Association between intimate partner violence & HIV/AIDS: Exploring the pathways in Indian context.

BACKGROUND & OBJECTIVES: Violence against women cutting across diverse socio-economic classes is an under-recognized human rights violation in the world. This analysis was undertaken to examine the prevalence along with predictors of intimate partner violence (IPV) and its association with HIV/AIDS and sexually transmitted infections (STIs) in Indian ever-married women. METHODS: The data obtained from 2005 to 2006 third round of National Family Health Survey-3 (NFHS-3) were used in this study. Analyses were conducted on ever-married women by linking individual women data including violence information and HIV test results. RESULTS: The analyses indicated all forms of violence to be prevalent in India. The prevalence of lifetime IPV reported was 35.3 per cent. Multivariate analysis using logistic regression identified younger age of women, higher number of children, low level of education of women as well as her partner, working status of women, higher spousal age, rural residence, alcohol consumption by husband, childhood witness of violence among parents, nuclear household and lower standard of living to be positively associated with the experience of IPV by the women (P<0.05). HIV-positive status of women, as well as women from high HIV prevalent State, were at increased odds of IPV (P<0.05). INTERPRETATION & CONCLUSIONS: Significantly higher reporting of HIV/STIs by women experiencing IPV hints at new pathways that link violence and HIV. Further, our analysis showed a high prevalence of IPV in India.

Outbreak of Influenza (H1N1) amongst children in a residential school.

BACKGROUND: An outbreak of pandemic Influenza H1N1 occurred from 13 Feb to 20 Feb 2010 in a residential school at Belgaum, India. METHODS: On report of sudden increase in number of students reporting sick with symptoms suggestive of flu like illness, an investigation was launched to detect the source of infection and to control the spread of infection amongst those not affected. Six random samples of throat from the initial cluster were collected and RT-PCR was done to confirm the diagnosis. The outbreak in this institution was effectively controlled by standard preventive & control measures in the absence of vaccine. RESULT: In a school of 335 children, 96 cases of Influenza like illness possibly resulting from pH1N1 (2009) were reported with an attack rate of 28.6%. Out of a total of 96 cases reported, 73 (76%) were hospitalized and 23 treated as outdoor patients. Serogroup A of Influenza H1N1 pandemic was identified to be the agent responsible for this outbreak as 06 random samples drawn from initial cluster tested positive on RT-PCR. A visit to an exhibition in the city was possibly the source of exposure amongst the children. CONCLUSION: An outbreak of Influenza H1N1 infection amongst students in a residential public School was found to be linked to a visit to an exhibition following which the secondary transmission led to further occurrence of cases.

Body composition parameters as correlates of coronary artery disease.

BACKGROUND & OBJECTIVES: Obesity is a major risk factor for cardiovascular disease (CAD). This study was aimed to assess the risk for CAD determined by certain new and conventional body composition parameters such as visceral fat area (VFA), body mass index (BMI), waist to hip ratio (WHR), etc. METHODS: We did an age and sex matched case-control study of acute myocardial infarction with 100 participants in a tertiary care hospital (50 cases and 50 controls) representing the serving army personnel. The relation between VFA, per cent body fat (PBF), BMI, waist and hip circumferences, and WHR to CAD was assessed. RESULTS: The study showed that there was a significantly increased risk for CAD associated with VFA (OR: 5.67; 95% CI: 1.96, 16.95), WHR (7.07; 2.19, 24.27), waist circumference (WC) (2.63; 1.05, 6.66) and BMI (2.53; 1.03, 6.26). INTERPRETATION & CONCLUSIONS: In conclusion, increased VFA, BMI, WHR and WC showed an association with CAD. VFA is a good index for assessing not only visceral fat accumulation but also cardiovascular risk factors.

Hand hygiene practices among health care workers (HCWs) in a tertiary care facility in Pune.

BACKGROUND: Improper hand hygiene by healthcare workers (HCWs) is responsible for about 40% of nosocomial infections resulting in prolonged illnesses, hospital stays, long-term disability and unexpected high costs on patients and their families, and also lead to a massive additional financial burden on the health-care system. OBJECTIVE: To assess knowledge and practices regarding hand hygiene among HCWs of a tertiary health care facility. METHODS: A cross sectional, questionnaire and observation based study was carried out in a tertiary care health care facility in Pune. Based on sample size calculations, 100 HCWs working in medical and surgical wards were studied. RESULTS: The proportion knowledgeable about hand hygiene practices was 85% and 73% HCWs were of the belief that unclean hands are an important route of cross transmission. WHO guidelines regarding procedure were being followed by 90% for hand washing with soap and water and 64% for alcohol based rubs. Majority preferred hand washing with soap and water over hand rubbing with alcohol based solutions. 21% of HCWs were missing hand hygiene opportunities 1 in 5 times. Heavy workload (38%), non availability (52%) and inaccessibility (9%) of hand hygiene facilities were the common reasons for non-compliance. Availability of 'one time use paper towels' was low (12%). CONCLUSION: Inadequate compliance despite knowledge and false sense of security by alcohol based rubs was seen. A multi disciplinary, multifaceted approach is required to tackle issues of non-compliance.

Infection control practices in health care: Teaching and learning requirements of medical undergraduates.

BACKGROUND: Compliance and implementation of infection control guidelines have been recognized as efficient means to prevent and control hospital acquired infections. OBJECTIVES: To evaluate knowledge and practices about infection control guidelines amongst medical students and to explore their education needs as perceived by them and faculty. METHODS: A total of 160 final year students and 100 faculty members of one of the top medical colleges in India were selected by simple random sampling in each group as per sample size of 143 students (alpha 0.05, error 7%, prevalence 60%) and 99 (error 7.5%) faculty. Data collected by pilot-tested, unlinked, anonymous questionnaire. RESULTS: Amongst students, knowledge (77.50%; 95% CI, 70.24-83.72) was mixed with misconceptions. Only 31.25% always followed hand hygiene procedure; 50% recapped needles; disposal of hazardous material into designated containers always was low (sharps 20%, contaminated items 25%). Despite experiencing needle stick injury (6.25%) and splashes (40%), less than 30% reported these as 44% were unaware of reporting procedure. The discord between the perceptions of faculty regarding students and students' own perceptions was clearly evident (all Kappa values less than 0.50). Students and faculty agreed on workshops (58.13% and 58%) and reinforcement by colleagues (51% and 54%) but not on on-job training (51% and 34%) and part of curriculum (48% and 40%) for teaching-learning infection control. CONCLUSION: Tackling disconnect between students and faculty perceptions and empowering students with knowledge and skills in infection control is important. Approach needs to be researched and formulated as current methods seem to be inadequate.

Biomedical waste disposal: A systems analysis.

BACKGROUND: In view of the contemporary relevance of BMW Management, a system analysis of BMW management was conducted to ascertain the views of Service hospitals/HCE's on the current system in BMW management in-vogue; to know the composition and quantity of waste generated; to get information on equipment held & equipment required and to explore the possibility of outsourcing, its relevance and feasibility. METHODS: A qualitative study in which various stake holders in BMW management were studied using both primary (Observation, In-depth Interview of Key Personnel, Group Discussions: and user perspective survey) and secondary data. RESULTS: All the stake holders were of the opinion that where ever possible outsourcing should be explored as a viable method of BMW disposal. Waste generated in Colour code Yellow (Cat 1,2,3,5,6) ranged from 64.25 to 27.345 g/day/bed; in Colour code Red (Cat 7) from 19.37 to 10.97 g/day/bed and in Colour code Blue (Cat 4) from 3.295 to 3.82 g/day/bed in type 1 hospitals to type 5 hospitals respectively. CONCLUSION: Outsourcing should be explored as a viable method of BMW disposal, were there are government approved local agencies. Facilities authorized by the Prescribed Authority should be continued and maintained where outsourcing is not feasible.

Study of blood pressure profile of school children 6-15 years in a rural setting of Maharashtra.

BACKGROUND: High blood pressure in childhood is a major risk factor for heart disease and stroke in adulthood. There is enough evidence to suggest that the roots of essential hypertension in adults extend into childhood. There is a paucity of literature on the blood pressure measurements amongst children. This study was done to study blood pressure profile of school children in rural area of Maharashtra. AIM & OBJECTIVES: This cross sectional study was carried out to determine the prevalence of hypertension in children 6-15 years and to study the association between selected variables and blood pressure. MATERIAL & METHODS: This study was done using a predesigned questionnaire and making measurements of height, BMI and Blood pressure using standardized physical instruments following standard guidelines. The data was collected and analyzed using appropriate statistical tests. RESULTS: The prevalence of hypertension in the study was found to be 4.4% with 3.5% in females and 5.1% in males. CONCLUSION: In the study, hypertension in students was found to be significantly associated with higher BMI and with family history of hypertension. Age, height and BMI were found to correlate positively with Blood pressure levels in this study.