OBJECTIVES: The present study was attempted to study the in-patient health care behaviour, particularly choice of health care providers and their determinants. METHODS: An analysis for treatment seeking behavior of 5989 inpatients which implied to 6726 hospitalized cases due to five ailments namely, heart, diarrhea, tuberculosis, urinary and gynecology diseases in India during the last 365 days prior to survey date has been revealed in this paper using data from the 60th round of National Sample Survey, 2004. Multivariate logistic regression model has been adopted to understand the correlates of being inpatients and of opting private hospitals. RESULTS: It is evident that crowded household, being female, having higher educational level, living in lower income households, and living in urban residents have lower chances of being hospitalized compared to their respective counterparts. Maximum people opted for expensive private health sector which accounts for around 59 per cent. This study also reveals that many people had some form of treatment before being an inpatient where 59 per cent had past treatment. CONCLUSIONS: Patients from the highest quintile of MPCE have higher chances of being hospitalized and also of choosing costly private health care sector. Significant differences were found within age, sex, education, residence and monthly per capita consumption expenditure for hospitalization. Older age groups, highly educated and urban patients have higher instances of choosing a private sector.

OBJECTIVE: To determine the sex ratio by birth order and to assess the sex preference of the couples in an urban community. METHODS: A cross sectional study, in an urban community in Manipur, was conducted among the currently married couples. Data on background characteristics of the couple, family pedigree chart (of the offspring) including history of abortion, stillbirth, death of child of the couple, sex preference and Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act [PNDT Act] were collected through a structured interview. Data were analyzed using descriptive and chi-square statistics. RESULTS: There were a total of 1777 births to the 855 couples interviewed. There were 900 females per 1000 males for the 1st birth order but the sex ratio was favorable towards females in the 2nd, 3rd and 4th birth orders. Among both the husbands and wives, being more educated was significantly associated (p<0.05) with preferring lesser number of children, using new technology for sex selection and having heard of the PNDT Act. Majority of those who wanted to use new technology for sex selection (128, 56.6%) preferred to have male child. CONCLUSION: Sex ratio in this community was favorable towards females, though it was less among the first born babies.

OBJECTIVE: To find out the prevalence of psychosocial problems among adolescents. METHODS: A cross sectional study was conducted at Doiwala block, Dehradun during 2006-2007 among 840 adolescents, selected by multistage random sampling. Data was collected on a structured and pre-tested questionnaire by interviewing the adolescents and conducting their thorough clinical examination. Epi Info statistical software package version 3.4.3 was used for analysis. RESULTS: The overall prevalence of psychosocial problems among the adolescents was found to be 31.2%. The psychosocial problems were more in males (34.77%) as compared to females (27.6 %). CONCLUSIONS: There is need of strengthening the existing "package" of services for adolescents in various initiatives and programmes.

Life expectancy is improving steadily but India needs rapid gains in health. Communicable diseases, maternal, perinatal and nutritional deficiencies continue to be important causes of deaths; non-communicable diseases and injuries are also taking a substantial toll of human lives. A basic health care package based on a core set of cost-effective health interventions can address existing disease burden. Its implementation requires increased investment and enhanced health care delivery capacity. Large diversity in India calls for local adaptation of the basic health care package and its delivery mechanism. To encourage accountability, access should be monitored at district level by an independent agency.

The present study was conducted to assess the prevalence of behavioural risk factors of non communicable diseases among urban adult population. The study participants included 531 adults residing in Mata Sundari road, which is an urban colony in New Delhi. They were interviewed using the WHO STEPS 1 questionnaire on lifestyle factors. Smoking prevalence was found to be 18.4% out of which over three fourth smoked more than one packet of cigarettes per day. Almost one third of known hypertensive patients were not on any treatment regimen. 80.6% did not undertake any kind of physical activity. 43% consumed only one serving of green vegetable in a day while 58% included fruits as a part of diet only once or twice in a week. There is a need to develop strong community based lifestyle behavioural intervention programs.

Death certification is believed to be very poor and inaccurate in most of the health institutions in India. A hospital based study on assessing the accuracy in completing the medical certificates of cause of death was conducted in Regional Institute of Medical Sciences (RIMS), Imphal during September to December 2007. Medical Certification of Cause of Death (MCCD) from the Medical Record Section for the period from 1st January up to 31st December, 2006 were audited for errors committed in completing the certificates. Data extracted using a proforma--age, sex, date of death, causes of death as recorded, department. Major error was observed in 38.3% and minor error was observed in 77.6% of the MCCD. Mechanism of death was listed as the cause of death in 21.9% of the certificates. The most prevalent type of error was the absence of time intervals (65.3%).

A community based cross-sectional study involving 168 women of reproductive age was carried out in urban slums of Cuttack city in 2005 to assess the iodine status. Pre-designed, pre-tested schedule was used to collect relevant information & urine samples collected from the study subjects were analyzed by ammonium persulfate digestion method to estimate the iodine level. The median urinary iodine concentration of the study subjects was 64.5 microg/L, 62.5% of study population had iodine deficiency i.e. < 100 microg/L & among them, 74.3% had moderate to severe iodine deficiency i.e. <50 microg/L. Iodine deficiency was significantly higher among women of Muslim religion & Hindu Scheduled Caste & those coming from joint families.

Hypertension is one of the major causes of cardiovascular morbidity and mortality. Community based studies in the rural areas of Tamil Nadu on the prevalence of hypertension and its associated risk factors are scarce. A cross-sectional study was undertaken among a sample of 406 individuals (45-60 years) selected by the standard 30 cluster systematic random sampling technique to find out prevalence of hypertension and its associated risk factors in a rural area of Tamil Nadu. Chi-square test and multiple logistic regression were employed using SPSS package. The overall prevalence of hypertension was 33% and higher among sedentary type (41%). In bivariate analysis many of the independent variables correlated with hypertension, but in multivariate analysis, only body-mass index, family history and age remained significant.

Infant and child mortality, including deaths due to vaccine-preventable diseases, remains high in the rural areas of India. In Andhra Pradesh, the immunisation coverage of children in the 12-23 month age-group has progressively declined to 43%, indicating the immediate need for taking corrective steps. The Rural Effective Affordable Comprehensive Healthcare (REACH) project, based on the health metrics strategy was initiated to improve childhood immunisation coverage. Information on the immunisation status of children was recorded and each child was tracked with the help of a computerised database to provide timely immunisation. The health metrics strategy resulted in complete immunisation (96%) of all the 698 children in the 12-23 month age-group residing in the villages of the Medchal Mandal in the year 2007, as compared to 43% reported by the National Family Health Survey-3. Action oriented health metrics coupled with information technology can thereby improve childhood immunisation significantly.

A community based cross-sectional study was conducted during April 2004-March 2005 in an urban resettlement colony in East Delhi to study the narcotic substance use and the socio-demographic characteristics of users. 208 male narcotic substance users aged 15-24 years were studied. 59.1% of the narcotic substance users were between 21-24 years of age. 78.8% were using ganja and 39.9% each heroin & bhang. 37% were abusers; 36% were dependent users. 58.7% were single at the time of interview. 48% were either illiterate or just literate; 64% belonged to middle socio-economic status. 68% had initiated narcotic substance use out of curiosity.

A retrospective data analysis from records of patients from medical record section of department of gynecology and obstetric, S. N. Medical College and Hospital, Agra was done to find out the trend and causes of maternal mortality occurred during 1999-2007. The maternal deaths in the context of different causes were analyzed. A total of 192 maternal deaths occurred on 6386 live-births during last 9 years which gives anoverall hospitalized Maternal Mortality Ratio (MMR) as 30.07 per 1000 live births during the period. Out of these total deaths more than half (51.04%) were due to indirect causes. Anaemia (47, 24.48%), hemorrhage (35,18.23%), toxemia (35,18.23%), septicemia (18, 19.23%) were the main causes.

Patient satisfaction is defined as a patient's personal evaluation of health care services and providers and thus a vital component of health care outcome and remains an area of interest and need in health care. Hence to assess in-patient satisfaction a study was conducted in a private tertiary care hospital on a stratified random sample of 100 in-patients drawn from four different general wards using a structured questionnaire. Overall the patients were found to be generally satisfied with care and services provided with a score of 87.12%.

A community based cross sectional survey was carried out to study the prevalence of the risk factors for CHD and identify the high-risk groups in the rural community. 924 subjects of 30 years and above were investigated using structured, pre-tested schedule. Coronary risk factors were assessed. Statistical analysis was done by using Chi square test for prevalence of coronary risk factors in the age and sex groups. The prevalence of coronary risk factors ranged from 5.4 to 41.3%. Tobacco use, alcohol consumption, truncal obesity and sedentary life style were significantly prevalent among males. Whereas truncal obesity and hypertension among females. Behaviour change communication strategies targeting these high risk factors need to be emphasized to lower CHD related morbidity burden in the community.

This investigation of the outbreak of mass psychogenic illness during July 2007 at three schools in Burdwan was done to observe the description of the epidemic, identify its characteristics and to study any particular factor associated with the spread of illness. Relevant data were obtained from medical and school records. All concurrent factors were considered. All the incidents happened prior to the examinations. There have been differences in presentations and final diagnosis among the schools. Intense media coverage influenced the manifestations. Poor school performance was associated with recurrence of symptoms. So understanding the academic anxiety is important to prevent such outbreaks.