ABSTRACT
Background: Tobacco is the major cause of preventable death globally, which kills one person prematurely every six seconds. In India, around 46.9% of men and women aged 15 years and above use any kind of tobacco, according to NFHS-5. Tobacco use for longer duration with increased frequency is often addictive. Nicotine in tobacco is often associated with dependence, which is recognized as a public health menace and the single most significant factor for premature death. Hence, assessment of nicotine dependence among tobacco users is essential to implement tobacco control measures effectively. To estimate the prevalence of nicotine dependence among tobacco users and to study the factors associated with nicotine dependence among those tobacco users in a rural area of Kancheepuram district, Tamil Nadu. Material and Methods: A community-based descriptive cross-sectional study was conducted among 375 tobacco users aged 18 years and above residing permanently in the rural field practice area of the Rural Health and Training Centre (RHTC) attached to a Tertiary Care Hospital in Tamil Nadu. The study has been conducted for 6 months. A systematic random sampling technique was used to recruit the study participants. Data was collected by conducting personal interviews using a pre-tested semi-structured questionnaire. The data obtained was subjected to statistical analysis using SPSS version 23. Result: About 48.7% of the study participants had high dependence, 25% had moderate dependence, and 26.3% had low physical dependence on nicotine. The duration of tobacco use (P < 0.0000) and age of initiation of tobacco use (mean age was 28 ± 7.1 years) (P < 0.0001) was found as a significant risk indicator for nicotine dependence. Conclusion: The high nicotine dependence (48.7%) among the study participants is quite alarming and warrants more visible and aggressive anti-tobacco campaigns and targeted preventive strategies.
ABSTRACT
One of the most important products of global addiction demand is an alcoholic beverage. In developing countries like India, alcohol consumption tends to be a major problem because of the various socio-cultural practices across the nation, different alcohol policies and practices across the various states, lack of awareness of alcohol-related problems among the community, false mass media propaganda about alcohol use, various alcohol drinking patterns among the alcohol consumers and the emergence of social drinking as a habit because of the widespread urbanisation across the country. Stringent alcohol policies are needed across the various states to reduce alcohol consumption, and alcohol consumers have to be educated about the various harmful effects of alcohol consumption and the effects it can have on their mind, body and soul. This review article focuses on the burden of alcohol consumption in context with its various harmful effects on the mind and body with a note on the alcohol policies in the country.
ABSTRACT
INTRODUCTION: Reproductive health of women is of special concern, especially during their reproductive years where the reproductive morbidity is very high, especially in countries like India. AIMS: This study was carried out to find the reproductive health status of rural married women and identify those suffering from reproductive morbidity to provide appropriate guidance and treatment. METHODOLOGY: This community-based cross-sectional descriptive study was carried among rural married women above 18 years of age in the field practice areas of a medical college. By simple random sampling method, the required sample size of 650 was identified. Data collected by female investigators using a pretested structured questionnaire was analyzed using SPSS version 22. RESULTS: Most of the study participants were in the age group of 21-40 years. About 32% of married women delivered by cesarean section and exclusive breastfeeding was followed by 88.9% of the mothers. Around 78% of the participants used contraceptive methods and the major reason given was for economic reasons (48%). About 67% of study participants suffered from one or more gynecological problems such as menorrhagia, lower abdominal pain, dysmenorrhea, and abnormal vaginal discharge. UTI (14%) and RTI (11.6%) were the most commonly diagnosed gynecological morbidity. Pallor was present in 45.5% of the study participants and 6.9% had clinical goiter. CONCLUSION: High prevalence of gynecological morbidity in this study shows that there is a dire need to plan and implement health education and awareness creation programs to complement the existing programs targeting women.
ABSTRACT
INTRODUCTION: In India, though the prevalence of alcohol consumption is low, nearly half of the alcoholic consumers fall into the category of hazardous drinking. There have been rapid changes in the trends and pattern of alcohol use in India. AIMS: The study was carried to find out the pattern of alcohol consumption, associated morbidities, and its association with related factors in an urban area of Tamil Nadu. MATERIALS AND METHODS: This is a descriptive cross-sectional study done among adult males >18 years of age in Kancheepuram district Tamil Nadu. Among the 400 study participants selected by simple random sampling, 156 were found to be alcohol consumers. A pre-tested structured questionnaire and Alcohol Use Disorders Identification Test (AUDIT) was used to identify the pattern of alcohol consumption and the associated health morbidities. Data analysis was done using SPSS version 22. RESULTS: It was found that 67% of alcohol consumers had a problematic drinking pattern with 52.5% having a hazardous/harmful drinking pattern and 14.7% were found to be dependent alcoholics. The associated factors of problem drinking among the alcohol consumers were illiteracy, having a history of tobacco use, being unmarried/divorced and consuming alcohol in wine shops. The health morbidities that were found to be associated with alcohol consumption were hypertension, gastritis/peptic ulcer disease, and psychiatric illnesses. CONCLUSION: More than half of the alcohol consumers had a problematic drinking pattern, which is an alarming public health problem. All the current drinkers in a community have to be screened for problematic drinking pattern and it has to be supplemented with referral services, health promotion, behavioral change communication to the alcohol consumer, and his family members.
ABSTRACT
INTRODUCTION: In India, the ever increasing production, promotion, distribution, and the easy availability and accessibility of alcohol together with the changing values in the society have resulted in alcohol consumption becoming one of the major public health problems. AIMS: The study was undertaken to find out the prevalence of alcohol consumption and its epidemiological determinants in an urban area of Kancheepuram district, Tamil Nadu. METHODOLOGY: This descriptive cross-sectional study was done among adult males above 18 years of age in Anakaputhur area of Kancheepuram district, Tamil Nadu. Simple random sampling method was used to select the study participants to reach the required sample size of 400. Pretested structured questionnaire was used as study tool to collect data regarding alcohol consumption practices. Data were analyzed using SPSS version 22. RESULTS: The prevalence of alcohol consumption among the study participants was found to be 39%. The major determinants of alcohol consumption which were found to be statistically significant were age less than 45 years, those belonging to a nuclear family, those who consume tobacco, consumption of alcohol by family members, those who did not receive advice regarding harmful effects of alcohol from family members, those having stigma of being a nondrinker among friends/peers and those having awareness of health problems caused due to alcohol consumption. CONCLUSION: This study shows that it is high time we change the approach of educating the public about the effects of alcohol consumption by intensive behavioral change continuum activities at a younger age group, coupled with encouraging refusal skills to overcome peer pressure.
ABSTRACT
Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. Type 2 (non-insulin dependent) Diabetes mellitus is one of the preventable non communicable disease resulting in increased morbidity and mortality in developing countries like India. It is characterized by disorders of insulin action and/or insulin secretion. Number of people with Type 2 Diabetes is growing rapidly worldwide with economic development, ageing populations, increasing urbanisation, dietary changes, reduced physical activity and lifestyle changes. The global prevalence of diabetes is 9%, while in India it is 8.63% and in Tamil Nadu it is 10.4%. National and State programmes on Diabetes control are implemented to combat the disease burden. A detailed review of the programme modules, operational guidelines and visit to health facilities were done to understand the implementation process related to control of Diabetes mellitus. As part of these programmes, opportunistic screening is implemented for target population. Though these programmes are unique, there are few lacunae identified which are missing opportunities and time consuming. There are no strategies so far in such programmes to make the screened positive cases to undergo confirmatory tests. Since screening is only opportunistic, the screened positive cases can be subjected to undergo confirmatory tests by different methods. The specified roles and responsibilities of health staffs at various levels to ensure follow up should also be framed and followed. The objective of this article is to review the existing strategies and to suggest the need for follow up pathways to be adopted from the first contact level to the level of final confirmation for better compliance.
ABSTRACT
Adolescence is a phase of rapid growth and development during which physical, physiological and behavioural changes occur. They constitute more than 1.2 billion worldwide, and about 21% of Indian population. Morbidity and mortality occurring in this age group is mostly due to preventable causes. Young and growing children have poor knowledge and lack of awareness about physical and psychological changes that occurs during adolescence and the ill health affecting them. Existing Adolescent health programmes focus on rendering services like immunization, health education for sexual and reproductive health, nutritional education and supplementation, anemia control measures and counseling. Adolescent health programmes are fragmentary at present and there is no comprehensive programme addressing all the needs of adolescents. Access and availability of health care services are severely limited. Lack of accurate information, absence of proper guidance, parent's ignorance, lack of skills and insufficient services from health care delivery system are the major barriers. Interventions should focus on providing psychological and mental health services and behaviour change communication towards leading a healthy lifestyle, restricting advertisement related to junk food products, awareness creation about reproductive and sexual health, educating parents to prevent early marriage, teenage pregnancy and to counsel their children on nutrition and reproductive health. Universal coverage of Adolescent friendly clinics is highly recommended. To be cost effective, all health services addressing adolescent should come under single programme. This review is intended to create awareness among the stakeholders about the importance of strengthening adolescent health services in order to meet their felt needs.
