The Journal of Community Health Management

7-11

Authors: Kavya M. A*,Shoba, ,Ranganath T.S,Vishwanath P.G

Context: A high suicide rate is an index of social disorganization. In India, it is the second leading cause of death among 15-29 years age group. Young age, female sex, poor education, unemployment and socio economic deprivation are some of the potential risk factors. Material and Methods: The aim of the study is to assess the life events that provoked suicide attempt in a tertiary care centre. It was a cross-sectional study conducted among 476 patients with attempted suicide by convenient sampling method. Study was conducted from January 2016 to May 2017.Data was collected using a pre-tested, semi-structured questionnaire. Descriptive and Inferential statistics were used to analyse the data. Results: Mean age of study participants was 30.65+0.75 years. Among 476, 57.78% of them were males and 24.57% of study participants had family history of suicide. There is association between life events that led to attempt suicide and number of previous attempts of suicide. Among various life events, family problems were the most common factor irrespective of number of previous suicide attempts followed by financial crisis, work-related factors and personal factors. Conclusion: Suicide and attempted suicides are becoming globally endemic. Socio-demographic factors and the nature of their living in a society plays a major role in this. Healthy living comes from healthy family and good working environment.

21-24

Authors: Nidhi D Sinha,B N. Mishra*,S C Mohapatra

The pandemic of essential hypertension, obesity, Type 2 diabetes, and there associate dislipidemia (HOD complex) have set a new benchmark in disease epidemiology.1-3 Their concordance is magnanimous and multifaceted but not universal. Thus the need arises to explore their geo-cultural associates. Aim: This cross sectional study explored this dimension for rural Indian inpatients in a Central Indian tertiary healthcare facility. Established anthropometric tools are explored for their association with the HOD complex in order to shortlist the valued ones. Result: BMI (body mass index) and WC (waist circumference) were found to be strong associates with HTN (essential hypertension) (?2 = 0.0034 d.f =1, P<0 d.f=1 p=0.003). d.f=2,> Conclusion: All recommended guide lines specially with respect to HOD complex demonstrates geo-cultural variation. There for it is pragmatic to test them for their suitability with reference to local population.

30-32

Authors: Shwetma Mishra*

Anemia is the most common disorder of the blood and it is very typical to identify anemia. Many biotechnological tools are developed regularly for identification of anemia e.g. Analyzers’ for CBC counting, Neubauer chamber for cell counting, Microscopic findings of Bone marrow examination etc. The tools are developed accordingly where there is less errors in assessing and also keeping in mind that less sample may be drawn from sufferer. The objectives of the study were to identify Anemia in various age groups females carried out with the following. Materials and Methods: The blood can be collected (without clots) by veripuncture in the EDTA tube (dipotassium salt) for the test performing are Complete Blood Count (CBC) including Erythrocyte Sedimentation Rate (ESR, method: wintrobe) by using automatic analyzer. Few samples was also examined by POC microscope for further evaluations or analysis. The collected blood samples of 1000 females includes with their symptomatic analysis of present and past history via questionnaire. Then findings are evaluated with sign and symptoms of sick persons, with their family history, clinical history and physical examinations (according to available data) for confirming Anemia. Results were categorized at different categories groups. Results: From the hematological analysis done by using automated analyzer and PDM device of one thousand samples, 57% samples are found as anemic. When their comparative analysis was performed with their weight it was found that about 34.9% females are overweight and affected with disease condition. When categorized type it was found that 29.2% students affected with mild anemia, 4.8% are by moderate anemia and 0.8% were with severe anemia. The maximum anemia cases of students living in PG or hostiles. Conclusion: After performing the hematological analysis it is found that 57% of sample indicating anemia. Day scholar 68.6% and hostiles 81.6% had prone to anemia. It was also seen 1.6% females with severe anemia. Some non anemic about 10% samples are also shows anemic condition with no symptoms of anemia. They are either suffered by chronic illness or infected by blood parasite. PDM device indicated around 5% of cases are with infectious disease cases like Tuberculosis or any other previous illness. The food habit of hostile was worse than those of day scholars. Their food may not contain nutritional content and their food habits are only sustaining their hunger but not supportive with health as much as they required. Based upon a relatively small body of evidence, there appears to be a strong and clinically significant association between anemia and different life threatening diseases like cardiovascular morbidity and mortality in MDS. While further research is needed, clinicians should seek to actively manage hemoglobin levels in all chronic disease patients before the point of transfusion dependency is reached.

177-187

Authors: Dalal Khaled Tashkandi*,Naeema Abdulkhader M Akber

Objectives: To assess and identify predictors of the quality of life among health care workers in the Ministry of Health (MOH) primary health care centers in Jeddah City, 2017. Materials and Methods: A cross-sectional study design was followed to include 489 health care workers. Results: The mean percent score for participants' quality of life physical component summary was 64.5±19.4% that of mental component summary was 60.9±17.5%, while their mean percent score of health related quality of life was 62.7±17.5%. Their best attained health-status components were "bodily pain" and "social functioning" subscales (72.9±23.7% and 68.4±22.3%, respectively). On the other hand, their least attained health-status components were "role limitations due to emotional problems" and "energy/fatigue" (58.7±4.7% and 56.6±18.6%, respectively). Conclusions: HRQoL of PHC providers in Jeddah City is suboptimal. The mental component of HRQoL is lower than the physical component. Some subscales of HRQoL are specially low. The main determinants of low HRQoL associated with PHC providers' personal and work characteristics include being a female, older age, having a chronic disease, serving at "Central" PHC, and being a dentistry assistant.

192-196

Authors: Sanam Anwa*,Bushra Aleem,Ghadeer Jamal Moslhey,Hajir Hamed Rashid

Introduction: The WHO report in 2010 on country profiles estimated that non-communicable diseases account for nearly 83% of the total deaths in Oman. Prehypertension can predict cardiovascular morbidities. Objectives: The study was carried out with the objective of identifying important covariates of prehypertension in Oman. Materials and Methods: In the cross sectional study, a structured questionnaire was used for data collection which had details on socio-demography along with measurements of blood pressure and anthropometry. Binary logistic regression was used to identify important predictors of prehypertension. Wald’s test was used to see the significance of coefficients of regression. Results: 233 individuals (46.6%) suffered from prehypertension out of the total 500 study population. Mean age of prehypertensives was 42.48 ±1.2. Most of them (70.8%) were males and 29.2% were females. 49.9% had secondary education and 46.4% had higher secondary education. Wald test was significant for gender (Wald= 7.263, p=0.007); sedentary occupation (Wald= 4.518, p=0.034) and age (Wald= 10.870, p=0.001). Percentage accuracy of classification of the model was 78.8%.The predictor model (chisquare =29.6, p=0.000) accounted for 14.7% variability in prehypertension. Area under the curve was 0.725, p=0.000. Conclusion: Age, occupation and gender were seen as important predictors of prehypertension in the study population.

202-204

Authors: Dipak Kumar Dhar,Sudeepa Chaudhuri,Sumit Kumar Singh,Sudip Bhattacharya

Exposure to formaldehyde is one of the various occupational hazards experienced by a doctor. It is used in its aqueous form, formalin for embalming cadavers which are used for teaching gross anatomy by dissection. Therefore, medical students in their first year routinely handle the cadaver and dermal contact is thus a significant and consistent portal of exposure to formaldehyde. The toxic and allergic potential of formaldehyde is well documented in research literature. The present study was intended to assess the various dermatological manifestations of this exposure and provide a possible understanding of the mechanism behind it by estimation of eosinophil count. Descriptive statistics, Friedman’s Test and paired-t test were used for statistical analysis. A p-value < 0>

209-214

Authors: Badrinarayan Mishra*,Sajjan Gupta,S C. Mohapatra

Introduction: The role of the mother is pivotal for good health of an under 5yr child. In developing countries the gap in their knowledge and consequently the ability to initiate health promoting activities remains as a chronic challenge. Materials and Methods: A descriptive cross sectional study was carried with 400 participants (mothers with at least one under five child) of which 200 were from rural and 200 from urban locations between 2012- 2013. Result: Most mothers preferred feeding colostrums to the child (90% in rural and 100% in urban) and kept their child away from prelacteals (75% rural and 94.5% urban). Advantages of exclusive breastfeeding were known to 74.5% rural and 94.5% urban mothers, but mothers were grossly negligent about duration per feed (15-20 minutes); only 11.5% urban and 6.5% rural mothers were aware of this. Acknowledgment of the signs of good attachment of the child to breast was significantly positive in urban mothers (p?0.001). Urban mothers were well informed about burping as an important component of breast feeding (p?0.001). High percentage of mothers practiced breast feeding during child’s illness (83% rural and 97% in urban areas). Anganwadi workers were the main informants about vaccines and vaccination related activities (p?0.001). Knowledge of optional immunization was higher in urban participants (76.5% Vs 30%). Lack of money and distance from health facility in rural areas and mother’s perception about severity of disease in urban areas were influential factors for seeking child health care (p?0.001). Conclusion: We observed better knowledge, attitude and practices in urban mothers about breast feeding and immunization. Financial constraint and distance of health care delivering centers were significant deterrent in seeking health for rural community.

122-124

Authors: Durbasree Sarkar,Samput Mallick,Sanjay Maitra*

Introduction: Anti-microbial peptides (AMPs) are among the first line defense mechanism of a variety of living organisms. The evidence on AMPs has increased considerably during the last two decades, showing they offer more than just antimicrobial activity, and presenting a broad spectrum of physiological functions. Plant AMPs are diverse families of peptides differing in their amino acid structure and composition, displaying broad spectrum antimicrobial activities. AMPs have a high potential for therapeutic use in medical sciences and can be used as alternate to antibiotics, for protection of animals and plants against diseases. Therefore, AMPs are good candidate for their possible beneficial role in public health. The present article reviews the role of plant AMPs in community health setting regarding treatment of cancer, infection control and food safety.

131-134

Authors: Piyush Kumar,Frederick S. Vaz

Objectives: To study the management of biomedical waste and to also evaluate knowledge, attitudes and practices regarding management ofbiomedical waste among health care personnel at a tertiary care hospital. Materials and Methods: A cross sectional study was conducted to study biomedical waste management at the tertiary hospital and to study the knowledge, attitudes and practices among health care personnel. Study participants consisted of 200 health care personnel.To study the management of biomedical waste, different sections of the hospitals were visited and data was recorded on a researcher designed checklist.Knowledge, attitudes and practices were evaluated using a pretested structured questionnaire. The data was analyzed using SPSS software. Approval of the institutional ethics committee was taken prior to the conduct of the study. Results: Overall 96.5% were aware about biomedical waste generation and its various other components. About 96% of the respondents were aware of the need to segregate biomedical waste. Around 34.5% of the participants expressed the opinion that the hospital doesn’t follow correct biomedical waste practices. Safe handling of biomedical waste was not an extra burden on their daily routine work for majority of the study participants (77.5%). Majority of the study participants (86.7%) reported practicing segregation of waste at source. Other findings were improper use of colour coded bins, recapping of needles and non-use of puncture proof containers for sharps. Conclusion: Knowledge and attitude among doctors and interns was higher than other health personnel, while it was lowest among Class IV employees making them vulnerable to infection which can spread through any mishandling of biomedical waste.

140-146

Authors: Iman Hewedi*,Riham Ibrahim,Tarek Elserry,Nourhan Taha,Hadeer Mohamed

Introduction: In Egypt, few epidemiologic reports have highlighted the national and regional epidemiologic data regarding primary CNS tumors. In this study we aim to identify the frequency of various primary CNS tumors and to demonstrate the age group distribution, gender, topographic data and the different histopathologic types among our patients. Materials and Methods: Data on all cases of primary CNS neoplasms received at Pathology department of Ain Shams University Specialized hospital in addition to a referral neuropathology lab during the period from 2010 to 2015 were collected with a total number of 996 cases. The patients were divided according to their age into two main groups, pediatric group including children and adolescents (from 0-18 years), and adult group (> 18 years). Patients’ demographic data and histopathologic tumor types were analyzed. Result: Frequency of primary CNS tumors among males was higher than females (51.7% vs. 49.3% respectively). Regarding patient age, frequency among adults was (89.4%) compared to pediatric age group (10.6%). Gliomas were the most common primary CNS tumors in adults (35%) followed by meningiomas (33.3%) then pituitary adenomas (15.6%); while in pediatric group embryonal tumors (17%) were the second most common following gliomas (59.4%). Conclusion: This study highlighted the frequency, spectrum and prominent features of primary CNS tumors among Egyptian patients, in comparison to many worldwide reports. This study recommends the establishment of specialized national center for CNS tumors in Egypt; this will provide efficient registry system and accurate data analysis for these tumors.

154-160

Authors: PADONOU Sètondji Géraud Roméo*,TOGNIFODE Mèdessè Véronique,MIZEHOUN-ADISSODA Carmelle,AGUEMON Badirou,AYELO Paul

This study aimed to identify the contribution of maternal undernutrition, characterized by maternal weight status and short stature, on the risk of Intra Uterine Growth Restriction. During June 2007 and July 2008, we carried out a cross-sectional study in three health centers in Benin. Mothers and newborns characteristics and anthropometric measurements were collected at delivery. IUGR was defined as a birth weight below the 10th percentile of William’s sex-specific reference curve of birth weight-for-gestational-age. Logistic regression was performed for statistical analysis. A total of 526 mothers and their newborns were enrolled. The prevalence of IUGR was 25.3%. Maternal low weight status and short stature (<155cm OR=2.53, OR=1.98, p=0.01) OR=1.68, p=0.01) p=0.02) p=0.13).>

58-63

Authors: Salil Sakalle, A.K. Khatri, Suraj Sirohi, Sanjay Dixit, Anubhuti Kujur

Introduction: Vector borne disease like malaria dengue and Chikungunya are major public health problem in recent years. Objectives: To assess knowledge regarding breeding places of mosquito causing Malaria, dengue and chikungunia. To assess the Knowledge of people towards preventing Mosquito Borne Diseases (Malaria, Dengue, Chikungunya). Materials and Method: A cross sectional observational community based study was carried out in different localities of Indore city. Simple random sampling technique was used to select 300 study participants of age group 18-65yr. Written Informed consent taken from the participants and pre designed, pre tested, semi structured questionnaire was used for elicit response from study participants . The data collected were analyzed and presented in table formats, charts which were obtained using excel and SPSS -22. Study duration was 6 Months. Relevant statistical test was applied and p value was calculated where ever required & considered significant when it is < 0> Results: Most of the population has been found to reside near stagnant water source, 73% the people either disagrees or doesn’t know that fumigation occurs in their colony or not, 74% didn’t have indoor residual spray in their houses, 54% clean their water tank within 1 month, 61% have crude knowledge about the symptoms of Malaria, Dengue and Chikungunya and they visit doctor for treatment. Conclusion: Measures taken to prevent mosquito bite, Symptom knowledge, and Knowledge of suffering second time with dengue can be hazardous has significant association with the education status of study population.

72-74

Authors: Vikas Deep Mishra, Nikhil Sinha

The ill-effects of environmental air pollution on respiratory and allergic diseases is increasing. The evidence is accumulating that the rise in the incidence of allergic diseases in the developing countries is largely due to the increase in air pollution as a result of rapid and ill-planned urbanization and industrialization. Major source of energy for today’s world is biomass fuel and burning of biomass fuel produces high concentration of respirable particulate matter, toxic gases like nitrogen dioxide, sulphur dioxide and carbon monoxide and various other organic compounds. These form an important constituent of environmental pollution, capable of worsening respiratory and allergic diseases.

78-83

Authors: Harjot Kaur, Gagandeep Singh, GPI Singh, Anil Sood, Varun MM.

Introduction: Contamination of ground water in Malwa region of Punjab has been in focus for at least last two decades. Higher than national incidence of cancer in Malwa region (107 against a national average of 80 per 100,000 population) is considered due to chemical contamination of ground water in this region . To ensure provision of potable water to rural Punjab, State government installed 1881 Reverse Osmosis (RO) plants in affected districts. Although 180 crores of rupees have been spent on installation of these RO plants, no study has been undertaken to evaluate the project. The present study attempts to fill this knowledge gap by quantifying the extent of utilization of Community RO plants, and assessing knowledge and attitude regarding this scheme of government. Materials and Method: One thousand rural households in two districts of Malwa region were randomly selected to study the knowledge, attitude and practices of target population towards Community RO plants and their utilization through a cross-sectional study. Results: The study revealed that 50.7% of households were consuming water from the Community RO plants, although the awareness regarding contaminated non- availability of any family member for fetching the water (32%), un-affordability (18%), distance of RO plant (15%) and disliking the taste of water (17%).ground water in the region, and potential of contaminated water to cause diseases were much higher. The reasons for this knowledge-practice gap are highlighted. Most common of which are Conclusion: The study shows that any health program to fulfill felt-need of community should be piloted, and planned and implemented with community involvement, otherwise it is doomed to fail as the case of Community RO plants in Punjab where the utilization is mere 50% in spite of positive knowledge and attitude of the people.

89-99

Authors: Krishna Kumar Choudhary

Introduction: Despite the advertised impressive economic growth, stunting in children continues to be an important problem in India demanding further exploration of enigma of height. Role of socio-economic factors, environmental variables and genetic factors have been documented. Till recent past it was also argued that Indians are a different genetic pool and would need separate standards for measuring heights. It is important to understand phenomenon of height and its determinants. Objective: The aim of the study is to identify the intergenerational variation in adult height among tribal men and its determinants; to understand the structural changes in the pattern of food composition and adequacy in the neoliberal era, and illness histories along with changes in the health care service accessibility for understanding determinants of the height. Materials and Method: Two groups of villages were selected with different developmental levels as reflected in their backwardness, road connectivity, employment opportunities and poverty levels from Salumber Block in Rajasthan. The social history of these two groups of villages was collected through key person interviews and available records to understand the changes happening in living condition over a period of time. Average heights of adults and its patterns from the selected six villages were assessed through a sample of 573 adult men. The selection of 573men was done through systematic sampling process household. Adult male (20-60 years) of every 3rd household were the part of study for analysis of the intergenerational variation. Childhood history of 120 adult males (10 from each stratum of 20-40 years and 40-60 years) was collected from every 5th household for detailed analysis of determinants of height. The childhood history was corroborated with the parents/guardian/caretaker or elder person of the family member who observed the growing periods of respondents. Women respondents were excluded from the study due to the corroboration issues. Because before and after 20 years women left their parental house due to marriage. So, in that case researcher was unable to track the person who observed the growing age periods of women. The selection of generations is based on the age group division. Age group 20-40 and 40-60 represent current generation and earlier generation, respectively. Results: The average heights of tribal men from six villages are 162.19 cm (95% CI (161.74-162.64, p-0.001). The Meena community from the group two villages showed significant improvement in current height about 2.17 cm (p-0.002) while group one villages showed decline in average height of current generation about 1.05 cm. The days of food shortage and reported hunger in the growing age/years is inversely associated with average height gain (p-0.001). The frequency of pulses and dairy product consumption significantly associated with average height gain (p-0.03 and 0.001, respectively). Occurrence of disease and recurrence of disease in the growing age is significantly and inversely associated with height gain (p-0.001). The episodes of diarrhoea in the growing age were observed to be a major impediment of the height growth (95%CI, 21.48-24.40, p-0.001). The villages where the employment opportunities are frequently available round the year showed improvement in the average height of current generation. Conclusion: The average height of the current generation is marginally improved. Changes in the pattern of food consumption and adequacy affected the average height of current generation in the new globalization era. Adequate nutrition intake, lower exposure to disease environment, and better access to health care services is positively and significantly correlated with height gain of the individual.

106-109

Authors: HS Sndhu, Shishir Jain, Ashish Bahal, Ayyappa G

Objective/Introduction: Tuberculosis is a overwhelming public health worry in India. The Indian Subcontinent accounts for about 25% of the TB burden worldwide. Across the world, India has the highest burden of both TB and MDR-TB. The aim of this study was to study the resistance pattern of Mycobacterium Tuberculosis to first and second line anti-TB drugs among specimens from a hospital in Tertiary Care Hospital in Western Maharashtra. Materials and Method: This record based study was conducted at Tertiary Care Hospital in Western Maharashtra, from January 2017 .Records of Sputum from 2013 to 2017 were obtained from patients with suspected TB. Drug-sensitivity testing was performed by the Mycobacteria Growth Indicator Tube (MGIT) method. Sensitivity to First line and second line drugs and Quinolones were tested. Results: Among 734 patients, 701(95.5%) were males and 33(4.5%) were females. Analysis of our Study result showed that 21.7% of patients were mono-drug resistant. Out of 734 isolates, 56 (7.62 %) showed multi-drug resistance (resistance to INH and RIF at least) and 33 out of 734 (4.5%) whereas 39 (5.6%) out of the 734 samples showed XDR. Conclusion:This study confirms that drug resistance, including MDR, observed against all first-line TB drugs was a real threat in the management of TB infection. The patterns of resistance in this study will assist clinicians in providing the right treatment regimen to TB patients and bring about an improvement in their clinical condition.

116-119

Authors: Niranjan Muralikrishnan, Rajeswaran Thiagesan

Introduction: The clean India initiative named as Swachh Bharat Abhiyaan (SBA) is India’s flagship program which provides impetus to sanitation, hygiene and micro environment like our immediate surroundings but it has few evidences about its trickling down (awareness levels) among rural masses. Objective:To find the awareness and knowledge levels on SBA among rural construction workers and to explore impact on respiratory system due to unhealthy environment. Materials and Method:Four villages were selected from Kanchipuram district and one village was selected randomly. To field test the questionnaire fifty construction workers were identified and data was analysed. Frequencies for some variables and association analysis was done between the subject’s year of exposure to dust/occupation and years of exposure to tobacco with lung volume. Results: The term ‘Swachh Bharat’ was known by 53.3% and samples who were knowing the aims of the program was 50%. This study came out with a result that 93.3% of the samples reported they open defecate. There was no association was found between years of exposure and lung volumes. Normal lung volume was only 10% prevalent among the samples. Conclusion:SBA Mission needs to be more rigour in spreading its goals among the rural parts. Personal Protection Equipment (PPE) must be supplied and made mandatory to these construction workers in rural areas to make their working environment more efficient.

10-12

Authors: Pragnesh Patel, Ritu Bhatnaga.

Dengue is one of the most important arthropod- borne viral infections, widely distributed throughout the tropics and subtropics. It is endemic to the Indian subcontinent and associated with explosive urban epidemics and has become a major public health problem in India. The present study was conducted to detect prevalence of Dengue virus infection in Udaipur, Rajasthan. Materials and Methods: Serum samples from 640 patients clinically suspected of having dengue infection visiting a tertiary care hospital during the period of August 2016 to February 2018 were screened for the presence of Dengue NS1 antigen and IgM and IgG antibodies using one-step immune-chromatographic assay (Dengue Rapid IgM/IgG test and NS1 test by SD BIOLINE). Result: Out of 640 samples 62 samples (9.68%) were positive for Dengue virus infection. Out of total positive Sample for dengue virus infection, 61% samples were of male patients and 39% samples were from female patients. Among them 28% positive samples were from paediatric age group (Age 1- 14 years) and rest were from Adult age group. Seasonal trend showed a gradual increase in Dengue positives starting from August with a peak in October. Most common presentation was fever (98%). Conclusion: Number of dengue cases is on increase in the region and continued surveillance is essential to determine epidemiological and seasonal trend.

17-20

Authors: Kishore Y. Jothula, Praveena Ganapa, Sreeharshika D, Pramodh Reddy P, Abhishek P.

Introduction: Aim of the study was to know career preferences and factors influencing speciality choices among the medical students in Telangana. Materials and Methods: An Institution based cross sectional study was carried out at Kamineni Institute of Medical Sciences, Narketpally with 150 first year medical students as study subjects from November 2017 to December 2017. Study tool was pretested semi structured questionnaire. Data was entered in Microsoft excel and analysis was done using SPSS statistical package version 22. Result: Out of 150 participants, 42 (28%) were boys and 108 (72%) were girls, with a mean age of 17.94 ± 0.82. Majority (62.6%) of the participants were city residents. 57.3% of the study population wants to pursue specialization. Among the students who wants to pursue specialization majority were interested in clinical branches compared to Community Medicine which was only 6.9%. There was significant difference between males and females selection of specialities like cardiology, gynaecology and orthopaedics. Most common factors for selection of speciality courses were reputation of the speciality (91.8%) and Self interest (76.7%). Conclusion: Majority of the medical students wants to pursue specialization and most of them showed interest in the clinical branches. Significant difference between males and females selection of specialities like cardiology, gynaecology and orthopaedics. Most common factors for selection of speciality courses were reputation of the speciality and Self interest followed by early settlement and to make more money.

26-31

Authors: Manuj C. Weerasinghe, Samanthi Bandara, Munsif Sanoon.

Register Introduction: Sri Lanka introduced school canteen guidelines in 2007 to promote healthy food choices and eating habits among school children. This initiative intended to combat malnutrition among school children through provision of nutritious, culturally acceptable food at affordable prices within the school premises. A formal assessment has not been done on the implementation of those guidelines for last seven years. The objective of this study was to assess the availability of healthy food items in school canteens and explore perceptions of providers on adherence to the guidelines. Materials and Methods: A cross sectional study was conducted in government schools in two districts. A mix methodology was employed. An observational check list was used to quantitatively assess the availability of healthy food items according to stipulated guidelines. This was followed by a qualitative inquiry to explore perceptions of school principals and canteen operators on adherence to the guidelines using in-depth interviews. Results: Only two out of ten food items encouraged in the guidelines were available in 50 % of the school canteens. In contrast, five out of nine items prohibited or discouraged were available in half of the canteens. Also 25% of canteens sold carbonated drinks that are totally prohibited. Differential understanding of healthy versus unhealthy, current food habits of students, present method of selecting canteen operators and other external factors contributed negatively. Conclusion: The rigor of implementation was sub optimal at present due to many reasons. Those obstacles can be addressed through coordinated efforts to transform canteen towards a nutrition promoting setting.

37-40

Authors: Rohit A., Chaya KA, Poornima MP, Balu PS, Manu AS.

Aim: To identify perception about BCG vaccination and Tuberculosis awareness among urban mothers. Methodology: A cross sectional study was carried out among mothers residing in urban areas through health camps to know awareness about schedule of BCG vaccination, purpose of giving it and also find out awareness about Tuberculosis disease. Data was collected from August 2016 to January 2017 using a standard semi-structured questionnaire. Chi-square test was utilized to find the factors which are associated with students’ knowledge about TB Results: Among 241 study participants, main source of vaccine information was health department [n=127, 52.7%] were aware of side effects of BCG vaccination [n=219, 90.9%] .All the participants had heard about Tuberculosis disease [n=241, 100%], majority knew that it was a contagious [n=236, 97.9%] and mode of transmission [n= 199, 82.6%]. Conclusion: Health workers continue to be main source of information for BCG vaccination and Tuberculosis. Awareness has to be improved regarding transmission of TB and prevention of TB meningitis through BCG vaccination.

49-52

Authors: Shwetha, Ashok J, Ashiq R Mir.

To study the health profile of the population under study 3. To assess the health insurance coverage and utilization patterns in the study population. Materials and Methods: It is a Cross - sectional study. This study was undertaken in the rural field practice area of Sri Siddhartha Medical College, Tumkur, Karnataka .Six villages were chosen randomly. Multi stage sampling method was used. Sampling units were households. Oral questionnaire was used to collect the data and physiological parameters were measured. Results: According to this study 80% were Hindus, 15% were Muslims, 5% Christians.57% of the families belonged to OBC (other backward castes). Average family size: = 3.5409 (SD±1.1861) Anaemia was present in 64.9% of the population. Major recent illness were URTI 53%, head ache 12% and myalgia 9%. Health insurance coverage is 20% in the study area. Conclusion: The major illnesses in the population were anaemia 65%, 58% had dental caries, hypertension was 24%, 15% of them had diabetes mellitus. Health insurance coverage was around 20%. Majority of the households( 93%) were not aware about any health insurance schemes Only 13% of the insured were aware about the benefits of health insurance scheme and 8% of those who insured utilised the health insurance scheme benefits.