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Background: Immunization plays an important role in reducing morbidity and mortality in children. Despite all the efforts put in by government for 100% immunization coverage, it was only 53.1% in District Sirmaur among children aged 12-23 months as per District level Health Survey -4. The objectives were to assess the primary immunization coverage among children in District Sirmaur of Himachal Pradesh as compared to NFHS-3 and DLHS-4. Methods: A cross-sectional study was conducted in District Sirmaur using the World Health Organization's 30 X 7 cluster sampling method for evaluation of immunization coverage during the period October 2015- January 2016. Results: A total of 210 children aged 12-23 months were covered for the evaluation, of which 95.20% of the children were fully immunized. However, immunization card was available with 77.14% of them. Zero dose of OPV was given to only 47.62% children and BCG scar was present in 82.38% of the study participants. The most common cause for partial immunization was being ‘unaware of need for immunization. Conclusions: Majority of the children ages 12-23 months were fully immunized. The key to further improvement is to monitor drop out at any stage of vaccination before completion of full course of immunization.

Background: Transfusion transmitted infections (TTIs) is a major concern for patients and physicians worldwide. Blood banks in all health care institutions worldwide screen blood for TTIs and ensure that only non-reactive blood is released for clinical use. The present study aimed to study the seroprevalence and trends of transfusion transmitted infections in blood donors in Shimla district of Himachal Pradesh, India. Methods: retrospective review of blood donor’s hospital records (replacement donors and as voluntary donors) covering the period January 2008 to December 2014 was conducted. The serological results for Hepatitis B, Hepatitis C, HIV, syphilis and malaria were retrieved. Results: A total of 39,083 blood donors of both sexes attended the blood bank during this period. Overall, HBC, HIV, syphilis and malaria rate for blood donors was found to be 0.45%. 0.16%, 0.08%, 0.07% and 0.003% respectively. There is a downward trend in sereoprevalence of all screened TTIs namely HBV, HCV, HIV and syphilis and malaria from 2008-2011. Conclusions: The study exhibits that over a period of years there is rise in voluntary blood donations which is heartening and encouraging. Trend analysis for prevalence TTIs among blood donors has shown a decreasing trend. It is recommended that continual quality assured screening of donated blood should be carried out as per the prescribed norms to deal with acquired TTI's.

Background: The world health organization (WHO) has defined quality of life as an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. The objective of study was to assess the quality of life among people living with HIV/AIDS by comparison of mean scores of their quality of life in physical, psychological, social and environmental domain.Methods: This cross-sectional study was conducted among PLWHA on ART during 2016-17. Data were collected using WHOQOLHIV‑BREF scale and mean±SD of score was calculated. The difference in mean scores of various domains were analysed using ANOVA test. All variables with p

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from September to December 2019, with sample size of 316. The eligible participants were administered a predesigned, pretested, semi-structured and anonymous interview schedule after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group 15-49 years. Male condom 36%, followed by female sterilization 30% were the most common methods preferred.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.

Background: Reproductive tract infection (RTI) is a public health problem, especially in developing country like India. The associated odium with this reproductive morbidity is often a stumbling block in seeking health care. The aim was to study the prevalence of RTI symptoms and its socio-demographic corelates.Methods: A cross-sectional study was undertaken in the rural field practice area of department of community medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to September 2018. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The prevalence of self-reported reproductive tract infections was found to be 41.2%. The prevalence was more in lower socio-economic classes, and it was statistically significant. Other socio-demographic corelates (age, education, occupation) did not showed any significant association.Conclusions: The reproductive tract infections prevalence is found to be considerably high in the women of reproductive age group. The frequency was higher among multigravida women and those using cloth during menstrual periods. RTIs are usually spurned by women and even the health care providers, so there is a need to give due consideration to this aspect of reproductive health.

Background: Rabies is a highly infectious zoonotic disease with a high case fatality rate. In India, approximately 20,000 deaths among 17.4 million exposed people occur every year. The data on animal bites is scarce and unreliable due to poor surveillance and hence, the projected figures are far less from the actual numbers. The present study was conducted to describe epidemiological characteristics of animal bite patients attending casualty department at a tertiary care Government health facility in Shimla, Himachal Pradesh.Methods: It was a retrospective study based on secondary data received from animal bite register for year 2017 at casualty department of the Indira Gandhi Medical College and Hospital, Shimla, Data of 1512 patients attending the casualty department with history of animal bite was included for the study purpose.Results: About 58% of victims were males and the maximum (22.6%) animal bites were seen in 21-30 years age group. Majority (51.6%) of patients were exposed to dog bites, followed by monkey bites (42.85%) and cat bite 49 (3.2%). About 69.9% of animal bites were in the lower limbs, followed by upper limbs (22.1%), abdomen (4.4%) and head and neck region (3.6%). Maximum bites were category III bites (74.6%) followed by of category II bites (12.9%).Conclusions: Study highlights the neglected but significant picture of animal bite in the Shimla city. Timely and correct post exposure prophylaxis for the animal bite victims is necessary to prevent rabies. This should be supplemented with a robust surveillance and reporting system. With the global aim of zero rabies deaths by 2030; it is time to strengthen the anti-rabies activities at every level.

Background: Tobacco smoking is a pandemic affecting populations and contributing to global morbidity and mortality. It is well known that the second hand smoke is equally hazardous like first hand smoke. Cigarette and other tobacco products act 2003 is an effort put forth by Government of India in order to curb this menace and protect people from ill effects of second hand smoke.Methods: The present study was conducted to assess the compliance to smoke free act in tertiary healthcare institutes in Shimla city, Himachal Pradesh. A total of 57 public places and 8 shops in five Tertiary healthcare institutes were evaluated for various provisions of the act. Compliance to different sections of the act was assessed using a structured observational checklist.Results: Signage indicating ban on smoking was seen at 71.9% places. Active smoking was absent at 77.2% places. About 25% shops around the institutes were found selling tobacco products. Signage displaying ban on sale within 100 m of educational institution and sale to minors was not observed at any shop. Tobacco product vendor was seen around 80% of educational buildings. Tobacco free institution signage was seen at 60% of educational premises.Conclusions: The study highlights that the level of compliance did not meet the standards laid down for a smoke free city. Timely and periodic assessment of the compliance must be conducted by the administrative authorities of the institutes for ensuring the adherence and strict implementation of the provisions of the act.

Background: Viral hepatitis B is a systemic infection affecting predominantly the liver, caused by hepatitis B virus. The similarity of hilly tribal’s in spiti and the Tibetans with documented high prevalence of HBsAg encouraged us to explore the burden of the hepatitis B infection in them as well. So the study was designed to document the prevalence of the chronic hepatitis B infection for timely intervention with the required prevention and control measures.Methods: 30 cluster villages from the 82 inhabitated villages were taken with 37 samples from each cluster village. Data was collected using interview schedule. Serum samples were taken and subjected to sandwich ELISA for the detection of HBsAg and positive samples were tested for the HBeAg then after.Results: The study included 1110 participants with 424 males. 99.7% of them were Buddhist and 98.5% belonged to Scheduled Tribe category. 60.1% were educated up to the middle and18% were illiterates. The prevalence of HBsAg was 21.9% (CI 19.6-24.6) with 22.6% in females and 20.9% in males. HBeAg was positive in 24.4% of HBsAg positive cases, higher in the 15-24 years age group and 30.5% in the reproductive females.Conclusions: The current study has reported hyper endemic (21.9%) sero-prevalence of HBsAg with infectivity rate of 24.4%, more in the young and reproductive population. The infection is homogenously distributed among the Buddhist tribal population in the study area.

Background: Patient satisfaction is the patient’s perception of care received compared with the care expected.Measurement of patient satisfaction helps in understanding patients’ experiences of health care, identifying problems and evaluation of health care. Increased patient satisfaction leads to increased patient retention and decreases medical malpractice claims. Dissatisfied patients may have worse outcomes as they may not follow treatment plans. The objective of the study was to determine the satisfaction level among people living with HIV/AIDS visiting ART Centre IGMC Shimla.Methods: A cross sectional study was conducted among >15 years from September 2016 to August 2017 in ART Centre IGMC Shimla and satisfaction level was assessed by using the PSQ18 instrument.Results: Total 160 participants were enrolled in study among which 71.9% were males while 92.5% were above 30 years of age. Most of the patients were asymptomatic (currently not ill) at the time of consultation and their mode of disease transmission was sexual. The mean scores of PSQ-18 domains i.e. general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with doctor, accessibility and convenience was calculated. Highest score in interpersonal manner, time spent with doctor (3.99±0.12) and lowest score in general satisfaction (3.77±0.54). There was no statistically significant difference between overall satisfaction in relation to different socio demographic and clinical variables found in our study.Conclusions: Our study reflects that patients were much satisfied with the way health care providers were treating them and spent time with them while they were dissatisfied with something about the health care they were receiving.