Diabetes self care activities among adults 20 years and above residing in a resettlement colony in East Delhi.

BACKGROUND: Self-care activities are the cornerstone of diabetes care that ensures patients participation to achieve optimal glycemic control and to prevent complications. OBJECTIVE: The aim of this study is to find the level of self-care activities among diabetics aged ≥20 years residing in a resettlement colony in East Delhi and its association with sociodemographic factors, disease, and treatment profile. METHODS: Using cross-sectional survey, 168 known diabetic patients were selected from Nand Nagri, a resettlement colony in East Delhi. Data were collected using Hindi translation of revised version-Summary of Diabetic Self Care Activities along with a pretested semi-open-ended questionnaire. Self-care was assessed on six parameters as follows: (a) general diet, (b) specific diet, (c) exercise, (d) blood sugar testing, (e) foot-care, and (f) smoking. The study period was from November 2014 to April 2016. RESULTS: Nearly 35.1% of respondents belonged to 60-69 years age group. About 52.4% of respondents were female. Fifty-two diabetics (31%) reported having practised diet control on all 7 days in the past 1 week. Nearly 39.3% of patients did not perform any physical activity. The blood test was not practised by 92.3% of respondents. Foot-care was practised by only 19% of patients. There was a significant association between general diet among diabetics with family support (P = 0.020), place of diagnosis (P = 0.033), and treatment funds (P = 0.017). The exercise score among diabetics who were below the poverty line was higher than those above poverty line (P = 0.029). Younger age (P = 0.005) and treatment with insulin (P = 0.008) were positively associated with blood glucose testing. The foot-care practice was better in patients aware of complications and foot-care practices (P < 0.001). CONCLUSION: Self-care activities among diabetic patients were very poor. Self-management educational programs at hospitals along with information, education, and communication activities at the community level and one-to-one counseling are recommended.

Prevalence of stress among resident doctors working in Medical Colleges of Delhi.

The present cross-sectional study was conducted from November 2007 to December 2008 in four medical colleges and associated hospitals of Delhi. Study subjects comprised 930 resident doctors. The overall prevalence of stress was found to be 32.8% in resident doctors from all colleges. Out of 930 resident doctors, 165 (17.7%) had mild stress, 113 (12.2%) had moderate stress, and 27 (2.9%) were severely stressed. Important reasons of stress as perceived by the study subjects included long duty hours, departmental academic activities, financial constraints, family and emotional problems in the decreasing order of preference. Important factors significantly associated with stress-included existence of children, year of residency, type of department, and presence or absence of job satisfaction, having close friends, spending time with family/friends, and place of graduation. In the multivariate model, year of residency, giving time to family and or friends, having close friends during residency, job satisfaction, and state of graduation came out as predictors of stress.

Sleep Quality of Call Handlers Employed in International Call Centers in National Capital Region of Delhi, India.

BACKGROUND: Call center sector in India is a relatively new and fast growing industry driving employment and growth in modern India today. Most international call centers in National Capital Region (NCR) of Delhi operate at odd work hours corresponding to a time suitable fortheir international customers. The sleep quality of call handlers employed in these call centers is in jeopardy owing to their altered sleep schedule. OBJECTIVE: To assess the sleep quality and determine its independent predictors among call handlers employed in international call centers in NCR of Delhi. METHODS: A cross-sectional questionnaire-based study was conducted on 375 call handlers aged 18-39 years employed in international call centers in NCR of Delhi. Sleep quality was assessed using Athens Insomnia scale along with a pre-tested, structured questionnaire. RESULTS: The mean age of respondents was 24.6 (SD 2.4) years. 78% of participants were male. 83.5% of respondents were unmarried. 44.3% of call handlers were cigarette smokers. Physical ailments were reported by 37% call handlers. 77.6% of call handlers had somesuspicion of insomnia or suspected insomnia; the rest had no sleep problem. Smoking, poor social support, heavy workload, lack of relaxation facility at office, and prolonged travel time to office were independent predictors of sleep quality (p<0.05). CONCLUSION: Call handlers have to compromise upon their sleep owing to the contemporary work settings in call centers. Safeguarding their health becomes an occupational health challenge to public health specialists.

Family caregivers' burden: A hospital based study in 2010 among cancer patients from Delhi.

BACKGROUND: A large number of patients with chronic diseases like, cancer are cared for in homes by the family members in India. The vital role that these family members play as "caregivers" is well recognized, however, the burden on them is poorly understood. AIMS: To assess burden and to determine the predictors of burden on family caregivers of cancer patients. SETTING AND DESIGN: A cross-sectional, hospital based study conducted in National Capital Territory of Delhi. MATERIALS AND METHODS: 200 family caregivers of cancer patients were selected by systematic random sampling and interviewed using standard, validated Hindi version of Zarit Burden Interview. STATISTICAL ANALYSIS: Univariate analysis and multivariable logistic regression were carried out using Statistical Package for the Social Sciences software (version 17.0). RESULTS: The study population consisted of 90 (45%) males and 110 (55%) female caregivers aged 18-65 years. 113 (56.5%) caregivers reported no or minimal burden while 75 (37.5%) caregivers reported mild to moderate burden. Using logistic regression marital status, education and type of family of caregivers, occupation of cancer patients and type of treatment facility were found to be the predictors of burden on caregivers. CONCLUSION: In view of the substantial burden on family caregivers coupled with lack of adequate number of cancer hospitals, there is a public-health imperative to recognize this important group. All levels of health-staff in cancer hospitals in developing countries should be sensitized to the various burdens faced by family caregivers.

Feasibility studies to control acute diarrhoea in children by feeding fermented milk preparations Actimel and Indian Dahi.

The aim of this work was to study feasibility of diarrhoea control in children (6 months to 5 y of age) by feeding fermented milk preparations. The design used was a randomized controlled clinical trial and the study was carried out at the Delhi University College Hospital providing tertiary care, and a nearby community centre Nand Nagri, a resettlement colony in East Delhi. Children suffering from acute diarrhoea (75 patients from the hospital and 75 from the community) were allocated to three groups by double-blind technique. Group 1 was given a fermented milk, Actimel, containing 10(8) of each Lactobacillus casei DN-114001, Lactobacillus bulgaricus and Streptococcus thermophilus per gram. Group 2 was given Indian Dahi (Lf 40) containing 10(8) of each Lactococcus lactis, Lactococcus lactis cremoris and Leuconostac mesenteroides cremoris per gram. Group 3 was given ultra-heat-treated yoghurt preparation (no live bacteria). Actimel was also used as a starter to prepare the curd in order to study the preventive effect of diarrhoea in children in a community. In the hospital study Indian Dahi and Actimel administration reduced mean duration of diarrhoea by 0.3 and 0.6 day (P<0.001), respectively. The corresponding figures in the community study were 0.2 and 0.5 day (P<0.05), respectively. The families using Actimel as a starter showed a reduction in diarrhoeal morbidity episodes by 40% of the children tested in a 3 month follow-up. In conclusion, Actimel, fermented milk containing Lactobacillus casei DN-114001, and Indian Dahi can significantly reduce the duration of diarrhoea in children; the former preparation being superior.

Perceptions of teachers regarding sex education in National Capital Territory of Delhi.

A cross sectional study was conducted to find out the knowledge and attitudes of school teachers regarding sex education. Information was collected from 476 senior secondary school teachers belonging both to the government and public schools, selected randomly in National Capital Territory of Delhi using pre-tested close ended questionnaires. A majority of school teachers (73%) were in favour of imparting sex education to school children. Regarding contents of sex education, 90% agreed to the inclusion of reproductive anatomy, physiology including menstruation and birth control measures like condoms and oral pills. However, a majority of school teachers did not want sex education to include topics like abortion, premarital sex and masturbation etc. Fourteen years of age was considered to be the most appropriate for imparting sex education by 28.6% of school teachers. School teachers and doctors were considered by 69.4% and 63.6% of the respondents respectively to be the most appropriate persons for providing sex education.

Long-term nutritional effects of ICDS.

Nutritional status of 1243 children (636 boys and 607 girls) in the age group of 7-13 years was assessed in relation to utilisation of Integrated Child Development Services (ICDS) during their childhood. All the houses in every 10th Anganwadi selected by systematic random sampling were surveyed in the ICDS project, Nand Nagri in East Delhi. Information regarding utilisation of ICDS facilities, sociodemographic details, general awareness etc. was collected by interview technique and anthropometric and clinical examination of every child was done and Anganwadi attendance score was calculated for each child. It was found that most of the children were non-beneficiaries (59.1%). On univariate analysis Anganwadi attendance score, age, sex of the child and education status of the father showed statistically significant association (p < 0.005) with malnutrition. On Multiple logistic regression analysis higher age (OR 1.4155 for grade 1 malnutrition and 1.6913 for grade 4 malnutrition) and being female (OR 1.5214 for Grade 4 malnutrition) remained significant risk factors for development of malnutrition for all grades. Anganwadi attendance score did not show any statistically significant association for decreasing the risk of getting malnourished for any grades of malnutrition in 7-13 years age group. There is special need to take special care for girls as well as to continue the special nutrition care even at an higher age. More in depth studies are needed so as to formulate effective nutritional policies for children.

Skinfold thickness in well-nourished school children in Haryana.

Skin fold thickness of 4405 (2212 male and 2193 female) well-nourished school children between 5 to 15 years of age in five public schools of Haryana was measured by standard accepted technique. The findings of the present study were comparable with earlier studies conducted in well-nourished Indian school children at Hyderabad and with the British children. Children belonging to low income groups had smaller fat folds at all ages as compared to the present study.

Height and weight of 'well-to-do' school children in Haryana.

A study was conducted in five public schools of Haryana. Height and weight of 4405 well-to-do school children (both sexes) between the ages of 5 to 15 years were measured using standard accepted technique. Height and weight of children were compared with the Indian Council of Medical Research (ICMR) standards; the values of mean height and weight of the Haryana children were significantly higher for both sexes at all ages.

Knowledge and attitudes of Anganwadi workers about infant feeding in Delhi.

PIP: In North Delhi, India, 83 community workers (anganwadi workers) in the ICDS project Alipur participated in a survey designed to assess their knowledge and attitude about breast feeding and to identify gaps in their knowledge of breast feeding. 98.7% knew that breast feeding should be begun immediately after birth. 92.7% knew that the newborn should receive the colostrum. Only 56.6% knew that top milk should not be diluted. 93.9% correctly knew that unhygienic bottle feeds are a leading source of diarrhea and that breast feeding should be continued during a diarrheal episode. Yet 48.2% did not know that mothers with tuberculosis should continue breast feeding and that infants with a fever should continue to receive breast milk. 25.4-48% of the anganwadi workers had incorrect perceptions on breast feeding and social considerations (e.g., 31.4% considered breast feeding to be embarrassing outside the house). Only 57.8% considered breast feeding to benefit maternal health. Only 50.5% knew that mothers should totally avoid bottle feeding. 75.9% incorrectly thought that almonds and dry fruits increase breast milk secretion. These overall encouraging findings about breast feeding may be due to the increased focus on the importance of teaching breast feeding during preplacement training and possibly due to repeated health education messages on breast feeding through the mass media. The findings indicate a need for educating anganwadi workers about continuation of breast feeding during diseases, however.^ieng

Knowledge of Anganwadi workers about growth monitoring in Delhi.

PIP: In an Integrated Child Development Services (ICDS) block, Alipur, in Delhi, India, interviews were conducted with 100 anganwadi workers (one of whose major functions is growth monitoring) to determine their knowledge on growth monitoring and to identify gaps in that knowledge. Each anganwadi worker serves a population of 1000. 99% had adequate knowledge about the significance of the lines on the growth charts that indicate different grades of nutritional status. Yet only 43% knew that they can begin growth monitoring for any child under age 6. 37% did not know that assessment of correct age is not essential for growth monitoring. 90-91% had correct knowledge about weight of a child at 1 and 3 years. Yet only 17-30% knew the correct mid-upper arm circumference (MUAC) for an optimally nourished child aged 2 and 4. These findings suggest that training programs and various meetings have emphasized inputs of growth monitoring but not on age at which growth monitoring can be started, on correct age for successfully conducting growth monitoring, and on the cut-off measurements for MUAC. Continued education on various aspects of growth monitoring are needed for anganwadi workers.^ieng

Psychosocial dysfunction in tuberculosis patients.

Tuberculosis continues to be a major health problem in India. It carries social stigma and results in adverse psychological sequelae. In the present study, 50 patients suffering from tuberculosis were examined. There was higher degree of neuroticism and the patients with tuberculosis showed marked to severe psychosocial dysfunctioning in personal, familial, vocational, social and cognitive areas.

Is education a determinant of knowledge about malaria among Indian tribal population?

Malaria is a major public health problem in tribal villages of India, where 8% of the country's population lives. Literacy level among tribal population is very low. This study aims to examine the relation between education status and knowledge about malaria among Indian tribal communities. 125 randomly selected tribal respondents from one tribal village each of 17 states were administered a close ended questionnaire by trained interviewers to assess their knowledge about various aspects of malaria. Effect of educational status on the level of knowledge was analyzed using chi square test. Stratified analysis was performed using Mantel Haenszel chi square test to eliminate gender bias. 2125 respondents', randomly selected from 17 tribal villages in as many states, findings were analyzed. Fifty seven percent male and 72% female respondents were illiterate. Only 2% respondents had college level education. Educated females were more knowledgeable than their male counterparts. Mantel Haenszel chi square analysis showed that educated respondents were more knowledgeable than the illiterates, after adjusting for sex of respondents. However, there was gross lack of knowledge regarding diagnosis and treatment of malaria and use of insecticides irrespective of gender and educational status. Improvement in literacy status of tribal population will help in increasing awareness about malaria. Opportunities for disseminating information about various aspects of malaria should be utilized during treatment of malaria cases by health workers.

Knowledge and practice of mothers regarding pulse polio immunization in National Capital Territory of Delhi.

PIP: Poliomyelitis continues to be a major public health problem in India leading to high morbidity and mortality among children under age 5 years. To address this problem, pulse polio immunization (PPI) on two National Immunization Days was conducted in the country in 1995. This paper presents findings of a study that was conducted in the National Capital Territory of Delhi to examine mothers' knowledge regarding PPI and routine Oral Polio Vaccine (OPV) immunization schedule and their practice regarding the availing of its services. A total of 481 mothers participated in the study. Findings showed that 97.7% of mothers were aware of this special poliomyelitis vaccination program, while 2.3% were unaware of it. 75% of mothers correctly reported the age group of children receiving OPV to be less than 3 years, while 11% reported that it was being given to all age groups. Moreover, awareness of mothers regarding some aspects of routine OPV immunization was very low. 43% of mothers had incorrect knowledge regarding age of initiation of OPV, and 68% had incorrect knowledge regarding the number of primary doses of OPV. Given the consistently high coverage of the three primary doses of OPV in Delhi, these findings could be explained on the basis of poor emphasis of information, education, and communication activities in routine functioning by health professionals and paramedical workers.^ieng

Knowledge amongst adult population regarding vectors of malaria in 21 states of India.

Malaria is the world's most important tropical disease which kills more people than any other disease except tuberculosis. It is a public health problem in more than 90 countries, inhabited by a total of some 2400 million people, 40% of the world's population. More than 90% of all malaria cases are in sub Saharan Africa, with two thirds of the remainder concentrated in six countries viz. India, Brazil, Sri Lanka, Afghanistan, Vietnam and Columbia in decreasing order of prevalence. Even now the problem of malaria in India is grossly underestimated. A rough estimate of morbidity due to malaria made on the basis of consumption of antimalarials comes to 35.5 million episodes in addition to malaria cases treated by the National Anti Malaria Programme (NAMP). In addition to large scale morbidity and mortality, it affects agricultural and industrial produce causing great socioeconomic losses.