SOP - Hip Circumference

Hip circumference measurements are taken in some sites as an expanded option to measure overweight and obesity.

To take hip circumference measurements we need : 

• constant tension tape (for example, Figure Finder Tape Measure)
• pen/pencil
• chair or coat stand for participant's to place their clothes.

A private area is necessary for this measurement. This could be a separate room, or an area that has been screened off from other people within the household. Hip measurements are taken immediately after waist circumferences.

• This measurement should be taken without clothing, that is, directly over the skin.
• If this is not possible, the measurement may be taken over light clothing (Must not be over thick or bulky clothing. This type of clothing must be removed)

This measurement should be taken:

• with the arms relaxed at the sides
• at the maximum circumference over the buttocks

Steps of measurement:

1. Stand to the side of the participant, and ask them to help wrap the tape around themselves.
2. Position the measuring tape around the maximum circumference of the buttocks.
3. Ask the participant to: 
• stand with their feet together with weight evenly distributed over both feet;
• hold their arms relaxed at the sides.Check that the tape position is horizontal all around the body and snug without constricting.
4. Measure hip circumference and read the measurement at the level of the tape to the nearest 0.1 cm.
5. Record the measurement on the participant’s instrument.

SOP - mid upper arm circumference (MUAC)

• The major determinants of MUAC are muscle and subcutaneous fat, both important determinants of survival in malnutrition and starvation. 
• MUAC is less affected than weight and height based indices (e.g. Body Mass Index) by accumulation of fluid (i.e. nutritional oedema, periorbital oedema and ascites). 
• So MUAC is a good predictor of mortality. 
• It is recommended for identifying young children with, or at risk of, severe acute malnutrition and adults with acute energy deficiency.
• In children between 6-59 months old, MUAC <110 mm indicates severe acute malnutrition and is recommended as a criterion for admission to therapeutic feeding programmes. 
• Values between 110 and 120/125 mm indicate moderate malnutrition. 
• Values below 250 mm in adults indicate severe wasting. 
(Note that MUAC is not sensitive enough to routinely monitor growth at young child clinics)

SOP

It's been quite a while since I posted something on my blog. Today while cleaning up the junk accumulated on my hard drive I came across several useful articles that I had prepared during my PG- ship.

SOP or standard operating procedures.

Sharing here are some of the articles that I found useful for public health purposes.

1. mid upper arm circumference 
2. waist circumference 
3. hip circumference 
4. height
5. weight
6. pallor

ECG monitoring using mobile device - when engineering met medicine

Innovativeness and creativity has always been a part of science. In this ever developing world, Science has made our lives easier. With every passing day a new development strikes the market and leaves it's imprint behind.

Mobile Technology has affected every aspect of the human life all over the world. Not only has mobile technology made connectivity easier, it has also positively impacted Healthcare services. In this regard and new development that caught my attention in recent times was the use of a smart phone to monitor ECG.

I came across such device on a Facebook Post. The interface uses ECG leads connected on the chest wall of the patient and transmitting data via cable directly to the mobile device. Once connected, an app installed in the mobile can recognize the electrical activity and display the graph. it can be used for continuous monitoring and also a graph can be printed. The best part of the system is that it can be used by Healthcare providers in Periphery (like in Sub Center or PHC) and the information can be transmitted to a higher setup.
In this manner even a health worker who has been trained to connect the leads on the patient's chest and run the app on mobile can take out an ECG from a patient who complains of cardiac or similar symptoms within moments. The data thus obtained can be analysed by doctor positioned more centrally and the health worker may be guided to take the best course of action which he may be unable to take himself otherwise.

For example, a patient visiting a sub Center located in a remote village complains of sudden onset chest pain. ECG taken out by the health worker may be immediately sent to the higher center to the consultant whereby a diagnosis of Acute Myocardial Infarction is suspected. Accordingly the health worker can be guided to provide the immediate care(like Morphine, Oxygen, Nitrate, Aspirin) and shift the patient as early as possible to a better equipped center for further management thus improving the chances of survival of the patient and bringing down the cost of therapy as well. This system may also help in avoiding unnecessary referrals.

Lifestyle Diseases and Prevention

From a discussion on Lifestyle Diseases and their prevention

Lifestyle Diseases and Prevention from Pallab Nath

People Who Travel Alone Are More Intelligent

A study by British Psychological Society revealed that people who experience solitude and who like to travel alone are more intelligent than others. They also concluded that, "lower life satisfaction with more frequent socialization with friends”, leads to an intelligent life.

The study was related to "savanna theory of happiness" according to which less socialising is equal to more intelligence and happiness.

They compared more rural living to how ancestors once traveled in close-knit, smaller tribes. Basically the lifestyles of hunter-gatherer tribes have formed the evolutionary foundation for what makes people happy now.

It was thus concluded that, for the average person, living in a smaller town and actively socializing with friends is key to happiness. However, for a highly intelligent person it was quite the opposite.

It was also observed that, smarter people try to spend time alone by taking days off to travel alone.

They contemplate on life and come back with some richer experiences.

Hiv and the truckers

according to UNAIDS sex workers are 10 times more likely than the general population to be HIV positive. Another high risk group consists of the truckers. Truckers spend weeks, even months, on the road ferrying loads across the length and breath of the country. But it's not just cargo that moves along these transportation routes, it's also HIV. Sexual health awareness is low among these truck drivers.

OTC INSIGHT Asia-Pacific reported recently that, in India, around 2 million truck drivers are frequently engaging in unprotected sex with sex workers and only 11.4% of these workers said they had used a condom.
Tata Motors decided to tackle the problem head-on with the target group, the truckers. Tata Motors with the help of creative agency Rediffusion Y&R and launched the “Use Dipper At Night” campaign in April 2016.

Indian truckers have a strong cultural identity and “Use Dipper At Night” (reminding drivers to dip their headlights during nighttime). The idea was to encourage truck drivers to practice safe sex by linking this concept to the phrase that resonates strongly with every member of the community. Thereby a new condom brand called Dipper was created and marketed exclusively for the truck drivers.

HLL Lifecare, a government-owned corporation and India’s largest condom manufacturer, produces the the condoms. Each wallet, which contains three condoms, is decorated with different truck art motifs and slogans, such as “Have a Safe Journey”, to make them more appealing to the target consumer.