Western Maharashtra Research Articles

Disease Patterns among rural residents—An Explorative Qualitative Study with Physicians in Private Practice of a Village in Western Maharashtra, India

Disease Patterns among rural residents—An Explorative Qualitative Study with Physicians in Private Practice of a Village in Western Maharashtra, India

Is occupation the "driving force" for tobacco consumption? A cross-sectional study to assess prevalence, patterns, and attitude towards tobacco use among long-distance bus drivers and conductors in Western Maharashtra.

Background:Tobacco use remains a major cause of preventable deaths worldwide. The recent Global Adult Tobacco Survey 2016–2017 has shown the prevalence of tobacco use among Indian population to be 28.6%. In Maharashtra, 35.5% of all adult males either smoke tobacco or use some form of smokeless tobacco. Not much data are available on tobacco use with respect to different occupations in India, though risk of tobacco use is known to be higher among individuals in certain occupations.Methods:This cross-sectional descriptive study was conducted among 190 long-distance bus drivers and conductors of long route buses departing from one of the main bus stations of the State Transport Corporation in Pune city. Data were collected using a pretested, structured questionnaire by interview method.Results:Prevalence of tobacco consumption (TC) among the respondents was 55.8% (95% confidence interval; 48.4–63). Among the tobacco users, 54% reported initiation at age <18 years “peer pressure” and “curiosity” were the main reasons for initiation while “feeling alert” and “feeling mature” were reasons for continued use. A large proportion (74.5%) of the respondents expressed their intention to quit tobacco in the near future.Conclusion:Long-distance bus drivers and conductors showed a high prevalence of TC which may be linked to certain occupation-related factors. Targeted tobacco cessation activities at workplaces may be considered as a strategy for better impact of tobacco control activities in India.

Correlation and comparison of dactyloscopy and palatoscopy with blood groups among dental students from Western Maharashtra

Background: Identification plays a major role in any crime investigation. Study of finger prints (Dactyloscopy) and palatal rugae patterns (Palatoscopy) have been recognized and accepted as gold standard for personal identification worldwide. Yet another biological record that remains timeless throughout the lifespan of a person is the blood group. Research works have been carried out on Dactyloscopy/Palatoscopy and blood groups independently. However, studies focusing on correlation and comparison of both these parameters have not been undertaken to a great extent. Aim: The aim of the present study is to correlate and compare Dactyloscopy and Palatoscopy with blood group among dental students from western Maharashtra population. Materials and Methods: A total of 200 dental students with age group ranging between 18-25 years with known blood group were included in the study. Finger print, Palatal rugae patterns were obtained and compared and the data was subjected to Excel sheet 2016 and Chi square test. Results: There was significant association between finger print patterns and ABO - Rh factors (χ2 statistic= 30.6, P value = 0.05). Conclusion: Hence, the study concluded that finger prints rather than palatal rugae when correlated with suspect's specific blood group - Rh factor can be used to narrow down the suspect list and can also prove significant in identifying individuals in case of any disaster. Though the comparison of palatal rugae and finger print with blood group - Rh factor yielded no result.

Determinants of the “know-do” gap regarding contraceptive use among married women of an urban slum in Western Maharashtra

Context: The importance of family planning to promote the health and welfare of the family group and thus contribute effectively to the social development of a country cannot be overemphasized. It is achieved through the use of contraceptive methods. Despite being the first country to launch the Family Welfare Program in 1952, India has not been able to achieve the desired population levels. Aims: The aim was to study the knowledge and practices related to contraceptive use among married women in reproductive age group living in an urban slum with the objective of assessing the factors responsible for the use and nonuse of contraceptives. Setting and Design: A cross-sectional survey was conducted among 300 married females in the reproductive age group of an urban slum. Subject and Methods: This was an interviewer-based study using a prevalidated questionnaire. Results: Out of the 300 respondents, 150 (50%) respondents had two children, 179 (64.1%) had delivered their first child within 1 year of marriage, and 106 (35.3%) had delivered their first child as teenagers (before 19 years of age). A total of 295 (98.3%) respondents had some knowledge of the contraceptives. The preferred method of contraception was tubectomy among 118 (41.7%) respondents. A total of 139 (47.1%) respondents had preference for having a male child. The main reasons cited for not using contraception was want of more children and fear of side effects. Conclusion: Our findings suggest that there is an obvious “know-do gap” as there was a wide discrepancy between the knowledge and practice of contraceptive usage. Knowledge about contraceptives was universal in our study; however, the contraceptive users were only 52.7%.

Knowledge, awareness, and practices in relation to potentially malignant disorders of the oral cavity in a rural area of Western Maharashtra, India

Background: It has been well established by researchers that virtually all oral cancers are preceded by visible clinical changes in the oral mucosa mostly in the form of white or red patch. The prevention and early detection of such potentially malignant disorders (PMDs) have the potential of not only decreasing the incidence but also in improving the survival of those who develop oral cancer. The lack of knowledge and awareness of public about the signs, symptoms, and risk factors is responsible for the diagnostic delay in identifying the PMDs. This study aimed to evaluate the knowledge, awareness, and practices in relation to the early detection of PMDs. Materials and Methods: It was a cross-sectional, community-based survey where 600 participants were enrolled in the study. A semi-structured preset, pretested questionnaire was used to elicit information about tobacco-associated oral habits, their knowledge and awareness toward PMDs, and to elicit information regarding practices in relation to these deleterious oral effects. The results obtained were statistically analyzed using the SPSS (version 11) software and Chi-square test. Results: This study showed that there is a lack of knowledge and awareness about the early signs and common symptoms of PMDs. The level of knowledge and awareness was directly proportional to the education level, whereas it was inversely proportional to the prevalence of risk habit. Conclusion: Lack of knowledge and awareness of early signs of oral cancer and oral PMDs was observed in studied population. As their general awareness about oral cancer and oral PMDs was good, a redirection of focus is warranted toward implementing intensive oral health education programs for the recognition of risk habits, warning signs of PMDs, and early detection of oral cancer.

Prevalence of oromucosal lesions in relation to tobacco habit among a Western Maharashtra population.

This study was conducted to determine the number and types of oromucosal lesions (OMLs) in relation to tobacco habits in patients who attended the outpatient department. A total of 1730 patients visiting the Department of Oral Medicine and Radiology were interviewed and screened for tobacco habits (smoking and smokeless). Clinical oral examination was conducted with diagnostic instruments using the Color Atlas of Common Oral Diseases as a guide for diagnosis. When clinical features were not diagnostic, a biopsy was done. Of the 1730 outpatients, 975 (56.3% ) individuals used tobacco in one or other forms and 687 (70.4%) of these had OMLs. The results of this study provide important information on the prevalence of OMLs in patients seeking dental care. This provides baseline data for future studies on the prevalence of oral lesions in the general population.

The effect of nuchal cord on mode of delivery and neonatal outcome in a semi-urban area of western Maharashtra

The effect of nuchal cord on mode of delivery and neonatal outcome in a semi-urban area of western Maharashtra

Various addiction patterns, dietary habits, associated medical problems, and socioeconomic status in gastrointestinal malignancies: A prospective study in rural area of Maharashtra, India.

Gastrointestinal (GI) malignancies are increasing with advancing age. Various addictions and poor dietary habits are among the major risk factors. Early detection is difficult until patient notices symptoms. Primary prevention by knowing various risk factors and early symptom awareness will help in early diagnosis and better treatment outcome. This study is carried out to see various addiction patterns, dietary habits, associated medical problems, and socioeconomic status with various sites involved in GI malignancies, at a tertiary care teaching hospital of Western Maharashtra, India. Prospective questionnaire-based study was carried out for 11 months. A total of 100 diagnosed carcinoma cases of GI tract malignancy were taken for study. Out of total 100 cases, 61 were male and 39 were female. The most common site involved was esophagus (41) followed by rectosigmoid, colon and cecum, stomach, and anal canal (29, 14, 13, and 3, respectively). There were 45% of cases above 60 years of age. The most common addiction was smokeless tobacco. Most of the patients belonged to lower and upper lower class (64%). Majority of cases (81%) were nonvegetarian, only 16% were pure vegetarian. Most of the cases (85%) were in advanced stage of disease (III and IV). Awareness program for harmful effects of various addictions and importance of high-fiber diet (vegetarian diet) will help in health promotion and prevention of various malignancies. Awareness about the early symptoms of GI malignancy will help in early detection of disease and better treatment outcome.

Knowledge, attitude, and practice regarding risk factors and lifestyle modifications in people with coronary artery disease in a rural area of Western Maharashtra

Aims: This study was done to assess knowledge, attitude, and practice (KAP) regarding risk factors and lifestyle modifications among people with coronary artery disease using a self-validated questionnaire. Design: It was a cross-sectional study. The sampling type was simple random sampling. A sample size of 82 was obtained. Methods: A self-validated questionnaire was used to conduct the survey. Informed consent was obtained from participants before filling of the questionnaire. Statistical Analysis: Frequency and percentages were calculated. Results: Only a few respondents had knowledge regarding exercising in exercise class/gym and that walking and gardening cannot be considered as exercises. A similar trend was seen for practice where few percent of the participants exercised for more than 20 min 3 days/week and under the supervision of a physiotherapist. An overall fair attitude was seen toward lifestyle modifications among the respondents. Conclusion: From this study, it was concluded that the lack of knowledge regarding certain factors also influenced the attitude and practice toward it. Furthermore, despite having knowledge regarding certain factors, people showed less willingness to make lifestyle changes which also affected their practices. Hence, it is necessary to study KAP of the population to educate people better and aid the planning of health promotion activities.

A descriptive study to assess the level of anxiety and depression among alcohol use disorder patient in a tertiary care hospital of Western Maharashtra

Background: Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. In addition to the direct pharmacological effects of alcohol on brain function, psychosocial stressors that commonly occur in heavy-drinking alcoholic patients (e.g., legal, financial, or interpersonal problems) may indirectly contribute to on-going alcohol-related symptoms, such as sadness, despair, and anxiety; the association of alcohol consumption and associated anxiety or depression need to be studied. The objectives of the study were to assess the (1) level of anxiety among the AUD patients and (2) level of depression among the AUD patients. Methodology: A descriptive study to assess the level of anxiety and depression among AUD patients in a tertiary care hospital of Western Maharashtra was conducted on 30 AUD patients from April 03 2018, to April 17, 2018. The Hospital Anxiety Depression Scale (HADS) containing 14 questionnaires, 7 for anxiety and 7 for depression, was administered; the collected data were analyzed and interpreted. Results: The analysis of the score has shown that 60% of the patients had mild anxiety and 40% possessed normal anxiety level in the anxiety component of HADS and 70% of the patients had mild depression and 30% of the patients had moderate depression in the depression component of the HADS. Those patients who have mild anxiety also have a mild or moderate level of depression. Conclusion: Assessment of associated anxiety and depression among AUD patients and subjecting to treatment if required will benefit the treatment compliance of AUD.

Prevalence and determinants of cessation of exclusive breastfeeding among primi-para rural Indian mothers

Background: Breast milk is first, natural and nutritious food for newborn that promote sensory and cognitive development as well as protect against infectious and chronic diseases. The aim and objective of the study was to estimate the prevalence and to point out determinants of cessation of exclusive breastfeeding among rural primi-para mothers.Methods: This is a hospital based cross sectional study conducted at rural tertiary health centre located Western Maharashtra, India in the month of November-December 2017. A total of 140 breastfeeding primi-para mothers were enrolled and interviewed by utilizing pretested questionnaire include socio-demographic data, obstetric and breastfeeding history after written consent. Data were analyzed for inferential statistics using SPSS Version 21.Results: Among 140 eligible mothers, max. 84.2% were in age group 18-24 years with high proportions, 72.8% housewives, 90% literate and 75.7% with joint family structure. Max. 92.1% mothers were institutionally delivered. The overall prevalence of cessation of exclusive breastfeeding was 22.85% with gradual and sudden cessation was 20% and 2.85% respectively. Maternal determinants like insufficient breast milk secretion (37.5%), maternal sickness (12.5%) were highly contributed for cessation of breastfeeding whereas, infant illness, 12.5% respectively. The nuclear family structure, caesarean delivery and low birth weight baby were significantly associated with cessation of exclusive breastfeeding. The risk of cessation of exclusive breastfeeding is of 4.5 and 2.5 times higher with maternal nuclear family structure and infant with low birth weight.Conclusions: Prevalence of cessation of exclusive breastfeeding was low among primi-para mothers residing in rural area of western Maharashtra, India. The nuclear family structure, low birth weight baby have had significant effect on cessation of exclusive breastfeeding.

Trends in growth and instability of major Rabi crops in Western Maharashtra

Trends in growth and instability of major Rabi crops in Western Maharashtra

Trends in growth and instability of major Kharif crops in Western Maharashtra

Trends in growth and instability of major Kharif crops in Western Maharashtra

Nesting Success and Nest-Site Selection of White-Rumped Vultures (Gyps bengalensis) In Western Maharashtra, India

A few breeding populations of White-rumped Vultures (Gyps bengalensis) still survive in pockets of their original vast range in India, having weathered a diclofenac-induced population decline of 99.9% since the early 1990s. These breeding populations are potential sources of recruits, now that the overall population appears to be stabilizing or even recovering in some areas. We studied two White-rumped Vulture nesting colonies in the Raigad district of coastal Maharashtra in 2013–2014, to investigate site-specific nesting success and nest-site selection. Our overall aim was to better understand the capability of these remnant populations to contribute to the stability of vulture populations at a landscape scale. We found that vultures preferred to nest in taller trees. Nest failure was high before hatching but declined thereafter. Overall nesting outcome was unrelated to the distance of the nest from areas of disturbance, but may have been influenced by characteristics of nest trees. The percentage of successful nests was higher in the smaller colony, suggesting that colony size may not be the only best criterion for targeting conservation efforts.

Trends in fertilizer consumption in Maharashtra

The regionwise compound growth rates were estimated for the time periods i.e. pre-WTO period (1960-61 to 1994-95), post-WTO period (1995-96 to 2012-13) and overall period (1960-61 to 2012- 13). During the pre-WTO period the rates of compound growth in consumption of N, P and K at the overall level of Maharashtra were 6.06, 7.11 and 5.87 per cent per annum, respectively. The highest consumption of nitrogenous fertilizers was observed in Marathwada region (10.38 %) while highest consumption of phosphatic (10.38 %) and potassic (9.92 %) fertilizers were observed in western Maharashtra. During post-WTO period the consumption of nitrogenous, phosphatic and potassic fertilizers was lowest in Konkan region with the rate of growth of 0.99 per cent, 1.67 per cent and 2.02 per cent per annum, respectively. For the overall period (1960-61 to 2012-13), the consumption pattern of total fertilizers exhibits variation among all the regions in Maharashtra. The annual compound growth rates in phosphorus and nitrogenous consumption were substantially higher during pre-WTO period as compared to overall period and post-WTO period in Maharashtra State. Wide variations in NPK consumption in various regions was observed may due to variations in soil type, nature of cropping pattern, availability of irrigation, rainfed nature of crops and varied stages of agro-economic development.

Health profile of school children of two schools in Palghar district, western Maharashtra, India

Background: Healthy childhood is basis for healthy and productive adult life. Mortality in school age children is low but morbidity and physical defects constitute major problems. With this background the present comparative study was conducted to explore the nutritional and morbidity patterns among government run primary school children and private school children in Palghar district, Maharashtra.Methods: A descriptive cross-sectional study was conducted during March 2018 in both government school and other private school. Total 400 children studying in class 1 to 4 were included. A pre-designed and pretested questionnaire was used during the interview and clinical examination was carried out to study nutritional status and morbidity pattern among the school children.Results: Out of 400 children, 61 (15.25%) were underweight, 82 (20.5%) were stunted, and 8 (2.0%) were obese. Dental caries was commonest morbidity (55.25%). Two study subjects (1.0%) had suspect cardiac problems.Conclusions: Under-nutrition and morbidities are prevalent in present study. Periodic complete health evaluation should be planned for early diagnosis of nutritional and morbid health problems.

Dissipation of fluopyram and tebuconazole residues in/on pomegranate and soil in western maharashtra

Dissipation of fluopyram and tebuconazole residues in/on pomegranate and soil in western maharashtra

MICRONUCLEI - AS A BIOMARKER OF GENOTOXICITY IN AUTOMOBILE MECHANICS OF WESTERN MAHARASHTRA

Objective: The aim of this study was to assess the potential cytogenetic damage associated with occupational exposure to polycyclic aromatic hydrocarbons (PAHs) among automobile mechanics (AMs) using micronuclei (MNs) and other nuclear abnormalities (NAs) such as binucleate cell (BN), karyorrhexis (KR), and karyolysis (KL) as biomarkers of genotoxicity.Methods: The study was conducted on 60 AMs between age group of 20–40 years who were working in automobile garages for more than 1 year from western Maharashtra, and 60 healthy males with same socioeconomic status were chosen as controls. AMs were divided into three groups based on their duration of exposure, i.e. 1–5 years, 6–10 years, and more than 11 years. The exfoliated buccal cells were obtained and fixed with methanol for 10 min. Then, air-dried and stained it with Giemsa stain. Statistical analysis was done using unpaired t-test for two groups and one-way ANOVA for multiple groups of exposures.Results: The mean values of MN, BN, KR, and KL in AMs (8.20, 13.57, 16.70, and 22.10, respectively) are significantly increased as compared to controls (5.10, 8.82, 12.30, and 16.12, respectively). As the year of exposure increased, the mean values of MN and other NAs were significantly increased in AMs (p&lt;0.05).Conclusion: MN and other NAs reflect genetic changes and events associated with carcinogenesis. Therefore, the results of this study indicate that AMs exposed to PAHs are under risk of significant cytogenetic damage. Therefore, it is important to provide and to create better awareness of occupational hazards among these workers to promote occupational safety.

Drug utilization study in a neonatal intensive care unit of a government tertiary care hospital in Western Maharashtra

Background: Presently drug utilization studies (DUS) are in an evolving era. Current literature search has shown paucity of epidemiological studies in the field of paediatric pharmacology. Hence the present study was designed to assess the drug utilization pattern in neonatal intensive care unit to improvise the current prescription practices, if required and to determine areas in neonatal pharmacology in need of further research.Methods: A prospective, observational study spanned for a period of one year from January 2015 to December 2015 was conducted at the neonatal intensive care unit (NICU), Government teaching tertiary care hospital, Maharashtra. Data of prescribed drugs was collected. WHO prescribing indicators were used for evaluating DUS. Assessment of exposure rates of different class of drugs in different gestational age groups was done. Data were analysed using descriptive studies.Results: Data of 205 neonates, showed male preponderance (53.17%) over female neonates (46.83%). With regard to the gestational age, 47.31% were term, 52.68% preterm. Average number of drugs per encounter was 6.69. 76.29% drugs were prescribed by generic name and 69.80 % drugs were from IAP list of essential medicines for children. Mean drug use was 6.23±3.34 per patient. Most common class of drug to which neonates were exposed was antibiotics (96.10%) and amikacin topped the list with exposure rate of 91.22%.Conclusions: The present study substantiates the need for implementation of institutional antibiotic policies, awareness regarding IAP list of essential drugs for children, prescription by generic name and rational drug use.

Role of line probe assay in detection of extra-pulmonary tuberculosis: Experience from a tertiary care hospital in western Maharashtra

BackgroundDiagnosis of extra pulmonary tuberculosis (EPTB) is challenging due to its atypical clinical presentation and frequently results in a delay or deprivation of treatment. Apart from rapid case detection, early determination of MDR status is imperative in such situations. The commercially available Geno Type MTBDRplus assay version 2.0 (Hain Lifescience, Nehren, Germany) detects both the presence of Mycobacterium tuberculosis (MTB) complex as well as the presence of INH and Rifampcin resistance. We aim to evaluate the role of this test in diagnosis and detection of resistance by comparing its performance against gold standard i.e. culture and against the composite reference standards (CRS) in the diagnosis of EPTB. Material and methodsThe data of 130 EPTB samples processed form January 2014 till May 2017 at Poona Hospital and Research centre were selected for the study. All the samples were processed for Ziehl–Neelsen stain, Geno Type MTBDRplus assay (LPA) and liquid automated culture (BacT/Alert) simultaneously. Geno Type MTBDRplus assay (LPA) was performed directly on the samples. The 24 samples giving positive results on LPA and grown M. tuberculosis on culture were subjected to anti mycobacterial susceptibility testing for 1st line anti-tubercular drugs by BACTEC MGIT 320 system. ResultsOut of 130 samples, 7 samples grew atypical mycobacterium and all the 7 samples turned negative on Line Probe Assay. Direct LPA on processed samples yielded 48/130 (36.9%) positivity. Geno Type MTBDRplus assay was positive for M. tuberculosis in (72.09%) 31/43 culture positive cases and (21%) 17/80 of culture negative cases. Geno Type MTBDRplus assay sensitivity and specificity results were assessed in comparison to CRS made up of culture results and clinical, radiological and histological findings. The overall sensitivity of Geno Type MTBDRplus assay was 45.19% (47/104) and specificity was 94.73 (18/19). Out of 24 samples which were compared for results between LPA and culture, Geno Type MTBDRplus assay accurately identified 3 of 3 of Rifampcin resistant strains and 20 of 21 Rifampcin sensitive strains. Geno Type MTBDRplus assay identified 4 of 4 INH resistant strains and 19 of 20 INH sensitive strains and MDR was obtained for 3 of 3 strains. ConclusionsGeno Type MTBDRplus assay can give early diagnosis and sensitivity for both INH and Rifampcin in extra pulmonary samples. More number of studies is further required to establish Geno Type MTBDRplus assay as an important tool for obtaining diagnosis and resistance to first line drugs in extra pulmonary samples.