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   2015| January-April  | Volume 2 | Issue 1  
    Online since June 4, 2015

 
 
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ORIGINAL ARTICLES
Prevalence of anemia and effectiveness of iron supplementation in anemic adolescent school girls at Amravati City (Maharashtra)
Ajay Keshavrao Jawarkar, Pushpa O Lokare, Anuradha Kizhatil, Jyoti A Jawarkar
January-April 2015, 2(1):7-10
DOI:10.4103/2394-2010.158122  
Introduction: In India, the prevalence of anemia in adolescent girls is estimated at 56%. The underlying sociodemographic factors and menstrual practices need to be studied in adolescent girls and a way to reduce the anemia not only by supplementation of iron and folic acid tablets and deworming but ensuring its regular consumption. Hence, the present study was undertaken to know the effectiveness of deworming and iron and folic acid supplementation in reducing the prevalence and severity of anemia in adolescent school girls. Aims and Objectives: To study the prevalence of anemia in adolescent girls in urban area and effectiveness of iron supplementation in them. Materials and Methods: The present interventional study was conducted at Sharada Kanya Vidyalaya, in Amravati city. Total 350 adolescent girls were selected by random sampling from August 2013 to November 2013. All the girls were given a single dose anthelminthic and the girls who were anemic were given iron and folic acid tablets for daily consumption. The hemoglobin was again assessed after three months. Statistical Analysis: Chi-square test of significance and standard error of difference between two means using SPSS version 16 software. Results: The overall prevalence of anemia in adolescent girls was found to be 55%. Mean and standard deviation of Hb% in adolescent girls significantly increased from 10.57 (±1.09) before to 11.78 (±0.99) after intervention. Conclusion: The contributing factors of anemia found in the present study were low socioeconomic status, onset of menarche, small family size, and vegetarian diet.
  12,621 1,330 10
Study on default and its factors associated among Tuberculosis patients treated under DOTS in Mayurbhanj District, Odisha
Sudipta Basa, Srinivas Venkatesh
January-April 2015, 2(1):25-28
DOI:10.4103/2394-2010.158125  
Background: Defaulting from tuberculosis (TB) treatment has been one of the major obstacles to treatment management and an important challenge for TB control. Understanding of various factors accounting for treatment default could help to achieve better compliance from patients. Thus the aim of the study is to estimate number of defaulters out of total TB patients registered under DOTS from January to June 2005 and to study the reasons for default in Mayurbhanj district, Orissa. Materials and Methods: A cross-sectional study was done by interviewing 41 defaulters using pre-tested semi-structured questionnaire to elicit reasons for default. Data was analyzed using Epi-info-(3.5.1), to find statistical significance among the variables. Results: Of the total 41 defaulters among 550 patients registered, only 31 could be interviewed, 10 were untraceable at the address provided. Default rate in our study was 7.5%. Majority of patients (73%) had defaulted during intensive phase of the treatment. A higher default rate associated with age group of 40-60 years, males and employed groups. The main reasons for default was due to drug toxicity (42%), feeling better so discontinued (35.5%), alcoholism (19.4%), migration (6.45%), wrong ideas (6.45%), DOTS provider absent (3.2%), DOTS provider rudeness (3.2%), and other reasons (9.7%), which includes family problems, timing inconvenient, and carelessness. Risk factors significantly associated were male, age, alcoholism, and distance of more than 5 km from treatment center. Conclusions: The majority of patients have defaulted in intensive phase of treatment. All efforts should be made to retrieve these patients and return them to treatment to achieve the expected goal of Revised National Tuberculosis Control Programme (RNTCP).
  8,269 755 6
REVIEW ARTICLE
Review of limb volume measurement techniques in assessing fetal weight by ultrasound with special reference to ImageJ package
Sukriti Malaviya, Shripad Hebbar, Lavanya Rai
January-April 2015, 2(1):1-6
DOI:10.4103/2394-2010.158121  
Traditionally intrauterine nutritional status of the growing fetus is evaluated using ultrasound estimated weight, which is then compared with standardized prenatal growth chart for that particular gestational age. The fetuses belonging to less than 10 th centile groups are considered to have reduced growth, whereas those who are more than 90 th centile belong to macrosomia group. Both these extreme groups have their own characteristic obstetric problems and may have poorer outcome. The conventional fetal weight formulae incorporated in regular ultrasound machines are largely dependent on head size, abdominal circumference, and femur length and are prone to random errors as high as 15% of actual birth weight. The margin of error further increases with very small and very large fetuses, and also, these measurements are not valid when the fetus has anterior abdominal wall defects. Malnourishment and obesity studies in pediatric subjects have shown us that subcutaneous fat significantly contributes to actual weight, and mid arm circumference can be used as screening tool for nutritional disorders. The errors in fetal weight estimation can be minimized if fetal soft tissues such as arm and thigh volumes are included for nutritional assessment of the fetus. The recent advances in three-dimensional (3D) ultrasonography has made limb volume estimation simple, easy, and birth weight models using limb volume measurements have higher accuracy, least systematic and random errors compared with the usual two-dimensional biometry of head, trunk, and limb length alone. However, these machines incur significant cost and procurement may not be feasible for resource poor organizations. The present review discusses developments in 3D analysis of fetal limb volulmetry, the methodologies, and affordable solutions using alternative image processing tools such as ImageJ in regular sonographic practice. We have also searched various databases (PUBMED, MEDLINE, SCOPUS, GOOGLE SCHOLAR AND SCIENCE DIRECT, J-Gate Plus and ProQuest) for birth weight models using limb volume measurements and have provided 13 different birth weight equations based on arm and/or thigh volumes.
  6,222 417 -
ORIGINAL ARTICLES
Impact of perceptions of key stakeholders in combating undernourishment among rural children in Delhi: A qualitative study
Sanjeev Davey, Anuradha Davey, Vivek Adhish, Rajni Bagga
January-April 2015, 2(1):11-18
DOI:10.4103/2394-2010.158123  
Background: The role of community members in deciding nutritional status of their children reveal many complex issues in studies done in the past; in that one such issue is the mutual perceptions of the multilevel stakeholders toward each other, for their efforts usually taken by them for reducing undernourishment in rural areas of Delhi. Aim and Objective: To gain insight in the perceptions of Opinion leaders, Health, and Integrated Child Development Scheme (ICDS) functionaries toward each other in reducing under nutrition among rural children. Materials and Methods: The study was done in one Rural ICDS project in Delhi from January 1, 2015 to March 15, 2015. The prevalence of undernutrition in two AWCs was taken from previous studies in the past and thereafter the mutual perceptions of the community-level stakeholders, ICDS, and health care functionaries toward each other were studied by Qualitative research methods. The primary qualitative and quantitative data and secondary quantitative data both were finally triangulated to find out the reasons for existing scenario of undernutrition in Delhi. Results: The higher prevalence of undernutrition (58% from past studies) was supported by inadequate, ineffective and defective perceptions and uncoordinated efforts of PRIs, ICDS, and Health department reducing undernourishment in their area. Conclusion: To gain quality services from ICDS scheme and Primary health care system in rural area of Delhi; the need of the hour is the regular refresher and reorientation nutritional and health training programs for multilevel stakeholders in rural areas for tackling undernourished children in Delhi.
  6,110 373 -
CASE REPORTS
Ascariasis presenting as hematemesis in a young boy
Mohammed Mushtaque Ahmad, Praveen Kumar Malik, Shahnawaz Hassan, Shridhar Dwivedi
January-April 2015, 2(1):37-38
DOI:10.4103/2394-2010.158128  
Most cases of round worm infestation are asymptomatic. Their migration to various unusual sites in the gastrointestinal tract leads to uncommon complications such as acute pancreatitis, biliary cholangitis, acalculus cholecystitis, and so on. Accumulation of worms inside intestinal lumen can lead to obstruction, intussuception, or volvulus. However, migration of the worm in the stomach and consequent hematemesis is a very rare complication. Acidic milieu of stomach and its strong peristalsis are considered to be the reason for this rarity. Mechanism of hematemesis is assumed to be erosion of the mucosa either by mechanical process or by the secretions of the worm. This young boy being presented here had vague abdominal complaints and later developed hematemesis along with vomiting out of three living round worms. He brought the worm to hospital and contributed in making prompt diagnosis. He was treated conservatively.
  6,124 335 3
ORIGINAL ARTICLES
Self-perceived oral function and factors influencing oral health of elderly residents in Bengaluru city, India
B Kumara Raja, G Radha
January-April 2015, 2(1):29-33
DOI:10.4103/2394-2010.158126  
Context: Oral health status plays an import role in patient quality of life, affecting mental, physical, and psychological wellbeing and complete social development by interfering with word pronunciation, social life, and alimentary function. Aims: To evaluate self-perception of elderly about the effect of oral health on quality of life using the geriatric oral health assessment index (GOHAI) index. Settings and Design: A cross-sectional study was carried out among 376, elderly individuals aged 60 years and above, residing in residential homes of Bengaluru city. Materials and Methods: The data were collected using GOHAI scale comprising of 12 items to measure the patient-perceived oral functional problems. In addition, a self-reported questionnaire was used to elicit demographic information. Statistical Analysis Used: A descriptive statistics along with Chi-square test was used. Results: Out of 407 individuals, only 376 fulfilled the inclusion criteria and constituted the final number of the participants. GOHAI was statistically significant with age (0.036*), gender (0.045*), dentition status (0.019*), and smoking status (0.042*), which showed a predictor for low oral health functional status. A majority of the subjects (66.1%) were "always" unhappy with their appearance of their teeth gums or dentures and 74.5% of the subjects were "always" concerned about their problems with their teeth, gums, or denture. Conclusions: The GOHAI final score was considered low, indicating a low self-perception by the elders of Indian residential homes.
  5,866 562 5
CASE REPORTS
Malignant parotid tumor with sialadenitis: A diagnostic dilemma
Pandiaraja Jayabal, Viswanathan Subramanian
January-April 2015, 2(1):34-36
DOI:10.4103/2394-2010.158127  
Malignant parotid tumor associated with chronic sialadenitis is a rare entity. These tumors mostly arise from epithelial component of chronic sialadenitis. Chronic sialadenitis of parotid with malignant epithelial tumor even rare compared to chronic sialadenitis of the other salivary gland with malignant component. This is a rare case report of a 70-year-old male smoker with diagnostic difficulty for painless parotid mass. Finally, the patient diagnosed as malignant parotid tumor with chronic sialadenitis.
  5,740 322 1
ORIGINAL ARTICLES
Knowledge of tuberculosis and human immune virus among tuberculosis suspects attending health facilities in Addis Ababa
Nebiyu Negussu Ayele, Amare Deribew Taddege, Kebede Deribe kassaye, Mulugeta Chaka, Ahmed Badei
January-April 2015, 2(1):19-24
DOI:10.4103/2394-2010.158124  
Background: Tuberculosis is a major public health problem throughout the world in general and in Ethiopia in particular. In this study, we assess the knowledge of TB suspects about TB and HIV in health facilities of Addis Ababa. Materials and Methods: In the period of February to March, 2009, a cross-sectional survey was done in 27 health centers of Addis Ababa among TB suspects who had cough, and fever for ≥2 weeks. A total of 545 adult pulmonary TB or extrapulmonary TB (TB lymphadenitis) suspects (>15 years) were studied. Information about TB and HIV were collected using pretested questionnaire. Data was collected by trained health professionals and analyzed using SPSS 20.0 statistical software. Result: Most (94.4%) of the TB suspects heard about TB before. A few (12.8%) knew TB can involve other organs other than the lung. Ventilating living room was perceived by 34.6% as a means of reducing TB infection. Suspects who work in the public sector had three times increased odds of being knowledgeable than daily workers (AOR = 3.00, 95% CI: 1.53-5.88, P = 0.001). On the other hand, illiterates had lower odds of being knowledgeable about TB than above 12 graders (AOR = 0.1, 95% CI: 0.03-0.38, P = 0.001). Even if all suspects heard about HIV, still sharing meal (10.7%) and mosquito bite (7.9%) perceived as modes of transmission for HIV infection. Suspects who are 25-34 years old (AOR = 3, 08, 95% CI: 1.4-6.78, P = 0.001) and 35-49 years old (AOR = 2.16, 95% CI: 1.04-4.48, P = 0.033) were more likely to have good knowledge about HIV compared with >50 years old. Conclusion: Overall, suspects heard about TB and HIV before. However, there was less knowledge regarding other forms of TB. Misconception still persists on the area of HIV/AIDS. Hence a comprehensive approach needs to be followed to improve knowledge about TB and misconception about HIV/AIDS.
  4,675 361 -