Background: Diabetes is rapidly emerging as a major health care problem, even in rural India. The earlier occurrence, delayed diagnosis and improper care leads to high complication rates, greater productivity loss and consequently higher costs. As the epidemiological burden of diabetes increases, the economic burden is expected to rise and the economically disadvantaged will be affected the most. Objectives: To assess the economic burden of diabetes among type 2 diabetic patients and to explore the factors associated with the economic burden of diabetes. Materials and Methods: Community based cross sectional study was carried out in rural field practice area of a medical college in Davangere for a period of six months during 2016-17 among 112 patients with type 2 diabetes mellitus. Information was collected using pretested predesigned questionnaire on socio-demographic details, health services utilization, expenditure incurred on diabetes care (both direct and indirect costs) in the past six months. Results: The direct cost accounted for 94.2% of the total cost of treatment, of which hospitalization for diabetes related complications and medications were major components. Source of health care significantly influenced the direct cost. About 8.9% of study subjects skipped medications at least once due to lack of money. Conclusions: Direct cost in the management of diabetes is major contributor to the expenditure. Availability of affordable essential quality diabetic medications and strengthening of public healthcare is crucial in reduction of these direct costs involved in diabetic management.

Background: Cervical cancer is the second most common cancer in women aged 15-44 years. The key to reducing cervical cancer morbidity and mortality is early detection and treatment of cervical pre-cancerous lesions through PAP and HPV tests. Objective: To explore the level of awareness about cervical cancer among women and to assess their awareness regarding preventive screening methods available and its utilization and perceptions. Methodology: A cross sectional community-based study was conducted on 120 women above 18 years of age. The study participants were randomly selected from four urban areas of Hubli and interviewed using a pretested semi structured questionnaire. The data was entered into Microsoft excel and analysed using SPSS. Results: In our study, 91.7% had not even heard of cervical cancer. 77.5% participants did not know the cause for cervical cancer. 29% thought it was preventable. Less than 1% had undergone screening tests. None of the women were vaccinated against HPV infection. 42% of the women think that cancer treatment facility is available in government hospital and 40% think that it’s available only in private hospitals with 18% having no idea where to go for treatment. Conclusions: As women are ignorant about the risk of cervical cancer and don’t prioritise their health, awareness can be created among them on days of ANC check-ups and immunisation. Health care workers also need to be sensitised towards the issue. There is need for effective and more efficient use of mass media in spreading awareness in form of advertisements, articles etc.

Introduction: Globally the issues of morbidity among female sex workers are major concerns but mostly have been neglected. Objective: To study the general and maternal health morbidities among female sex workers. Material & Methods: This was a cross sectional study carried out in a red-light area of metro city with the help of a local NGO. Using Purposive sampling method, each female sex worker was interviewed individually by a resident doctor with nonbiased, non-provocative, non-judgmental interview technique. Results: The mean age of 99 respondent was 29.3 years and 69.2% were migrated from West Bengal and Orissa. 78% were sold by their Husband and family members. The mean age at which they have started sex work was found to be 17.6 years. Current study noted 63.64% female sex workers were mother which is in correspondence with different researchers finding. Home deliveries and early weaning was reported by respondents. 63% females reported musculoskeletal pain, 54% with itching and rashes over body and 45% reported weakness, in addition 38% delineate vaginal discharge and 34% pain in lower abdomen which suggestive of sexual transmitted diseases. Conclusion: The high prevalence of health conditions is found in female sex workers demands urgent actions.

Background: The health and nutritional problem are most common in tribal women of India. According to NFHS-4, 26.7% (CG-29.6% Bastar-40.6%) women in rural areas had BMI below 18.5, indicating chronic energy deficiency, and the prevalence of anemia was found to be 54.2% (CG-48.2% Bastar-68.1%). Based on this background present study was carried out in the rural practice area of Department Community Medicine to assess the health status of the tribal women. Objectives: To assess the health status of tribal women and determine the factors. Material & Method: A cross sectional study conducted in field practice area of RHTC of Department of Community Medicine late Baliram Kashayp Memorial Govt. Medical College Jagdalpur covering Village Dimrapal, Marenga, Pamela, and Biringpal. Total 107 women were interviewed. Study period is July to December 2017. Pre designed structured questionnaire was administered to collect the information. Anthropometric measurements were done and conjunctival pallor was observed to assess anaemia. Statistical analysis was done by MS excel 2010 and SPSS versan 21. Results: Mean height of women is 155.86 ± 5.88 cm. and mean weight is 50.48 ± 7.83 kg. Pallor was observed among 19.6% women, 17.75% women had BMI less than 18.5. Conclusion: Continue awareness is required to elevate the health status among women in tribal area.

Background: Rabies, a fatal disease but preventable, requires proper management of the bite victim that includes post-exposure prophylaxis (PEP) which is a multi-dose schedule extending to one month. Due to this long schedule patient adherence reduces and leads to associated mortality. The aim of the study was to assess the adherence of the animal bite victim to the ARV regimen. Methods: A cross-sectional retrospective record-based study was conducted in the Rabies Clinic, GTB Hospital Delhi. All animal bite victims seeking PEP at Rabies clinic were given a unique Anti-Rabies Clinic (ARC) number and classified according to WHO guidelines, using the ARC number the cases were selected randomly and the details of the cases were taken from the PEP-register from December 2016 to January 2017. Results: A total of 100 bite victims were assessed of which 73% were males. 43% of the victims completed their IDRV schedule of which 58.1% adhered to the schedule without any delays. Reported number of defaulters was 53. The age of the victim (p=0.037) and category of exposure (p=0.019) were found to have a statistically significant association with adherence to ARV regimen. Conclusion: The completeness of IDRV schedule despite of being essential is being neglected by animal bite victims. Need of the hour is to raise awareness and provide effective counselling to prevent defaulters and finally rabies.

Background: India has the largest number of diabetic populations in the world, Depression is common among people with diabetes, and it is associated with worse diabetes outcomes, non-adherence to medication is potentially one of the most serious problems facing diabetes care delivery. The objective of the study was to assess depression among type II diabetes patients and to assess adherence to therapy among type II diabetes patients. Methodology: This cross-sectional community-based study was conducted in the urban field practice area of the Department of Community Medicine, SSMC, Tumkur. A total of 200 type II diabetes patients were selected by simple random sampling method from the database of Urban Health Training Centre and were traced to their homes for data collection. Data analysis was done using descriptive statistics like proportion and inferential statistics like Chi-square test. P-value less than 0.05 was taken as statistically significant. Results: Out of 200 diabetic subjects, 80 (40%) belongs to age group 50-59 years, females were 132 (66%), Most of them 66 (33%) were having diabetes for duration of 6-10 years, most of them 176 (88%) were on oral hypoglycaemic agents. Out of 200 study subjects 93 (46.5%) had low adherence, 106 (53%) had medium adherence. 34 (17%) study subjects had depression using PHQ9 questionnaire. When we studied association of depression with other factors, it showed statistically significant results with gender (P=0.003), glycaemic status (P=0.01) and adherence to drugs (P=0.03). Association of drug adherence with depression showed statistically significant results (P=0.01). Conclusion: Health care professionals can play a major role in improving adherence to therapy in patients of DM which prevents complication and improve Quality of life.

Background: The prevalence of malnutrition is a significant area of concern in many developing countries, where it is a major public health problem. Objective: To estimate the prevalence of malnutrition and to find out association of malnutrition with some common variables amongst up to two years girls children. Material and Methods: Nutritional assessment was done using anthropometry and clinical examination. Children were weighed and measured as per the WHO guidelines on Anthropometry. Epi. Info 2002 software package was used to calculate the Z scores and for statistical analysis. Results: The study findings revealed that out of total 126 girls, more than half (53.2%) of the children studied were normal. Peak prevalence of malnutrition was observed in 1-2 years of age. Majority of the mothers of malnourished girls were illiterate (52.5%) and lower class (84.7%). More than half (52.2%) of the children were found normal who were on exclusive breastfed up to 6 months. Conclusions: The study found that malnourishment is linked with breast feeding practices, complementary feeding, literacy, socio-economic status, immunization status, looks (hygiene) and knowledge of mother about childhood illnesses, their treatment and family planning practices.