Indian Journal of Forensic and Community Medicine

13-18

Authors: Ashok S. Dorle, Harshavardhana V. Naik.

Introduction: Malnutrition is responsible for serious health, social and economic consequences throughout the life course as well as across generations, making it the leading risk factor among children under five. In recognition of the burden of malnutrition among under-five children, United Nations SDG’s are specifically directed towards improving child health in developing countries. In India, like many developing countries, the most common nutritional problems in infancy and early childhood are stunting, wasting; iron-deficiency anaemia, poverty and low birth weight. When there is a failure to achieve the expected height/length as compared to the healthy well nourished children indicates stunting. It is an indicator of linear growth retardation that results from failure to receive adequate nutrition over a long period or recurrent infections. It is an indicator of past growth failure. Objective: To study the prevalence of Stunting in under 5 children in the rural field practice area of S.N. Medicalcollege, Bagalkot. Materials and Methods: According to the study done by Shreyaswi MS et al, taking prevalence of Stunting in Rural Karnataka as 63.16%, sample size was calculated using N=4PQ/L.2 The sample size was calculated as 372.2 and a sample of 384 was collected. Stunting was assessed by anthropometric measurements and data regarding sociodemographic factors affecting Stunting were also considered. Data was compiled and tabulated by using MS EXCEL. Data was analysed using Spss. Binary logistic regression was applied. Results: The prevalence of Stunting was 39% and 4.4% were severely stunted. Stunting was significantly associated with age, birth weight, socioeconomic status, ANC visits, pre-lacteal feeds, Place of delivery, Immunisation status and H/O diarrhoea or ARI in the past one year. Conclusion: The prevalence of stunting in the rural areas still remains high despite the measures taken by the government to reduce undernutrition. The issues giving rise to undernutrition need to be addressed.

22-25

Authors: Rakesh Bahl, Renu Sharma, Abroo, Rashmi Kumari.

HIV infection is known to have established in India since year 1986 and three decades are over since then. A lot of activities have been since then going on by the government of India sponsored NACP under the aegis of NACO. The endemicity of this infection in populations is known to be inversely proportional to the level of awareness about HIV/AIDS. As per the data available, there are variations in level of awareness about the HIV/AIDS and it’s prevention among the general populations as well as the at risk populations. So it is always prudent to assess the level of awareness among the general population. For this reason survey of awareness level among the high school students can give a reliable indication as they represent the level of awareness of their families. Hence a study was conducted among the adolescent students in age group of 14-19 years ie. Class 9-12 years. Study Design: Cross sectional study. Study Subjects: adolescent students in age group of 14-19 years ie. Class 9-12 years. Study Period: Dec 2015 Materials and Methods: The study was conducted in village Maralian of Block RS Pura (rural field practice area of Department of Community medicine, GMC Jammu). The schools chosen were High and Higher secondary standards where the students of age group >14 years could be contacted. Study Instrument: A pre tested schedule containing (47) questions related to Knowledge, attitudes and practices of adolescents about modes of transmission and prevention of HIV infection, attitudes and beliefs about it and their related practices was used to interview. It was seen that the students in age group of 14-18 years were much aware about the HIV/AIDS, it’s causes, routes of transmission, risk factors, preventive measures and facilities for diagnosis and drugs. Students of this age group can be taken as proxy to the families they belong to and hence the general population of the area under study. But still, a large proportion is having wrong concepts or no ideas about all the aspects associated with HIV/AIDS.Conclusion: Hence, conducting and sustaining IEC activities in the area is recommended.

31-33

Authors: Phani Kiran Peethala, Pothula Umamaheswara Rao.

The basic fundamental aspect of the human development is the potential of the individual to live a long and healthy life. Periodic statistical evaluation of the changing trends of unnatural deaths will provide valuable data to adopt effective preventive measures in this respect. The aim of the present research is to retrospectively study the prevalence and the changing trends in the unnatural deaths in and around Kakinada during the period of two years from January 2015 to December 2016 in the department of Forensic Medicine & Toxicology, Rangaraya Medical College, Kakinada, Andhra Pradesh.

39-43

Authors: Bawa Mukesh, Patil Sarika, Kinge Amol, Borde A.N..

Introduction: Community Medicine (CM) is meant to equip the students with the knowledge and skills order to identify the prevalent health problems in the community and find methods of alleviating them. The present study is undertaken to assess the general perception of students towards Community medicine and analyze if students prefer community medicine for a career. Materials and Methods: This was a cross sectional study, carried out in a Government Medical college of Dhule City, from August to October 2017. Present study carried out among students from IV and VII semesters who belonged to 2nd year and Final (3rd) year part I of MBBS respectively. A predesigned, pretested, semi structured questionnaire was used for evaluation. Data was analyzed with SPSS version 20.0. Results: 165 students were included in the study; of them 50.3% were females. Common general perception of Community medicine was as paraclinical subject by 55.7%, as only preventive and health education role by 77.6% and 65.5% students. 83% thought that the curriculum is relevant to present era. 50.9% had perception of CM focus only on prevention while there were varied views regarding the topic irrelevant and exempted from the syllabus. 47.9% felt than CM lack application and needs practical example rather than just being theoretical. Only 36% students were ready to opt career in community medicine. Conclusion: Students seem to understand the subject and don’t have an issue with the topics, or its projection, however there is reluctance to choose it as a career.

48-51

Authors: Aloke Kr. Misra, Ashok Kr. Maini, S. P. Singh, Ajay Bhagoliwal.

Introduction: Obesity is emerging as a serious problem throughout the world, not only among adults but also children, teenagers and young adults. Of the factors contributing to obesity, stress seems to be particularly important as stressful condition leads to irregularity in diet, lack of exercise and addiction, each being considered an independent factor leading to obesity. Objectives: To find out the prevalence of overweight and obesity among medical students. To study the effects of physical activity on over weight /obesity and its Barriers among medical students of Rama Medical College Mandhana (Kanpur). Study Design: A cross-sectional study was conducted among total 200 subjects included by simple random sampling method out of 480 medical students. Material and Methods: Anthropometric measurements (height and weight) were taken as per WHO criteria. Body mass index were calculated and classified accordingly as under weight normal weight, over weight and obese. Details of factors influencing BMI were obtained using a pretested questionnaire in a pilot study. Results The study revealed high prevalence of overweight/Obesity (33.6% with 95% CI 33.5%-40%).Out of 200 subjects (25.5%)were overweight and (8.1%) found obese respectively rest 61% subjects with Normal weight and 5.5% were under weight. In our study only 106 (57%) subjects were physically active and 94 (47%) were physically not active having deferent barriers to physical activity. Among those who were physically not active, 22(23.40%) students reported personal barriers as a cause for physical inactivity. 23(24.46%) were having psychological barriers. But majority of subjects 49 (52.13%) were having social cognitive behavior related barriers to physical activity. Conclusion: Increased prevalence of overweight and obesity among medical students were observed. The importance of regular physical activity and certain aspects of healthy life style are to be stressed. Social cognitive behavior related barriers to physical activity should be removed among future doctors who are not physically active.

57-61

Authors: Manjul Kumar, Dheeraj Raj, Yogita Singh.

Introduction: Meningomyelocele is a birth defect in which the backbone and spinal canal do not close before birth. Neural tube defects are one of the most common congenital malformations affecting the brain and spinal cord & Meningomyelocele is one of the commonest neural tube closure defects. The global prevalence of Meningomyelocele has been reported to be 0.8–1 per 1,000 live births. Hydrocephalus may affect as many as 80% of children with Meningomyelocele. The use of periconceptional folic acid supplements, prevents ~50–75% of cases of neural tube defects. This study aims to evaluate demographic and clinical profile, associated anomalies & outcome of children with Meningomyelocele. Materials and Methods: 113 patients with Meningomyelocele admitted to SVBP hospital, Meerut between Sept’16 to Aug’17, were analyzed prospectively. The data regarding demographic and clinical profile with associated congenital anomalies were obtained by questionnaire- interview with the parents and patients themselves. MRI was the essential investigation in all patients. The data was analyzed by SPSS 21.0 version. Results: Mean age of presentation is 9.1 months. M:F ratio is 1.1:1. Lumbosacral region is involved in 73.5% patients. Hydrocephalus was the most common (64.6%) associated anomaly. In 92% cases there is no history of folic acid supplementation & all patients were from low socioeconomic status. Excision & repair of Meningmyelocele is the most commonly (51.3%) performed surgery while surgical site infection is the most common (19.5%) complication. In our study (91.2%, n=103) patients improved & discharged, 2.7% (n=3) patients expired, 4.4% (n=5) patients left against medical advice while 1.8% (n=2) patients referred to higher centre due to various reasons. Conclusion: Low socioeconomic status & no maternal supplementation of folic acid are the important risk factors for the development of Meningomyelocele. Timely intervention with excision and repair gives good result. Modified rhomboid flap can be use to cover large defects.

65-70

Authors: Yogita Singh, Devinder Kumar Vohra, Nitin Kumar.

Introduction: There is increase in prevalence of metabolic syndrome in younger population in India. Epicardial fat is one of the components of visceral adipose tissue. There is little evidence to suggest that the extent of epicardial fat is strongly related to overall adiposity. The relationship between epicardial fat and metabolic syndrome is still unexplored. Hence the hypothesis of the study is to evaluate whether epicardial adipose tissue is related to anthropometric, clinical and biochemical parameters of metabolic syndrome. Materials and Methods: The present study is a case control study which included 66 subjects- 33 cases (patients who fulfilled the NCEP ATP III criteria for metabolic syndrome) and 33 Controls. Detailed clinical history and physical examination (including blood pressure, height, weight, waist/hip circumference) along with biochemical examination (blood glucose, HbA1C, HOMA IR, serum insulin levels, fasting lipid profile) was done. Each subject underwent transthoracic two dimensional M-mode echocardiogram in left lateral decubitus position on Philips Sonos 5500 echocardiography machine to evaluate epicardial fat thickness. Results: In our study we found a strong positive correlation between the epicardial fat thickness and the following parameters in patients of metabolic syndrome: BMI: r = 0.52, p =0.02; HOMA IR; r = 0.58, p =< 0.001; FPG; r = 0.79, p =< 0.00; HbA1c, r = 0.59, p =<0.001; Triglyceride levels; r = 0.75, p =< 0.001. Conclusion: Our study show a positive correlation with body mass index, blood pressure, fasting plasma glucose HBA1c, HOMA IR and Serum triglyceride level with epicardial fat thickness. We suggest that echocardiographic epicardial adipose tissue could be applied as an easy and reliable imaging indicator of cardiometabolic risk.