Sunday, May 27, 2012

Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital

Aman Deep Dr. Gopal Krishna Ingle Dr. Jugal Kishore

Background: Benign Prostatic Hyperplasia is a widely prevalent condition
affecting elderly men throughout the world. With increasing
life expectancy, there has been a rise in the percentage of
elderly men and so for this disease across the globe. There is
lack of information about health seeking behaviour of patients
with Benign Prostatic Hyperplasia. Therefore the study was
designed with the objectives of assessing health-seeking
behaviour and the effect of literacy on it among adult and
older subjects suffering from Benign Prostatic Hyperplasia
attending a tertiary care hospital.
Method: A series of 81 patients suffering from Benign Prostatic
Hyperplasia above the age of 50 years, attending surgical Out
Patient Department of a tertiary care hospital in Delhi, were
assessed for their health seeking behaviour using a pre-tested
and a modified questionnaire designed for assessing health
seeking behaviour.
Positive health seeking behaviour of patients was observed in
44%, who reported to a doctor within a month of noticing
their problem. A greater proportion of the literates was aware
about the symptoms suggestive of enlarged prostate and
consulted a qualified health care practitioner as their first
action. More literates approached the higher level of health
care facility on being referred and had maximum faith in
allopathic system of medicine. Also, lesser number of literates
had performed pooja (Hindi word for worship) or other
traditional rituals for relief of their problems.
Conclusion: We concluded that majority of subjects suffering from
Benign Prostatic Hypertrophy were not aware of their
disease and their health-seeking behaviour was poor and
could be related to literacy. Our data highlights the need
for public awareness program targeting the younger male
population so that early detection and treatment can be
Key Words: Benign Prostatic Hyperplasia, Health Seeking Behaviour,

Recommendations of Conference on Environment Health

The International Development Centre (IDC) Foundation in collaboration with department of Community Medicine MAMC, and CPCB, has organized the National Conference on Management of Water, Air, Noise, Solid Waste and Plastic Waste during Commonwealth Games at New Delhi, 6 -7 November 2009.

1. Public information
The Conference is duly informed of the overall planning and certain micro-planning exercises conducted by various organizations belonging to Municipal Corporation of Delhi, the Delhi Development Authority, the Government of National Capital Territory and the Central Government. Much of the information was not known to most of the participants. It is recommended that a vigorous campaign be made by a designated coordinating agency to inform the general public through various media so as to generate confidence in the public that care for environment is part of the efforts being made to hold a successful and green Commonwealth Games at Delhi.
2. Air quality management
The Olympics held in China in 2008 owe part of the success to certain bold decisions, such as closing down polluting industries one month before the event. Likewise, a large number of public offices were closed one week before the Olympics. The strong democracy that we are may not accept such arrangement. However, potential polluters need to be identified and sternly warned to keep pollution under control failing which immediate action to shut them down would be taken. Such units may be in Delhi or near its border in Sahibabad, Ghaziabad and Faridabad. In any case, coal-based thermal power stations of Delhi and near its border will need to be shut down two weeks before the Games are held. The diesel generating sets, which number more than 2 lakh in Delhi, can remain out of operation if uninterrupted power supply is assured. It is recommended that a close scrutiny be made as to which polluting industrial units should be so warned and which thermal power stations should be shut down. It may also be assessed as to which offices can be closed for four weeks without significant interruption in public service. The manpower thus made idle may be utilized for assisting in the organizing the Games. Uninterrupted power supply should be arranged for Delhi for the period of the Games. It is further recommended that as a mitigative measure, greenery should be increased near the sporting arena.
3. Air quality monitoring
Delhi is noted by the World Health Organisation among the major cities that have poor environmental conditions. While poor quality of water can be countered by bottled drinking water, there is no such alternative to poor quality of air. Athletes are particularly sensitive to air quality because heavy breathing during running and other exercise sports can cause serious injury to their pulmonary and cardiovascular systems. It is therefore recommended that air quality is monitored regularly and accurately right from now to get baseline data, obtain actual trend of results of measures implemented to improve air quality and predict with confidence the anticipated air quality during October 2010, when the Commonwealth Games will be held.
4. Prediction of air quality
In the last decade, introduction of CNG-run public transport vehicles, manufacture of fuel-efficient automobile engines and production of lead-free petrol and low-sulphur diesel did cause a remarkable improvement of air quality of Delhi. The advantage is wearing out on account of a phenomenal increase in the number of automobiles on the road in spite of the recently established Delhi Metro system and an improved fleet of buses. Traffic jams are becoming more frequent and more intense with time. Emission of certain pollutants, such as ozone and fine particulate matter, has tended to increase with the aforesaid changes in fuel and engines. In the euphoria of gains noticed earlier, the new threats are overlooked. While data on concentration of ozone is scanty, a lot of data is available on the precursors of ozone, which are the hydrocarbons, oxides of nitrogen and sunlight. It is recommended that careful observations need to be made to assess the concentration of ozone and fine particulate matter and to relate such observations to the doze-effect on health of the affected population. In particular, it is recommended that concentration of ground level ozone is observed and estimated by modelling, and its trend be analysed to provide authentic information for the athletes who can be at threat if it rises above a certain level.
5. River quality
River Yamuna will be viewed by a large number of athletes, visitors, journalists and commentators during the Commonwealth Games. The view is appalling. The adverse publicity of the care given to this major water body, which is included among the holy rivers according to faith of the majority of population of the country, will reflect adversely on the responsiveness and effectiveness of our administration. By now several authorities have conceded that hardly anything is possible to upgrade the river water quality to an acceptable level. This myth can be blown away with the application of bio-remediation, i.e., by dosing selected bacteria into a body of water, which quickly multiply, decompose organic pollutants and mitigate odour. Thus, the drains of Delhi can be made to clean the Yamuna. It is recommended that bioremediation be applied on the tributary drains, the river and poorly performing sewage treatment plants in Delhi.
6. Solid wastes management
Packaging and containers are likely to be discarded in large quantities during the Commonwealth Games. To regard them as wastes is to increase the burden of their handling and disposal. To regard them as resource is an approach to get wealth and energy from waste. Biodegradable packaging is technically possible. Most of the containers have the possibility of reuse by segregating them according to the possibility of their reuse. It is, therefore, recommended that bio-degradable packaging is prescribed for certain items carefully selected for the purpose and arrangements are made to segregate the containers according to the potential of their reuse.
7. Household garbage disposal
The sweepings from the dwellings and kitchen wastes make an excellent combination to be treated by vermiculture process at the household level. Residents that have small garden or large enough terraces can adopt this technique to produce and utilise compost from the wastes generated in their own homes and thereby significantly reduce the quantity of garbage that need to be handled and disposed of by a municipal service. It is recommended that domestic vermiculture units may be vigorously promoted including technical and financial support for the manufacture and use of the bins required in the process.
8. Mock drill
Whatever services and regulatory controls are planned for the duration of the Commonwealth Games should be rehearsed in order that the deficiencies in the plan are noticed and rectified. Such mock drills are also greatly helpful in generating awareness and co-operation of the people and in the assessment of net benefits of the plan. It is recommended that at least two mock drills may be held before the Commonwealth Games to practice and validate planned services and regulatory controls.

How to make healthy India: Series of thoughts and discussion

Health a state of physical, mental and social well bring and not merely absence of disease or infirmity and ability to lead a socially and economically productive life. This shows that health is not just related to body and mind but also social and economic sector. When it is social and economic productive life then other domains play a significant roles such as occupational, vocational, etc. To achieve them all suitable environments are required whether it is biological, physical, chemical, water, electricity, transport, etc. In true sense nothing is possible without health and health is not possible without support of so many determinants. This need to be understood by any human system, particularly who are responsible for safety and protection of humanity. But majority of times neither the health professionals nor governments understand comprehensively. Doctors are support to lead the health team but they themselves isolated in some domain and never learn skills in all aspects of health to better realize the meaning of health profession.      

Sunday, May 20, 2012

Awareness about Environmental Health among Nursing Personnel in Delhi

The environment is one of the primary determinants of individual and community health. Nursing personnel are considered as one of the vital messengers of knowledge to bring change in total health. The study has been conducted with the aim of comparing the knowledge level of nursing personnel regarding environment and health and the related legal issues. It is a hospital based cross-sectional comparative study conducted on sample of 82 and 120 nurses in the year 2000 and 2011. The results show a marked difference in the awareness level of the subjects in the two years. However the knowledge regarding the legal issues and correctness of knowledge is still lacking. Effect of environmental pollution on health is yet to be understood in its totality. There is a need to impart environment education. A suitable modification for inclusion of environmental health in nursing curriculum may be needed.

Jugal Kishore, Rajbala Rojha, Dipanweeta, Sumeena. Journal of Nursing Science and Practice 2012; 2 (1): 1-8. Availabe from