Indian Journal of Forensic and Community Medicine

5-9

Authors: Mohammad Suhail Khan, Atul Kumar Singh, Shyam Bihari Gupta, Sumit Saxena, Sonam Maheshwari

Introduction: Diabetes exhibits the iceberg phenomenon i.e. the burden of disease is much higher than what we see. Today in this world of industrialisation, prevalence of diabetes is increasing day by day. In urban population prevalence of diabetes is more as compared to rural population. It is estimated that there are currently 285 million people with diabetes worldwide and this number is set to increase to 438 million by the year 2030. So there is a need to know the real picture of diabetes in the community and risk factors which can cause diabetes mellitus. Objectives: To asses risk factors of type 2 diabetes mellitus in an urban population. To determine the prevalence of type 2 diabetes mellitus in study population. To find out the risk factors of type 2 diabetes mellitus in study population. Material & Methods: It was a Cross Sectional observational Study done Area covered under Urban Health Training Centre of SRMS Institute of Medical Sciences, Bareilly. Study subjects: Adults age more than 30 years in area under Urban Health Training Centre (UHTC). Study Period was from 14 February 2014 - 14 February 2015. Results: The overall prevalence of Diabetes Mellitus in the present study was found to be 97 (15.2%). Out of these, almost half 46 (7.18%) were newly diagnosed while the remaining half were known diabetics. 61 (9.5%) of the study population was found to have Impaired Fasting glucose. Age, Socio-economic status, General caste and Family History, BMI and Waist Circumference was found to be statistically significant.

13-19

Authors: Suchithra E.T, Sujina C.M

Background and objectives: Contraceptive prevalence rate is an indicator of health, population, development and women’s empowerment. Contraceptive choice and use will vary according to the socio-cultural factors of that geographical area. This study was done to find out the percentage of married females who is currently using contraceptives as well as various factors associated with its use and along with that, assessed their current knowledge regarding various contraceptive methods. Methods: A community based cross sectional study done in Mulamkunnathukavu panchyat of Thrissur district in Kerala among 203 married females in the 15-49 age group using a pre-tested questionnaire. Results: The prevalence of current use of family planning methods was 48.8% with 95% CI was (47.8 - 49.8). In various contraceptives 16.7% were using Female sterilization, followed by IUD (14.8%) and rhythm method (7.9%). Mean age (SD) at marriage is 21.67(5.67) years. Contraceptive prevalence was shown statistically significant association with age of female (p=0.036) number of child (p=0.03), male preference (p=0.031), age of last child (0.013). Age of the female (p=0.005), spouse education (0.046) and spouse occupation (p=0.04) number of child (p=0.0001), male preference (p=0.001) were the statistically significant factors associated with pattern of use of contraceptive. Majority of study participants were aware about Copper T (80.8%), followed by Condom (73.9%), Rhythm method (72.9%) and female Sterilization (71.9%) Health workers played a big role in disseminating information regarding family planning (68%). Conclusion: Current use of family planning method and female sterilization was started to decline but knowledge and acceptance of Intra Uterine Device increased .Male participation in family planning method was very poor. So we have to think about the new initiatives to improve the male involvement in family planning practice. Intensify the measures to improve permanent methods.

25-30

Authors: Mathur SM, Brajesh Kumar, Hossain Samar, Mathur Rekha

Background: Uncontrolled fertility in rural areas without the requisite economic and social infrastructure has resulted in a great problem of malnutrition among the under five children of rural population. Their nutritional status is far from being satisfactory. Objectives: To determine the nature and extent of the health and nutritional problems of under-five rural children, to highlight the various factors contributing to the health and nutritional problems, and to develop a project for solving the nutritional and health problems. Method and Material: A cross sectional epidemiological study was conducted in field practice area of Rural Health Training Center, Achrol village, district Jaipur (Rajasthan). The mothers or care givers of under-fives were interviewed and the children were examined clinically with the help of a pre-designed, pre-tested pro-forma after taking informed consent. WHO Child Growth Standards were used to assess the nutritional status of children. Results were subjected to statistical analysis. Results: In present study of rural children, out of 334 children 137 (41.01%) were found to suffer from various grades of malnutrition. Among malnourished 45.98% were male and 54.01% were female under-fives. 42.33% children belonged to nuclear family, 29.92% to joint family and 27.73% children belonged to three generation type of family among the malnourished children. 35.03% of malnourished children were delivered at hospital and remaining 64.96% were delivered at home. Among the malnourished only 5.10% mothers were studied up to secondary and above, a majority i.e. 46.71% were illiterate. 41.60% malnourished children were having three and more siblings. Third and above birth order children suffered more from malnutrition (44.52%). Among malnourished only 12.81% were weaned by 4-6 months.SC (48.17%)/ST/OBC (33.57%) children suffered more from malnutrition than general caste. Malnourished children were from grade I (3.64%), grade II (6.56%), grade III (25.54%), grade IV (29.19%) and grade V (35.03%). Most of the malnourished belonged to the age group 2-3yrs (48.90%) and 3-5yrs (35.03%). 56.93% female and 43.06% male were among the malnourished children. 40.87% malnourished were from grade I, 29.19% were from grade II, 18.24% were from grade III, and 11.67% were from IV grade of malnutrition. Vit. A deficiency was observed in 7.29% malnourished, Vit. D deficiency in 11.67% malnourished, Vit. B. deficiency in 18.97% malnourished, and Protein deficiency was observed in 17.5% of malnourished children in present study. Most of the deficiency signs were seen in 2-3 years and 3-5 yrs age groups. Conclusion: Malnutrition is the most widespread condition affecting the health of children. Scarcity of suitable foods, lack of purchasing power of the family as well as traditional beliefs and taboos about what the baby should eat, often lead to an insufficient balanced diet, resulting in malnutrition.

36-39

Authors: Rajesh C. Sambutwad, Mohd. Shafee, Pankaj R. Gangwal

Background: Today many health authorities consider human breast milk the healthiest form of milk for babies. Breastfeeding promotes the health of both the mother and the infant and also helps to prevent disease. Inadequate knowledge of breastfeeding may lead to undesirable consequences. Methods: A cross-sectional study was carried out from July to September 2014 in the field practice area of Dept. of Community Medicine of Indian Institute of Medical Science & Research (IIMSR) Medical College, Badnapur, Jalna, Maharashtra, India. A total of 200 antenatal care women were selected by convenience sampling method. Results: Out of 200 ANC women, 63.5% showed average quality of knowledge about breast feedings. 68.5% participants know that first milk (colostrum) should be given to a newborn. 47% participants know that breastfeeding should be started within one hour after delivery. 59% of participant knows that exclusive breast feeding should be continue up to 6 month and 65.5 % knows that breast feeding should be continue up to two years. Conclusions: The study shows that there is inadequate knowledge regarding breastfeeding amongst ANC women. Hence there are need to improve the level of knowledge about breast feeding among ANC women.

43-46

Authors: Hina Kausar, Shruti P

Background: Violence against women is a major public health problem and a violation of human rights. It affects the life span from sex selective abortion of female fetuses to forced suicide and abuse and is evident, to some degree, in every society in the world. Objective: To study domestic violence against working women. Material and methods: An Institutional based cross sectional observational study was carried out in Chalmeda Anand Rao Institute of Medical Sciences and hospital for a period of one year. All professionals and working class women including doctors, nurses, administrative staff sweepers were inclded. Three hundred working women in Chalmeda Anand Rao institute of medical sciences, Karimnagar were taken as sample. The data was collected in a predesigned and pretested proforma. Results: The prevalence of domestic violence was 15%. Psychological form of domestic violence was more common(44.44%), and most (55.6%) of women had domestic violence occasionally, in 82.2% women husband was perpetrator for violence and in 57.77% women’s husband were intoxicated during the act of violence. Among the reasons for violence most common reason was not obeying or arguing back (35.55%) and least (8.88%) had this for refusing the sex. Domestic violence was more among sweepers 26.33% followed by administrative staff (10.66%), the difference was statistically significant. As socioeconomic status decreases domestic violence increases but it was not statistically significant. Conclusion: Working women too suffers from domestic violence. Domestic violence was significantly associated with type of work but relation was not statistically with socioeconomic status.

51-55

Authors: Selvam Paramasivam, Jayakrishnan Thayyil, Meera S Nair

Abstract Background: Cancer is a major disease that affects all sections of the human population. The stage at presentation is the most important determinant of survival in cancer. It was aimed to find out whether primary health care workers could be used for cancer screening effectively. Materials and Methods: A screening programme was conducted among persons aged ≥30yrs. This screening programme was conducted in three stages. The first stage is done by primary health care workers for cancer symptom screening, the second stage by specialist doctors to confirm symptoms and to collect specimens and next confirmation by cytology. Sixty out of sixty-six primary health care workers and volunteers were selected and trained by faculties in various departments from medical college to administer the tool for cancer screening. The initial survey was conducted by each worker visiting 50 families with a pre-tested semi-structured questionnaire. Those people who found to have cancer symptoms were examined by the specialist doctors at the primary health centres. Results: In the initial survey, 6801 individuals aged ≥ 30 yrs were studied. Mean age in years was 47.5 (±13.2) and men constituted 49.9% of the study population. Among the study population, 299(4.4%) showed symptoms suggestive of cancer (4.3% of males and 4.5% of females). Swelling was the most common symptom. Among the symptomatic individuals, 29(9.7%) have already been diagnosed as having cancer and on treatment. The positive predictive value found to be 11.4% for cancer detection but when the precancerous lesions considered the positive predictive value increased to 21.4%. Conclusion: The cancer detection rate in our study was comparable with the incidence rate in India. Utilization of primary care workers for cancer screening through this model would ensure that the population over 30 years of age would be screened once every 3-5 years without burdening the routine health system.

60-63

Authors: Manoharan C, Jeyasingh T, Dhanalakshmi V, Thangam D

Background & objectives: Determination of sex is a vital part of medico-legal practice. The objective of the study was to obtain cut off values for determination of sex by measuring the length and breadth of manubrium and body of sternum. Methods: Through dissection and maceration of soft tissues, 103 sterna (53male and 50female) between 15 years to 75 years were obtained from known corpses during medico-legal autopsies at Tirunelveli Medical College, Tamilnadu, India. Results: This study revealed that it could be a male if the length of body of sternum is greater than 87mm, length of manubrium is greater than 50mm, breadth of body of sternum is greater than 38 mm, breadth of manubrium is greater than 60mm, combined length of manubrium and body of sternum is more than 136mm and sternal index is 47 or below whereas it could be of female if the length of body of sternum is less than 72 mm, breadth of manubrium is less than 48 mm, breadth of body of sternum is below 29 mm, combined length of manubrium and body of sternum is below 119 mm and sternal index is 70 or above. Interpretation: Higher percentage of accuracy is found with length of body of the sternum, combined length of manubrium and body of sternum in both sexes, whereas they are more reliable in males. Conclusions: This study proves that the sternum is a reliable bone to determine the sex of a person.