Indian Journal of Community Medicine (Indian J Community Med )

Publisher: Indian Association of Preventive & Social Medicine, Medknow Publications


Published Quarterly at Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh-160012, India

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  • Website
    Indian Journal of Community Medicine website
  • Other titles
    Indian journal of community medicine (Online)
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  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Medknow Publications

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    • Author can archive a post-print version
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    • Non-commercial
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  • Classification
    ‚Äč green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Accepted - In Press
    Indian Journal of Community Medicine 08/2014;
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    ABSTRACT: Context: Assam's main lifeline, the Brahmaputra river, braided nature created numerous sand bars and islands known as chars/sapories. They are home to more than 3 million people. Over 90% of the cultivated land on the river islands is flood-prone; the flood leaves the islands completely separated from mainland, preventing access to health infrastructure and services. Aims: To assess the nutritional status of under 5 children residing in the char areas of Dibrugarh district and to identify the factors influencing their nutritional status. Settings and Design: A community-based cross-sectional study conducted in the riverine areas of Dibrugarh district of Assam. Materials and Methods: Nutritional status was assessed using anthropometry. Undernutrition was classified using World Health Organization (WHO) recommended Z- score system. Data collection was done by house to house visit of all chars using proportionate allocation. Statistical Analysis Used: Rates, ratios, proportions, and chi-square test. Results: Overall prevalence of underweight, stunting, and wasting was 29%, 30.4%, and 21.6%, respectively. Prevalence of underweight and stunting was less than the prevalence of underweight (36.4%) and stunting (46.5%) in Assam, but the prevalence of wasting was more than that of Assam (13.7%) as observed in National Family Health Survey-3. Significant association was observed between the prevalence of undernutrition and socioeconomic status, literacy status of parents, infant, and young child feeding practices and size of the family (P < 0.05). Conclusions: Special focus is needed for nutritional improvement of under 5 living in char areas to prevent preventable morbidities and to achieve optimum development.
    Indian Journal of Community Medicine 07/2014; 39(3):169-174.
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    ABSTRACT: Multiple choice questions (MCQs) are frequently used to assess students in different educational streams for their objectivity and wide reach of coverage in less time. However, the MCQs to be used must be of quality which depends upon its difficulty index (DIF I), discrimination index (DI) and distracter efficiency (DE). To evaluate MCQs or items and develop a pool of valid items by assessing with DIF I, DI and DE and also to revise/ store or discard items based on obtained results. Study was conducted in a medical school of Ahmedabad. An internal examination in Community Medicine was conducted after 40 hours teaching during 1(st) MBBS which was attended by 148 out of 150 students. Total 50 MCQs or items and 150 distractors were analyzed. Data was entered and analyzed in MS Excel 2007 and simple proportions, mean, standard deviations, coefficient of variation were calculated and unpaired t test was applied. Out of 50 items, 24 had "good to excellent" DIF I (31 - 60%) and 15 had "good to excellent" DI (> 0.25). Mean DE was 88.6% considered as ideal/ acceptable and non functional distractors (NFD) were only 11.4%. Mean DI was 0.14. Poor DI (< 0.15) with negative DI in 10 items indicates poor preparedness of students and some issues with framing of at least some of the MCQs. Increased proportion of NFDs (incorrect alternatives selected by < 5% students) in an item decrease DE and makes it easier. There were 15 items with 17 NFDs, while rest items did not have any NFD with mean DE of 100%. Study emphasizes the selection of quality MCQs which truly assess the knowledge and are able to differentiate the students of different abilities in correct manner.
    Indian Journal of Community Medicine 01/2014; 39(1):17-20.
  • Indian Journal of Community Medicine 01/2014; 39(1):3-7.
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    ABSTRACT: In India, the opportunities for professional education of the grass root level health workers are grossly inadequate. Capacity building of all categories of health workers is needed for enhancing health outcomes. To plan and implement a professional development training program for all categories of allied health workers and to assess its outcomes in terms of knowledge and skills. We planned and organized a 'one week'(15 h) training program for 10 categories of allied health workers (1260) working in our hospital. The program included nine generic skills/topics: the prestige of AIIMS, sterilization & infection control, universal precaution, biomedical waste management, public health, life style & healthy nutrition, fire safety, communication skills and office procedure besides subject specific skills. Trainers were drawn from 12 departments. Training methodology included interactive lectures, narratives, demonstrations, videos, PPT slides, and informal discussions with participants. The effectiveness of the program was judged on the basis of participants' feedback, feedback from the supervisors, and our own observations post training. Feedback from the participants and their supervisors after training was encouraging. The participants described training as a "life time experience". The supervisors reported improvement in confidence, communication skills, and awareness of workers. The success of the program was due to the use of interactive methods, involvement of multidisciplinary team, and commitment from leadership. We recommend that professional education should be linked with career advancement. Academic institutions can play a key role in taking such initiatives.
    Indian Journal of Community Medicine 01/2014; 39(1):38-42.
  • Indian Journal of Community Medicine 01/2014; 39(1):47-8.
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    ABSTRACT: Mental health is an important component of the total positive health and is interwoven closely with the physical and physiological dynamics of the human body. Worldwide, about 500 million people are believed to be suffering from neurotic, stress related and psychological problems. In India, surveys on mental morbidity in various parts of the country suggest a prevalence rate of 18-20 per 1000. A community-based, cross-sectional descriptive study was carried out amongst married women in the age group 18-45 years in an urban community of South Mumbai. Self-reporting questionnaire of 20 items (SRQ 20) developed by the WHO was administered. Statistical analysis was carried out to estimate the prevalence of psychiatric disturbance. The prevalence of psychiatric disturbance was found to be 27.27% for the total sample. The study results indicate that somatic symptoms were reported more commonly which could be a manifestation of underlying/burgeoning mental disorders. The results imply a high prevalence of 27.27% of psychiatric disturbance in our community. However, defining mental disorder from a clinical standpoint necessitates identification of the dividing line between despair and depression. It is recommended that women be encouraged to approach counsellors and thus enable further diagnosis and management of Common Mental Disorders in the community.
    Indian Journal of Community Medicine 01/2014; 39(1):43-6.
  • Indian Journal of Community Medicine 01/2014; 39(1):49-50.
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    ABSTRACT: Expansion in road network, motorization, and urbanization in the country has been accompanied by a rise in road accidents leading to road traffic injuries (RTIs). Today RTIs are one of the leading causes of deaths, disabilities, and hospitalizations with severe socioeconomic costs across the world. The following study analyses the: Age and sex distribution of injured in road traffic accidents (RTAs).Circumstances leading to RTA.Pattern and severity of injuries sustained in RTAs cases. Retrospective record-based study. The aim of this study was to audit retrospectively the circumstances, severity, and pattern of injury sustained by vehicle occupants presenting to the Saraswathi Institute of Medical Sciences (SIMS) hospital Hapur, for a period of one year. Data were collected using the case sheets of 347 patients from the medical records section of hospital and analyzed using SPSS computer software version 16.0. Results are interpreted in terms of percentage, mean, chi-square, and z-test. The pattern and severity of injuries sustained by 347 vehicle occupants admitted to the emergency department of SIMS, Hapur were retrospectively documented. Male victims 258 (74.35%) were more commonly involved than females 89 (25.65%) and majority of victims 141 (40.63%) were in age group of 20-30 years. Urban victims 222 (64.00%) outnumbered rural. The most frequently injured body regions were the extremities 499 (53.54%), followed by maxillofacial180(19.31%).. Out of total 802 external injuries, the most common type of injury was lacerations 307 (38.28%), abrasions 306 (38.15%)and followed by bruises 154 (19.20%). Multiple external injuries were more common on upper limb 216 (26.93%), lower limbs 210 (26.18%) and face 170 (21.20%), while crush injuries were more predominently seen in both the limbs. While laceration were common on face 120 (38.83%). Injuries to the chest 19 (2.36%), abdomen13 (1.61%), and spine 11 (1.36%) were seen in roughy equal proprotion of victims. The bones on right side 55 (55.55%) were more commonly fractured which is statistically significant. Skull injuries were mostly found on frontal 77 (47.53%), followed by parietal bone 33 (20.37%), mostly on right side. RTAs constitute a major public health problem in our setting. Urgent preventive measures targeting at reducing the occurrence of RTAs are necessary to reduce the morbidity and mortality resulting from these injuries.
    Indian Journal of Community Medicine 01/2014; 39(1):30-4.
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    ABSTRACT: Maternal mortality ratio (MMR) is an indicator of effectiveness of health care facilities for women of child bearing age group. Andaman and Nicobar (A&N) group of islands are unique as they are situated 1200 km from the mainland India. Healthcare delivery for the these islands is exclusively provided and controlled by only one authority, Directorate of Health Services, A&N Islands. GB Pant Hospital, Port Blair is the only referral hospital with round the clock specialists and surgical services. To estimate the MMR in A&N islands from 2001 to 2010, and study the causes of maternal mortality. Retrospective. Data for the estimation of MMR were collected from office of Registrar of Births and Deaths, Hospital and Peripheral Health Centres. Case records of maternal deaths in GB Pant Hospital were reviewed to study the causes of death. Proportions and Ratios. Ten years average MMR for the entire island was 85.42. Analysis of 30 maternal deaths in GB Pant Hospital showed that 63.3% were due to direct obstetric causes (eclampsia 30%, hemorrhage 23.33%, sepsis 6.66%, and 3.33% amniotic fluid embolism). Of the indirect causes, anemia was the commonest (16.66%). The MMR of A&N islands is much lower than the national average of 250. Direct obstetric causes accounted for more than half of maternal deaths 63.33%.
    Indian Journal of Community Medicine 01/2014; 39(1):35-7.
  • Indian Journal of Community Medicine 01/2014; 39(1):8-12.
  • Indian Journal of Community Medicine 01/2014; 39(1):1-2.
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    ABSTRACT: Infant death depends upon the care during the infancy and also upon the service utilization during antenatal and intra-natal periods and with its decline, it is necessary to find the under-reporting if any and identify the most appropriate agency for its reporting. (1) To document disparities between different reporting systems about infant deaths and find out the under-reporting if any and identify the most appropriate agency and (2) To identify utilization of health services during ante, intra and post-natal period for all infant deaths. Study was conducted in 51 villages of 3 Primary Health Centers (PHCs) from a tribal dominated Taluka (block) of South Gujarat during September - November 2005. Information was gathered for 1 year (1 September 2004 to 31 August 2005) from 4 sources namely health care system, Integrated Child development services (ICDS) scheme, Civil Registration System (CRS) and Investigator himself (Gold standard). Data was collected in a designed verbal autopsy questionnaire by house to house survey and analyzed in Epi Info. A total of 48 infant deaths were recorded by investigator against reported 2, 10 and 8 infant deaths by CRS, Health System and ICDS respectively. While profiling these 48 infant deaths it was found that only 29.2% mothers received full antenatal care (ANC) and 60.4% delivered at home (by untrained personnel). Not a single delivery was done at PHCs or its sub centers (SC). In 25% cases there was poor cord care. 39.6% mothers did not breastfeed and 35.4% gave pre-lacteal feeding. There was gross underreporting of infant mortality in all 3 agencies. The utilization of ANC and post natal care (PNC) services was poor in these death cases. Health system and ICDS need to be sensitized to work in coordination to provide quality ANC, INC and PNC to prevent such avoidable infant deaths.
    Indian Journal of Community Medicine 07/2013; 38(3):152-6.
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    ABSTRACT: To study the feasibility of use of color-coded rings as a proxy for partograph for early identification of slow progress of labor. Color-coded rings were devised as a tool using appropriate technology to translate the partographic principles into simpler, easy to understand methodology. The rings were in pairs of 4 colors i.e., red, blue, yellow, and green, ranging from 3 cm to 10 cm in diameter with a difference of 4 cm between rings of the same color. The midwife performed p/v examination of the woman in labor to assess the initial cervical dilatation and identify corresponding ring. P/V was to be repeated after 4 hours to reassess the cervical dilatation and compare it with the bigger ring of the same color indicating expected cervical dilatation. If existing cervical dilatation measured lesser, it was interpreted as slow progress of labor indicating referral. 44 women [23 (22.1%) primis and 21 (13%) multis] showed delayed progress of labor as judged by use of color-coded rings. 20 women (4 primis and 16 multis) showed satisfactory progress or delivered by the time arrangements for referral were made. Use of color-coded rings may serve as a valuable tool based on appropriate technology to assess slow progress of labor not only in the hands of nurse midwives but it also can serve as a training tool for TBAs to help facilitate timely referral of such cases.
    Indian Journal of Community Medicine 07/2013; 38(3):157-61.