Sustainability of exclusive breast feeding among primigravida women: a hospital based study in eastern India

Background: EBF for 6 months is a challenge for many mothers. The WHO reported the prevalence of EBF lasting at least 6 months as 38% in 2013 and most recently reported as 44% in 2021. As a result, the WHO has set strategic goals for 6-month EBF to achieve 70% prevalence worldwide by 2030. Methods: Descriptive survey research design was used, with the variables as sustainability of Exclusive Breast Feeding among 100 postnatal primi gravida attending a tertiary care hospital in Eastern India. Sampling technique was Systemic random sampling technique. Standardized tool (Feed Cat Tool) was used as a data collection instruments. Results: 93% mother fed exclusively their infant with breast milk whereas 5% fed their infant both with breast milk and formula milk and 2% did not fed their infant with breast milk they gave only formula milk to their infant upto 1.6 months of their infant age. At 3 months, 81% fed exclusively their infant with breast milk only whereas 17% fed their infant both with breast milk and formula milk At 6 months 73% fed exclusively their infant with breast milk whereas 24% fed their infant both with breast milk and formula milk. Conclusions: The sustainability of Exclusive Breast Feeding reduces with the increase in infant’s age. The study had limitations like, the data were collected after their discharge form hospital stay during their follow up visits and by interview technique only which may lead to inaccurate evaluation.

Prevalence of Major Depressive Disorder among Mothers of Childrenand Adolescents with Attention Deficit Hyperactivity Disorded Attending a Tertiary care Centre

Introduction:Attention deficit hyperactivity disorder (ADHD) accounts for the majority of referrals to child and adolescent psychiatry services because of the associated poor scholastic performance. Despite the possibility of depressive symptoms in caregivers, there is a paucity of studies on major depressive disorder among mothers of children and adolescents with ADHD in our setting. Objectives:Assessing the prevalence of major depressive disorder and the association of sociodemographic and clinical variables among mothers of children & adolescents with ADHD attending a tertiary care centre. Studying the correlation between the severity of ADHD and maternal depression. Methods: Cross-sectional study on 150 mothers of children and adolescents aged 5-18 years with ADHD attending the Child and Adolescent Psychiatry Clinic of the Govt. Medical College, Thiruvananthapuram. Results:The prevalence of Major Depressive Disorder among mothers belonging to the age group of 30?39 years was found to be 20%. Across age groups, 28.7% of the subjects had minimal depressive symptoms, while 10% each had mild and moderate symptoms. We found a positive correlation between the severity of maternal depression and the child’s ADHD. The association of major depressive disorder with medical comorbidities and having another offspring with ADHD was statistically significant.Conclusion:Owing to the statistically high prevalence of depressive disorders, routine screening for depressive symptoms has to be considered for mothers when their children are diagnosed with ADHD, with the provision for appropriate intervention.

The pattern of Parental Handling in Children with Emotional and Behavioural Disorders - A Cross-Sectional Study

Introduction: This study is to determine patterns of parental handling in children with emotional and behavioural disorders, and to determine the correlation of parental handling patterns to the child’s behavioural and emotional symptom s. Methods: A cross-sectional study was conducted over one year among the parents of children and adolescents aged 4 to 17 years diagnosed with emotional and behavioural disorders and consulting a tertiary care centre in Kerala, South India, for the first time. Results: Most parents showed low care and low control patterns, while a majority of the children were at high risk for clinically significant problems. Approximately 62% of the children were at high risk due to hyperactivity/inattention, 45% for issues with peers, and 33% for poor prosocial behavior. There was a significant negative correlation between the control and conduct symptoms (?=-.232, p=0.020) and between control and hyperactivity (?-.221, p=0.027). A significant positive correlation was observed between emotional symptoms and the educational status of the parent (?=.265, p=0.008), and between peer problems and the age of the child (?=.232, p=0.020). There was also a significant correlation between externalising disorders and control scores. Conclusion: The population was found to predominantly have low care and low control patterns, i.e., less optimal parenting styles. Parental control was found to positively influence conduct symptoms and hyperactivity symptoms. There was no relation between socio-demographic factors and the pattern of parental handling or between parental handling patterns and other emotional and behavioural symptoms in the child

A community-based cross-sectional study on hypertension screening in Puducherry, India

Background & objectives: Hypertension is a health problem of global priority. Screening and early diagnosis is important to plan appropriate interventions. The present study objectives were to screen the urban population aged 30 yr and above and diagnose for hypertension and to identify the factors associated with poor screening for hypertension, if any. Methods: A community-based descriptive cross-sectional study was conducted in urban field practice area of a tertiary care hospital in Puducherry, India, among individuals aged 30 yr and above. Individuals were asked if they have tested themselves for hypertension in the past two years. Pretested questionnaire was used for data collection. Data collection was done during regular working time of the health centre. All eligible participants from consecutive households were included till the required sample size of 394 was achieved. Results: Of the 394 individuals interviewed, 252 (64%) had undergone screening for hypertension. The prevalence of self-reported hypertension among those screened was 26.2 per cent with no significant gender-wise differences. Screening for hypertension was better among females (71.6%) as compared to males (55.2%). Population who were at a higher risk of not getting screened for hypertension were relatively younger (30-44 yr) individuals and males. Interpretation & conclusions: The prevalence of self-reported hypertension among those screened was 26.2 per cent [95% confidence interval (21.1-31.9)]. Screening needs to be targeted more towards males and younger population.

Effectiveness of a community-based intervention on nutrition education of mothers of malnourished children in a rural coastal area of South India

Background: There is a paucity of evidence on improvement in malnutrition status after follow-up intervention among malnourished under-five children. Objective: The objective of the study is to assess the effect of community-based follow-up health education intervention on the awareness level of mothers, calorie intake, protein intake, and weight gain of malnourished children. Methods: This intervention study was conducted from December 2012 to October 2014 in three phases at rural Puducherry, coastal South India. The intervention group (57 mothers of 64 children) and control group (60 mothers of 64 children) included moderate and severely malnourished children aged 13� months. Children in the control group were taken from different areas and matched for age (�months) and sex. Health education intervention and follow-up supervision for 15 months were given to the mothers. Results: Awareness level in all domains increased significantly in the intervention group. In the intervention group, 81% (52) of malnourished children turned out to normal, whereas in the control group, 64% (41) of them became normal. There was a statistically significant difference between the mean changes in the protein intake among boys (15.34 g to 19.91 g in the intervention group against 13.6 g to 16.24 g in the control group) and girls (15.09 g to 19.57 g in the intervention group against 13.36 g to 16.51 g in the control group) and calorie intake among girls (993.86 kcal to 1116.55 kcal in the intervention group against 992.65 kcal to 1078.75 kcal in the control group) between the two groups. Conclusion: There was comparatively marginal increase in protein intake, calories' intake, and weight gain in the intervention group.

Spectrophotometric determination of chlorpheniramine maleate and phenylpropanolamine hydrochloride in dosage forms.

A rapid and simple method for simultaneous determination of Chlorpheniramine Maleate (CPM) and Phenylpropa-nolamine Hydrochloride (PPM) by first derivative UV spectrophotometry has been developed in combined pharmaceutical dosage forms. The proposed method was successfully applied for the determination of drugs in physical mixture and commercial formulations and results showed good linearity, precision and reproducibility.

Spectrophotometric determination of chlorpheniramine maleate and phenylpropanolamine hydrochloride in dosage forms.

A rapid and simple method for simultaneous determination of Chlorpheniramine Maleate (CPM) and Phenylpropa-nolamine Hydrochloride (PPM) by first derivative UV spectrophotometry has been developed in combined pharmaceutical dosage forms. The proposed method was successfully applied for the determination of drugs in physical mixture and commercial formulations and results showed good linearity, precision and reproducibility.

Colonic mucosal changes in portal hypertension.

Forty one consecutive patients with portal hypertension (PHT) were evaluated by colonoscopy to study the prevalence, type, extent and predictors of haemorrhoids, colorectal varices, and portal hypertensive colopathy. Specific inquiry and regular follow-up assessed frequency of hematochezia. Twenty five patients with obscure gastrointestinal bleeding without PHT who underwent colonoscopy served as controls. Haemorrhoids were seen in nine of 41 (21.9%) patients with PHT and four of 25 (16%) controls (p = ns). Colorectal varices were seen in 13/41 (31.7%) patients with PHT and none of the controls (p = 0.005). Portal colopathy was present in 15/41 (36.6%) patients with PHT and none of the controls (p = 0.0005). None of the parameters (e.g. aetiology of PHT, Child's class, oesophageal variceal eradication by EST with or without EVL, history of variceal bleeding, grade of oesophageal varices, presence of portal hypertensive gastropathy or gastric varices) predicted the occurrence of colorectal varices and portal hypertensive colopathy. Detection of colorectal varices but not portal hypertensive colopathy was associated with occurrence of hematochezia.

Effect of medroxy progesterone acetate and testosterone enanthate on vas deferens of rats.

Effects of medroxy progesterone acetate (MPA; 5 mg/kg) and MPA + testosterone enanthate (TE) (3 mg + 2 mg/kg) were investigated in vas deferens and on fertility (along with reversibility study) for 60 days through histopathology, morphometric and certain biochemical parameters such as total proteins, sialic acid, ATPase, SDH and testosterone. The study revealed for altered histopathology and contratile pattern of vas deferens resulting in reduced fertility. The study also indicated androgen antagonistic effect. These effects were found to be reversible 4 and 3 months after withdrawal of MPA and MPA + TE injections respectively. Thus, both types generated functional sterility in the rat, but MPA affected histophysiology of vasal tissue.

Effect of thyroxine on experimental bronchospasm in guinea pigs.

Effect of Thyroxine was studied in histamine induced bronchospasm in guinea pigs. Chronic treatment with the drug significantly protected against experimental bronchospasm. Thyroxine also potentiated salbutamol evoked bronchodilation in this experimental model. Up-regulation of beta-2 adrenoceptors in bronchial smooth muscle may be the probable mechanism of action of thyroxine.

Frusemide-induced diabetes mellitus in insulin pretreated rabbits as an experimental model.

Single dose of frusemide 0.1 mg/kg orally was administered in 10 rabbits pretreated with soluble insulin 4 IU intravenously. Induction of diabetes after 24 h was confirmed by an increase in blood sugar and glucosylated haemoglobin and a decrease in serum insulin levels. Ten diabetic rabbits which received only frusemide without insulin pretreatment were used as controls, whereas equal number of insulin-pretreated rabbits receiving hydrochlorothiazide 250 mg/kg orally served as the positive control group. All biochemical parameters remained unaltered in the frusemide-treated test group as well as the positive control group after two weeks. The pancreatotoxic effect of frusemide may induce a stable hyperglycaemic state in rabbits which could lead to a useful diabetic model.

Ocimum sanctum Linn--a study on gastric ulceration and gastric secretion in rats.

The antiulcerogenic property of Ocimum sanctum Linn (Tulsi) was studied in pyloric ligated and pyloric ligated & aspirin treated rats. The extract of OSL reduced the ulcer index, free & total acidity on acute and chronic administration. Seven days pretreatment with the drug increased the mucous secretion also. It may be concluded that OSL extract has antiulcerogenic property against experimental ulcers, and it is due to its ability to reduce acid secretion and increase mucous secretion.

Biochemical and morphological changes of spermatozoa in progestin-androgen injected rats.

Bimonthly injections (im) of medroxyprogesterone acetate (MPA, 5 mg/0.2 ml) and testosterone enanthate (TE, 2.5 mg/0.2 ml) to rats for 30 and 60 days induced oligospermia. The sperms from epididymis had defective metabolism, alterations in their morphology, viability and acrosome integrity. Thus this altered sperm function resulted in reduction in the fertility rate of MPA+TE treated animals.

sexual responsibilities of physicians

Sexual problems are medical problems and, therefore, the responsibility of the practicing physician regardless of his specialty. This article looks into the expectations and needs of the patient and the responsibility of the doctor. Suggestions are made on dealing with overt and covert sexual problems, attitude modifying, sexual education, history taking, and aims of sexual counseling