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Introduction: Almost 40% of Delhi's population lives in slums and is vulnerable to tobacco use. It is therefore important to assess their opinion and ensure compliance to antismoking legislation. The present study was undertaken to assess the awareness of the general public residing in slums in Delhi regarding the smoke-free initiative of 2009, 3 years after intensive implementation.Methods: It was a cross-sectional study conducted among participants selected by cluster sampling from the slums in six districts of Delhi using a pretested semistructured questionnaire. A total of 708 slum dwellers were interviewed.Results: Out of the total, only 16.1% (n = 114) of the participants had heard of The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA), though, they were aware about some of the provisions of the COTPA. Majority (n = 529; 74.7%) perceived the smoke-free zones as the places where smoking forms of tobacco are banned. Regarding the awareness about the places designated as smoke-free zones, 82.1% (n = 581) of the respondents named educational institutions. About 61% of the people interviewed reported to have seen people smoking at public places on the day of interview while only 21.5% reported to have seen any one getting punished for smoking.Conclusions: Awareness about COTPA was low. The study respondents perceived that no action was being taken against persons acting in violation of the law. Thus, there is a need for stricter implementation of COTPA and increased spreading of awareness among the general public.Implications: While awareness about antismoking legislation among general population (particularly slums) has been studied world over, this has not been the case in India. The study depicts opinion of one of the susceptible populations regarding tobacco control legislation, which has hitherto not been studied in the Indian context. This study has an important implication as it highlights the need for stringent enforcement of antismoking legislation for tobacco control. [ABSTRACT FROM AUTHOR]

Background: Work-related diseases contribute immensely to the global burden of diseases. Better understanding of attitudes of health care workers towards occupational safety and health (OSH) is important for planning. Objective: To assess the attitude of medical students towards OSH around the globe. Methods: A questionnaire assessing the attitude towards OSH was administered to medical and paramedical students of 21 Medical Universities across the globe. In the current study 1895 students, aged 18-36 years, from 17 countries were included. After having performed a principal components analysis, the associations of interest between the identified components and other socio demographic characteristics were assessed by multivariate linear regression. Results: Principal component analysis revealed 3 components. Students from lower and lower-middle-income countries had a more positive attitude towards OSH, but the importance of OSH was still rated higher by students from upper-income countries. Although students from Asian and African continents showed high interest for OSH, European and South-Central American students comparatively rated importance of OSH to be higher. Paramedical students had more positive attitude towards OSH than medical students. Conclusion: The attitude of students from lower-income and lower-middle-income towards importance of OSH is negative. This attitude could be changed by recommending modifications to OSH courses that reflect the importance of OSH. Since paramedical students showed more interest in OSH than medical students, modifications in existing health care system with major role of paramedics in OSH service delivery is recommended. [ABSTRACT FROM AUTHOR]

Background: Hypertension is fast emerging as a major health problem amongst all school adolescents, particularly in urban areas. Regular screening of the students for this is required for preventing the emergence of complications later in life. Therefore, the present study was undertaken with the objective to determine the prevalence of hypertension amongst urban school adolescents and its correlation with anthropometric measurements. Methods: A cross-sectional study was conducted in a school in Central Delhi involving all 315 students of 9th and 11th standard. A preforma was filled by the students and anthropometric measurements along with blood pressure (BP) measurements were taken for each student. Data was analyzed using Epi-info 2005 and SPSS 16.0. Results: Out of the total 315 students, 208 (66%) were boys and 107 (34%) were girls and the mean age was 14.31 ± 0.96 years. Overall prevalence of malnutrition was 24% and boys were found to be more obese as compared to girls. There were 5 students (1.6%) who were found to have systolic hypertension while 17 (5.4%) were found to have diastolic hypertension while 4.1% (n = 13) of the participants were systolic pre-hypertensive and 26% (n = 82) were in stage of diastolic pre-hypertension. Body mass index and gender were found to be independent predictor for systolic hypertension. Conclusions: Prevalence of hypertension and pre-hypertension was high amongst the school children. BP check-up for children and adolescents is thus recommended to take remedial action on time. [ABSTRACT FROM AUTHOR]

A matrix based on coupling of cost (always, better and control) analysis and criticality (vital, essential and desirable) analysis was employed for drug inventory containing 129 items of drug store in the Department of Community Medicine of a Medical College in Delhi. The annual drug expenditure incurred on 129 drug items for the year 2010-2011 was found to be Rs. 4,35,847.85. On always, better and control analysis, 18.6, 24.0 and 57.4% drugs were found to be always, better and control category items, respectively, amounting for 69.1, 20.8 and 10.1% of annual drug expenditure. About 13.2 (17), 38.8 (50) and 48.0% (62) items were found to be vital, essential and desirable category items, respectively, amounting for 18.7, 49.5 and 31.8% of annual drug expenditure. Based on always, better and control--vital, essential and desirable matrix analysis there were 37 (28.68%) items in category I, 53 (41.09%) items in category II and 39 (30.23%) items in category III, amounting for 73.0, 22.2 and 4.8% of annual drug expenditure, respectively. To conclude, scientific inventory management tools are needed to be applied in routine for efficient management of the pharmacy stores as it contributes to not only in improvement in patient care but also judicious use of resources as well. [ABSTRACT FROM AUTHOR]

BACKGROUND: Breast cancer is associated with substantial medical and economic burden. This study assisted the expenditure incurred by the subjects on diagnosis and treatment till the period of follow-up. MATERIALS AND METHODS: This is a prospective study; a case series of patients studied at the time of diagnosis and followed after 6 months. The study was conducted at one of Hospitals in India, from January 2006 to December 2007. One hundred and seventy-two women with new primary breast cancer were included in the study. During the study period 69 subjects were lost to follow-up. The comparative analysis was done for 103 subjects. Cost implications of breast cancer include direct medical costs and indirect costs. Questionnaire for the data collection was used. Descriptive statistics and correlation analysis were used. RESULTS: The median total direct and indirect expenditure was Rs. 12,100 (US$ 1 = Rs 50) with the range of Rs. 0-54000. The largest component of total direct medical costs was in stage I (median Rs. 6530), total indirect costs (median Rs. 7500), and median total cost was Rs. 17,600. The total expenditures (median Rs. 13,100) were the highest in younger age group (<40). The median direct expenditure was higher in the subjects who visited private setup before coming to Hospital (Rs. 8250) than those who came directly (Rs. 4500). CONCLUSIONS: Cost of treatment for breast cancer depends on many factors, including the stages of the cancer, the woman's age, perhaps the costs of treatment, private hospital and insurance. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship of psychosocial factors (lack of social support, stress and subjective well-being) and personality traits with myocardial infarction (MI). Materials and Methods: A case-control study involving 100 cases and 100 matched controls was conducted in Lok Nayak Hospital, New Delhi. Results: Stress over 1 year was significantly higher in cases (P < 0.001). However, difference was not significant when scores of social support (P = 0.2), Presumptive Stressful Life Event (PSLE) over lifetime (P = 0.058) and subjective well-being (P = 0.987) were compared. MI was significantly associated with hyperactive (P < 0.001), dominant (P = 0.03), egoistic (P < 0.001) and introvert (P < 0.001) personalities. Conclusion: Certain personality traits and recent stress may be important risk factors of MI, especially in Indians. The finding may have implications on the preventive strategies planned for MI patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: The incidence of breast cancer is on the rise in India, breast cancer is the second most common malignancy in Indian women. AIM: The aim of this study was to find out the association of various risk factors with breast cancer among women in Delhi. SETTINGS AND DESIGN: This was a case-control study in Lok Nayak Hospital, Delhi. METHODS AND MATERIAL: 332 women were studied. Subjects were women with breast cancer (N = 115) and age matched Control subjects (N-217) without breast cancer, attending Lok Nayak Hospital during 2006. Subjects were interviewed using a pretested questionnaire. The risk factors studied were: age, parity, socioeconomic status, marital status, breast feeding, menarche, menopause, family history. STATISTICAL ANALYSIS: Data was expressed in proportion. RESULTS AND CONCLUSIONS: Age of the patient ranged from 25 to 80 years. In this study, 69 (60%) cases and 127 (58.5%) controls were illiterate, the mean duration sum of total breast feeding for all children was 6.58 years in cases and 7.4 years in controls (OR = 1.91; 95% CI, 1.17 - 3.13) (P < 0.006). In the present study 52.9% of the cases and 47.9% of controls had attained menopause before the age of 45 years, and a higher number of controls were living with spouses than cases (P < 0.0001). A larger number of controls (150, 69.1%) were living in urban areas than cases (65, 56.5%) (P<0.05). There was a significant difference between breast cancer cases and controls in relation to place of residence, occupation, marital status, body mass index and breast feeding. [ABSTRACT FROM AUTHOR]

Corneal transplantation remains a major treatment option for restoring sight among those suffering from corneal blindness. The number of corneal transplants done is far less than the actual requirement in India. This is largely due to the inadequate numbers of corneas collected. Medical students can be involved in the motivation of patients and relatives to pledge their eyes and to do grief counseling for donating eyes. The aim of the study was to assess the perception and willingness of 180 first-year medical students towards eye donation in Delhi. They were administered a pretested semi-structured questionnaire on eye donation. Data were analyzed using Epi-Info software package 6.04 version. The majority (99.4%) of students knew that eyes can be donated after death but only 41.1% knew that the ideal time of donation was within six hours of death. Most participants (87.2%) were willing to donate eyes. Nobility in the act of eye donation was the main motivational force for eye donation according to 85.5% of students. Perceived reasons for not pledging eyes by the people were: lack of awareness (32.7%), objection by family members (27.7%), unsuitability to donate because of health problem (17.7%) and the unacceptable idea to separate the eye from the body (15.5%). Mass media such as television, newspapers, magazines and posters were important sources of information on eye donation. Perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. [ABSTRACT FROM AUTHOR]

Background: Life style related behavioural risk factors are mainly implicated for increased burden of cardio- vascular diseases. Research related to these risk behaviours especially among medical students is essential, considering their role as future physicians and role models in public health intervention programmes. Objective: To evaluate the burden of cardiovascular risk behaviours among students of a medical college of Delhi, India. Materials and Methods: A cross sectional study was carried out among undergraduate medical students of a medical college in Delhi. Self administered questionnaire was used to collect information on identification data and risk behaviours in relation to cardiovascular diseases. Binary logistic regression analysis was done to calculate adjusted odds ratio to assess association between risk behaviours and covariates. Results: The minimum recommendation of taking at least five servings per day of fruits and vegetables was complied only by 12% of students. Consumption of carbonated soft drinks either once or more on daily basis was present in 23.7% students and 32.0% reported frequent consumption of fast foods in past week. Consumption of alcohol was present in 28.8% students but only small proportion of students (7%) was current tobacco users. Large proportions of students (42.6%) were either not carrying out or were involved in only occasional physical activity in past week. Conclusions: Unhealthy behavioural practises are present and may progress as student advance through medical college. Developing strategies targeting at these risk behaviours and determining factors is necessary to promote healthy life style among medical students. [ABSTRACT FROM AUTHOR]

The article analyzes the results of a cross-sectional study of the treatment-seeking behavior of parents of children with locomotor disability in New Delhi, India. Based on the pattern of first consultation, parents of disabled children were found to have little confidence in the government health care system. Also noted is the relationship of socio-economic status and place of residence with the treatment seeking pattern. The need for coordination and smooth referral link-ups among health service providers is emphasized.

The article discusses a study on the beliefs and attitudes of medical professionals towards mental health in Delhi, India. Only around 60% of the respondents considered mental illness to be a disease and almost 80% considered psychiatry to be a difficult discipline. It notes that attitudes evaluated in the study reflect primarily a subjective value system and cannot objectively be deemed accurate or inaccurate. Also mentioned is the lack of importance given to mental health in India.

The article provides an overview of the Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy in India. The major objective of IMNCI is to reduce mortality and the frequency and severity of illness and disability as well as to improve growth and development during the first five years of a child. The strategy is divided into three components namely the health-worker, health-service and community components. The IMNCI uses evidence-based management decisions such as oral rehydration therapy for diarrhea.

The article highlights a study on the impact of tuberculosis (TB) on the quality of life (QoL). QoL is defined as a person's perception of his or her physical and mental health and covers broad domains, including physical and social well being. It was found that TB patients had significantly lower mean scores than the controls for overall QoL and the worst affected domains were physical and psychological.

The article discusses a study on the career aspirations and apprehensions concerning medical education among first year medical students in Delhi, India. The study was conducted among medical students of Maulana Azad Medical College during their preadmission check-up. Majority or 74.6% cited serving the sick and society as their reason for opting for medical profession. 21.7% of them were apprehensive regarding the long period of study course.

Skill-based education has been shown to reduce high-risk behavior among adolescents, but in India, life skills have often been looked at only from the reproductive health perspective. Therefore, the current study was undertaken to assess the effect of life skills training on dietary behavior of adolescents studying in grades 9 and 11 of 2 schools in Delhi. This was a nonrandomized interventional study with a control group. A self-administered questionnaire was used for assessment of dietary behavior at baseline, 15 days, and 3 months after the life skills training. Two life skills training sessions were imparted to the intervention group, focusing on the use of life skills in making healthy choices. Participants in the intervention group (n = 180) showed significant improvement in knowledge (P < .001), attitude (P = .007), and practices (P < .001) following the life skills training. To conclude, a skills-based approach does help improve the dietary behavior in adolescents. [ABSTRACT FROM PUBLISHER]

Introduction: With times, increasing attention is being given to doctor's own health as it is known to influence their patient care. Little is known about preventive health practices among them., Objective: To assess preventive health practices among doctors in Delhi., Material and Methods: It was a cross-sectional study undertaken amongst the doctors working in selected hospitals, dispensaries and private clinics in Delhi. A self-administered questionnaire containing items for assessment of preventive health and self-care practices was used to collect the data., Results: Out of the total 160 participants, there were 118 males (73.8%) and 42 (26.2%) females. The mean age of the participants was 29.9±7.4 years. There were 55 doctors (34.4%) who were suffering from chronic diseases like vision problems, dental problems, hypertension and diabetes. Nearly half of the doctors (n=74; 46.2%) did not have any for health insurance. Majority of the doctors (n=65; 40.6%) were obese. The knowledge regarding preventive health guidelines regarding all of the tests asked for, was low among the study participants. As far as preventive health practices were concerned, only 8.8% (14) had checked their blood pressure according to recommended guidelines while none of them had their lipid profile done. While there were 9 female doctors (21.4%) who had done their self breast examination in last six months, there was only 1 participant who had undergone pap test. With respect to self-care practices when the physicians last fell ill, majority had self-managed themselves (n=108; 67.5%)., Conclusion: Preventive health care practices among the doctors are low. There an urgent need for them to follow good health care practices which they in turn can advocate to their patients., (© Journal of the Association of Physicians of India 2011.)

Background: The rising trend of non-communicable diseases (NCDs) has led to a "dual burden" in low and middle-income (LAMI) countries like India which are still battling with high prevalence of communicable diseases. The incorporation of a target specially dedicated to NCDs within the goal 3 of the newly adopted Sustainable Development Goals indicates the importance the world now accords to prevention and control of these diseases. Mobile phone technology is increasingly viewed as a promising communication channel that can be utilized for primary prevention of NCDs by promoting behaviour change and risk factor modification., Methods: A "Before and After" Intervention study was conducted on 400 subjects, over a period of one year, in Barwala village, Delhi, India. An mHealth intervention package consisting of weekly text messages and monthly telephone calls addressing lifestyle modification for risk factors of NCDs was given to the intervention group, compared to no intervention package in control group., Results: After Intervention Phase, significant reduction was seen in behavioural risk factors (unhealthy diet and insufficient physical activity) in the intervention group compared to control group. Body mass index (BMI), systolic blood pressure and fasting blood sugar level also showed significant difference in the intervention group as compared to controls., Conclusions: Our study has demonstrated the usefulness of mHealth for health promotion and lifestyle modification at community level in a LAMI country. With the growing burden of NCDs in the community, such cost effective and innovative measures will be needed that can easily reach the masses., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Background: Burden of tuberculosis in India remains enormous. The Revised National Tuberculosis Control Programme (RNTCP), based on the Directly Observed Treatment Short course (DOTS) strategy, was launched in 1997 in India. The question of what DOTS has or has not accomplished over the past 15 years is a central technical question., Objectives: To assess the decadal impact of DOTS strategy on some epidemiological factors such as age and gender of new sputum positive (NSP) TB patients in Delhi., Material and Methods: Secondary Data for Delhi was obtained from the state wise performance of RNTCP (Annual Summary) for the year 2001 and year 2012. Data was analyzed in Microsoft Excel 2007., Results: The population of Delhi covered under DOTS has considerably increased over the decade. The case detection rate has also shown a considerable increase from 196/100,000 population in 2001 to 306/100,000 population at the end of Quarter 3 of 2011. The number of NSP male and female patients have increased in all age groups from 2001 to 2011 except in 25-34 years age group. NSP male patients on DOTS aged 15-44 years showed a left ward shift in increase, a significant right ward shift was noted in increase in female NSP patients of similar age group., Conclusions: The decadal assessment of DOTS in Delhi on TB epidemiology has pointed towards beginning of epidemiological transition in TB control in India., (Copyright © 2017 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.)

Background: Rabies is a fatal disease of the central nervous system caused by the bites of warm-blooded animals. One of the important methods of controlling rabies is by interventions to limit the number of dog bites, the most common source of transmission of rabies to humans in the community. Community-based data on dog bites are rare from India., Aim: The aim of this study is to determine the prevalence of dog bites and knowledge and practices relating to its management and prevention in an urban and a rural slum of North West Delhi, India., Subjects and Methods: A cross-sectional house to house survey of 500 households covering a population of 2887 individuals was conducted. The families were selected by systematic random sampling. A pretested and a prevalidated questionnaire was used. Chi-square test was applied for comparing proportions related to the categorical variables and t-test was used for comparing means., Results: The dog bite incidence rate for the study population for the last year was 25.2/1000 population with higher rates in urban (30.1/1000) than rural (19.6/1000) slum. Two-fifths of the dog bite patients did not wash the wound with soap and water. The practice of washing the wound with soap and water was significantly higher in urban than rural slum. One-fifth of the patients did not receive anti-rabies vaccine. There was lower coverage in rural than urban slum. A majority (79.0%) of the patients did not receive anti-rabies serum., Conclusion: A high prevalence of dog bites coupled with poor knowledge and dog bite management practices is a worrisome trend which policy makers should take into account to make India rabies free.

Background: In India, Tuberculosis (TB) continues to be a public health problem. One of the key reasons for it is the stigma associated with the disease which affects the treatment seeking behaviour and hence the outcome., Objectives: To assess the perceived and enacted stigma among TB patients and perceptions of other patients related to TB in Central Delhi., Methods: A cross-sectional study conducted in urban field practice area of a medical college of Delhi, using a pre-designed questionnaire containing items for assessment of stigma being faced by a TB patient in family, social life and workplace. It also contained questions pertaining to reaction of patients from general OPD to a family member who develops TB., Results: A total of 100 patients on DOTS and 200 patients from general OPD were interviewed. There were 21 patients who reported to have delayed treatment seeking due to stigma. Nearly one third patients (n=34; 34%) noted negative changes in the behaviour of their family members towards them while 40% were isolated on being diagnosed with the disease. Out of the 36 employed TB patients, 65.5% (n=23) experienced negative change in the behaviour of their colleagues. In general OPD patients, significantly higher proportion of female patients said that they would not disclose the disease status of a family member suffering from TB to their neighbours (p<0.001)., Conclusions: Perception of stigmatizing effect of Tuberculosis was high both amongst TB and other patients. Behaviour Change Communication (BCC) strategies are needed to address the effects of stigma like delayed treatment seeking.

A cross-sectional study was conducted to assess the pattern of antepartum morbidities and its relationship with socio-economic, demographic characteristics and the health seeking behaviour among 214 women in an urban slum community of Delhi. Interviews were conducted in the households using a pretested semi-structured schedule. The age at marriage, age at co-habitation, and age at child-birth were below 18 years in 36.4%, 32.7%, and 5.1% respectively. The average number of antepartum morbidities per woman was 1.7. Commonest morbidities were: Urinary problems (11.2%), swelling over hands and feet (9.3%), fever > 3 days duration (7.5%), antepartum bleeding (7.0%), etc. The antepartum morbidities were found to be significantly higher among wives of illiterate (p = 0.01) husbands and of unskilled workers (p = 0.01). Out of 144 morbidities, consultation was sought for 101 morbidities (70.1%), mostly in a government hospital (78.2%). Main reasons for non-consultation among 43 women were: Non-availability of persons to accompany (32.6%), or to look after the children (23.3%) and feeling unnecessary to consult (23.3%). Study findings revealed the need for family support, sensitising men about women's health problems during pregnancy and education regarding identification of danger signs during pregnancy for reducing maternal morbidity and related mortality.

As per global HIV/AIDS estimates, a total of 33 million [30.3 - 36.1 million] People were living with HIV in 2007. The world's second-most populous country, India, is experiencing a highly varied HIV epidemic, which appears to be stable or diminishing in some parts while growing at a modest rate in others. Quality of life (QOL) of HIV/AIDS patients is becoming an important component of overall assessment of health care and management in health care settings. It is one of the indicators effectiveness of management of PLHAS. The objective of this study was to determine the QOL of patients with HIV/AIDS in New Delhi. Purposive sampling was used to identify subjects from the antiretroviral therapy clinic (ART) in Lok Nayak hospital. 180 patients were interviewed with the WHOQOL-HIV instrument. This questionnaire included demographic data, multi-item scales and six domains namely physical, psychological, level of independence, social relationships, environment and spirituality religion. Study subjects were aged between 20-56 years. Mean age of all study subjects was 33.85 +/- 7.01 years, comprising of 34.4 females. More than 50% of the total subjects had received less than secondary school education. All domains have higher scores for women than men except the psychological domain. Correlation of scores of six domains with overall QOL score and among individual domains was statistically significant. Younger people showed poorer QOL and level of education correlated positively with all domains of QOL Overall results indicate that quality of life of AIDS attending Lok Nayak hospital is satisfactory.

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.

Malaria affects millions of people in India despite decades of efforts to control it. It has acquired greater importance in last two decades due to emergence of vector resistance, poor quality of care and low utilization of services. The study was conducted to improve the management of malaria by IEC and training activities in slum areas of Delhi. The baseline and post intervention data on knowledge, attitude, behavior and practices (KABP) regarding malaria was collected from 601 and 593 subjects respectively from two zones of Municipal Corporation of Delhi (MCD). At the same time, knowledge and skills regarding management of malaria were assessed among 15 health workers working in these two zones of MCD. An intervention package in the form of health education material for the community and training modules for the workers were designed and implemented. Post intervention data were collected. The knowledge about cause of malaria, season of malaria and breeding places of mosquito increased among community members after the intervention, which was found to be statistically significant. Similarly, more people were aware about the methods of prevention of mosquito breeding after the intervention. Methods like mosquito coil (post-64.92% vs pre-55.41%) and bet nets (post-24.96% vs pre-14.47%) were used by more people in post intervention phase. The Interval between onset of symptoms and seeking treatment decreased after the intervention from 1.66 days to 1.37 days. Among the workers, knowledge and skills regarding malaria management improved after the intervention. More blood slides were made, side effects of the treatment were explained to the patients and better compliance to treatment was observed in post intervention phase. IEC activities using attractive pamphlets to the community and on-job training of workers improves management of malaria and should be used more frequently more so in the slum areas for the success of the National Anti-Malaria Program.

Objective: To assess knowledge of childhood asthma among general practitioners (GPs) in Delhi, India., Design: In this cross-sectional study, a total of 157 GPs were interviewed using a validated questionnaire, including six questions of local and social relevance. A response rate of 78.5% was obtained., Results: Although the GPs who participated in the study had adequate knowledge of the importance of appropriate treatment, the safety of inhalers/oral steroids and the role of medicines in the prevention of frequent asthma attacks, the majority lacked knowledge of symptomatology, exercise-induced asthma and inhaled corticosteroids. GPs with >5 years of practice were more likely to have significantly less knowledge about preventive drugs, certain aspects of treatment of acute asthma and misconceptions, such as 'drinking milk increases mucus production' or 'children with asthma should not consume dairy products, chilled drinks, sour or chilled food'. On the other hand, GPs with < or =5 of practice had misconceptions such as 'children with asthma have abnormally sensitive airways' and 'asthmatic children develop dependence on inhalers'., Conclusions: The gaps in knowledge about asthma and its management highlight the need to design well-structured educational strategies for health professionals.

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.

Background: The past decade has seen a decline in the disability-adjusted life years (DALYs) contributed by communicable diseases while lifestyle changes and rapid urbanization have led to an increase in DALYs contributed by non-communicable diseases. We studied the causes of death in a low socioeconomic area over 11 years to help identify changes in the pattern of disease., Methods: We did this study in Gokulpuri, a resettlement colony in East Delhi. All deaths occurring from 1994 to 2004 were analysed using a verbal autopsy questionnaire completed by trained health workers during their home visits in the area., Results: A total of 515 deaths occurred during the period; 340 in men (66%) and 175 in women (34%). The six commonest causes of death were tuberculosis (24.8%), chronic obstructive pulmonary disease (11.6%), pneumonia (8.7%), accidents and poisoning (8.6 %), coronary heart disease (8.2%) and cancer (4.6%). The age-specific mortality rate was highest among people > 45 years of age. The cause-specific mortality rate due to communicable diseases showed a decline while that due to non-communicable diseases showed a rising trend in all age groups., Conclusion: Our study shows the coexistence of communicable and non-communicable diseases in a low socioeconomic area with a rising trend in non-communicable diseases. Surveillance for risk factors of non-communicable diseases should be done even in predominantly low socioeconomic areas. The coexistence of communicable and non-communicable diseases and the increase in non-communicable diseases among the economically deprived sections of our society suggest the need to re-prioritize components of healthcare among these sections.