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Byline: Akanksha. Rathi, Vikas. Kumar, Amrita. Singh, Panna. Lal Background: The profession of drivers is one of the occupational groups exposed to very poor working conditions. This study aimed to [...]

Background: Cervical cancer is the commonest malignancy among women in developing countries. Cytological screening (Pap smear) have been claimed to reduce incidence and mortality of carcinoma cervix significantly for which sensitization of women is required through community-based approach. Objectives: To find out number of cervical cancer cases among patients reporting to a general health care camp through screening program and study the prevalence of perceived morbidity and its confirmation. Settings: Cross-sectional study among women attending cancer awareness camps. Materials and Methods: A total of 435 women attending cancer awareness camps were screened for carcinoma cervix. The findings of history and clinical examination were recorded. Pap smears of all the symptomatic patients were collected and cytological diagnosis was confirmed by a pathologist. Results and Conclusions: The perceived gynecological morbidity was observed to be 59.8%. The smear of the women who were suspected of carcinoma on clinical examination was confirmed to be the cases of carcinoma-in-situ (7.8%) and high-grade neoplasia (2.9%) on laboratory investigations. The findings of the study highlight the utility and need of cancer cervix screening among the women at regular intervals through camp approach in the community.

Background: Rickshaw pullers work in unorganized sector. Ignorance, poverty, and strenuous physical exertion make them vulnerable to ill health and disease. Objectives: To assess the magnitude and pattern of morbidity, associated sociodemographic factors, and health-seeking behavior of the participants. Materials and Methods: A cross-sectional study was conducted on 305 participants. Predesigned, pretested questionnaire was used for data collection. Statistical Package for the Social Sciences (SPSS) 16 version was used for data analysis. Results: About 61% of the participants had morbidity in their lifetime and 49.5% fell sick in the last 15 days. Substance abuse in any form was reported by 73.1%. Grade-1 hypertension was reported in 28.2% and 7.5% was having grade-2 hypertension. Age, monthly income, substance abuse, and availing of health services were significantly associated with the development of health problems. Conclusion: Need to devise interventions that will focus on health awareness and early health-seeking behavior among the participants. [ABSTRACT FROM AUTHOR]

Research question: 1. What is the utilization of medical library by undergraduates? Objectives: (1) To know about frequency of library visit and use of various reading materials available in library by undergraduates.(2) Opinion regarding reading of scientific journals. Study design: Cross- sectional study. Participants : 129 medical interns. Study period: Month of December, 1994. Study variables : Frequency of library visit, purpose of visit and opinion regarding scientific journals. Statistical analysis: Percentages, Chi square test. Results : Although 97% interns visited library during undergraduate period, only 41.1% of them had regular visits. Majority (81.7%) consulted textbooks only. Forty six percent interns accepted utility of journals whereas 33.4% had negative opinions. Conclusion: There is a need of training and motivation to the undergraduates for regular use of library and reading selected articles useful for them.

Context: Exclusive breastfeeding for the first 6 months of life is highly beneficial to the child. Unfortunately, it is frequently not practiced among women due to a lack of knowledge. Aims: The study aims to to find the prevalence of exclusive breastfeeding among children aged less than 2 years of age and to study the factors influencing the practice of exclusive breastfeeding among the mothers of the study participants. Methods and Material: The design was a community-based cross-sectional study. Between January 2019 and January 2020, we enrolled 190 children aged less than 2 years of age and their mothers residing in a rural area of Delhi, India. We collected baseline sociodemographic data and details of feeding practices followed using a pretested semi-structured questionnaire. To measure association, the chi-square test or Fischer exact test was used. Statistical analysis used: Collected data was entered into MS-Excel and analyzed using IBM Statistical Package for the Social Sciences - 25 for descriptive and inferential statistics. Results: Of the 190 participants with complete information, 74 were under 6 months of age and it was found that 57 (77.0%) of those were exclusively breastfed till their present age. The remaining 116 children were aged between 6 and 23 months and the prevalence of exclusive breastfeeding in these children was found to be 55.2% (64). The mean duration of exclusive breastfeeding was 5.75 ± 1.79 months. The age of the child was found to be statistically significant with the practice of exclusive breastfeeding (P = 0.01). Conclusions: The exclusive breastfeeding up to 6 months of age was practiced only by approximately half of the mothers. [ABSTRACT FROM AUTHOR]

Background: Satisfied human resource is an essential asset for high productivity, efficiency, and quality of care in a healthcare organization. Job satisfaction among healthcare professionals assumes further significance for the purpose of maximization of human resource potential in the context of the shortage of manpower in the health sector in India. Objectives: The objective of the study was to assess the job satisfaction among medical officers (MOs) working in Delhi and to study the factors influencing the satisfaction level amongst them. Material and Methods: It was a cross-sectional study conducted amongst selected MOs (by convenience) in all the districts of Delhi. A structured, self-administered questionnaire was used to collect data from the participants. Results: A total of 115 MOs completed the questionnaire. There were 61 (53%) female doctors and 54 (47%) male doctors. The mean age of the study participants was 38.28 ± 7.37 years. The experience of the study group ranged between 1 and 28 years (9.59 ± 6.47 years). Of the total, 59.1% of participants were found to be satisfied with their job. The most common reason given for satisfaction with job was the timing of their job that suits them. The reason given for not being satisfied with job was salary not at par with work pressure. A significantly higher proportion of male participants considered "lack of accommodation" (P < 0.03) and "frequent detailment" (P < 0.031) are big problems faced in their jobs as compared with the female participants. Only 37 (32.2%) participants felt that the MO is able to give enough time to patients for clinical assessment in Out Patient Department. Conclusions: Although majority (59%) of the study group was satisfied with their job, there were numerous problems faced by the doctors at their workplace. Low pay was one of the important reasons cited for being dissatisfied. There is an urgent need to address all the factors affecting job satisfaction through proper planning and implementing relevant human resource policies for improvement in the work environment at public health institutions. [ABSTRACT FROM AUTHOR]

Objectives: Healthcare workers (HCWs) are at a high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to the increased likelihood of clinical exposure during patient management. The study objective was to determine the seroprevalence of antibodies to SARS-CoV-2 and its predictors among hospital employees. Methods: The cross-sectional study was conducted at a teaching hospital from August 2020 to September 2020 among 1,401 employees, including 1,217 HCWs, in New Delhi, India. The serum samples were examined for immunoglobulin G (IgG) antibodies to SARS-CoV-2 using the COVID Kavach-Anti-SARS-CoV-2 IgG Antibody Detection enzyme-linked immunosorbent assay kit. Data were collected electronically using the EpiCollect mobile platform. A p<0.05 was considered to indicate statistical significance. Results: A total of 169 participants (12.1%) had detectable IgG antibodies to SARS-CoV-2. The highest seropositivity rate was observed in the administrative staff (20.1%), while it was lowest among medical doctors (5.5%, p<0.001). Male sex and ever having lived in a containment zone were independently associated with past infection with SARS-CoV-2. Conclusion: The seroprevalence of SARS-CoV-2 infection in health workers may be lower than in the general population in New Delhi. However, nonpharmaceutical interventions were not associated with a reduction in the risk of acquisition of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Context: Medical undergraduates are an important health resource for the country in the future. Their health status and risk for the development of non-communicable disease need to be studied. Early diagnosis and management of these physiological risk factors among adolescents and young adults are of utmost importance for a healthy world in the future. Aims: The study was performed to assess the trend of non-communicable disease risk factors among adolescents and young adults of a government medical college in Delhi over 13 years from 2000 to 2013. Subjects and Design: A record-based cross-sectional study was conducted in a medical college in Delhi. The records of the routine health screening of MBBS students from 2000 to 2013 were analyzed. The data related to the student's age, sex, height, weight, blood pressure, family history of diabetes, family history of hypertension were utilized for the study. Results: Among 1350 study participants 63.5% were males. Female MBBS students were constantly lesser than males with a minimum of 20% in 2006. The trends of obesity among MBBS students were increasing from 11.3% in 2000 to a maximum of 31.7% in 2013. The prevalence of hypertension was 8.1% in the year 2000 which increased to 16.4% in 2001, 10.6% in 2002, 15.3% in 2006, 14.% in 2007 and then it decreased to 1.5% in 2013. Conclusion: Our study has found that there was an alarming increase in the trend of prevalence of obesity among medical undergraduates which indicates the need for urgent interventions to minimize unhealthy behaviours among future doctors. [ABSTRACT FROM AUTHOR]

Public health response and measures are vital to contain an infectious disease outbreak/epidemic. The discipline of Community Medicine, which provides comprehensive primary health care to the entire population at all times, plays a crucial role in times of disease outbreak/epidemic also, being equipped with skills in providing managerial, clinical, and community care, through policy making, surveillance activities, preventive strategies, primary care, capacity building, and awareness generation in addition to generation of evidence-based strategies. The Departments of Community Medicine in Medical Colleges can play a crucial role in this direction and should be involved to share the expertise as well as the best practices adopted, which will go a long way in containing an epidemic at the earliest. The Department of Community Medicine of a leading Medical College in Delhi, along with the clinical departments, is playing a stellar role in response to the pandemic of Corona Virus Disease of 2019 (COVID-19). This article highlights the response to the situation, the challenges faced, and the success stories. Activities have been categorized as Fair, Good, and Best. Activities that are routinely performed are taken to be "Fair" and activities that are beyond routine activities have been labelled "Good". "Best" practices have been identified to be those that involve representation at the national/State/District level, activities for capacity building, contribution toward evidence generation, and work with risk of exposure. The best practices adopted by the Department of Community Medicine of this institution can be collated for future use in teaching hospitals where Community Medicine departments are equipped with manpower skilled to face such a challenge. It will serve as a blueprint for action, if the need be, for handling similar situations in the future. [ABSTRACT FROM AUTHOR]

Background and Objectives: Outbreaks of vector‑borne diseases (VBDs) such as dengue and malaria can overwhelm health systems in resource‑poor countries. Teachers can act as excellent educators by playing a key role of delivering important health education messages to school children and targeting an important health determinant – the health behavior. This study was done to assess the knowledge, attitude, and practice (KAP) of school teachers regarding VBDs and the effect of a sensitization workshop on the same. Materials and Methods: This is a cross‑sectional study done on 212 school teachers to know their KAP regarding dengue and malaria. They were also exposed to an intervention workshop after the pretest, and the gain in knowledge scores was compared. Results: The mean age of respondents was 38.5 years and 57.5% of them were females. Participants had fairly good knowledge about dengue and malaria. More than 90% participants knew that mosquito bite is responsible for dengue and malaria. Around 75% of respondents were also aware of the symptoms of these diseases. The number of participants having a low, medium, and high pretest knowledge score (<50%, 50%–74%, and ≥75%, respectively) was 6.6%, 42.5%, and 50.9%, respectively. A significant improvement was seen in the knowledge score after the intervention workshop (χ2 = 23.6, P < 0.001). Conclusion: Key success for mosquito‑borne diseases control depends not only on services provided by Health Authority but also on knowledge, awareness, preventive practices, and early care‑seeking behavior of the community. There is a need to know and improve existing knowledge and practice regarding mosquito‑borne diseases and its control in community, especially with the collaboration of school teachers as health educators. [ABSTRACT FROM AUTHOR]

BACKGROUND: India is in the intermediate hepatitis B virus endemicity zone with hepatitis B surface antigen prevalence among the general population ranges from 2% to 8%. Among health-care workers, seroprevalence is two to four times higher than that of the general population. AIM: The aim of the study was done to assess the knowledge, attitude, and practices (KAPs) of medical students regarding hepatitis B. MATERIALS AND METHODS: This is a cross-sectional study that was conducted from March to April 2018. Students were invited to the department on specified dates for awareness and immunization against hepatitis B. Their KAP was assessed with the help of a self-administered questionnaire. RESULTS: With a response rate of 81.3%, a total of 161 students participated in the study out of 198. Out of the 161 study participants, only 13 (8%) students had received a completed course of hepatitis B vaccination in the past, 30 (18.7%) students had a history of inability to complete the three doses of hepatitis B vaccination, and the rest 118 (73.3%) students were never immunized against hepatitis B. The knowledge about the risk of acquiring the disease at the hospital or high-risk setting was present in less than half of the students. The average knowledge score was 10.63 out of 16 and average healthy practice score was 2.94 out of 4. On applying Pearson correlation test, it was found that there was a positive correlation of knowledge and practices of the students (P = 0.012), implying that better knowledge of the disease has a positive effect on the practices exercised by an individual. CONCLUSION: Newly enrolled students and other individuals attached to a high-risk setting such as a medical institution should be screened for immunization status during initial medical examination as the number of unimmunized persons, especially against hepatitis B is high. [ABSTRACT FROM AUTHOR]

Vaccine vial monitor (VVM) is now commonly used for vaccines that are included in the National Immunization Schedule in India. It helps to indicate the viability of the vaccine and of the proper functioning of the cold chain. This is useful as it prevents health personnel from administering damaged vaccine. Studies have shown a lack of awareness of health workers regarding the use and interpretation of a VVM. The current study, undertaken among the caregivers of children who were immunized, showed that this lack of information about the VVM also exists among the caregivers. This deficiency in knowledge, both in the health workers and the caregivers, can affect the health of the child and needs urgent attention. [ABSTRACT FROM AUTHOR]

Background. Sexual assault is said to be an underreported and under-researched crime worldwide. The high number of cases of sexual assault reported in India is the tip of the iceberg. We did this study to understand various factors associated with this crime. Methods. We did a retrospective analysis of 312 forensic examination reports of alleged sexual offenders, available from a tertiary care hospital of Delhi from January 2014 to December 2016. Results. Of the 312 victims of sexual assault, 62.9% were adults and 37.1% minors. The time of assault was mentioned in only 73 cases. Among these, about two-thirds of cases (60.3%) occurred during daytime. Among the 213 cases where the reporting time of the crime was mentioned, only 35.7% of cases were reported within 24 hours of the crime. Around 92% offenders were known to the victims. Conclusion. More than one-third of sexual assaults were against minors and in a majority of instances the alleged offenders were known to the victims. A major delay in reporting the crime was observed when the victim was known to the perpetrator. [ABSTRACT FROM AUTHOR]

Background: Reproductive tract infections (RTIs) have adverse implications on the health of the women. Community-based studies in India have shown a high prevalence of RTIs but here is a lack of sizeable literature from urban slums and resettlement areas. Aims and Objectives: The objective was to document the prevalence and determinants of RTIs in married women (15-49 years) residing in an urban slum in Delhi, India. Materials and Methods: The study was conducted in an urban resettlement colony of Gokulpuri in the North-East district of Delhi. Systematic random sampling method was adopted to choose the study subjects, that is, married and non-pregnant women in the reproductive age group (15-49 years) residing in the study area. Data were collected using a pretested semi-structured questionnaire, through the house to house visits. The diagnosis of RTIs was made as per the World Health Organization syndromic approach. Data were analyzed in SPSS version 16 (Chicago, IL, USA). Results: A total of 802 women were interviewed. The mean age of study subjects was 30.79 ± 7 years. A total of 352 (43.9%) women currently had symptoms of RTIs. The most frequently reported symptoms included abdominal pain (68.2%), back pain (69.6%), and vaginal discharge (59.3%). Older women (≥25 years) (odds ratio [OR] 2.2, 95% confidence interval [CI]; 1.4-3.5), those belonging to the lower socioeconomic status (OR 2.1, 95% CI; 1.5-2.9), those using cloth during menses (OR 2.6, 95% CI; 1.6-4.3), those having more than three pregnancies (OR 1.8, 95% CI; 1.2-2.6) and those using an intrauterine contraceptive device (OR 11.8, 95% CI; 4.3-32.0) had higher odds of having RTIs. Conclusions: A high case load was found based on the syndromic approach. Generating community awareness, ensuring proper menstrual hygiene, and improving the socioeconomic status would help in reducing the cases of RTI. [ABSTRACT FROM AUTHOR]

A house to house survey was conducted in December 2005 in the Railway Colony of Shamli, located in the state of Uttar Pradesh, India using a semistructured questionnaire to study the awareness level regarding HIV/AIDS among Indian Railway's employees and their family members. Information regarding demographic characteristics and knowledge about various aspects of HIV/AIDS was recorded by a trained staff nurse of the local Railway Medical Unit from at least one person, aged 15 years to 59 years, from each household. Among 293 individuals interviewed, majority were males (61.8%), aged > 30 years (56.6%) and literate (85.3%). Majority were aware about existence of HIV infection in India (92.5%), AIDS is a fatal disease (92.8%) and laboratory tests are available for detecting HIV infection (89.4%). Although most of them knew the correct routes of HIV transmission viz. sexual (91.50%), parentral (90.8%), perinatal route (86.3%) and blood transfusion (86.0%), misconceptions such as transmission through shaking hands (89.1%), hugging (88.4%), sharing utensils (82.6%), mosquito bite (74.1%) and using public toilets (73.4%) were also observed. Most of them were also aware about preventive measures. Knowledge about various aspects was observed to be significantly higher among females, among individuals aged <45 years and literate individuals. The findings highlight the need of intensified health education focusing on removal of misconceptions and further improvement in awareness level of the study population.

The present study assessed change in knowledge, attitudes, and self-reported hand-washing practices of 136 food handlers 3 months after providing them health education using posters and interactive sessions using a flip chart. There was a significant change in the proportion of study participants who named food borne or waterborne diseases, including gastroenteritis (79.4% to 91.9%), worm infestation (39.0% to 55.9%), cholera (16.2% to 42.7%), and typhoid (9.6% to 28.7%). Significant increase in knowledge about hand hygiene measures, namely, washing hands before handling food (23.5% to 65.4%) and keeping nails cut and clean (8.1% to 57.4%), was observed. Baseline self-reported hand-washing practices revealed low figures for washing hands after micturition (82.4%) and smoking (52.8%) and consistent use of soap at the workplace (24.3%) and after micturition (14.0%), which improved after health education but not to the desired extent. Findings highlight the importance of providing health education in food and personal hygiene to food handlers and incorporating the same in existing guidelines for food establishments laid down by civic agencies in Delhi and elsewhere.

A cross sectional study was conducted among 129 medical interns of Maulana Azad Medical College, New Delhi for assessing the perceived levels of risk of acquiring HIV infection in the health care settings among medical interns, reasons for the same and their exposure to situations having potential of HIV transmission. Majority of the interns (68.3%) perceived themselves to be at a very high/high risk of acquiring HIV infection during their medical career. The common reasons for perceived risk of acquiring HIV infection were getting injuries due to needle pricks/cuts during surgical procedures (32.4%), frequent exposure to the blood/ secretions of patients (28.5%) and insufficient availability of gloves (17.6%). Some (23.2%) were of the opinion that students in future might lose interest in the medical profession due to increasing risk of HIV infection and few (3.1%) were even considering to leave the medical profession for the same reason. Majority of the interns (72.9%) had experienced needle pricks and more than half (53.7%) of them even had had blood splashes in their eyes/ nose/ mouth during surgical procedures. The findings of the study call for efforts for bringing a reduction in the risk perception of the interns through awareness campaigns and reorientation trainings, ensuring availability of gloves and other items necessary for observing universal work precautions and proper disposal of potentially contaminated articles.

A cross sectional study was conducted among 129 medical interns of Maulana Azad Medical College, New Delhi for assessing the perceived levels of risk of acquiring HIV infection in the health care settings among medical interns, reasons for the same and their exposure to situations having potential of HIV transmission. Majority of the interns (68.3%) perceived themselves to be at a very high/high risk of acquiring HIV infection during their medical career. The common reasons for perceived risk of acquiring HIV infection were getting injuries due to needle pricks/cuts during surgical procedures (32.4%), frequent exposure to the blood/secretions of patients (28.5%) and insufficient availability of gloves (17.6%). Some (23.2%) were of the opinion that students in future might lose interest in the medical profession due to increasing risk of HIV infection and few (3.1%) were even considering to leave the medical profession for the same reason. Majority of the interns (72.9%) had experienced needle pricks and more than half (53.7%) of them even had had blood splashes in their eyes/nose/mouth during surgical procedures. The findings of the study call for efforts for bringing a reduction in the risk perception of the interns through awareness campaigns and reorientation trainings, ensuring availability of gloves and other items necessary for observing universal work precautions and proper disposal of potentially contaminated articles.

The present study was conducted to assess: 1) Prevalence of enteroparasite infestation among food handlers working in food service establishments located in the campus of a medical college, 2) Presence of enteric organisms on their hands and nails and their hand washing practices. A total of 151 food handlers were interviewed regarding their socio-demographic and professional characteristics. Their hand washing practices were also observed. Stool examination for enteroparasites and stool culture for Salmonella & Shigella and culture of nail clippings / nail bed swabs for detecting presence of enteric organisms were also carried out. Prevalence of enteroparasite infestation was observed to be 41.1%. None of the stool samples was observed to be positive for Salmonella or Shigella. Enteric organisms were isolated from nail clippings/nail bed swab samples of 76 (73.1%) study subjects. Hand washing practices were observed to be poor with low use of soap. Findings highlight importance of periodic stool examination and deworming of food handlers and need to educate them about importance of maintaining hand hygiene with a focus on improving their hand washing practices.

A cross sectional study was done to assess the performance of Pulse Polio Immunization Booths on National Pulse Polio Immunization day (NID) observed on 2nd December 2001. 55 booths located in Delhi were visited. House to house visits were made on 5 successive days to assess out-reach activities and hold focus group discussions with workers and mothers of the beneficiaries. Majority of the booths were within walking distance (96.4%) and accessible (94.5%) to the beneficiaries, had adequate trained staff reporting in time (88.5-90.4%), displayed IEC material (89.1%), marked the tally sheets in a correct manner (86.5%) and were administering polio vaccine within acceptable norms. Correct knowledge regarding vaccine vial monitor (VVM) was present among workers of 82.7% booths. The marking of children was not being done correctly in 38.2% booths. Efforts to disseminate key messages of next date of NID and routine immunization schedule, information about the disease and it's impact on life and removal of misconceptions regarding polio was observed to be poor (28.9-48.1%). During house-to-house visits coverage was found to be excellent barring a few isolated cases of unimmunized children due to various reasons. The finding of the study implies increased focus on training of the workers manning these booths, especially on dissemination of key messages and information about early symptoms and signs of polio, removal of misconceptions, correct marking of the children and houses and countering resistance to immunization.

Prescribing habits of interns posted at a primary health centre for a period of 2 months (January 1994 and February 1994) were studied. Among the 1457 prescriptions collected, the average number of drugs per prescription was 2.47. The commonest groups of drugs prescribed were antibiotics (33.9%), analgesics and anti-inflammatories (17.0%), vitamins (13.0%), cough syrups (10.5%) and antihistamines (8.6%). The use of injectables was uncommon (0.9%). Most of the drugs prescribed were from the local drugs list of the centre (84.2%) consisting of 36 drugs. The list contained 20 drugs with proprietary names of which six were fixed-dose combinations. The local drug list needs modification. The proportion of drugs prescribed by generic name was 49.5%. As per Kunin's criteria, 57.9% of the antibiotics used were appropriate. Interns often forget to write the diagnosis (43%), signs and symptoms (50.2%), dosages and frequency of treatment. The result of this baseline study may be useful in promoting the education necessary in order to achieve the objectives of good prescribing.