National Journal of Community Medicine

Health Related Quality of Life Among Private School Teachers in Chengalpattu District, Tamil Nadu, India-A Cross Sectional Study

Lavanya M — 2024-11-01

Background: Teachers are the foundation of any civilized society, as they preserve information, wisdom, and ideals. The study was conducted to analyze the Health-Related Quality Of Life among private school teachers and associate the findings with various demographic and occupational parameters.

Methodology: This cross-sectional study was conducted among 300 private school teachers in Chengalpattu district from March-to May 2024.Sample size was determined by multistage random sampling technique. A semi-structured questionnaire consisting of background, occupation related details, and SF-36 to assess the HRQOL were used to collect data. Data was entered in excel and analysed using SPSS version 26.

Results: Out of 300 teachers,233 were female and 152 were above the age of 40. Most affected domains were Bodily Pain and General Health Perception. In both these domains, very low mean levels of quality of life were significantly associated with teachers age more than 40 years old, those who got monthly income of more than 40k, married, teaching experience more than 20 years, those who travelled more than 60 minutes to reach school and those who had comorbidities.

Conclusions: At least one variable across all domains analysed was associated with lower quality of life scores. Administrators and policymakers must provide appropriate health education or health promotion programs and comprehensive prevention strategies for improving their HRQOL.

Neck Circumference as A Screening Tool for Obesity in Pre- and Primary School Children in Puducherry India – A Cross-Sectional Study

Gayathri G Nair — 2024-11-01

Introduction: Obesity has become the 21^st Century’s greatest challenge and threat. Around 50% of the obese children become obese adolescents, of which 80% become obese adults.

Methodology: Cross-sectional analytical study was done on 930 pre- and primary school children. Neck circumference, weight, height, waist and hip circumference was recorded. Overweight/obese identified according to WHO standards. Age-specific percentile charts for boys and girls were drawn with data from the apparently normal children in the study population.

Results: The Neck Circumference measurements ranged from 23.64(±1.16) to 28.49(±2.87) in boys and 23.59(±1.63) to 27.6(±2.67) in girls. ROC analysis derived cut-offs for overweight and obesity in each age group/gender were found to have high sensitivity (80-100%) and specificity (60-95.9%). Using the reference percentile data/curves, and the cut –offs obtained by ROC analysis, a neck circumference above the 75^th percentile for age and gender can be regarded as overweight and above the 90^th percentile as obese in both boys and girls.

Conclusion: The study concludes that the Neck circumference is a valid and effective screening tool for overweight/obesity in pre and primary school children.

Birth Preparedness & Complication Readiness Among Pregnant Women in A Rural Area of North Karnataka - A Community - based Cross - sectional Study

Sandhya Gowthaman — 2024-11-01

Introduction: Globally, approximately 810 women die daily from preventable causes related to pregnancy and childbirth. Birth Preparedness and Complication Readiness improves the use and effectiveness of key maternal and newborn health services, by reducing the phases of delays in receiving these services. This study assessed the knowledge, attitude & practice regarding BPCR among rural antenatal women in Belagavi.

Material & Methods: A community - based cross – sectional study was conducted from 1^st January to 31^st December 2019 among 400 pregnant women in the rural field practice area of a Primary Health Centre, Belagavi. Pre – validated and tested questionnaire from Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) was used for the interview. Data was analyzed using SPSS 25.0 trial version.

Results: The BPCR index was 47.1 %. Positive association with being well prepared were found among women from upper and middle socio-economic status, multigravida, those ≥ 34 weeks of gestational age and those who availed their first antenatal care in the first trimester.

Conclusion: Nearly three – fourth of the rural pregnant women were well prepared for birth, highlighting the need for continued efforts to enhance BPCR among diverse groups.

Prehospital Care and Clinical Characteristics of Patients With Diabetic Emergencies at A Tertiary Care Hospital in Mysuru, India: An Observational Study with Emphasis on Geospatial Analysis

Priyanga Thirunavukkarasu — 2024-11-01

Background: Diabetes Mellitus is a chronic, progressive disease with serious complications, and its prevalence is rising, especially in India. This study evaluates the clinical characteristics, prehospital care, and proximity to healthcare facilities among patients presenting with diabetic emergencies at a tertiary care hospital.

Methodology: A cross-sectional study was conducted with 70 diabetic emergency patients (hyperglycemia, hypoglycemia, and DKA). Data were collected using a semi-structured questionnaire assessing clinical characteristics, prehospital care, and health-seeking behavior. Geospatial analysis measured the distance from patients' residences to the hospital.

Results: Among the 70 participants, 36 (51.4%) were over 60 years old, and 55 (78.6%) were male. The most common symptoms were polyuria (85.7%) and excessive thirst (57.1%). Hyperglycemia was diagnosed in 68 (97.1%) cases, with 46 (65.7%) showing high random blood sugar levels (>200 mg/dl). Severe symptoms led 55 (78.6%) to seek emergency care, with 17 (24.3%) requiring ambulance services. Geospatial analysis revealed that 50% of patients lived 1-50 km from the hospital.

Conclusion: The study emphasizes the need for improved access to diabetes care near patients' homes to prevent emergencies, highlighting the importance of decentralizing services to improve health outcomes.

Elevated Blood Pressure and Behavioral Risk Factors of Non-Communicable Disease Among School-Going Adolescents in Chengalpattu District, India: A Cross-Sectional Study

Harishma Ramesh — 2024-11-01

Background: Elevated Blood Pressure (BP), often termed the "silent killer," is characterized by a BP of 140/90 mmHg or higher, influenced by modifiable and non-modifiable factors, particularly during adolescence. Hypertension prevalence among Indian adolescents varies from 2% to 20.5%. Despite the critical impact of adolescent health on India's overall health landscape, literature on the non-communicable disease (NCD) burden and risk factors among Indian adolescents remains limited. The aim is to assess the prevalence of elevated BP and associated risk factors among school-going adolescents in Chengalpattu district.

Methodology: A cross-sectional study was conducted in Chengalpattu district schools. Utilizing ChatGPT, multi-stage simple random sampling was performed to select 206 adolescents. They were surveyed using adapted questionnaire from the WHO Global School-Based Student Health Survey, covering sociodemographic details, behavioral risks, and anthropometric data and data analysis was conducted using SPSS.

Results: Among the 206 participants, 54 (26.2%) had elevated BP. Key predictors of elevated BP were age, gender, family history, physical education, and serious injuries. Cyberbullying was also associated with elevated BP (P=0.020).

Conclusions: The increasing trend of NCDs necessitates school and community-based campaigns for risk reduction. Further research on cyberbullying and long-term health interventions is recommended to improve adolescent health and reduce NCDs in Chengalpattu and beyond.

Investigating Influence of Multiple Risk Factors on Survival Likelihood in Esophageal Cancer Patients: Evidence from Assam, North-East India

Biraj kumar Kalita — 2024-11-01

Background: To comprehend the complex interplay of multiple risk factors impacting survival at a localized level is imperative. This study aimed to explore survival patterns and identify the underlying causal factors linked to mortality risk in the region.

Methodology: Data from 200 patients with esophageal cancer treated at three prominent hospitals over the course of one year is collected for the study purpose. The Kaplan‒Meier curve and Cox proportional hazard regression model were employed.

Results: This study identified smokeless tobacco consumption habits showing a 6-fold elevated mortality risk (HR 6.22, p<0.001). Subsequently, cultivator (HR 4.85, p=0.001) and male gender (HR 4.24, p=0.001) showed higher mortality risk. Additionally, a significantly higher prevalence of death among smokers with comorbidity (66.0%) is found compared to smokers without comorbidity (44.1%), p=0.043. The survival probability shows a declining trend, i.e. 84.50% in the first year to 13% in the 6th year. With an 82% change, this variation was greatest between the 3rd and 4th years.

Conclusions: To better understand mortality risk, certain risk factors, such as salted fish, fertilizer and pesticide exposure, and length of marriage, need to be thoroughly investigated in future studies due to limited knowledge about this exposure at a localized level.

Magnitude and Correlates of Nicotine Dependence Among Brick Kiln Workers in A Rural Block of Murshidabad District, West Bengal, India

Prithwish Bandyopadhyay — 2024-11-01

Background: Nicotine dependence, a major public health problem, causes respiratory illnesses like asthma, COPD, chronic bronchitis, pneumoconiosis (e.g. silicosis) and respiratory infections. Occupational exposure of smoke and dust among brick kiln workers, in addition to tobacco addiction result in worsening of lung function and increase the risk of mortality. This study planned to estimate the prevalence of nicotine dependence among tobacco users of a brick kiln factory and identify the factors associated with nicotine dependence among them.

Methodology: A cross-sectional study was conducted for a period of one month in a brick kiln of Murshidabad district among 135 adult workers who had been consuming any form of tobacco. Nicotine dependence was assessed by interviewing the participants using Fagerstrom Test for Nicotine Dependence (FTND) and Fagerstrom Nicotine Dependence Scale for smokeless Tobacco (FTND-ST) questionnaire.

Results: About, 52.6% were smokers, 24.4% were smokeless tobacco users and 23% were addicted to both. Approximately 73.6% and 78.2% were nicotine dependent among smokers and smokeless tobacco users respectively. Age, illiteracy, initiation of nicotine consumption at an adult age and long duration of consumption were found to be significantly associated with nicotine dependence.

Conclusions: A high level of nicotine dependence was found among workers. Awareness generation and behavior change communication is recommended.

Experiences & Perspectives on Injectable Contraceptive on Its Users in Tamil Nadu- A Qualitative Report

Rajalakshmi Rajaraman — 2024-11-01

Background: Injectable contraception, Depot Medroxy-Progesterone Acetate (DMPA), is a popular birth control option due to its safety, effectiveness, and discretion. It offers three months protection with minimal impact on the daily lives, reducing the need for frequent visits to healthcare facilities. Understanding women’s experiences with DMPA is crucial for improving the quality of contraceptive services and their reproductive health outcomes. This study aimed to elucidate the experiences and perspectives of women using injectable contraceptive - Depot Medroxy-Progesterone Acetate.

Methodology: The study employed a Phenomenological approach, with in-depth, semi-structured interviews among ten women, aged 21-40 years, who received DMPA at a Family Planning Clinic in Tamil Nadu, India. Participants who had used DMPA for at least three months to one year were selected using convenience sampling. Data were analysed and identified themes through the Colaizzi method.

Results: Thematic analysis revealed eight key themes: reasons for choosing DMPA, decision-making process, concerns and discontinuation, information sources, management strategies, willingness to recommend, reluctance to recommend, and suggestions for improving DMPA utilization.

Conclusions: This study highlights the need for enhancements in injectable contraceptive services, providing insights to inform future family planning policies and strategies.

Relationships Between Health Beliefs, Fear of COVID-19, Knowledge of HIV Transmission, And HIV Preventive Behaviors Among Young Thai Men Who Have Sex with Men During the COVID-19 Pandemic

Anongluk Vongtree — 2024-11-01

Background: Young Thai men who have sex with men (MSM) are at high risk of HIV transmission, making effective prevention crucial. This study aimed to examine the relationships between health beliefs, fear of COVID-19, knowledge of HIV transmission, and HIV preventive behaviors among young Thai MSM during the COVID-19 pandemic.

Methodology: A cross-sectional online questionnaire study guided by the health belief model was conducted among young Thai MSM using snowball sampling. Data on HIV/AIDS health beliefs, knowledge of HIV prevention, fear of COVID-19, and HIV preventive behaviors were collected and analyzed using descriptive and inferential statistics.

Results: The study included 134 participants (59.7% gay, 40.3% transgender). Knowledge of HIV prevention, fear of COVID-19, and HIV preventive behaviors were at a moderate level. Perceived severity of HIV/AIDS, perceived benefits of HIV prevention, self-efficacy for HIV prevention, knowledge of HIV transmission, and fear of COVID-19 were significantly related to HIV preventive behaviors among young Thai MSM (p<.05). These five variables were predictors of HIV preventive behaviors (Adjusted R² = 0.304, F=6.740, p<0.05).

Conclusions: The findings highlight the need for intervention programs focused on improving health beliefs and promoting HIV preventive behaviors among young Thai MSM.

Prevalence and Determinants of Hypertension Among Urban School Teachers in Patna, India

Vikash Kumar — 2024-11-01

Background: Hypertension, a major cause of cardiovascular disease, is increasingly common among urban professionals, including school teachers, who face unique stressors and lifestyle challenges. Understanding these factors is essential for developing targeted health interventions. This study aims to determine the prevalence and key determinants of hypertension among government school teachers in Patna.

Methodology: A cross-sectional survey was conducted from November 2021 to October 2022 with 1321 teachers from 325 urban schools in Patna. The sample size was calculated based on a 45.4% estimated hypertension prevalence, with a 3% margin of error and 20% non-response rate. Teachers were selected using stratified sampling with probability proportional to size.

Results: Of the 1283 respondents, 61.34% were male and 38.66% female. The overall prevalence of hypertension was 14.1%, higher in males (15.5%) than females (11.9%). Hypertension was significantly associated with frequent fast-food consumption, extra salt intake, tobacco use, stress, and higher BMI (p<0.05), though not with age, gender, physical activity, or depression.

Conclusions: Improving dietary habits, reducing tobacco use, and managing BMI among teachers can significantly reduce hypertension. Healthier teachers create a better teaching environment, positively impacting student learning outcomes and enhancing the overall educational experience.

Association of Geriatric Depression with Biosocial Factors and Malnutrition in Rural Areas of District Gautam Budh Nagar, Uttar Pradesh: A Community-Based Study

Amit Singh Pawaiya — 2024-11-01

Background: Aging mainly affects human appetite, food intake, and body weight. Physiological and psychopharmacological pathways demonstrate variations in hunger. Bodily signs characterize Elderly Depression, altered eating and sleeping patterns, cognitive impairments, and low mood. Objectives: To study the prevalence of Depression and Malnutrition in the geriatric population in the rural community and to examine the association between them among the study population.

Methods: A community-based cross-sectional study was conducted in the rural areas of district Gautam Budh Nagar among geriatric population using a pre-designed pretested semi-structured questionnaire.

Results: In the study, the prevalence of Depression among the study participants was found to be 155(41.2%) and malnutrition was found to be in 67 (17.8 %). Among bio social characters Age (p-value-0.000), gender (p-value-0.012), marital status (p-value-0.026), physical activity (p-value-0.004), and Malnutrition (p-value-0.000) found to be significantly associated with Depression among elderly. On multiple logistic regression, physical activity [aOR 23.6; 95% CI: 11.4-48.8] and Malnutrition or its risk [aOR 0.272; 95% CI: 0.130-0.569] were significantly associated with Geriatric Depression.

Conclusions: Depression is recognized to have a significant impact on nutritional health in the elderly and is a major factor in weight loss.

Comparative Analysis of Self-Medication Practices with Antibiotics Among Non-Medical and Medical College Students in India

Manthan Dhingra — 2024-11-01

Background: Self-medication is prevalent globally, making the processes easier but raising potential hazards like antibiotic resistance. College students, influenced by social media, exhibit alarming self-medication behaviours. This cross-sectional study surveyed undergraduate students across medical, nursing, and non-health science institutions to assess the self-medication habits, knowledge and attitude of students.

Methods: This descriptive cross-sectional study was conducted across various educational institutions from August 2023 to February 2024, targeting undergraduate students aged 18 and over. Using a pre-validated questionnaire, data on socio-demography, self-medication with antibiotics, and related knowledge were collected via Google Forms. The sample size was doubled to 1175 for better statistical power. Data analysis was performed using standard statistical tools.

Results: Analysis of data demonstrated that a substantive proportion of students self-medicate with antibiotics. For medical students, convenience was the biggest issue and for non-medical students, it was cost-saving coupled with distrust in doctors. The most common complaint received for self-medication was throat pain. Medical students used textbooks for necessary information whereas non-medical students went to local shops for advice. Patterns differed somewhat in comparison with international studies, indicating regional differences. Strikingly, medical students predominantly relied on academic knowledge and previous experiences while using antibiotics, whereas non-medical students often obtained antibiotics from shops or the internet, making them vulnerable to misdiagnosis and inappropriate treatment.

Conclusion: This highlights the importance of implementing specific interventions to reduce unsafe self-medication practices in students.

Breast Self-Examination Self-Efficacy Scale: Translation and Validation in Pakistani (Urdu) Version

Sumaira Naz — 2024-11-01

Introduction: There is a necessity of Pakistani (Urdu) translation and validation of Breast self-examination (BSE) self-efficacy scale to access high- risk women confidence in doing self-examination of breast as screening measures. The study aim is to translate and validate breast self-examination self-efficacy scale in Pakistani high-risk women.

Methodology: The 12 items BSE Self-Efficacy scale was translated and validated by using Brislin (1970) and Sperber (2004) methodology. Psychometric properties of Pakistan version BSE Self-Efficacy scale were assessed among 120 women from oncology department of the tertiary care hospital in Pakistan selected with simple random sampling. CFA (Confirmatory factor analysis) was done for measuring the construct validity and reliability was assessed by Cronbach alpha coefficient. Demographics characteristics were analysed by descriptive statistics with SPSS and Mplus software was used for CFA.

Results: The translated version showed semantic equivalence to the original English version. CFA results indicated that all 12 items were consistent with a unidimensional scale (χ2=464.3, p > .05, df=54, RMSEA =.025, CFI=.965, TLI=.913, SRMR=.062), Cronbach’s α value .96, demonstrating high reliability.

Conclusion: The twelve-item BSE self-efficacy scale Pakistani version established appropriate translation, validity and reliability in measuring confidence of doing BSE.

The Importance of Optimal Nutritional Intake for The Health of Pregnant Women in Indonesia: Key Challenges and Strategic Solutions

Suparji Suparji — 2024-11-01

Optimal nutrition during pregnancy plays a vital role in ensuring maternal health and healthy fetal development. Appropriate nutritional needs, including macronutrients and micronutrients, are essential to support fetal growth, prevent pregnancy complications, and reduce the risk of premature birth and low birth weight. In Indonesia, maternal nutrition is still a major challenge, with a high prevalence of anemia and chronic energy deficiency. Factors such as economic constraints, unequal access to health services, lack of education about the importance of nutrition, and socio-cultural influences on diet, exacerbate this condition. The challenge in meeting the nutritional needs of pregnant women is also related to the low awareness and knowledge of nutrition among the community, especially in remote areas. To overcome this problem, a multi-sectoral approach is needed involving government intervention, community empowerment, and increasing access to health services. Continuous education and targeted nutritional assistance programs can be effective solutions in improving the nutritional status of pregnant women in Indonesia. Thus, strong cooperation is needed between various stakeholders to ensure optimal maternal health, which will ultimately improve the quality of future generations.

Prevalence of Depression Among Elderly Population in India - A Systematic Review & Meta-Analysis

Bincy K — 2024-11-01

Background: Depression among the elderly is a global public health concern, impacting quality of life and overall well-being. However, there is a lack of recent systematic reviews or meta-analyses on its prevalence in India. This study aims to update this information through a systematic review and meta-analysis.

Methods: The study utilized the Geriatric Depression Scale (GDS) as a screening tool for depression among individuals aged 60 and older in India, utilizing electronic databases for community-based cross-sectional studies from inception to date. Pooled prevalence with 95% CI was performed using R statistical software.

Results: 23 community-based cross-sectional studies were included representing 13 Indian states, meeting the inclusion criteria. The combined prevalence of depression among the elderly was estimated to be 47% (95% CI: 0.39; 0.55), with significant heterogeneity observed among studies (I²=98%, p<0.01). The study underscores the considerable depression issue among India's elderly population, emphasizing the urgent need for tailored mental health interventions.

Conclusion: The meta-analysis reveals a high prevalence of depression among India's senior population, highlighting the need for targeted public health initiatives to address this growing crisis and support the mental health needs of the elderly.

Developing Research Skills in Medical Students- Experience from Research Methodology Workshops for Indian Medical Graduates

Geetu Singh — 2024-11-01