Community Medicine Papers & Publications

BACKGROUND: Cervical cancer is the second‑most common cancer among women in the developing world and approximately 500,000 cases are diagnosed each year. In developed countries, cervical cancer (CCa) accounts for only 3.6% of newly diagnosed cancers. OBJECTIVE: The present study aims to identify the most effective barriers associated with CCa screening uptake in low and middle-income countries (L and MICs) and aid to adopt effective measures to overcome prevailing barriers to the attainment of CCa uptake in the community. MATERIALS AND METHODS: Health sciences electronic databases like MEDLINE, PubMed, Cochrane library, and Google Scholar were searched for studies published until August 2017. Keywords used for the search were ("cervical cancer screening"), ("barriers"), AND ("low income countries" OR "Middle income countries"). Articles were reviewed and data were extracted by using Mendeley Desktop Software (V‑1.17.10). Income-level classification of countries was done as per the World Bank 2017 report. Statistical software like SPSS‑V.23 and Medical‑V.14 were used for the statistical application. RESULTS: A total of 31 studies met the inclusion criteria with a total of 25,650 participants. The sample size of the included studies ranged from 97 to 5929 participants. Articles majorly reported data on participants from African region (51.6%) and minimally in the Western Pacific region (3.2%). Sampling methods among studies varied from convenience sampling‑12 (39.7%) to consecutive sampling‑1 (3.2%). Besides, two studies (6.5%) did not discuss their sampling procedures. It was observed that “Lack of information about CCa and its treatment” (Barrier of lack of knowledge and Awareness); “Embracement or shy” (Psychological Barrier); “Lack of time” (structural Barrier); and “Lack of family support” (Sociocultural and religious barrier) were the most commonly reported among all 22 barriers. CONCLUSION: There is a need of policies advancement of CCa screening programs by focusing on aspects of accessibility, affordability, CCa education, and the necessity of screening to improve screening uptake to control the CCa morbidity and mortality rate in L and MIC’s.

NAGARJUNA NARAYANASETTI

Context: Menstruation is one of the most basic characteristic features of girls and inadequate knowledge of adolescent girls about menstruation can result in faulty menstrual hygiene management (MHM) and inappropriate dietary management both of these can causes diseases which is a major threat for adolescent health in developing countries like Bangladesh. Aim: To identify current knowledge, attitudes, and practices related to menstruation and menstrual hygiene management (MHM) among adolescent girls. Settings and Design: It is a descriptive cross-sectional study conducted in Jashore, Bangladesh. Methods and Materials: A pre-formed, pre-tested questionnaire was used. The questionnaire-based survey was conducted among randomly selected 250 adolescent girls between 10 and 19 years. Statistical analysis used: Data were analyzed statistically by Microsoft office excels and SPSS windows version 16 software programs. Results: Among 250 adolescent girls majority had their menarche between 12 and 15 years of age, 70% of adolescent girls of this study belonged to lower class families. This study revealed that 85% of the respondents had regular menstruation whereas 15% had irregular menstruations also. Most of them faced different types of Premenstrual syndrome including 76% from headache, 80% from lower abdominal pain, and 62.5% from fatigue and weakness. Only 56% had previous knowledge about puberty before attaining menarche. There was a statistically significant correlation between the mother’s education and the knowledge of participants about menstruation at puberty. All the participants used to bath and wash hand after changing pads whereas 80.8% used to avoid all types of exercises. Almost 94% of respondents used to dispose of their napkins properly. The micro-nutrient deficiency was also common; especially 49.2% were suffering from Iron deficiency and 69.6% from folic acids deficiency. Conclusion: Awareness programs regarding both menstrual hygiene and dietary management can aid to alleviate some complications during puberty and ensure better health for adolescent girls.

Arafat Hassan Razon

Background: Irritable bowel syndrome (IBS) is a very common gastrointestinal dis-order worldwide, but research regarding this disease is rare in Bangladesh. This studyaimed to assess the prevalence of IBS and its associated risk factors among universitystudents in Bangladesh.Methods: This is a cross-sectional study. A total of 300 randomly selected partici-pants were included in this study. By using a structured questionnaire and anthropo-metric methods, we collected all the required data for our study. The diagnosis of IBSwas based on Rome III criteria.Results: The overall prevalence of IBS was 39.3%, but the majority (77.3%) had nobasic awareness of IBS. In our study, anxiety and depression (χ2 = 6.817; odds ratio[OR] = 1.910; 95% confidence interval [CI] = 1.172, 3.113; P = 0.011) had a signif-icant relationship with IBS and IBS had a significant (P < 0.001) relationship withfood intolerance (χ2 = 8.737; OR = 2.130; 95% CI = 1.284, 3.531), chest pain(χ2 = 7.482; OR = 2.035; 95% CI = 1.218, 3.401), and insomnia (χ2 = 19.320;OR = 2.907; 95% CI = 1.794, 4.709). In our dietary data, the intake patterns of vege-tables (P = 0.000), fast food (P = 0.000), and tea–coffee (P = 0.003) showed astrong significant association with IBS. On the other hand, monthly household income(P = 0.154) and body mass index (BMI) (P = 0.138) showed no significant associa-tion with IBS. Among our study subjects, IBS-constipation (54.2%) was more com-mon than IBS-diarrhea (27.1%) and IBS-mixed (18.6%). Moreover, among the 118IBS respondents, 67.8% had a headache with increased flatulence (95.8%) as the mostcommon IBS-related complication.Conclusion: IBS is common in university students of Bangladesh and is associatedwith anxiety, depression, and particular dietary patterns.

Arafat Hassan Razon

Background: The deliberate postponement of significant academic assignments with due dates is known as academic procrastination. The undesirable habit known as procrastination is the inability to start or finish a task within the allotted time, which results in detrimental effects on students' future employment, as well as stress, guilt, poor academic achievement, and low self-esteem. Method: Descriptive Research design was adopted for a study to assess the Variables influencing Nursing students' Academic Procrastination at selected Nursing college of Bhopal, M.P. Sample size 60 B.Sc. Nursing students. Result: Result revealed that majority of students were females, 27 out of 60 were in age group of 20-21yeras, 25 (41.6%) were studying in B.Sc. N 3rd year. Most of students resided in Rural area (36), 54 out of 60 belong to nuclear family and 35 mothers of students were educated as compared to 51 fathers. The mean score and SD of influencing variables of academic procrastination were as follows Personal variable was 2.6 ± 0.48, Environmental 2.26 ± 0.71, and Academic was 1.78 ± 0.41. Majority of nursing students 39 (65%) were moderately affected by Personal variables, Environmental variables affected 23 (38%) students moderately and academic variables affected 17 (28%) students moderately. Only Personal factor had more effect on 5 students as compared to none in other two variables. Conclusion: The study concluded that Environmental and personal factor had more effect on Academic procrastination as compared to academic variables.

Dr K C Yadav

Background: Although geriatric depression is widespread in primary health care (PHC), local studies on the prevalence of depression in elderly PHC patients appear to be scarce. This study aimed to determine the prevalence of depressive symptoms and some of the associated risk factors among elderly PHC patients. Methods: A cross-sectional study recruiting elderly people (60 years or older) from five PHC centers in Port Said Governorate was conducted. All participants had a structured interview. The long version of the geriatric depression Scale (cut-off point ≥10) was used in elders with a Mini-Mental State Examination ≥24. Results: About two-thirds of the total sample (65.7%) was female. The total prevalence of depressive symptoms was 49.4% of all subjects, more commonly in women (58.1% vs. 32.8%). Multiple regression analysis shows that female gender, high education, unemployment, low income, lonely life, loss of a close person, chronic diseases, tumor, iatrogenic medications, and depression history were the significant associated risk factors of depression in the studied elders after adjusting all previous variables in addition to age and marital status. Conclusion: Depressive symptoms constitute a significant health problem among older PHC patients in the Port Said governorate. Routine screening for depression of every elderly PHC patient is recommended for early detection.

Karishma