The Journal of Community Health Management

99-100

Authors: Paramita Sengupta, S.C. Mohapatra

Socio-epidemiology, migration

103-107

Authors: Prabhakar Patro, Nakul Kothari, NC Mohanty

Infection contrsuitable for a peripheral newborn care unitol protocol in NICU ,

113-122

Authors: S.P. Singh, Dhiraj Bhawnani, Ajit Parihar, Nirmal Verma

Human lathyrism continues to be a public health problem in central India. While osteolathyrism, as such, is not a public health problem, neurolathyrism is of particular importance especially in central parts of India. In particularly Rewa, Satna, Sidhi, Sagar, Seoni, Hoshangabad and Chhattisgarh area of Madhya Pradesh bear the brunt of lathyrism. Ganapathy and Dwivedi (1961) carried out epidemiological study in estate of Vindhya Pradesh (now part of Madhya Pradesh). The sale of L. sativus has been banned in many states in India, but there has not been an effective ban on its cultivation. Lathyrus sativus is hardy crop and survives adverse agricultural conditions. For this reason it has become a main stay of some Indian diets, especially under famine conditions. India farmers continue to grow this pulse despite their awareness of its poisonous nature. It is difficult to provide an alternate crop that would grow under the semi-arid condition of these areas. In recent times, the problem has acquired new dimensions, which hold out possibilities of wider dissemination of the disease. It was probably true that the consumption of Lathyrus seeds had dropped during recent times, but this was probably because other crops like wheat, barley, lentils and Bengal gram had flourished. Material & Method: In order to study the recent trends of lathyrism, the same area and technique have been adopted as were follow by Ganapathy & Dwivedi (1961) and Dwivedi and Prasad (1964). Revisit to study the same area where detail epidemiological work was carried out and reported by Dwivedi & Prasad (1964). They were the following 18 village of Rewa and 10 village of Satna districts. The other part of study included the collection of information of occurrence of cases occurred during the last 10 years period i.e. case occurring from 1975 to 1982. The area of survey restricted to Rewa division to determine those factor responsible for secular variations in the prevalence of disease from the previous I.C.M.R. study spread over a period of 1956 – 1961 (Ganapathy and Dwivedi. 1961). The standard survey protocol was adopted. Only the established form of disease was investigated. The latent form of disease was not investigated. The established form directly affects the man power and in major public health problem. Observations: The prevalence of disease is higher amongst the male in previous studies (1964) as well as in year 1982. The maximum duration of disease was 10 to 14 years (32.72%) in previous study (1964) where as it is only 4.30 percent in year 1982. Cases of lathyrism occur round the year, both studies reveal that maximum cases occurred from June to October. The maximum cases being 58 (32.76%) were among Kole (S.T.) followed by Chamar being 16.38 percent. The cases amongst Kurmi and Brahmins are equally high being 14.12 and 13.55 percent respectively. The disease was mainly present in low socio-economic group of people being 67.79 percent and 26.5 percent had from class IV socio-economic group. Maximum patients i.e. 115 were landless and 47 had land only up to two acres. Out of them 72.34 percent were growing ‘Birri’ i.e., mixture of L. Sativus 25-50 percent. Disease was mainly restricted amongst the illiterate but as the literacy status increases the disease was is decreasing. Conclusion: Though the frequency and the magnitude of lathyrism had been reduced, but sporadic cases do occur in some part of the country. Therefore, it is necessary that prevention of lathyrism shall be integrated in general health care programme on regional basis. Surprisingly researches are going on to develop high yielding and less toxic variety of Khesari dal and certainly one cannot ignore the health of the people which is jeopardized by the use of the poisonous pulse resulting in permanent paralysis simply because they belong to the under- privileged sections of the society.

127-132

Authors: Nimila Elsa Mathews, Paramita Sengupta, Anoop Ivan Benjamin

Effect of Vitamin-D supplementation on blood pressure in post-men A community based interventional studyopausal women,

138-143

Authors: Sunitha Mathai, Harold Andrew Patrick

To identify health related quality of Life (HqOL) of nurses working across three major types of hospitals in Bangalore namely- trust, government and private hospitals. The role of nurses is to provide social and emotional support and care to the hospitalized patients. Investigating the health and well-being of the nursing personnel helps us in understanding the effect of their occupation and surrounding on their health and well-being. Materials & Method: A cross-sectional field survey was conducted by administering the health related QoL (SF-12v2) questionnaire to nurses working in three types of hospitals. The survey had a random sample of healthy nurses (n=115) participating between the age group of 21-50 years. The nurses were met personally in small groups to assign the questionnaire and gather data information. The scale consists of 12 items with varied option for each statement and numbering ranging from 1-5. The final output calculates the health and well-being of the respondents among the three groups. Result: Mental health and well-being of nurses indicated a below average score for Trust and Private hospital that was significantly lower than the Government hospital nurses. While the physical health and well-being was below average not found significant for all the three types of hospital, indicating that the impact to mental well-being (P<0.01) was greater for nurses. Conclusion: Hospital administrators and healthcare consultants must plan better work environment to improve the health of nurses and thus enhance their productivity.

47-48

Authors: S.C. Mohapatra, Paramita Sengupta, VP Gupta

The Journal of Community Health Management is a peer reviewed journal and an official publication of Innovative Publications. The journal publishes papers, original research articles, editorials on Preventive Medicine, Community Health, Health Management, Health Statistics, Biostatics, Nutrition, Epidemiology and Health Services Research. All correspondence to the Journal be made to the Chief Editor, The Journal of Community Health Management (JCHM).

55-58

Authors: Sarita Tripathi, TB Singh, Kusumakar Gautam, Indira Bishnoi

Background: Mass media plays a significant role in strenghring the rural resources of the individual as well as the whole society and motivating the families for the adoption of new technologies. Mass media like Television, News paper, Radio, Magazines are playing a key role in information dissemination to rural population of the community. It may be more effective if the centers of information sources, their availability and utilization pattern is known to media planners. Taking this drawback, the present study was conducted with the objective to know the utilization pattern of information sources among the families residing the rural areas of Kacchehriya village of Varanasi district. Most of the village populations were engaged in vegetable production. Total agriculture land was approximately100 acre of the village with population of nearly three thousand.

64-66

Authors: Shavi Garg, Sushil Kumar Srivastava, Vishal Singla, Ashish Singla

The Journal of Community Health Management is a peer reviewed journal and an official publication of Innovative Publications. The journal publishes papers, original research articles, editorials on Preventive Medicine, Community Health, Health Management, Health Statistics, Biostatics, Nutrition, Epidemiology and Health Services Research. All correspondence to the Journal be made to the Chief Editor, The Journal of Community Health Management (JCHM).

72-74

Authors: V P Gupta, Patel Puja Bharat, Anuj Kamboj, Bharat Paul, S C Mohapatra

Iodine is one of the essential micronutrients required for the normal mental and physical well being of human beings. Iodine Deficiency Disorder (IDD) has been considered as major public health problem in India including Mewat. The present goiter survey was done in Mewat district with the objective of estimating the prevalence of goiter in primary school children, of age six to twelve years. 1050 children from six to twelve years were clinically examined for the presence of goitre during survey. Overall goitre prevalence rate was 15.2%. Prevalence was significantly higher among females than males (P=0.039). Age-specific prevalence rate (ASPR) was higher in 9 to 12 yrs age group as compared to 6 to 8 yr age group and it was statistically significant.

80-84

Authors: Karan Talreja, Ladusingh Rajput, Pooja Thawani

Context: Government is trying diligently to reduce the sale of tobacco products among the consumers by taking proactive measures like mandatory statutory and pictorial on the tobacco packaging. This study was conducted to check the effectiveness of such warnings amongst consumers. Aim: To assess the effect of statutory and pictorial health warning among individuals consuming smokeless tobacco product. Settings and design: The questionnaire study was conducted among 203 smokeless tobacco consumers of Pune from 01st August to 30th August 2015. Material and Methods: 203 consumers formed the sample size of the study. 12 closed ended questions were asked by interview method. The responses were collected, tabulated and analysed. Statistical Analyses used: Descriptive analysis. Results: Mean age of the study participants was 37.67±8.14 ranging from 23-65. 198(97.5) of the study participants were aware of the pictorial warning. Though 157(77.3) wanted to quit tobacco, 33(18.2) were not able to understand pictorial warning. Conclusion: It was concluded that though there was awareness about pictorial and statutory warnings which are found to be effective tools to help consumers quit tobacco. Poor quality of packaging and absence of warnings on few of smokeless tobacco did not serve the purpose.

92-95

Authors: Sebastian N.M, Sheela P. Haveri, Jesha M.M

Background and Objectives: India is facing the dual burden of non-communicable disease along with communicable diseases. High prevalence of hypertension, diabetes and their risk factors are being reported in India. For reducing the high cost of health care and premature loss of life these risk factors are to be identified early and controlled. This study aims to estimate the burden of diabetes, hypertension, renal failure and risk factors like overweight, smoking, over use of alcohol and physical inactivity among a rural community in Kerala, India. Methods: A survey was conducted among an estimated sample of 802 adults aged 20 years and above in a rural Panchayat in northern Kerala. The presence of diabetes, hypertension and renal diseases among the subjects were obtained from medical records and treatment history. Data on smoking, alcohol consumption and physical activity were obtained by interview, and Body mass index and blood pressure were obtained by measurement. Prevalence rates were obtained by data analysis using computer software. Results and Interpretations: The mean age of subjects was 47.1(CI = 46 to 48.2). The prevalence of hypertension was 25.7% and diabetes 21.3% (already diagnosed cases only) and 10.3% of subjects had both. 5.7% of subjects had chronic kidney disease already diagnosed indicating inadequate control of diabetes and hypertension. Smoking was reported by 37.2% of men, regular alcohol consumption by 2.5% men and low level of physical activity by 17.7% of all. Conclusions: There is high prevalence of hypertension and diabetes. High prevalence of kidney disease points to inadequate control of diabetes and hypertension. There is also high prevalence of smoking among men.

100-101

Authors: T.B Singh, D. Kumar

The Journal of Community Health Management is a peer reviewed journal and an official publication of Innovative Publications. The journal publishes papers, original research articles, editorials on Preventive Medicine, Community Health, Health Management, Health Statistics, Biostatics, Nutrition, Epidemiology and Health Services Research. All correspondence to the Journal be made to the Chief Editor, The Journal of Community Health Management (JCHM).

1-2

Authors: Raja Danasekaran, Kalaivani Annadurai, Geetha Mani

Inadequate and inappropriate handling of health-care waste may have serious public health consequences and a significant impact on the environment. Sound management of health-care waste is thus a crucial component of environmental health protection. Establishment of a national policy and a legal framework, training of personnel, and raising public awareness are essential elements of successful health-care waste management.

5-10

Authors: Akash Ranjan Singh, Ashok Madhukarrao Mehendale, Pradeep Ramrao Deshmukh, Abhishek V Raut, Arun Maha

Background: Despite the large numbers of women who are estimated to have suffered maternal hemorrhage, little is known about their health effects, psychological, social and economic consequences. This study was carried to find out the magnitude and epidemiological determinants of Maternal hemorrhage through a community based cross sectional study. Method: This cross sectional study was conducted in field area of a Primary Health Center of Central India. The study subjects were mothers who delivered a live baby or still birth, within the past one year from the date of interview. Thirty clusters of individuals recruited through cluster sampling method. From every cluster 12 subjects were selected using random walk method giving a total sample size of 360. Data collection was done by using pre-tested and pre-designed questionnaire. ANC card and/or any medical record if available were used to retrieve the relevant data. The data was entered and analysed by using Epi_info (Version 6.04d) software package. Results: The prevalence of maternal hemorrhage was found 15% among study subjects. Out of those who suffered Maternal hemorrhage 30% suffered from Antepartum and 70% from postpartum hemorrhage. Maternal hemorrhage was significantly associated with ANC package utilization however, it was not found to be associated with age, caste, parity and birth order of mothers. Conclusion: Maternal hemorrhage is significantly associated with the ANC services utilization. ANC services, in spite of being easily accessible to the mothers, are poorly utilized and this might be an important determinant of maternal hemorrhage and subsequently ‘continuum of care’.

16-18

Authors: Bindhu.V.R, Ganga. S, Susha Dayanandan

Two medicinal plants Centella asiatica and Boerhavia diffusa were found to be effective in controlling the larval instars and adults of Callosobruchus chinensis. Formulations of granules of the two plants were prepared and they caused significant mortality in adults and larvae of the insect. Thus the plants are proved to be effective in controlling the pest.

23-27

Authors: D. Kumar, A.K. Goel, V. Ghanghoria, P. Ghanghoria

Introduction: Health improvement for the tribal and their delivery system cannot be the same because of cultural pattern, lifestyle and health seeking behavior of tribal population. Maternal and child health care practices observed to be poor among particularly vulnerable tribal groups (PVTGs) in India. Methods: Focus Group Discussions (FDS) were conducted among ever married women aged 15-49 years. Areas explored included disclosure of pregnancy status, access barriers, perceptions about existing maternal and child health (MCH) services and influencing factors for utilization of traditional health care facilities. Content and thematic analysis was used to identify common responses and ideas. Results: Twelve FDGs were undertaken by trained investigators one in each village. Participants were identified through the Accredited Social Health Activists (ASHAs) residing in the same village. It was observed that few women are disclosing their pregnancy status to their family members after first trimester; women have many wrong perceptions about safe delivery and abortions. Due to lack of transport facilities and poverty they felt seeking health care was difficult and costly. Conclusion: This study demonstrates that Baiga is one of the PVTGs residing in dense forest in central India have low awareness and underutilization of MCH services.

33-36

Authors: Jeroen F De Man, Bheemaray V Manganawar, Arupa J Das, Bart Criel, Narayanan Devadasan

One of the strategies of the National Rural Health Mission (NRHM) was the appointment of Block Programme Managers (BPMs) to support the management of the rural health system. This descriptive study provides first insights on who BPMs are, what they do, and what they perceive as barriers to their well-functioning. Data were collected through a semi-structured and self-administered questionnaire from 117 BPMs of Karnataka. Seventy four percent of the contacted BPMs responded. Their average age was 30.4 years, 85% was male, 88.8% had a Master in Business Administration. Self-reported performance and perceived ability is high. BPMs report low salary, lack of cooperation from higher level and field staff, lack of training, lack of logistic support and lack of authority as important barriers to their work. This study suggests that the BPMs require capacity building and supportive supervision with regular feedback to improve their performance. We encourage more research on this important element of NRHM.

41-43

Authors: Sankalp Yadav, Gautam Rawal, Mudit Baxi

The present state of emerging and re-emerging infections around the world has resulted in panic and confusion. The loss of lives due to these infections is huge. Also, the absence of clear guidelines and definitive treatment due to the paucity of literature has instilled fear among the general public. In this paper authors discuss some of these infectious diseases that have led to a state of complete chaos in the recent past.