Objectives : To describe the pattern of adherence to Highly Active Antiretroviral therapy (HAART) and ascertain the factor(s) associated with nonadherence. Methods: This was a cross-sectional, two-site, hospital-based study. The study was undertaken in 2005; as a result of phased roll out of free HAART as part of National AIDS Control Program, patients at Lok Nayak Jai Prakash (LNJP) hospital were receiving free HAART, while patients at All India Institute of Medical Sciences (AIIMS) had to bear out-of-pocket expenses for HAART. Adherence was defined as not having missed even a single pill over the previous 4-day period on self-reporting. Results: Adherence at AIIMS was 47%, whereas it was 90% at LNJP. The difference was statistically significant. Multivariate analysis showed that nonadherence was associated with not having been told about the importance of HAART, having to pay out-of-pocket for HAART and reported continued risk behavior post HAART. Conclusion: With the provision of free HAART, adherence is likely to be high. Emphasis should be given on simultaneous recruitment of counselors, and physicians should be made aware about the need to inquire and counsel patients against continued risk behavior.

In order to effectively respond to a changing public health paradigm, it is imperative that the medical education and overall public health education (PHE) parallel the public health challenges faced by countries. Community medicine departments play a crucial role in PHE. This review analyzes the current situation of community medicine departments in the context of PHE, using a framework that outlines academic activities undertaken by these departments. This framework includes the syllabus of academic programs, internship, and infrastructure and faculty strength in the community medicine departments. The review also discusses how skill building of existing faculty members can help us in addressing emerging public health issues, and the role of partnerships and collaborative activities in advancing the PHE agenda, thereby continuing to shape the role played by these departments toward shaping the future of PHE in India.

Objective : To assess whether measles elimination goal would be feasible for India or not. Methodology: Secondary review of data from WHO Regional Consultative Meet on Measles and Workshop on Rubella. Discussion with stakeholders such as UNICEF experts, PATH, and Government officials. Results: The National Technical Advisory Group of India (NTAGI) has chalked out two broad strategies depending on the routine measles coverage of first dose (MCV1). In 18 states with sustained MCV1 coverage ≥80%, a second routine dose of measles would be given, whereas those states with <80% coverage, supplementary immunization will be introduced in a phased manner. There are many challenges at this juncture-unfinished agenda polio eradication, lack of VPD surveillance system, financial and manpower constraints. However, solutions are possible. Conclusion: Before setting an elimination goal in India, a thorough understanding of the regional situation is required. India should opt for the Measles Mortality Reduction before proceeding to the Elimination Goal by 2020.

Fluorosis is an important public health problem in certain parts of India. Nalgonda is one of the fluorosis endemic districts of Andhra Pradesh. A cross-sectional study was undertaken to assess the prevalence of dental and skeletal fluorosis in Panagal, one of the urban slum areas of Nalgonda town of Andhra Pradesh. 265 individuals residing in 92 households of five colonies of Panagal were selected by multi-stage random sampling. Fluorosis was assessed by standard clinical methods and water samples were tested for fluoride level. It was observed that mean fluoride level in ground water samples in the area was 4.01 mg/l and that of Nagarjunsagar water was 0.74 mg/l. The mean age of the study subjects in the area was 34.73 years. The overall prevalence of skeletal fluorosis was 24.9% and that of dental fluorosis was 30.6%. The prevalence increased with age. Skeletal and dental fluorosis is endemic in the study area.

Adolescent boys are recognized as a vulnerable group to substance abuse. The present study has the objective to study the biosocial profile and habit pattern of substance abusers. The study was conducted on 511 male adolescents, students of 10 ^th to 12 ^th class from the four intermediate schools of the Doiwala block of Dehradun district. 46.9% students accepted substance abuse. In 75.5% cases, friends were providing the substances. 80.2% substance abusers expressed their desire to quit the habit. The study is indicative of need for developing a supportive environment involving both parents and teachers so that adolescent can decide and sustain with the right choices for healthy life.

A cross-sectional survey of Cu T users in a rural area of the Yavatmal district was carried out using stratified sampling, to identify interventions that can improve intrauterine device (IUD) service provision processes and their acceptance. The average age at Cu T insertion was 23.8 years. Cu T acceptance with one child was 55.5%. 80.8% of Cu Ts were inserted within 10 days of menstruation, while there were no post-partum Cu T insertions. 51.8% Cu Ts were inserted in PHC's. At the time of the survey, 48.2% users already have their Cu T removed. Only 22.7% couples utilized some alternate contraception after Cu T removal. Post-discontinuation contraceptive use was lower in a tribal area. 30% Cu T acceptors received less than two health checkups. 78.8% (58.1% in a tribal area and 84.9% in a non-tribal area) beneficiaries received information about Cu T from health workers. Only 6.6% Cu T acceptors received specific advice of checking the Cu T string. Utilization of private facility was more common among tribals. Reach of health service regarding Cu T need to be improved in tribal areas. Health service providers need to be more proactive, especially about utilization of the immediate post-partum period for Cu T insertion, clients counseling, and follow up of users.

Data were collected from 78 teenage pregnant mothers (15-19 years) out of 1446 pregnant mothers who attended the primary health centers situated in the field practice area of the rural health center, Kengeri of Kempegowda Institute of Medical Sciences, Bangalore, between May and July 2009 to study the factors associated with teenage pregnancies and awareness regarding family planning. This was a descriptive study. Out of 78 teenage pregnant mothers, 57 (73%) were Hindus and 45 (57.7%) belonged to joint families. 76 (97.4%) teenage pregnant mothers were housewives, i.e. 55 (70.5%) of the spouses of the teenage pregnant mothers were laborers, in majority, i.e. 40 (51.3%) teenage pregnant mothers' age at marriage and the age at first pregnancy were 18 years. The mean age at marriage increased significantly with an increase of the educational status of the teenage pregnant mothers (F value = 7.08%, P< 0.002). The mean age at first pregnancy was also increased with an increase of the education status of both the teenage pregnant mothers and their spouse. The most common reason for early marriage and early pregnancy was traditional practices and family pressure among 50 (64%) and 45 (57.7%) teenage pregnant mothers, respectively. 49 (63%) teenage pregnant mothers were not aware of any family planning methods.

India has witnessed a decline in sex ratio in the past few decades. A hospital-based cross-sectional study was carried out to find out the attitude toward gender preference and knowledge as well as practice toward prenatal sex determination and female feticide among pregnant women. A majority (66.0%) of the pregnant women did not show any gender preference, followed by male preference (22.2%) and female preference (11.8%). A high proportion, i.e. 84.7% and 89.7%, of the total subjects were aware that prenatal sex determination and female feticide is illegal, respectively.

The objective of present study was to determine the profile and antimicrobial sensitivity pattern of bacteria isolated from various cultures in a tertiary hospital in Delhi. Culture and sensitivity of all blood, urine, pus, and throat sample reports obtained from May 2006 to April 2007 were analyzed from the central microbiology laboratory register. Among 6918 sample reports analyzed, about half (46%) of them were positive. The most commonly bacteria isolated in 35% of positive blood and pus samples was vancomycin-sensitive Staphylococcus aureus. Most common organism isolated in 54% of positive urine samples was imepenem-sensitive Escherichia coli.

For last few years in the early spring bird flu poses a threat to India. The causative agent H5N1 virus is also getting robust day by day acquiring an ability to cross the species barrier. It is now known as (H5N1) which is emerging as killer virus to man. Although human casualty is yet to be recorded from India, but the threat is not over. The present study had been undertaken in the village of Hakimpur of Singur Block of District Hooghly, West Bengal, with a population 862 of 215 families. The objective of the study was to assess the knowledge of the study population regarding bird flu and to study their practice regarding poultry maintenance. The head of the family from each family was interviewed. A house to house survey in the census method on a pre-designed, pre-tested, semi-structured schedule was done. Information regarding socio-demographic profile, poultry keeping, correct knowledge about bird flu, mode of transmission, culling, etc was recorded. The data were collected and analyzed by relevant statistical methods. The results showed that 46% respondents knew what bird flu is, 62.8% knew the mode of transmission, and 35.3% knew the procedure of culling. Out of literates about 53% and out of the illiterates only 0.93% were aware of the transmission of the virus through body fluids. The predominant source of information was mass media. 57.14% of the families rearing poultry, kept the birds in shed, 40.48% in cage, and 2.38% in living room.

The present cross-sectional study was conducted from November 2007 to December 2008 in four medical colleges and associated hospitals of Delhi. Study subjects comprised 930 resident doctors. The overall prevalence of stress was found to be 32.8% in resident doctors from all colleges. Out of 930 resident doctors, 165 (17.7%) had mild stress, 113 (12.2%) had moderate stress, and 27 (2.9%) were severely stressed. Important reasons of stress as perceived by the study subjects included long duty hours, departmental academic activities, financial constraints, family and emotional problems in the decreasing order of preference. Important factors significantly associated with stress-included existence of children, year of residency, type of department, and presence or absence of job satisfaction, having close friends, spending time with family/friends, and place of graduation. In the multivariate model, year of residency, giving time to family and or friends, having close friends during residency, job satisfaction, and state of graduation came out as predictors of stress.

A mass measles campaign was organized in AILA-affected areas of West Bengal in July-August 2009. The present cross-sectional study was conducted with the objectives to monitor and assess the cold chain maintenance, safe injection practices, IEC methods adopted, and to observe the conduction of the sessions in the campaign. All the cold chain points at the block level had adequate vaccines and equipments, twice monitoring of temperature which was in optimal range. 82% sessions had team according to microplan, AWW was present and team members were actively mobilizing the children in 83% sessions, puncture proof container was used and vaccines were given in correct sites in more than 95% sessions. The study observed satisfactory conduction of the whole campaign, still the injection safety procedures should be strengthened considering the potential harm to the health care providers.