Comparative Assessment of Periodontal Status in Subjects with and without Polycystic Ovary Syndrome and its Correlation with Body Mass Index: A Cross-Sectional Study.

New avenues for research have opened, which assess the influence of systemic disease on periodontium and vice versa. To find the correlation between polycystic ovary syndrome (PCOS) and periodontium by assessing clinical parameters [plaque index (PI), probing depth, periodontal disease index (PDI)] and the anthropological parameter [body mass index (BMI)] and to find the correlation between body mass index and periodontal disease index in subjects with and without PCOS. Sixty females comprising 30 with PCOS and 30 without PCOS were selected. Clinical, anthropological, and radiological assessment was done. Double blinding was incorporated. There was a statistically highly significant difference in mean age, mean PI, and mean PDI (P < 0.001) in PCOS group when compared to those without PCOS group by unpaired t-test for inter-group analysis. A statistically significant difference was found in mean probing depth and mean BMI (P < 0.05) in PCOS group when compared to those without PCOS group by unpaired t-test for inter-group analysis. No statistically significant correlation was found between mean PDI and mean BMI in PCOS and non-PCOS group subjects using Spearman's rank correlation. Women suffering from PCOS may be at a heightened risk for developing periodontal disease as our study re-establishes this association with respect to some periodontal parameters. With such a result, general practitioners/gynecologists can be encouraged to refer cases of PCOS to periodontists for early detection, prevention of periodontal disease, and maintenance of periodontal health.

A Study of Complications, Sinonasal Predispositions and Microbiological Profile of Chronic Otitis Media.

Keeping in view the changing flora of chronic otitis media (COM), geographical variability of its complications and differential prevalence of sinonasal predisposing diseases in these patients, we studied the microbiological profile along with the complications and sino-nasal diseases in patients with COM. It was a Cross-sectional study conducted during Nov 2017 to Dec 2019 in department of Otorhinolaryngology, Jawaharlal Nehru Medical College, AMU, Aligarh. The study included 200 cases of chronic suppurative otitis media, both Mucosal (safe) and Squamous (unsafe) type, out of which 111 (55.5%) were males and 89 (44.5%) were females. The overall prevalence of complications in patients with COM in our study was high at 6.5% with 61.54% complications being extracranial and 38.46% were intracranial. DNS was the most common sino-nasal disease found in 22.5% of patients followed by Inferior turbinate hypertrophy, Adenoid hypertrophy and polyp in 6.5%, 5.5% and 4% of participants respectively. A culture positive result was found in 84.5% of the samples with 55.5% samples being monomicrobial and 29.0% being polymicrobial. COM like the other chronic diseases impacts quality of life. As long as health-care delivery fails to target high-risk groups in developing countries such as ours infections like CSOM will persist with its adverse consequences. With the development and widespread use of antibiotics, the types of pathogenic micro-organisms and their sensitivity to antibiotics have changed. Continuous evaluation of pattern and antibiotic sensitivity of isolates is necessary to decrease the potential risk of complications by early institution of appropriate treatment.

Prevalence of bronchial asthma in school going children: A cross-sectional study from Uttar Pradesh.

Background: Asthma is coined as a chronic inflammatory disorder and disarrays of the airways and respiratory tract which manifests as recurrent episodes of wheezing, breathlessness, chest tightness, and cough. The World Health Organization recognizes asthma as a major health problem. Although asthma can occur at any age, children and young adults are the age groups which are affected more commonly. Objectives: The objective of this study is to find the prevalence of bronchial asthma in school-going children (6-16 years) and its associated factors. Materials and Methods: A cross-sectional study among the school-going children in the age group of 6-16 years was done in the field practice areas of urban health and training center and rural health and training center of the Department of Community Medicine, JNMCH, A. M. U., Aligarh, U.P. the study done for a period of one year. The validated questionnaire (International Study on Allergy and Asthma in Childhood) was used. The sample size was taken as 902. The data were entered and analyzed in the SPSS statistical software version 20.0. Chi-square was used. Results: The prevalence of asthma among the study population was found to be 26.9%. Family history of smoking and history of allergy in an individual came out to be a significant factor associated with asthma. The association is also significant between asthma and the diet of an individual. Conclusions: Asthma among school children is a public health problem in urban and rural areas. There was a rising pattern in the prevalence of asthma at national and subnational levels.

Facilitators and barriers influencing the post-crash emergency care of road traffic injuries in district Aligarh of Uttar Pradesh.

Context: Road traffic injuries (RTIs) will become the fifth leading cause of death by 2030. It is often possible to mitigate the consequences of serious injury if victims have access to prompt, effective pre-hospital care within minutes following the crash. Aims: To find out the facilitators and barriers for providing post-crash emergency care in Road traffic injuries in district Aligarh. Settings and Design: The present study was undertaken on both the National highways (NH-91 and NH-93) and the bypass roads passing through district Aligarh of Uttar Pradesh. Subjects and Methods: All the individuals who met road traffic accidents (RTA) between the earmarked areas from 1st October 2018 to 30th November 2020 and reported for treatment to the selected hospitals were included in the study. Statistical Analysis Used: Data is presented in the form of frequency tables and percentages. Results: A total of 1126 patients were interviewed during the study period. Out of 1126, 937 (83.2%) were males, and 189 (16.8%) were females, with M:F ratio being 4.96:1. Six hundred sixty-two (58.8%) of the respondents identified the layperson or common man as the first person to respond at the time of the crash. 1110 (98.58%) respondents identified the layperson as the facilitator in providing post-crash emergency care, followed by police and roadside shopkeepers/dhabawalas. The role of the layperson in calling for help by utilizing the helpline numbers, suggesting a nearby health facility together with facilitating for transportation of the victim to the nearby health facility was appreciated by the majority of the respondents. An ambulance was the best available mode of transportation. Seven hundred thirty-three (65.10%) of the total respondents were aware of the toll-free number to be dialled in case of RTA. However, only 320 (43.70%) among them used this toll-free facility after meeting the crash. Conclusion: A layperson is the single most important facilitator for providing post-crash emergency care.

Premenstrual syndrome: Prevalence, symptoms, and associated risk factors among adolescent girls in Aligarh, Uttar Pradesh.

Premenstrual syndrome (PMS) is a collection of physical, cognitive, affective, and behavioral cyclically occurring symptoms during the luteal phase of the menstrual cycle which resolves later. The study aims to find the prevalence and symptoms of PMS and risk factors associated with it among school-going adolescent girls in Aligarh. A total of 422 girls (Class 6th to 12th) were taken by systematic random sampling with probability proportionate to size. 37.7% (159) of the girls reported PMS with abdominal bloating (35.2%) as the most common somatic symptom and social withdrawal (69.2%) as the most common effective symptom. The multivariable analysis showed that occurrences of PMS were significantly associated with age, adjusted odds ratio (AOR) (95% confidence interval [CI]): 2.19 (1.22-3.93); education status of participants, AOR (95% CI): 2.97 (1.37-6.45); mothers who are graduate and above, AOR (95% CI): 2.59 (1.40-4.77); working mothers, AOR (95% CI): 1.81 (1.04-3.14); long menstrual cycle (>35 days), AOR (95% CI): 0.40 (0.19-0.85); and irregular cycle, AOR (95% CI): 2.83 (1.48-5.38). Cox and Snell R2 was 0.2 and Nagelkerke R2 was 0.3.

Post-crash emergency care: Availability and utilization pattern of existing facilities in Aligarh, Uttar Pradesh.

CONTEXT: Road traffic injuries is estimated to be the ninth leading cause of death across all age groups globally. People in need of trauma care, after a road crash, are most likely to survive if they receive definitive care within the first hour (Golden hour) after the crash. Essential prehospital care includes prompt communication, treatment, and transport of injured people to formal healthcare facilities. AIMS: To assess the availability and utilization pattern of existing facilities for post-crash emergency care in Aligarh. SETTINGS AND DESIGN: The present study was undertaken on two National highways- NH-91 and NH-93 and the connecting bypass roads of Aligarh district of Uttar Pradesh. SUBJECTS AND METHODS: All the individuals who met road traffic accident (RTA) between the earmarked areas from 1st October, 2018 to 30th September, 2019 and reported for treatment (either on their own or brought by relatives, passersby, ambulance or police) to the selected hospitals were included in the study. STATISTICAL ANALYSIS USED: Data presented in the form of frequency tables and percentages. RESULTS: Out of 665 patients interviewed during the study period, 556 (83.61%) patients were males and 109 (16.39%) were females with M: F ratio been 5.10:1. Among the first responders, 448 (67.36%) were lay persons and 42 (6.31%) were police personnel. 261 (39.25%) of patients received help within 10-30 min of RTA. Use of toll-free no. was limited to 265 (39.84%) patients. Ambulance was the mode of transport in 155 (23.30%) of RTA cases. 589 (88.58%) of patients reported to Government hospitals. CONCLUSIONS: Post-crash emergency care is in nascent stage in Aligarh district of Uttar Pradesh. Toll free numbers and ambulances are available but proper utilization and quality of care is lacking. Lay person is the most important personnel in improving the post-crash care.

World Health Organization Dimensions of Adherence to Antiretroviral Therapy: A Study at Antiretroviral Therapy Centre, Aligarh.

INTRODUCTION: With the availability of antiretroviral therapy (ART) and subsequent change in the HIV/AIDS disease dynamic to a chronic manageable disease, adherence studies have received increasing attention. However, there is a paucity of studies that have considered World Health Organization (WHO) dimensions of adherence to ART. Therefore, this study was conducted with the objectives of determining the prevalence of adherence and the association of various factors across five WHO dimensions to adherence. METHODS: A cross-sectional study was carried out at the ART Centre, Aligarh. A total of 440 adult patients, taking treatment from the ART Centre, Aligarh were selected. A self-reported instrument of missing pills was used to measure adherence. Various factors across five WHO dimensions were studied. RESULTS: Prevalence of adherence in our study was 81.3%. Among the five dimensions of adherence, distance from home (odds ratio [OR] 0.980; 95% confidence interval [CI] 0.964-0.997) among socioeconomic determinants, frequent adherence counseling (OR 8.737; 95% CI 4.076-18.727) among health system-related, drug regimen (OR 2.202; 95% CI 1.023-4.738) and absence of side effects (OR 3.293; 95% CI 1.473-7.365) among therapy related, absence of substance abuse (OR 2.747; 95% CI 1.209-6.243), and perceived change in health status (OR 4.196; 95% CI 1.613-10.915) among patient-related dimension were found to be significantly associated with adherence to ART, while clinical condition dimension did not play a significant role. CONCLUSION: The ART adherence rate is still below satisfactory levels for long-term viral load suppression. WHO multidimensional approach - which was found to be quite relevant in our study setting - could be applied to effectively solve the adherence problem in our country.

Disrespect and abuse during facility-based childbirth and its sociodemographic determinants - A barrier to healthcare utilization in rural population.

CONTEXT: The provider-driven disrespect and abuse (DA) of women during childbirth is a marker for quality of maternal care and violation of basic human rights. AIMS: This study was done to assess prevalence and sociodemographic determinants of DA experienced during facility-based childbirth. SETTINGS AND DESIGN: This is a cross-sectional, community-based study done in six villages in the district of Aligarh, north India. SUBJECTS AND METHODS: In all, 305 women who underwent facility-based childbirth were interviewed by pretested and structured questionnaire at home between 4 and 6 weeks postpartum period. STATISTICAL ANALYSIS USED: Descriptive statistics, Chi-square test, and bivariate regression analysis using SPSS 20.0 were used. RESULTS: A total of 257 (84.3%) of 305 women reported any form of DA. Nonconsented services (71.1%) and nonconfidential care (62.3%) were the most common types. Abandonment/neglect during childbirth was reported by 10.2% women, nondignified care by 9.2%, physical abuse by 5.9%, detention in the health facility by 3.3%, and discrimination by 3.9%. Women who had undergone vaginal birth [odds ratio (OR) 3.36; confidence interval (CI) 1.7-6.5], at public health facility (OR 2.65; CI 1.4-5.0), given care by providers other than doctors (OR 2.89; CI 1.5-5.5), who belonged to low socioeconomic status (OR 3.68; CI 1.4-9.7), and who did not decide place of delivery themselves (OR 4.49; CI 2.0-12.1) were more at risk of DA. Out of all females unwilling to attend facility in future, 93.8% reported experiencing DA. The association between any DA and decision to attend the facility in future was statistically significant. CONCLUSION: More than 8 of 10 women experienced any DA during facility-based childbirth. It can be a barrier to utilization of facility for childbirth. Preventing DA is important to improve quality of maternal care and institutional deliveries.

Adverse eating behavior and its association with obesity in Indian adolescents: Evidence from a nonmetropolitan city in India.

INTRODUCTION: With the so-called modernization, the epidemiological and sociocultural context of adolescents in developing countries is rapidly changing and is affecting their eating behavior and dietary choices. The objective of our study is twofold. First, our study seeks to find whether there is a prevalence of the adverse eating behaviors among the adolescents. Second, our study seeks to examine whether the prevalence of the adverse eating behavior is related to obesity and quantifies their association of with body mass index (BMI) status. MATERIALS AND METHODS: A cross-sectional school-based study was conducted in 13-15-year-old adolescents from schools of Aligarh, India, with prevalidated study tools and standardized anthropometric measures. The Z-scores were found by the WHO recommended AnthroPlus. RESULTS: The results indicate a high prevalence of different adverse eating behaviors. The dietary behavior was found to be poor in 19.3%, fair in 54.4%, and good in only 26.3% of the study population. The mean BMI for age Z-score was found to be 0.87 and 0.02 in poor and fair dietary behavior. The odds of being overweight and obese were high (1.82 [1.20-2.78]) in those with poor dietary behavior. CONCLUSIONS: Our findings suggest that more research and timely intervention in adverse eating behaviors are much needed in India before this widely neglected problem acquires even more alarming and gigantic proportions.

Improvements in Essential Newborn Care and Newborn Resuscitation Services Following a Capacity Building and Quality Improvement Program in Three Districts of Uttar Pradesh, India.

BACKGROUND: Neonatal death remains a global challenge contributing to 45% of underfive deaths. With rising institutional delivery, to accelerate decline in neonatal mortality rate (NMR) improvement in the quality of perinatal care requires attention. OBJECTIVES: This implementation research targeted improving service delivery readiness for quality of newborn care at public health facilities in three districts of Uttar Pradesh, India, with high NMR. MATERIALS AND METHODS: This before-after study assessed the facility readiness and quality of newborn services at 42 health facilities. The changes in 26 signal functions for routine and emergency obstetric and newborn care were tracked. RESULTS: There was marked improvement in newborn service availability: skilled birth attendants (51%), resuscitation (30%), and kangaroo mother care (27%) at these facilities. A multifold rise in newborn resuscitation efforts and documentation (n = 4431 vs. n = 144 in preintervention period) with high success rate (98.6%) was observed. There was also improvement in obstetric care services including partograph use (31%) and active management of third stage of labor (46%). However, several infrastructural indicators (electricity, water supply, toilets, and sanitation) remained unchanged. CONCLUSION: Overall improvements were observed in the majority of the signal functions for perinatal care and newborn resuscitation efforts. There was a limited impact on the infrastructural and supervision components.

Dietary Diversity and Stunting among Infants and Young Children: A Cross-sectional Study in Aligarh.

CONTEXT: Child undernutrition is a public health problem in a developing country like India. Dietary diversity is an important immediate determinant of undernutrition. AIMS: The aim of this study is to find the prevalence of stunting among infants and young children aged 6-23 months and its association with dietary diversity. SETTINGS AND DESIGN: This study was community-based cross-sectional study. It was carried out in the registered families of the Urban Health Training Centre and Rural Health Training Centre, Department of Community Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh. METHODS: A total of 326 children aged 6-23 months were included in the study. Study tools were predesigned and pretested questionnaire, modified infant and young child feeding practices questionnaire, and infantometer. Systematic random sampling with probability proportionate to size technique was utilized to drawn necessary sample size. STATISTICAL ANALYSIS: Wald's statistics, Z-scores, and bivariate and multivariate logistic regression (LR) (stepwise backward LR) were used. RESULTS: The prevalence of stunting in study population was 45.7% (95% CI - 40.1%, 51.1%); moderate stunting was 33.7% (95% CI - 28.8%, 39%); and severe stunting was 12% (95% CI - 8.8%, 16%). The prevalence of stunting was significantly associated with dietary diversity (OR - 0.17, 95% CI - 0.10-0.29). CONCLUSIONS: The study concludes that dietary diversity is a significant predictor of stunting. Therefore, interventions aimed at improving dietary diversity should be taken to reduce the burden of stunting among infants and young children.

Locomotor problems among rural elderly population in a District of Aligarh, North India.

INTRODUCTION: Locomotor functions decline with the age along with other physiological changes. This results in deterioration of the quality of life with decreased social and economic role in the society, as well as increased dependency, for the health care and other basic services. The demographic transition resulting in increased proportion of elderly may pose a burden to the health system. OBJECTIVES: To find the prevalence of locomotor problems among the elderly population, and related sociodemographic factors. MATERIALS AND METHODS: The study was a community-based cross-sectional study done at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India. A sample of 225 was drawn from 1018 elderly population aged 60 years and above using systematic random sampling with probability proportionate to size. Sociodemographic characteristics were obtained using pretested and predesigned questionnaire. Locomotor problems were assessed using the criteria used by National Sample Survey Organization. Data were analyzed using SPSS version 20. Chi-square test was used to test relationship of locomotor problems with sociodemographic factors. P <0.05 was considered statistically significant. RESULTS: The prevalence of locomotor problems among the elderly population was 25.8%. Locomotor problems were significantly associated with age, gender, and working status whereas no significant association with literacy status and marital status was observed. CONCLUSION: The study concluded that approximately one-fourth of the elderly population suffered from locomotor problems. The sociodemographic factors related to locomotor problems needs to be addressed properly to help them lead an independent and economically productive life.

Complementary feeding practices among children aged 6-23 months in Aligarh, Uttar Pradesh.

CONTEXT: Complementary feeding practices play an important role in the growth and development of the children. AIMS: The aim of this study is to determine the prevalence of complementary feeding practices among children aged 6-23 months and its association with various sociodemographic factors. SETTINGS AND DESIGN: The study was a community-based, cross-sectional study conducted at field practice area of Urban Health Training Centre and Rural Health Training Centre, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh. MATERIALS AND METHODS: Mothers of children aged 6-23 months of age interviewed using the infant and young child feeding questionnaire for complimentary feeding indicators, namely, minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). The sample size drawn was 326 using systematic random sampling with probability proportionate to size. STATISTICAL ANALYSIS USED: Wald's statistics, bivariate and multivariate logistic regression. RESULTS: MDD was adequate in 42.6% children, MMF in 50.9% children, and MAD in 35.6% children. MDD was significantly associated with area of residence, birth order of child, and Standard of living index (SLI); MMF was significantly associated with area of residence, sex of child, and literacy status of mother; MAD was significantly associated with area of residence, sex of child, birth order of child, and SLI. CONCLUSION: The study revealed that approximately 50% of mothers practiced inadequate complementary feeding. The feeding practices were found to be significantly associated with various sociodemographic factors highlighting the importance of addressing these factors if we aim an improvement in feeding practices.

A study on nutritional status of school-going adolescents in Aligarh, India.

Adolescence is a highly vulnerable period for malnutrition. This study was based on a Global School Health Survey methodology in the 13-15-year age group; employing WHO AnthroPlus to evaluate the nutritional status, find the prevalence of both extremes of malnutrition, compare with the growth curves and to find its sociodemographic correlates. A total of 1456 students were sampled and the mean BMI for age Z score was found to be -0.11. The prevalence of overweight and obese were 11.95% and 2.27%, respectively, whereas 2.75% suffered from thinness, defined as BMI for age <2 standard deviations. The prevalence of being overweight and obese was associated with a higher standard of living, a higher education of father or mother, working mothers and father's occupation being service/business. The evident double burden of malnutrition presages a large public health burden in future, requiring interventional attention.

The dire need for primary care specialization in India: Concerns and challenges.

Primary health care is an evidence-based priority, but it is still inadequately supported in many countries. Ironically, on one hand, India is a popular destination for medical tourism due to the affordability of high quality of health care and, on the other hand, ill health and health care are the main reasons for becoming poor through medical poverty traps. Surprisingly, this is despite the fact that India was committed to 'Health for All by 2000' in the past, and is committed to 'Universal Health Coverage' by 2022! Clearly, these commitments are destined to fail unless something is done to improve the present state of affairs. This study argues for the need to develop primary care as a specialization in India as a remedial measure to reform its health care in order to truly commit to the commitments. Three critical issues for this specialization are discussed in this review: (1) The dynamic and distinct nature of primary care as opposed to other medical specializations, (2) the intersection of primary care and public health which can be facilitated by such a specialization, and (3) research in primary care including the development of screening and referral tools for early diagnosis of cancers, researches for evidence-based interventions via health programs, and primary care epidemiology. Despite the potential challenges and difficulties, India is a country in dire need for primary care specialization. India's experience in providing low-cost and high quality healthcare for medical tourism presages a more cost-effective and efficient primary care with due attention and specialization.

EXISTENCE OF RULE OF HALVES IN HYPERTENSION: AN EXPLORATORY ANALYSIS IN AN INDIAN VILLAGE.

INTRODUCTION: India is a country in transition, the population is graying and the non communicable diseases are rising. In the rural areas of India, the detection of hypertension is poor because of limited healthcare facilities and poor awareness among the people. In one such village, Mirzapur, adopted by the Aligarh Muslim University, there is a planned project to control hypertension in the villages through some innovative approaches. This study was the assessment phase of this project for mass management of hypertension to steer and guide the next phase of the project. AIM: The main objectives of this study were: to determine the prevalence of hypertension in residents ≥ 40 years in Mirzapur village, Aligarh, and, to assess the presence of rule of halves in hypertension. RESULTS AND DISCUSSION: The present study in residents more than 40 years of age in the Mirzapur village in Aligarh found that the prevalence of hypertension in the study population was 41.9%, with a higher prevalence in older age groups. The mean blood pressure of the study population was found to be 100.03±13.17 mm Hg. The high prevalence reported in the present study reflects and reaffirms the increasing trend of hypertension in not only the urban, but also rural India, at least in the older age group. The problem of hypertension, due to its silent and asymptomatic nature, frequently depicts a rule of halves in places with weaker health system and an equally weaker health awareness and information among populations and the same is true for this village. CONCLUSION: There is an urgent need to conduct similar researches in other adopted villages of the country for the sake of inclusive development to find the exact burden of this silent and asymptomatic killer. More importantly, there is a need to find innovative solutions to combat the problem of hypertension detection and management.

Role models and occupational ambitions of in-school male adolescents.

BACKGROUND: A role model is perceived as worthy of imitation, their selection can indicate significant elements of psychosocial health and self-projection in adolescents. Patterns of behavior and lifestyle choices established during adolescence can have immediate and lasting effects on health. MATERIALS AND METHODS: Cross-sectional study was undertaken in the schools of Aligarh, Uttar Pradesh, India. The sample frame was 2347, out of which a sample of 390 students was studied. Data collected were entered and analyzed by SPSS for Windows version 10%). RESULTS: Majority (62.7%) of adolescents revealed that their role models were Film Star (34.8%) and their Teachers (27.9%), Parents (14.3%), Sportsman (12.0%). Politicians as the role models were opted by least proportion (1.2%). Desire of future occupation was Businessmen (27.9%), Doctor (18.6), and Engineer (14.4%). CONCLUSION: Nearly all adolescents had a role model. There is greater impact of cinema on the minds of adolescents, which resulted in choosing film actors as their role model. Aspiration of future occupation was not related to the characteristics of the role model.

Impact of behavior change communication among pregnant women regarding neonatal care.

OBJECTIVES: To assess the behavior of pregnant women regarding neonatal care. Also to implement and assess impact of Behaviour Change Communication (BCC) package among pregnant women regarding neonatal care. METHODS: This community based intervention study was conducted in field practice area of Urban Health Training Centre (UHTC), Department of Community Medicine, Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University (A.M.U), Aligarh (UP), India. Two hundred pregnant women were included. Epi Info version 3.5.1. Percentages, and Chi square test were used for statistical analysis. RESULTS: Due to implementation of BCC package, institutional deliveries improved (RR = 2.47, P < 0.05), delivery practices significantly increased (RR = 2.47, P < 0.05). There was significant difference regarding breastfeeding practices on 7th and 28th d of delivery. More (80 %) deliveries were conducted in warm room (RR = 1.87, p < 0.05), bathing to the baby was delayed (RR = 0.81, p < 0.05) and decreased, vigorous removal of vernix caseosa was observed (RR = 0.45, p < 0.05). Correct knowledge about danger signs and physiological conditions in newborns were increased (RR = 2.5.0, p < 0.05 for cold to touch, RR = 1.22, p < 0.05 for peeling of skin). CONCLUSIONS: There was a significant impact of BCC package on the behavior of pregnant women regarding neonatal care.

Home-based management of acute diarrhoeal disease in an urban slum of Aligarh, India.

INTRODUCTION: Diarrhoea is a major cause of morbidity and mortality in children. Most deaths are caused by dehydration and are easily preventable by using oral rehydration therapy. Early management and recognition of danger signs are key strategies in treating diarrhoeal diseases at home. This study assessed the knowledge and health-care seeking behaviour of families regarding diarrhoeal illness in children aged under five years. METHODOLOGY: The study was undertaken during June and July 2009 in an urban slum of Aligarh, Uttar Pradesh, India. Mothers of children (n = 101) suffering from diarrhoea with at least one episode in the last two weeks prior to the interview were included. Information was gathered on a predesigned and pretested questionnaire. RESULTS: Overall prevalence of diarrhoea in children under five was 36%. Life-threatening symptoms which the mothers knew were watery stool (85%) and repeated vomiting (54%). Two thirds (69%) of the mothers continued breastfeeding their children during the episode, while the remaining either withheld or interrupted breastfeeding. The majority visited a nearby unsanctioned health practitioner. Less than half (46.5%) of the mothers knew about oral rehydration salt solution and only 29.8% of those knew the correct method of preparation. Only 38.7% of the respondents knew about suitable fluids available at home, out of which salt sugar solution was the choice in most cases. CONCLUSION: The study highlights that the mothers' knowledge is not adequate. Educating mothers and caretakers regarding early home-based case management of childhood diarrhoea may substantially decrease morbidity and mortality due to diarrhoea.

Determinants of vitamin A deficiency amongst children in Aligarh District, Uttar Pradesh.

OBJECTIVES: To determine the prevalence and determinants of xerophthalmia among children aged 0-60 months . METHODS: This cross-sectional study included 3571 children under 5 years of age from six villages and four periurban areas. Children with xerophthalmia were identified and severity graded using the WHO classification. The main outcome measures were socio-demographic, nutritional and comorbidity related risk factors of xerophthalmia. A pretested questionnaire carrying information on the above factors was administered to the caregivers. Univariate and multivariate binary logistic regression analyses were performed to examine the association of each of these factors with xerophthalmia. RESULTS: The overall prevalence of xerophthalmia was of serious public health importance at 9.1%. Prevalence of both mild (night blindness, and Bitots spots) and severe forms (corneal changes) of xerophthalmia increased with age. Bitots spots and night blindness were the commonest manifestations. Rural dwelling, lower social class, maternal illiteracy and occupation outside home were significant antecedent socio-demographic risk factors on univariate analysis. Multivariate analysis revealed low intake of proteins and vitamin A containing foods as well as predominant maize diet to be significant dietary factors. Nutritional wasting and a preceding history of measles were significant comorbid determinants (P<0.05). None of the socio-demographic variables emerged significant on multivariate analysis. CONCLUSIONS: Vitamin A deficiency remains a significant public health problem in Aligarh district. The proximal factors in a child's milieu viz nutrition and comorbidities were more significantly associated with xerophthalmia than the distal socio-demographic factors, thereby making a case for their cost effective prevention. The high magnitude of the problem calls for intensification of existing prophylactic measures in these areas.