Community Medicine

Introduction: Raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of all deaths worldwide. It is a major risk factor for cardiovascular diseases. Raised Blood pressure among children and adolescents has shown tracking to adulthood.

Introduction: Effective hand hygiene is essential for reducing iatrogenic infections. However, compliance of healthcare workers to hand hygiene guidelines are reportedly poor. The objective of the study to identify gaps in knowledge, attitudes and practices of medical and nursing students in the faculty. Material and Methods: A self-administered questionnaire based cross sectional study was done to assess the knowledge, attitudes and of practices of hand hygiene in final year medical and nursing students of the J.N. Medical College, Aligarh Muslim University, Aligarh. Results: A total of 130 students participated in the study out of which majority of both the nursing and medical students had moderate knowledge. Attitude was good among half of the nursing and about one-third of the medical students. About 66% of nursing students and 40% of medical students showed good practices. Overall satisfaction with facilities available for hand hygiene levels was poor among nursing and medical students. Discussion: Hand hygiene is recognized as the most effective intervention for prevention against hospital acquired infections, leading to shorter hospital stay, reduction in patient morbidity and decreased health care costs. But, at the same time, the adherence to proper hand hygiene by the health workers has been reported to be poor in many studies. Conclusions: The knowledge was adequate and attitude was positive and constructive. However in practice 100% compliance was not there. Improvement of the facilities for hand hygiene and training programmes are recommended.

—Introduction: According to World Health Organization, insufficient physical activity is the fourth leading risk factor for mortality and among the main predisposing factors for non-communicable diseases (NCDs) including obesity. Promoting physical activity is one of the major areas of intervention for preventing overweight and obesity (7) and assessment of the same among the adolescents is required for planning a preventive programme for obesity. Aims and objectives: To study the physical activity level and its socio-demographic determinants among school going adolescents in a small but growing city of Aligarh in India. Methodology: A cross-sectional study done in two affluent and two non-affluent schools in Aligarh, taking 330 adolescents from each group (total-660). Study tools included Global Physical Activity Questionnaire (GPAQ) and anthropometric measurement of height, weight, body mass index (BMI). Statistical significance was tested by chi square test. Results: Among the study subjects, 57.6% (380) were males. Among all the adolescents, 28% were having low physical activity level whereas only 19.4% had high PAL. Majority of the adolescents (52.6%) were having moderate PAL. High PAL was found to be significantly lower among girls (5.7% as compared to 29.5% among boys) and adolescents of affluent schools (15.7% as compared to 23% among those of non-affluent group). A significantly higher proportion of girls spent more than 2 hours per day viewing Television (17.1% vs 9.7% of boys) and more than 10 hours per day in overall sedentary pursuits (10% vs 4.5% of boys). 10.3% of overweight and obese adolescents had high PAL as compared to 21% among the non-overweight adolescents (statistically significant difference). Conclusion and recommendations: PAL among majority of school going adolescents is inadequate. Behavior change communication and built environment for physical activity are recommended among adolescents with more focus among females and adolescents of affluent group for primary prevention of obesity.

Obesity has reached epidemic proportions globally and the prevention of adult obesity will require prevention and
management of childhood obesity. A study was conducted to determine the prevalence and behavioral determinants
of overweight and obesity in school going adolescents. A total of 660 adolescents from affluent and nonaffluent
schools were taken. Overweight and obesity was defined as per World Health Organization 2007 growth reference.
Prevalence of overweight and obesity was 9.8% and 4.8%, respectively. Prevalence of both overweight and obesity
was higher among males. Statistically significant difference was found in prevalence of overweight and obesity among
affluent schools (14.8% and 8.2%) and nonaffluent schools (4.8% and 1.5%). Important determinants of overweight
and obesity were increased consumption of fast food, low physical activity level and watching television for more
than 2 h/day. The prevalence of obesity is high even in small cities. Dietary behavior and physical activity significantly
affect weight of adolescent children.

Introduction: There has been an increasing secular trend in the prevalence of overweight and obesity in developing countries. The
prevalence reported among children and adolescents of some metro cities in India are comparable to that in some developed countries.
Westernization of culture, rapid mushrooming of fast food joints, lack of physical activity, and increasing sedentary pursuits in the
metro cities are some of the reasons implicated for this. The nutritional changes in small town school children might be following the
same pattern of larger cities. Aims and Objectives: To study the prevalence of overweight and obesity among school-going adolescents
of Aligarh and to study the sociodemographic and behavioral correlates of the same. Materials and Methods: A cross‑sectional
study done in two affluent and two nonaffluent schools in Aligarh, taking 330 adolescents from each group (total‑660). Study tools
included a predesigned and pretested questionnaire, Global Physical Activity Questionnaire, and anthropometric measurement.
Overweight and obesity were defined based on World Health Organization 2007 Growth Reference. Chi‑square test and multiple
logistic regression analysis were done. Results: Prevalence of overweight and obesity was 9.8% and 4.8% among school-going
adolescents. The difference in prevalence of overweight and obesity among affluent schools (14.8% and 8.2%) and nonaffluent
schools (4.8% and 1.5%) was significant. Risk factors for overweight and obesity were affluence, higher maternal education, parental
history of obesity, frequent fast food intake, and television (TV) viewing more than 2 h/day. Conclusion: Overweight and obesity
among school-going adolescents is a crisis facing even smaller cities in India. Behavior change communication should be focused
to adolescents, especially of the affluent section, toward restricting fast food intake, and TV viewing.

Tuberculosis affects much of the world's population, and 1-5% of all cases are musculoskeletal. Tuberculosis of the soft tissues secondary to underlying bone involvement is not uncommon, but selective tissue involvement without bony abnormality is rare. We present a case in which two tubercular abscesses presented at an unusual site with no underlying bony involvement, simulating a pyogenic abscess.

There has been a rise in the incidence of tuberculosis in recent years. This increase appears to be due to several factors including development of resistance to the most commonly-used chemotherapeutic substances, human immunodeficiency virus (HIV) infection, and increased travel and migration. Most of the cases are treated by early diagnosis and use of very effective drugs but problem arises when either there is difficulty in diagnosis or the case is complicated by presence of immunodeficiency, multidrug resistance or non compliance to treatment. We present a case of 5 year old male child who presented tubercular lumpadenitis as scrofulderma and abscess formation.

Tuberculosis affects much of the world's population, and 1-5% of all cases are musculoskeletal. Tuberculosis of the soft tissues secondary to underlying bone involvement is not uncommon, but selective tissue involvement without bony abnormality is rare. We present a case in which two tubercular abscesses presented at an unusual site with no underlying bony involvement, simulating a pyogenic abscess.

of 85.2% (95.0% CI 81.9% to 88.4%) participants affirmed that they could move with a deformed leper to the market or church. 71.5% (95.0% CI 67.5% to 75.5%) participants stated that they could offer a job to a deformed leper. Conclusion The high proportion of positive attitudes among the participants and in different divisions is a positive indicator that the elimination of leprosy social stigma is progressing in the right direction.

Abdominal Tuberculosis includes tuberculosis infection of gastrointestinal tract, mesentery, lymph nodes and omentum, the peritoneum and related solid organs such as liver and spleen. This study aims to document the trend of different types of presentation and treatment approach in Abdominal Tuberculosis according to involved sites and surgical pathology over a period of six years. 786 patients of abdominal tuberculosis admitted in emergency as well as in outdoors of various department of J. N. Medical College, Aligarh during the period of July 2004 to June 2010 were analyzed. Abdominal pain and altered bowel habit were two most common presenting complaints. A clear trend towards conservative approach for management of abdominal tuberculosis was found. Irrespective of surgery, all patients of abdominal tuberculosis require a full ATT

Growth retardation is highly prevalent in developing countries. Inadequate dietary intakes and frequent infections are well-known causes of growth retardation. However, the role of specific micronutrient deficiencies in the etiology of growth retardation has gained attention more recently. Micronutrient deficiencies are highly prevalent in low-income countries, and the most probable causes are low content in the diet and poor bioavailability. More than half of preschool children are anemic, and an estimated 75 million and 140 million preschool children have clinical and subclinical vitamin A deficiencies (VAD), respectively. 1 Vitamin A is an essential micronutrient for the immune system. Its deficiency is one of the most important causes of preventable childhood blindness and is a major contributor to morbidity and mortality from infections. The primary cause of VAD is lack of an adequate intake of vitamin A, and may be exacerbated by high rates of infection, especially diarrhoea and measles. 2 ABSTRACT Background: Vitamin A is an essential micronutrient for the immune system. Its deficiency is one of the most important causes of preventable childhood blindness and is a major contributor to morbidity and mortality from infections. Studies have linked vitamin A deficiency to a greater risk of malnutrition. Therefore the present study was planned to assess the intake of Vitamin A in preschool children and to find out its association with nutritional status of PreSchool children. Methods: A cross-sectional study was conducted in urban and rural Lucknow, Uttar Pradesh, India. Children (n=400) of 12-59 months were randomly selected and mothers were interviewed after taking informed consent on pretested predesigned questionnaire on socio-demographic and Dietary intake. Anthropometry was performed using standard procedures. Results: The mean age of children was 31.9 months and mean intake of Vitamin A was 344.8 µg. Underweight, stunting and wasting was seen in 43.7%, 51.3 % and 21.8% of children respectively. Stunting was associated significantly with mean Vitamin A intake (p<0.005). 54% children had been administered Vitamin A in past six months. Signs of Vitamin A deficiency were seen in only 6.2 % children. On Multivariate analysis Height / Age Z score was significantly associated with Vitamin A intake (OR-2.8, 2.5-14.0). Conclusions: The prevalence of malnutrition for preschool children is worrying. There is low intake of Vitamin A. There is need to find innovative and effective ways of reaching the community for educating them on balanced diet particularly rich in vitamin A.

Background: An important aim of medical education is to provide sufficient surgical training to residents. Attitudes of patient toward the surgical training of residents and the impact of resident's participation on patients' perceptions of care are relatively unknown in India. We therefore undertook this study to assess patient attitudes towards resident cataract surgery training in a teaching hospital. Methods: An anonymous survey was conducted in a teaching hospital on all patients undergoing elective cataract surgery. A questionnaire was developed with inputs from published work, modified according to local needs to record demographic information and elicits patient perspective and attitude towards resident training. Responses of patient's were graded using a 5-point Likert scale. The data was analysed using SPSS-version 19. Results: Only 35% of surveyed patients selected the most accurate definition of a resident and teaching hospital. The majority (63%) felt "assistance" meant that the resident would be performing parts of surgery, but not the entire procedure. 25% of patients were comfortable having a resident assist their surgery, while only 07% were comfortable with residents performing the entire surgery. Majority (58%) agreed that residents should be involved in the surgical care. Patients demographic background had a significant association with attitudes toward resident involvement in surgery (p<0.05). Conclusions: Results showed varied opinions amongst patients toward the involvement of residents in surgical care. Patient orientation on the resident education process is vital to their perceptions of care and may render them willing to participate in training if they are taken into confidence by the faculty surgeon.

Background: Most microbial eukaryotes are uncultivated and thus poorly suited to standard genomic techniques. This is the case for Polykrikos lebouriae, a dinoflagellate with ultrastructurally aberrant plastids. It has been suggested that these plastids stem from a novel symbiosis with either a diatom or haptophyte, but this hypothesis has been difficult to test as P. lebouriae dwells in marine sand rife with potential genetic contaminants. Results: We applied spliced-leader targeted PCR (SLPCR) to obtain dinoflagellate-specific transcriptomes on single-cell isolates of P. lebouriae from marine sediments. Polykrikos lebouriae expressed nuclear-encoded photosynthetic genes that were characteristic of the peridinin-plastids of dinoflagellates, rather than those from a diatom of haptophyte. We confirmed these findings at the genomic level using multiple displacement amplification (MDA) to obtain a partial plastome of P. lebouriae. Conclusion: From these data, we infer that P. lebouriae has retained the peridinin plastids ancestral for dinoflagellates as a whole, while its closest relatives have lost photosynthesis multiple times independently. We discuss these losses with reference to mixotrophy in polykrikoid dinoflagellates. Our findings demonstrate new levels of variation associated with the peridinin plastids of dinoflagellates and the usefulness of SLPCR approaches on single cell isolates. Unlike other transcriptomic methods, SLPCR has taxonomic specificity, and can in principle be adapted to different splice-leader bearing groups.

Directly observed treatment short-course (DOTS) strategy is one of the components of Revised National Tuberculosis Control Programme (RNTCP) which came into existence in the year 1997. The goal was to achieve and maintain a cure rate of at least 85% among newly detected infectious (new sputum smear positive) cases and to achieve and maintain detection rate of at least 70% of estimated new sputum positive cases in the population. [1] The treatment success rate has increased from 25% in 1998 to 86% in 2009, and the death rate has come down 7-fold, from 29% to 4%. [2] India has already achieved tuberculosis (TB)-related millennium development goal by 2015 and is committed to reduce mortality and incidence to 10% and 20%, respectively by 2030 as per sustainable development goal. [3,4] Despite high cure rates, queries and doubts have been raised about the effectiveness of RNTCP regimens, inadequate diagnosis, method of administration, wrong categorization, and increased rate of multi-drug resistant TB. [5] It was observed that among all patients recorded to have received directly observed treatment (DOT); more than a quarter did not actually receive it in the district of Kerala, India. This accounts for 86% of total treatment failure and relapse. [6] DOT being the most important component of the treatment strategy needs to be followed meticulously. Besides, directly observation documentation, follow-up, and counseling of patients make this strategy more patient-friendly. To maintain the quality of DOTS, DOT provider should be properly trained and equipped with essential consumables and facilities. That includes optimum numbers of

Introduction: Refractive errors are the commonest cause of visual impairment in school children worldwide. They are correctible and after screening, spectacles can easily enhance vision. This can be achieved only when spectacles are used regularly.  Objective: This study was conducted to study the compliance of spectacles wear among children and to determine the reasons associated with non-compliance. Methodology: 400 children in the age group of 5-15 years with refractive errors attending the eye OPD, using spectacles for more than three months were included. Spectacle wear and reasons of noncompliance were enquired. Data was analyzed to determine the factors associated with spectacle wear compliance. Results: Among 232 boys and 168 girls 142 were from rural and 258 from urban areas. 244(61%) children were compliant. Compliance was better in older children and those from urban areas. Children of educated parents and with power more than -1.0 D were more likely to be compliant. Main...

Purpose: To test the basic knowledge of population pertaining to cataract and its treatment and to determine the best method among conventional written, audiovisual and oral presentation by surgeon for informed consent before cataract surgery. Method: Randomized prospective study at the JN Medical College, AMU Aligarh. Patients were divided into 3 groups and pretested by a 12 point multiple choice questionnaire for baseline knowledge. They were subjected to informed consent by conventional written material or audiovisual aid along with written aid or by oral presentation by surgeon along with written and audiovisual aids respectively. Post-test by same questionnaire was taken to find out gain, retention and recall of knowledge by the patient and identify the best consent practices for cataract surgery. Results: Of the 126 patients enrolled, 3 randomized groups of 42 each were pretested and administered informed consent. The baseline knowledge of patients was similar before consent i...

Introduction Methodology Results Conclusion References Citation Tables / Figures Corresponding Author Dr M. Athar Ansari, Professor, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh-202002, India E Mail ID: atharansari777@rediffmail.com

Non-communicable diseases (NCDs) are responsible for almost 70% of all deaths worldwide. Almost 75% of all NCD deaths, and 82% of the 16 million people that died prematurely, or before reaching 70 years aged, occur in low and middle-income countries. The epidemic of NCDs including heart condition, stroke, cancer, diabetes, and chronic lung disease poses devastating health consequences for people, and threatens to overburden the health systems. In finances starved countries, the costs associated with NCDs make the management of these diseases a major development concern for the 21st century.[1]