A Time Log Study of Activities of Medical Officers Working at Urban Health Centres of Ahmedabad City, Gujarat

Introduction: Medical Officer (MO) of an Urban Health Centre (UHC) is responsible for implementing all activities grouped under Health and Family Welfare delivery system in UHC area. While RBSK MO of UHC works under Rashtriya Bal Swasthya Karyakaram (RBSK). Objective: To assess various activities carried out by MBBS MOs and RBSK MOs at UHCs with proportion of time spent on each of activities. Method: The study was conducted at randomly selected 12 UHCs from randomly selected 3 zones of Ahmedabad city. Data regarding activities of MBBS and RBSK MOs were collected using predesigned matrix time log sheet wherein the MOs had to fill up their activities on 15 minutes slots for 2 weeks. Data were entered and analyzed using MS Excel. Results: Effective working time per day was 7 + 1/2 hours &6+1 hours for an MBBS & RBSK MO respectively. Majority of time spent per day by the MBBS MO was in conducting general OPD (mean 149 minutes) followed by preparing/checking reports. While, for RBSK MO, it was in health checkup at Anganwadis & Schools(118& 93 minutes respectively) followed by preparation of reports. Both MOs spent maximum time towards clinical work (48.51% by MBBS& 68.45% RBSK MOs) followed by administrative work (33.73% by MBBS & 18% by RBSK), field visits (11.5% by both), CME/workshops/trainings (2.02% by MBBS and 0.66% by RBSK) and other activities (4.2% by MBBS and 0.8% by RBSK). Conclusion: Frequency of various major activities was as per the recommendations for most of the MOs. However, many of them were not able to cover all the activities mentioned under guidelines.

Knowledge, attitude and practices of Ramadan fasting on health and disease among pregnant Muslim women in urban health centre of a medical college

Background: Fasting during the holy month of Ramadan entails abstinence from food, water, smoking and drugs from dawn to sunset. In Islamic religious rule fasting during Ramadan is not mandatory if there is any contraindication such as illness, old age, pregnancy, etc. Many studies have shown that most Muslim women choose to fast during pregnancy because of a sense of religious duty, familial support, positive views on fasting and difficulty in completing the missed fasts at another time.Methods: A cross sectional study was conducted on 124 pregnant Muslim women attending urban health centre for antenatal care during the month of Ramadan at Davanagere city. Data was entered in the Microsoft Excel and presented in the form of frequencies.Results: In this study majority of pregnant women believed that fasting during pregnancy is harmful to mother as well as child. Overall, 80.6% of pregnant women did not observed fasting during pregnancy.Conclusions: In this study majority of the pregnant women did not observed fasting during the month of Ramadan. Health education should be given to all pregnant women and family members regarding adverse effect of fasting on mother and child health.

Pattern of maternal weight gain among primigravidae in tertiary care hospital and urban health centre

Background: The appropriate amount of weight gain during pregnancy has been a topic of interest and debate over a century. A low body mass index (BMI) and suboptimal weight gain during pregnancy are long recognised risk factors for delivery of infants too small for gestational age.Methods: The present study was observational prospective study conducted among primigravidae in two groups with sample size 197 in tertiary care hospital antenatal clinic and 97 in urban health centre antenatal clinic for the period of 1year and 6 months.Results: In tertiary care hospital average weight gain was 10.04 kg with 33 (16.75%) women gained less than or equal to 8 kg weight gain, 148 (75.13%) gained weight in range of 8.1 to 16 kg while 16 (8.12) gained more than 15 kg weight during pregnancy while In urban health centre average weight gain was 8.96 kg with 46 (47.42%) women gained less than or equal to 8 kg weight gain, 45 (46.39%) gained weight in range of 8.1 to 16 kg while 6 (6.19%) gained more than 16 kg weight during pregnancy. Women with lower BMI found to gain lesser weight compared to normal body mass women.Conclusions: Presence of low BMI was an add on social risk factor which may adversely impact the weight gain in the mother and expected child.

AN ASSESSMENT OF XEROPTHALMIA PROBLEM AMONG SCHOOL GOING CHILDREN IN URBAN SLUMS OF RAIPUR

Introduction: Present study was carried out in school children (6-15 years age) from slum areas of Raipur city near its Urban Health Centre to see the Magnitude of Xerophthalmia. Very few studies have been done to clinically assess the extent of Ocular manifestations of Vitamin A deciency in primary school children Method: Study was designed as a cross sectional study conducted in primary schools of urban slums of Raipur city near its Urban Health Centre . 1000 children were randomly selected from 10 schools and examined . From each school 100 children were randomly selected from standard I-VII. Xerophthalmia was diagnosed if there was a history of night blindness, or on examination, there were signs of conjunctival xerosis, Bitot's spots, corneal xerosis or keratomalacia. Information was analysed by using the Microsoft Excel and SPSS . Chi square test was used for analysis. Results: 0.5% cases of nightblindness, 1.4% cases of conjunctival xerosisand2.1% cases ofBitot's spot were found. Types offamily, lower social class (class IV&V)andpoorintakesofgreenvegetablesweresignicantlyassociatedwiththevitaminAdeciency. Conclusion: Study showed that this preventable cause of ocular morbidity is still prevalent in fair magnitude. Studies are needed on this issue to highlight the importance

Management of patients with obstructive lung disease in South India: a retrospective study of spirometry and bronchodilator use in an urban health centre

Background: Based on the burden of obstructive lung diseases program (BOLD), the global prevalence of chronic obstructive pulmonary disease (COPD) was 11.7% in which 90% of the deaths occur in low- and middle-income countries. India and China are estimated to account for 66% of total global COPD mortality. The Indian Chest Society (ICS) recommends spirometry to document irreversible airflow limitation in patients suspected of having COPD. However, the reported usage of spirometry among primary care physicians in India is only 10-20% as primary health care centers in India are not equipped with spirometry or inhaler devices.Methods: A retrospective study was done on patients treated for respiratory symptoms with bronchodilators at an urban health centre to document the practice pattern of primary care physicians with regards to use of spirometry in patients on bronchodilators.Results: Of the 1196 patients on bronchodilators, spirometry was documented in 15.5%. Patients on inhalers, using more than one therapy and males less than 55 years were more likely to undergo spirometry. About 52.4% of patients who underwent spirometry were found to have post bronchodilator forced expiratory volume at first second (FEV1)/ forced vital capacity (FVC) less than 0.7 of which 43% had severe disease and 44% had poor post-broncho-dilator reversibility.Conclusions: Besides diagnostic spirometry, management guidelines for COPD should be complemented by health education to change patients’ perception of respiratory symptoms, increase awareness of COPD in those with risk factors and change their health seeking behaviour along with continuous professional development activities for primary care physicians.