 11.28, P = 0.023), education (χ(2) = 32.27, P = 0.003), and occupation (χ(2) = 10.69, P = 0.03). Awareness, attitude, and practice score of women having history of cancer in family or relative was significantly high than women without history. CONCLUSIONS: Cognitive barrier was the important barrier which has to be taken care of.

A Cross-sectional Study of Correlation of Body Image Anxiety with Social Phobia and Their Association with Depression in the Adolescents from a Rural Area of Sangli District in India.

BACKGROUND: Prevailing socio-cultural influences lead females to desire a thin body and males a muscular body, especially in adolescents. This results in body image anxiety which may lead to social phobia. Together they can develop depression. The aim was to study the correlation of body image anxiety with social phobia and their association with depression, among adolescents. METHODS: This was a cross-sectional study conducted in randomly selected colleges from a rural area of Sangli district Maharashtra, India. Stratified random sampling technique used with sample size 805. Pretested self-administered questionnaire used. Percentage, Chi-square test, binary logistic regression model was used to estimate odds ratio (OR) and its 95% confidence intervals. RESULTS: Of 997 study subjects body image anxiety, social phobia and depression were observed in 232 (23.3%), 193 (19.4%) and 326 (32.7%) participants, respectively. Binary logistic regression showed that body image anxiety (OR = 1.849 [1.22, 2.804]; P = 0.004) and social phobia (OR = 4.575 [2.952-7.09]; P < 0.001) were significant predictors for depression. CONCLUSIONS: Body image anxiety and social phobia are linked with the development of depression. This impresses the need for timely counseling and education among adolescents.

A Study of Stress among Students of Professional Colleges from an Urban area in India.

OBJECTIVES: Various studies across the globe have emphasised that students undertaking professional courses, such as medical and dental studies, are subjected to higher stress. Excessive stress could lead to psychological problems like depression and anxiety. The objective of the current study was to assess stress among students of various professional colleges and its association with various academic, social and health-related factors. METHODS: This cross-sectional study was conducted from September 2011 to February 2012 among students of medical, dental and engineering colleges from the urban area of Sangli district, Maharashtra, India, using a convenience sampling technique. The calculated total sample size was 1,200. A pretested self-administered questionnaire was used for the data collection. Analysis was done using percentage, the chi-square test, binary logistic regression and multinomial logistic regression. RESULTS: Out of the 1,224 respondents, 299 (24.4%) experienced stress. Among them 115 (38.5%), 102 (34.1%) and 82 (27.4%) were dental, medical and engineering students, respectively. There was a statistically significant association between stress and the field of education. Stress was observed in 187 (27.7%) females and 112 (20.4%) males; the association with gender was statistically significant. By applying binary logistic regression, medical studies, health and lifestyle factors, and academic factors were the significant predictors for stress. CONCLUSION: Students from all the three fields studied were exposed to stress. Academic factors were one of the most important stressors. The introduction of stress management education into the curriculum could prove useful in combatting this problem.

Prenatal Sex and Other Preferences for Reproductive Career of Final Year Graduation Girl Students.

BACKGROUND: Marriage of girls just after graduation is common in Western Maharashtra. This study was planned to know the views of final year graduation student towards reproductive carrier. AIM: To interact with final year girl students of various streams to know their preferences on various aspects of reproductive carrier and contraceptive awareness. STUDY-DESIGN: Cross-sectional. STUDY-SETTING: Academic institutes of Sangli-Miraj-Kupwad Corporation area. Study-subject: All willing final year Girl students. EXCLUSION CRITERIA: Married girls. SAMPLE SIZE: All final year girl students Sampling Technique: Cluster sample Study-Duration: 7 months. Study-tool: Pretested questionnaire. STATISTICAL ANALYSIS: Percentages, Chi-square test. RESULTS: All girls who have responded prefer marrying and having first child at right age. All feel spacing is needed, at least of 2 years. Two children was the most common choice (52.3%). Forty-three percent girls feel male child is must and 52.3% of total girls will like to have sex determination done if required. Total 47.24% girls were unaware about any contraceptive methods but 88.2% girls knew the place of its availability. Most common source of information about contraceptive was school and friends. E-pill was known to 41.5% of girls. All girls felt the need for more information about reproductive health and according to 81.3% right age for it is 15-18 years. CONCLUSION: Girls have correct reproductive preferences except sex of child. Sex preference and Low contraceptive awareness needs strong intervention.