Background: With the availability of low-cost mobile devices and the ease of internet access, mobile health (mHealth) is digitally revolutionizing the health sector even in resource-constrained settings. It is however necessary to assess end-user perceptions before deploying potential interventions. Objective: This study aimed to assess the mobile phone usage patterns and the acceptability of mobile phone support during care and treatment in patients with tuberculosis (TB) in South India. Methods: This exploratory study was conducted at an urban private tertiary care teaching hospital and nearby public primary-level health care facilities in Bangalore, South India. We recruited 185 patients with TB through consecutive sampling. Subsequent to written informed consent, participants responded to an interviewer-administered pretested questionnaire. The questionnaire included questions on demographics, phone usage patterns, and the benefits of using of mobile phone technology to improve health outcomes and treatment adherence. Frequency, mean, median, and SD or interquartile range were used to describe the data. Bivariate associations were assessed between demographics, clinical details, phone usage, and mHealth communication preferences using the chi-square test and odds ratios. Associations with a P value ≤.20 were included in a logistic regression model. A P value of <.05 was considered significant. Results: Of the 185 participants, 151 (81.6%) used a mobile phone, and half of them owned a smartphone. The primary use of the mobile phone was to communicate over voice calls (147/151, 97.4%). The short message service (SMS) text messaging feature was used by only 66/151 (43.7%) mobile phone users. A total of 87 of the 151 mobile phone users (57.6%) knew how to use the camera. Only 41/151 (27.2%) mobile phone users had used their mobile phones to communicate with their health care providers. Although receiving medication reminders via mobile phones was acceptable to all participants, 2 participants considered repeated reminders as an intrusion of their privacy. A majority of the participants (137/185, 74.1%) preferred health communications via voice calls. Of the total participants, 123/185 (66.5%) requested reminders to be sent only at specific times during the day, 22/185 (11.9%) suggested reminders should synchronize with their prescribed medication schedule, whereas 40/185 (21.6%) did not have any time preferences. English literacy was associated with a preference for SMS in comparison with voice calls. Most participants (142/185, 76.8%) preferred video-based directly observed treatment when compared with in-person directly observed treatment. Conclusions: Although mobile phones for supporting health and treatment adherence were acceptable to patients with TB, mHealth interventions should consider language, mode of communication, and preferred timing for communication to improve uptake.

Mobile Health for Tuberculosis Management in South India: Is Video-Based Directly Observed Treatment an Acceptable Alternative?

The protection of women from domestic violence act 2005 its implementation in the aligarh district

Background: There is a paucity of data on knowledge, awareness, and practices (KAP) of patients with hypothyroidism in India. Aims and Objectives: To study the KAP and adherence to treatment of participants with primary hypothyroidism. Materials and Methods: An observational cross-sectional study was conducted in Endocrinology Outpatient Department of Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi. Two-fifty consecutive primary hypothyroidism participants, aged ≥18 years, who were on treatment for at least 3 months responded to a structured questionnaire, to assess their KAP about the disease and adherence to treatment. Results: A total of 250 patients completed the questionnaire. The mean age of the participants was 43.24 ± 10.80 years; with majority being females (85.6%). The median duration of hypothyroidism was 8 years (range: 3–10). Most were well educated, with 53.6% being graduates/postgraduates. Knowledge and awareness related to hypothyroidism was poor in majority of participants. Only 35.2% and 51.2% knew correct meaning of the terms “thyroid” and “hypothyroidism” respectively. Only 25.6% participants knew correctly that thyroxine (T4) is used to replace and normalize blood levels of thyroid hormone. Forty percent had false dietary beliefs in the context of hypothyroidism. Ten percent participants felt T4 can be stopped once laboratory reports return to normal. Only 36.4% participants knew correctly that T4 need to be continued during pregnancy. Many participants (30.4%) believed hypothyroidism can lead to weight gain in excess of 10 kg. Regarding adherence, 90.4% participants were adherent to T4, 2.4% were moderately adherent, and remaining 7.2% participants were nonadherent to T4. Conclusion: A large number of patients with primary hypothyroidism lack basic knowledge about disease and have dietary and treatment-related prejudices and poor treatment adherence. Public health measures are required to improve KAP in patients with primary hypothyroidism.

Knowledge, Awareness, Practices and Adherence to Treatment of Patients with Primary Hypothyroidism in Delhi.

Background: Injuries are an important public health problem worldwide, accounting for 5 million deaths, of which unintentional injuries account for 0.8 million deaths in children. Though there are many factors responsible for injury in the home, the environment plays an important role. Objectives: The objectives were to study the magnitude and pattern of home injuries in children aged 0–14 years and to assess the environmental risk associated with home injuries. Methods: A community-based, cross-sectional study was conducted in 2015 in a ward of Mehrauli containing 20,800 households, and the total sample of children was selected from 400 households by systematic random sampling, with sampling interval being 52. Information was taken using a predesigned, semi-structured, pretested proforma from both the parents and children. The data collected were analyzed using SPSS version 12. Results: The prevalence of home injury was found to be 39.7% in the last 1 year, significantly higher in the age group of 1–3 years (54.3%) followed by 5–10 years (45.1%) (P = 0.000). The total number of injuries and the average number of injuries in girls were significantly higher than those of boys. The most common type of home injury was falls (59.5%) followed by injury with sharps and burn injury. The environmental risk was assessed using standard and working definitions and found unsafe electrical points (95.3%), unsafe stairs (100%), unsafe kitchen with access to sharps (29.3%), access to active fire (19.3%), and unsafe furniture and objects (22.8%). Conclusion: Though home injury did not occur in 60% of the children during the study period, the risk of injury in the future is high. Educating the parents and the children at schools and environmental modification are important strategies for prevention of home injury.

An epidemiological study on home injuries among children of 0–14 years in South Delhi

Background. Sleep is important for the growth, development and good health of adolescents. We assessed sleep patterns, hygiene and daytime sleepiness among school-going adolescents in 3 districts of Tamil Nadu. Methods. We conducted a cross-sectional survey among 538 school-going adolescents between the ages of 10 and 17 years, from 8 schools in 3 districts of Thiruvallur, Thiruppur and Namakkal selected through multistage sampling. A questionnaire with items focusing on demographic details, sleep patterns, sleep hygiene behaviour and daytime sleepiness was given to the students for self-administration after obtaining informed consent from their parents and school authorities. Results. Over 64% of adolescents sleep 23% reported use of mobile phone in bed. About 64% of adolescents had at least one form of poor sleep hygiene behaviour. Decreasing age (0.7; 95% CI 0.582–0.843), studying while lying in bed (1.72; 95% CI 1.009–2.942), greater time gap between dinner and bedtime (0.795; 95% CI 0.650–0.972), staying awake late in the night and chatting on mobile phone (2.24; 95% CI 1.266–3.978) and watching TV (3.41; 95% CI 2.037– 5.722) significantly influenced excessive daytime sleepiness. Conclusion. A large proportion of adolescent students have abnormal sleep patterns and sleep hygiene behaviours. There is a need for concerted sleep-related education at the school level.

Sleep patterns, hygiene and daytime sleepiness among adolescent school-goers in three districts of Tamil Nadu: A descriptive study.

"Background: Even in 21st century, very few people really know much about the small thyroid gland located at the back of the neck and its vitally important function. Any dysfunction of the thyroid has profound impact on health and well-being. 
Methods: This cross-sectional study was conducted in September 2014 in 4 different areas of Indore city of MP. 250 females of age group 18-50yrs residing in Indore, belonging to different residential areas. 
Results: In the study 29.2% females do not have heard the word THYROID, 48.8 % females had excessive sensitivity to heat or cold, 25.2 % females had constipation/diarrhoea from long time, 61.2% females had joint or muscle pain/weakness, 69.6 % females had anxiety/depression /mood swing, 39.6 % females had menstrual irregularity, 82.4 % females had problem of hair loss/skin changes, 18.67% females have trouble in getting pregnant/repeated miscarriages/stillbirth Only 49.20% females knew about hyperthyroidism and hypothyroidism, 25.2% females have undergone the thyroid screening test, 55.2% females thought that thyroid disorders could be cured by using alternative medicine. 
Conclusion: In general, the females have inadequate knowledge of thyroid gland, & associated disorders and they had myths and misconception regarding thyroid disorders.
"

Assessment of Knowledge and Awareness Regarding Thyroid Disorders among Women of a Cosmopolitan City of Central India

Background: Domestic accidents are emerging as a new epidemic. They result in significant mortality and morbidity. Majority of the domestic accidents are preventable.

Objective: To study the occurrence of domestic accident and awareness on its prevention in an urban community. 

Materials and Methods: A community-based cross-sectional study was conducted on 300 members residing in an urban area. Complete information was collected through a semi-structured, pretested questionnaire. Domestic accident was considered when any of these individuals had met with an accident inside the house or in the immediate surroundings of the house. The data were analyzed using appropriate statistical software (MS Excel and SPSS, version 20).

Results: This study on the assessment of the level of awareness on preventive measures revealed that 40% respondents used apron while working in kitchen, 58% did not have a first-aid kit in the kitchen; 84% respondents said that subdue fire caused by electricity should be dealt with pouring water on fire; and 56% respondents were unaware that keeping the handle of the pan toward oneself may lead to tipping on contents on them and cause injury. Sixty-eight percent respondents were unaware about the storage of medicines in cool and dry places.

Conclusions: The most common accident reported was cuts. The level of awareness regarding domestic accidents was not high among the residents and hence there is a serious need to address the problem through public health education.

Domestic accidents: an emerging threat to community -

Background: Safe maternity with improved neonatal outcomes is predicated on proper antenatal care services. Exercise has become a fundamental aspect of women's lives and an important constituent of antenatal care.
Objective: To find out effectiveness of antenatal exercise in facilitating normal labor and also other benefits associated with antenatal exercise during pregnancy.
Methodology: A cross-sectional study was conducted in urban area (private clinic and government institution) of Indore district where antenatal exercise facility was available. Samples were selected using sequential sampling method. Sample size included 200 females (100 performing antenatal exercise and 100 non exercising females). Inclusion Criteria included all the recently delivered females practice exercise or not during their pregnancy, stand in age group of 20 to 35 years, not had any history of medical condition like Asthma, Diabetes, Hypertension, Bad obstetric history, Cephalo-pelvic disproportion and Twin pregnancy, and gave informed consent to participate in study. A semi structured questionnaire was used as study tool for interview. Chi square test was applied for significance association between variable.
Result: In this study, only 36% group B females were delivered normally, as compared to 74% group A females who delivered normally. In group A only 9% females had urinary incontinence after delivery and 30% females had complain of backache. Major source of information (87%) for females were gynecologist. Main reason for not doing antenatal exercise was not having enough time (42%) followed by not having enough knowledge (31%).
Conclusion: Females practiced antenatal exercise had less chances of caesarean section, back ache and urinary incontinence. Gynecologists were major source of information for antenatal exercise.

Effect of Antenatal Exercise on Outcome of Labor

Background: Domestic violence against women is widely recognized as important public health problem, owing to its substantial consequences for women’s physical, mental and reproductive health. This study tried to assess the frequency and patterns of domestic violence against women experienced by attendees of Domestic Violence counselling centre Department of Psychiatry, MY Hospital, Indore.
Aims & Objective: To study the nature and causes of domestic violence.

Material and Methods: Cross sectional study using a pre designed pre tested semi structured questionnaire was carried out and the data were analyzed using MS excel.

Results: Most common type of domestic violence faced is physical (80%) followed by mental (8%), social (8%) and sexual (4%). Monetary issues (26%) and alcoholism (22%) are the two most important causes of domestic violence, other causes being extra marital affair (6%), Family conflicts (6%) and dowry (6%). 64% victims were either illiterate or primary pass; 34% were skilled workers; 56% victims had their per capita income between ` 980 and 2935; 76% had their modified Kuppuswami score between 5-10. 56% victims face domestic violence daily.

Conclusion: Monetary problems, alcoholism, illiteracy, extramarital affairs and dowry are the major causes of domestic violence. The victims most commonly face physical violence by their partners daily. There is an urgent need of more and more domestic violence counseling centers throughout the country.

/pdf/a-study-of-the-nature-and-causes-of-domestic-violence-among-24phb0gr1b.pdf

A study of the nature and causes of domestic violence among the attendees of a domestic violence counseling center of a tertiary level hospital of a city of central India

Background: It is well known that Medical education is highly challenging and mind exhausting field which affect the mental health of Medical students. Stress is an external constraint which upsets an individual both mentally and physically and Medical education is perceived as stressful. The postgraduate students of Medical field suffer from higher stress that definitely affects the mental wellbeing of these students.
Methods: This cross-sectional study was conducted in January 2014 on 300 Medical students to assess the level of stress, anxiety and depression in Postgraduate Medical aspirants, belonging to different Medical Colleges of Indore with the help of Pre-designed semi-structured questionnaire schedule. Graded using Mental Health Inventory Scale.
Results: It was found in present study that out of randomly selected 300 students, 24% students had depression, 42% had anxiety, 27% experienced change in behaviour, only 35% had general positive effect & life satisfaction and 49% had emotional ties.
Conclusion: The present study concluded that depression, stress and anxiety are the major growing mental problems among the medical post graduate aspirants students. Student counselling services need to be made available and accessible to come out from this morbidity.

Keywords: Depression, Stress, Anxiety, Postgraduate Medical Students, MHI 38

https://www.ijfcm.org/journal-article-file/2137

Suraj Sirohi

Papers

Assessment of Knowledge and Awareness Regarding Thyroid Disorders among Women of a Cosmopolitan City of Central India

Domestic accidents: an emerging threat to community -

Effect of Antenatal Exercise on Outcome of Labor

A study of the nature and causes of domestic violence among the attendees of a domestic violence counseling center of a tertiary level hospital of a city of central India

Assessment of Stress, Anxiety and Depression among PG Aspirants of Medical Colleges of Indore City