Maternal mental health and its determinants - A community-based cross-sectional study in Aligarh, Uttar Pradesh.

BACKGROUND: Maternal mental health problems are one of the major public health challenges. Globally, depression and anxiety cause immense suffering and disability among mothers who later contribute to compromise parenting practices and increased unmet needs of their newborn and young children. OBJECTIVES: The aim of this study is to determine the prevalence and determinants of maternal common mental disorders (CMDs) among the study population. METHODS: A community-based cross-sectional study was conducted in Aligarh, Uttar Pradesh, India, from July 2016 to June 2017, among 415 women of child-bearing age who had one or more children in the age group of 0-23 months. A World Health Organization prequalified questionnaire Self-Reporting Questionnaire 20 was used to assess the CMD of mothers. Binary logistic regression was used for finding out predictors of mental disorders. RESULTS: Overall prevalence of maternal CMDs was 38.8%. The prevalence of maternal CMD was significantly higher among mothers in a higher age group, belonging to low socioeconomic class, nuclear type of family, living in the urban locality, having lower or no education, being single mothers, housewives, and having higher parity. CONCLUSION: Substantially, high prevalence of CMD among mothers suggests for further research to explore the factors affecting the mental health of mothers. Measures for the early identification, treatment, and prevention of maternal mental disorders should be taken.

Reducing resistance against polio drops.

AIMS: The present study was carried out to impart correct health education regarding polio eradication programme and to assess the impact of social mobilization of a Muslim community carried out by medical interns. METHODS: One round of a polio immunization campaign was selected randomly. Five highly resistant areas were included in the study. During house to house A-Team activity, teams of health workers visited the houses and resistant families were identified. These families refused to give polio drops to their children. On the second day of A-Team activity, medical interns visited those identified resistant families. They imparted correct health education and tried to convince them to give polio drops. However, after prolonged persuasion, some of the families were not ready to give polio drops. These more resistant families were again visited by more motivated and enthusiastic teams during B-Team activity, started two to three days after the completion of A-Team activity. Data were collected, tabulated and analysed. RESULTS: Total number of resistant families identified during house to house A-Team activity was 1025 in five high risk areas of Aligarh, India. Out of 1025 resistant houses, 510 (49.76%) houses were converted to P houses where polio drops were given to the children. Five hundred and fifteen (50.24%) houses remained resistant even after social mobilization by A-Team members. These most resistant houses were again visited by B-team members. Out of these 515 houses, polio drops were administered in 303 (58.83%). The overall number of converted houses was 813 (79.32%) after A and B-team activities. 20.68% of families remained resistant and their children could not be given polio drops. CONCLUSIONS: In all high risk areas, maximum numbers of resistant houses were converted to P houses. These families were persuaded and convinced by the teams of interns, social workers and influential persons that polio drops did not have any side effects. They were more receptive to the advice given by medical interns compared to other staff members of the Government District Hospital because of quality of health services provided to the community. There is a need to impart correct health education regarding importance of polio drops and routine immunization more vigorously through information, education and communication (IEC) activities.

Locomotor problems among rural elderly population in a District of Aligarh, North India.

INTRODUCTION: Locomotor functions decline with the age along with other physiological changes. This results in deterioration of the quality of life with decreased social and economic role in the society, as well as increased dependency, for the health care and other basic services. The demographic transition resulting in increased proportion of elderly may pose a burden to the health system. OBJECTIVES: To find the prevalence of locomotor problems among the elderly population, and related sociodemographic factors. MATERIALS AND METHODS: The study was a community-based cross-sectional study done at field practice area of Rural Health Training Centre, JN Medical College, AMU, Aligarh, Uttar Pradesh, India. A sample of 225 was drawn from 1018 elderly population aged 60 years and above using systematic random sampling with probability proportionate to size. Sociodemographic characteristics were obtained using pretested and predesigned questionnaire. Locomotor problems were assessed using the criteria used by National Sample Survey Organization. Data were analyzed using SPSS version 20. Chi-square test was used to test relationship of locomotor problems with sociodemographic factors. P <0.05 was considered statistically significant. RESULTS: The prevalence of locomotor problems among the elderly population was 25.8%. Locomotor problems were significantly associated with age, gender, and working status whereas no significant association with literacy status and marital status was observed. CONCLUSION: The study concluded that approximately one-fourth of the elderly population suffered from locomotor problems. The sociodemographic factors related to locomotor problems needs to be addressed properly to help them lead an independent and economically productive life.

A Community Based Study on Pelvic Inflammatory Disease in Postmenopausal Females: Microbiological Spectrum and Socio-Demographic Correlates.

INTRODUCTION: Pelvic Inflammatory Disease (PID) is a common and serious complication of sexually transmitted diseases in young women but is rarely diagnosed in the postmenopausal women. Very few studies have been done regarding post-menopausal PID. AIM: To determine the burden of PID, associated micro-organisms, pathophysiology and risk factors among post-menopausal women of the community. MATERIALS AND METHODS: A cross-sectional study was conducted among 530 post-menopausal women in the registered field practice areas of the JN Medical College and Hospital, Aligarh, Uttar Pradesh, India. A pre designed and pre tested proforma was used to obtain data regarding socio-demographic details and factors associated with PID. Clinical and laboratory examinations were done to confirm the diagnosis of PID. Data was analyzed using SPSS 23.0. Association between categorical variables was tested with chi-square test and logistic regression analysis was used to find independent risk factors. The value of p<0.05 was considered as significant. RESULTS: About 11.55% of the study subjects were diagnosed with PID (12.5% in rural areas and 10.6% in urban areas). Bacterial vaginosis followed by Trichomonas vaginalis were most common. Among the important risk factors, significant association was found with occupation of the women, increasing parity, multiple sexual contacts, and associated pelvic organ prolapse. Association with smoking, chronic illnesses, diabetes mellitus and hypertension, and associated urinary tract infection were not found to be significant. CONCLUSION: The study shows the hidden burden of the disease in the community and the associated risk factors, which can be prevented by life style and cultural changes if incorporated earlier in the lives.

Lifestyle and gallstone disease: scope for primary prevention.

OBJECTIVE: To study the antecedent risk factors in the causation of gallstone disease in a hospital-based case control study. MATERIALS AND METHODS: Cases (n = 150) from all age groups and both sexes with sonographically proven gallstones were recruited over a duration of 3 months from the surgical wards of a tertiary care teaching hospital. Modes of presentation were also noted among cases. Age- and sex-matched controls (n = 150) were chosen from among ward inmates admitted for other reasons. Univariate and multivariate logistic regression analyses were performed for selected sociodemographic, dietary, and lifestyle-related variables. RESULTS: Females had a higher prevalence of gallstone disease than males (P < 0.01). Among males, the geriatric age group (<60 years) was relatively more susceptible (28%). Prepubertal age group was least afflicted (3.3%). Univariate analysis revealed multiparity, high fat, refined sugar, and low fiber intakes to be significantly associated with gallstones. Sedentary habits, recent stress, and hypertension were also among the significant lifestyle-related factors. High body mass index and waist hip ratios, again representing unhealthy lifestyles, were the significant anthropometric covariates. However, only three of these, viz., physical inactivity, high saturated fats, and high waist hip ratio emerged as significant predictors on stepwise logistic regression analysis (P < 0.05). CONCLUSION: Gallstone disease is frequent among females and elderly males. Significant predictor variables are abdominal adiposity, inadequate physical activity, and high intake of saturated fats; thus representing high risk lifestyles and yet amenable to primary prevention.