Vol 8, Issue 4, Oct-Dec, 2018

World Health Organisation’s (WHO) End TB Strategy has set the target for TB elimination globally at 2035.1 But India has set its own target for TB elimination a decade earlier that is at 2025. With 17% of the world population, India contributes to a quarter of TB cases of the world; the incidence of TB being 204 per lakh population with 31/lakh dying due to TB every year.2 To eliminate TB means to reduce the incidence to less than 10 cases per 100,000 population.1 The reduction from 204 to less than 10 is an uphill task for the Revised National Tuberculosis Control Programme (RNTCP). Though RNTCP still retains some vertical structure, it is mostly integrated with the other programmes in the health system under the National Health Mission. Therefore the success of the programme depends to a great extent on the health infrastructure and manpower available in the states. To be more specific, elimination of TB will be determined by the performance of the states and the country in the six components of the health system.

Background: In critical illness blood levels of trace elements vary with the acute phase reaction. Quantitative estimation of it (Serum Selenium and Serum Zinc) can be used as prognostic markers. Aim and Objective: To evaluate the correlation between trace elements and sepsis and correlate it with various other prognostic markers with mortality in sepsis. Materials and Methods: It was a prospective, observational study. One hundred and fifty patients of sepsis were enrolled after using inclusion and exclusion criteria for study. Serum Selenium and Zinc were done by Perkin-Elmer Optima ICP spectrometer. Results: One hundred and fifty patients of sepsis due to various pathological causes included in study. Mortality was 37.34%. APACHE II (33.23±5.93) and SAPS II score (67.43±10.55) was found to statisticallysignificant in predicting the mortality (p<0.001). Serum selenium in expired group of patients was found to be lower (38.26±20.82) as compared to survivors (44.34±18.99). Similarly serum zinc also appears to be lower amongdeceased (65.90±54.72) as compared to survivors (71.94±54.29) but this difference was not statistically significant. Conclusion: Our study shows that the patients with sepsis with lower level of serum selenium and serum zinc have poor outcome, but levels fails to correlate with severity of illness and death statistically. Key words: Trace elements, Sepsis, Selenium, Zinc.

Introduction: Hypertension is a serious public health problem, globally and can be controlled by proper adherence to medications and lifestyle modifications. Though the efficacy of exercise in lowering blood pressure is a proven fact, little is known about the knowledge and practice of exercise in hypertensive. This study aimed at assessing the knowledge and practice of exercise in the hypertensive patients and finding the correlates of the knowledge. Materials and Methods: This hospital-based, cross-sectional study was done among 400 hypertensive patients attending NCD clinic at tertiary care hospital and 5 CHCs of Jamnagar district of Gujarat from July 2013 to June 2014 .50% of the sample was collected from the tertiary care centre where as remaining 50% were selected from 3 selected CHCs by simple random sampling technique. Pre-tested semi structured proforma was used to collect information from participants by one to one interview. Results: The majority (67.5%) were not aware regarding the benefits of exercise in hypertension and only 8.3% exercised. Patients who were exercising had 9.39 times more odds of higher knowledge of its benefit as compared to those who were not (p<0.05). The most common form of exercise was walking (87.9%). Majority (90.9%) practised for less than 30 min/day while only 27.3% exercised for at least 5 days/week. Younger the age group, more aware about benefit of exercise. Same was observed for male gender, urban area residence. Conclusion: Exercise is a cornerstone of such self-care behaviours, however knowledge and practice of exercise were found to be poor in the present study. Proper communication and motivation by health professional especially focussing on high risk groups observed in this study is of utmost importance. Key words: Hypertension, Non-communicable diseases, NCD.

Objective: To study the knowledge, attitude and practices of breast cancer among the women of Chhattisgarh for identifying their knowledge gaps about breast cancer symptoms, risk factor and screening methods. Methods: (i) Design: Cross sectional descriptive study. (ii) Setting: Women registered outdoor clinics of surgery department of a Medical College and Hospital, from Sep 2016 to March 2017. (iii) Sample Size: Participants number was 500. (iv) Participants: Women > 18 yrs except those suffering from breast cancer. (iv) Main outcome variables: level of breast cancer knowledge, source of knowledge and correlation of knowledge with participant demography. Conclusion: There were wide knowledge gap for breast cancer symptoms, risk factor and screening methods in women. The lack of knowledge about symptoms, risk factor and screening methods cause delay in the diagnosis of breast cancer. Clinical breast examination by health care personnel (doctors, nurses, multipurpose health worker) in women > 35 yrs; and training for breast self-examination can be introduced as a mandatory policy for women attending out door clinics. Key words: Breast cancer awareness, Breast self-examination, Knowledge attitude behavior and practices for breast cancer, KAP Survey Breast Cancer, KAPB survey on breast cancer India.

Introduction: Usually Perinatal Mortality Rate [PMR] constitutes a proportion of IMR. But in Karnataka State of India it is almost equal to IMR. A field based study exploring and comparing the Maternal and Child Health Care Facilities in a well-developed district and backward district of Karnataka State would help in understanding the reasons behind this. So, this study was undertaken. Objectives: 1]. To know the infrastructure and facilities that exist for the perinatal care in two districts of Karnataka. 2]. To know the deficiencies in Infrastructure and facilities if any in the 2 districts. Methodology: A Field based study was conducted in 2 districts of Karnataka State. Maternal and Child Health Care Units which met our criteria in Dakshina Kannada and Koppal Districts were included. Checklists were developed to evaluate the facilities present in these health care units. Trained field workers collected the data from the health care facilities of both the districts. The collected data was scrutinized by the investigators. Results are presented as frequencies and proportions in appropriate tables. This being a qualitative data, the implications have been explained. Results: Totally 63 and 65 Health care facilities met the criteria in Dakshina Kannada and Koppal Districts respectively. Dakshina Kannada District showed a predominance of Private Health Care Facilities [52 out of 63]. Koppal District showed a predominance of Public Health Care Facilities [40 out of 65]. The deficiencies in Health care facilities of both the districts increase the chance of Perinatal Deaths. Conclusion: This study helped in understanding the deficiencies in Health Care facilities. But studies exploring the functioning of these facilities and the Health care Personnel would be necessary. Key words: Perinatal Deaths, Maternal and Child Health Care Facilities, Dakshina Kannada District, Koppal District.

Context and Aims: Antepartum depression in women is common and is of immense public health importance, as it can adversely affect both the mother and child; therefore it is necessary to identify women suffering from antepartum depression. The associated risk factors can be used for the screening to identify and manage the problem in time. This study was planned to evaluate women attending the hospital for Antepartum depression and to identify the probable risk factors. Methods and Materials: Pregnant mothers in second and third trimester coming for antenatal checkup Inclusion-criteria: All Antenatal women willing to participate in study. Exclusion-criteria- H/O any psychotic disorder, diabetes,any obstetric complication. Sample-size: 665, Sampling-Technique: Two stage sampling: Hospitals selected randomly. Purposive sampling for Study-subject. Study-duration: 6 months Study-tools: i. Edinburgh Postnatal Depression Scale [EPDS]. ii.Pre designed, pilot tested questionnaire. Results: There were 665 mothers with age ranging from 18 to38 years, mean 25.42± SD 3.57. Possible depression (EPDS score ≥ 10) was present in 71 (10.7%) of mothers. Possible Depressionwas significantly high in age 34-38yrs (33.3%, x²=59.02, p=0.00), third gravida (42.9%, x2=83.516, p=0.000), mothers with 5-10std education (20%, x²=7.723, p=0.02), in employed women (33.9%, x²=42.62, p=0.00), in mothers whose husbands with 5-10 std education (18.2%, x²=16.98, p=0.000), in joint family type (14.5%, x²=6.917, p=0.009), having previous female child (92.9%, x²=71.626, p=0.000), financial constrains (50%, x²=6.52, p=0.011) and stressful life events (71.4%, x²=27.37, p=0.00). Strong Predictors of antenatal depression were employed mothers and female sex of previous child. Conclusion: Possible antepartum depression was common as nearly 11% of mothers were having EPDS score above or equal to 10. Risk factors were previous female child and mother working as a employee. Key words: Antepartum Depression, EPDS score, Risk factors for antepartum depression. Key Messages: Antenatal depression is common in antenatal women with risk factors like having a previous female child and employed mothers. Mothers with these strong predictors can be screened for possible depression and managed.

Child abuse and neglect, i.e. maltreatment usually are common to under 18 children globally. It varies from physical, mental and social ill-treatment which harms the child. It has short-term and lifelong consequences which can ultimately slow down the countries social and economic development indirectly. It is estimated that 1 in every 5th women and 1 in 13th men reported being sexually abused during their childhood.Though the issue is quite complicated and apparently the above figure underestimates the actual value. Mostly, it is due to disruption of the social fabric in a community. Extensive failure by the pillars of the community like schools, institutions, families, to timely notify and take action against proper authorities to maintain high status of their organisation and avoiding to be stigmatised. This case study describes how a school girl was sexually exploited and how the intersectoral coordination could prevent it. Key words: Child abuse, Sexual abuse, Health promotion.