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BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) and ergonomic risk factors are very common in bakery workers. OBJECTIVE: The purpose of this study is to (1) assess the prevalence of musculoskeletal disorders among bakers because they use automated machines or traditional baking, and (2) to determine the strategies to prevent musculoskeletal disorders in bakers. METHODS: A systematic review of PubMed, Scopus, and Web of Science was conducted from the beginning to February 4, 2022, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Mesh keywords and phrases were used to execute the search strategy. Information on MSDs and ergonomic risk factors in bakery workers was collected. Two reviewers worked independently on study selection, data extraction, and paper quality ranking. RESULTS: This study identified 14 papers from seven countries. Although the prevalence of MSDs in bakery workers has been studied, only a handful of them have been studied ergonomic risk factors, and the findings have been very limited. The association between different risk factors and MSDs seemed significant compared to many other occupational diseases. The traditional bread-baking system and lack of mechanization may increase the risk of MSDs in bakery workers. CONCLUSION: WRMSDs for bakery workers have been less studied than other occupational diseases. Our systematic review found several significant relations between the factors influencing the prevalence of MSDs. This study also showed the comparison of traditional and modern cooking systems with diseases of the upper limbs, shoulders, and back pain as possible fields for future research. [ABSTRACT FROM AUTHOR]

Background: In India, twenty-five percent of women who menstruate are unable to utilize sanitary methods, and even among those who have access, there are multiple obstacles to achieving proper menstrual hygiene management. The consequences of inadequate menstrual health may extend to affect a girl's socialisation, empowerment, overall well-being, and even survival. Objectives: To estimate the prevalence of unmet menstrual practice needs and its determinants among college going women in Coimbatore district, India. Methodology: A questionnaire based analytical cross-sectional study was conducted among 3144 college going women from October 2022 to January 2023. Menstrual Practice Needs Scale (MPNS-36) was used to collect data regarding the unmet needs and their mean scores were compared across socio-demographic variables, menstrual knowledge, and the choice of hygiene material. Results: The mean (SD) age of the study population was 19.3 (1.8) years. The prevalence of unmet menstrual practice needs was 62.8% with a mean (SD) MPNS score of 1.8 (0.4). The total MPNS score was low for those currently residing in rural or having a rural hometown. The unmet need was better for those residing in-campus of the educational institute and having educated parents. The socioeconomic class and presence of a personal income also influenced the total MPNS scores significantly (p < 0.05). Menstrual talks with friends before puberty and with friends and family after puberty improved the MPNS scores. Regarding menstrual hygiene methods, modern menstrual methods (MMM), disposable and bio-degradable materials had a lower unmet need. Marital status, freedom to manage expenses, pre-pubertal menstrual talks with family, and total number of family members did not influence the scores of MPNS. Multivariate regression analysis showed that maternal education, menstrual talks with family after puberty, and type of menstrual hygiene method including its disposability were independent predictors of total MPNS scores. Conclusion: Addressing unmet menstrual practice needs among college-going women in Coimbatore district necessitates a multifaceted approach encompassing education, access to affordable and sustainable menstrual products, and destigmatization efforts. [ABSTRACT FROM AUTHOR]

Background: A decline in fertility rate and expansion in life span has resulted in the growth in the percentage of aged populations in the whole world. India and Odisha are no exceptions. Objectives: The objective of the present paper is to find out the incidence of functional ability/inability among the aged people of the rural areas of western Odisha of India. Materials and Methods: Katz Scale of ADL was used to assess the functional ability of elderly people. Six activities of daily living such as (Bathing, Dressing, Toilet, Mobility, Continence, and Feeding) were analyzed as per age and sex of the samples. Results: Of all the samples (1992), 98.5 percent are physically independent and only 1.4 percent are physically dependent. Out of 945 female elderly people, 931 (98.1%) are independent and out of 1047 male elderly people 1033 (98.6%) are independent. The physical dependency of females is more with a χ² -- value of 0.075 and p -- value of 0.466. The age group wise χ² -- value is 20.899 (3) and p -- value of 0.001. Conclusion: Lesser physical dependency is found among the elderly people in rural areas. An increase in dependency is seen with the increase in age. [ABSTRACT FROM AUTHOR]

Background: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. Methods: We used information on 109,439 women of reproductive age (15–49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. Results: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15–24 (OR: 12.01, p < 0.001) and 25–34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. Conclusion: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country. [ABSTRACT FROM AUTHOR]

Background: Visceral leishmaniasis (VL) patients are at high risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infections during multiple injections and the anti-leishmanial treatment possesses a potential hepatotoxic effect. This systematic review and meta-analysis determined the pooled prevalence of HBV and HCV infections in VL patients. Methods: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with the assigned number CRD42024516889, and conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Medline, EMBASE, Google Scholar, Web of Science, and Science Direct databases. Data were extracted using Microsoft Excel and analyzed using STATA version 11.0 software. A random-effects model was used to estimate the pooled effect size of outcome variables across studies with a 95% confidence interval and was displayed in a forest plot. The I2 statistic was used to check for heterogeneity. The presence of publication bias was determined using a funnel plot and Egger's test with a p value <0.05 evidence of statistically significant bias. Results: Among 216 retrieved records, seven studies were eligible for systematic review and meta-analysis. A total of 937 VL patients were examined, revealing that 105 and 93 were infected with HBV and HCV, respectively. The pooled prevalence of HBV was 16.15% (95% CI: -4.10 to 36.39), with a significant heterogeneity (I² = 91.4%, p < 0.001). The combined prevalence of HCV was 13.74% (95% CI: 1.32-26.16, I² = 71.6%, p = 0.003). The funnel plot (symmetry), and Egger's test in both HBV (p value = 0.650) and HCV (p value = 0.841) revealed no publication bias. In subgroup analysis, high HBV and HCV prevalence was detected in Sudan; 20.64% (95% CI: -13.60 to 54.88) and India; 18.26% (95% CI: -0.40 to 36.92%), respectively. Conclusion: This study revealed a high prevalence of both HBV and HCV infections in VL patients. In subgroup analysis, the prevalence of HBV and HCV was high in Sudan and India, respectively. Therefore, screening of VL patients for HBV and HCV, vaccination of VL patients in endemic regions, and collaboration between kala-azar and hepatitis elimination programs are required. [ABSTRACT FROM AUTHOR]

Iron deficiency anaemia (IDA) is unusual in sickle cell disease (SCD). However, excessive urinary iron loss and mucosal/submucosal infarcts may result in poor absorption of iron in SCD. During the first decade of the disease, environmental factors and poor nutrition may also affect iron metabolism and contribute to iron deficiency in SCD. The present study assessed iron status and haematological profile of young children with SCD using serum Iron, Ferritin and Total Iron Binding Capacity (TIBC) to establish early diagnosis of IDA.Results showed that out of 6276 newborns screened, 33(0.52%) were detected to have SCD. Amongst 33,14(14.28%) children were suspected to have IDA. Iron studies revealed 42.4% of coexistent IDA with low serum Iron among 3 children, whereas high normal or raised TIBC was seen in 14 children. The findings emphasize that raised TIBC with normal serum iron may indicate early onset of IDA in the early decade of SCD, highlighting the need of timely initiation of iron therapy to prevent further severe events. [ABSTRACT FROM AUTHOR]

Objectives: Diabetic foot syndrome is becoming increasingly common in India with a prevalence ranging from 24.9% to 49%. Diabetic foot syndrome patients have an increased likelihood of developing ulcers in their feet. Accordingly, this study evaluates the influence of photobiomodulation on altered plantar pressure distribution and ankle biomechanics in individuals with diabetic foot syndrome. Methods: A total of 20 diabetic foot syndrome patients with an absence of 10 g monofilament in one out of six sites at the plantar surface of feet, a biothesiometer for vibration perception threshold of >20 V, and diminished or absent ankle reflexes were included. The evaluation of ankle biomechanics was performed by SIMI motion analysis. In addition, the plantar pressure distribution was measured by the WinTrack pressure platform at baseline and the end of 10 sessions. They were treated with scanning mode on the foot plantar surface and probe laser at the popliteal fossa region for three sessions per week, for ten sessions. Results: Plantar pressure parameters were significantly improved (P<0.01) and ankle biomechanics (P<0.01) after the intervention, respectively, except for no significant difference in the total contact area and ankle midstance kinematics. Discussion: Photobiomodulation therapy can be an effective treatment for improving foot plantar pressure redistribution and ankle biomechanics in individuals with diabetic foot syndrome [ABSTRACT FROM AUTHOR]

Background: Several observational studies have reported the prevalence of cerebral microbleeds (CMBs) and their risk factors in an elderly population. Any information in this regard is currently lacking from India. Aim of this study was to estimate the prevalence, risk factors of CMBs, and association with cognition in an Indian urban population aged 50 years and above. Methods: Household surveys were conducted as part of ongoing Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) study in areas of urban Delhi. Magnetic resonance imaging of the brain was performed in 2599 participants. Using standard neuropsychological battery, mean Z-scores for each domain (memory, executive, information) were derived. Binary and stepwise logistic regression models were used to determine associated risk factors for the presence of CMB and its association with cognitive domains. Results: The prevalence of CMBs was 14.42% (95% confidence interval [CI]: 13.06-15.73). Of these, 203 (7.81%) participants had single CMBs and 172 (6.61%) had multiple microbleeds (≥2). Higher prevalence was observed in older age (6070 years: odds ratio [OR]: 1.25 [95% CI: 0.93-1.67]; 70-80 years: OR: 2.05 [95% CI: 1.48-2.84]; ≥80 years: OR: 3.27 [95% CI: 1.97-5.44]) compared to individuals in the age group 50-60 years. History of stroke (OR: 2.97 [95% CI: 1.56-5.66]), hypertension (OR: 1.36 [95% CI: 1.05-1.75]), and smoking (OR: 1.43 [95% CI: 1.11-1.85]) was associated with at least one CMB. Multiple CMBs were associated with worse scores in memory and executive domains. Conclusion: Older age, hypertension, history of stroke, and history of smoking emerged as important risk factors for the presence of multiple CMBs. Follow-up study is required to determine implications of CMBs. [ABSTRACT FROM AUTHOR]

Intellectual disability in India is substantially under-reported, especially amongst females. This study quantifies the prevalence and gender bias in household reporting of intellectual disability by estimating the age-and-gender specific prevalence of the intellectually disabled by education, Socio-Demographic Index (SDI) score, place of residence, (rural/urban) and income of household head. We estimated prevalence (per 100,000) at 179 (95% CI: 173 to 185) for males and 120 (95% CI: 115 to 125) for females. Gender differences declined sharply with increased education, was higher for lower ages and low income and varied little by state development. Under-identification and under-reporting due to stigma are two plausible reasons for the gender differences in prevalence that increase with age. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have previously estimated the dementia prevalence in India. However, as these estimates use different methodologies and sampling strategies, generating definitive prevalence estimates can be difficult. Methods: A Delphi process involving eight clinical and academic experts provided prevalence estimates of dementia within India, split by sex and age. The experts were also asked to estimate the number of people potentially living at different stages of the condition. A priori criteria were used to ascertain the point in which consensus was achieved. Results: Our consensus estimates generated a dementia prevalence of 2.8% (95% CI = 1.9 to 3.6) for those aged 60 years and above in India. Consensus was achieved across age and sex prevalence estimates, with the exception of one (females aged 60–64). Our experts estimated that 42.9% of people living with dementia in India had a mild severity. Conclusions: The findings indicate that there could be approximately 3.9 million people living with dementia in India, of which 1.7 million could be living with dementia of mild severity. Such estimates can better help researchers and policy makers to estimate the true cost and impact of dementia in India and can inform resource allocation decisions. [ABSTRACT FROM AUTHOR]

Background: The WHO defines LBW as "Birth weight less than 2500 grams" regardless of gestational age. Being born with a low birth weight also incurs enormous economic costs, including higher medical expenditures and social service expenses, and decreased productivity in adulthood. Objective: To study distribution of newborns' according to pregnancy related factors and its association with newborns' birth weight. Methods: An institutional based cross-sectional study. New-borns delivered at study institute were considered as study participants. Estimated final sample size was 500. Guardians (mothers) were face-to-face interviewed and also recorded data were collected from the case file and Mother and Child Protection Card. Results: Prevalence of LBW newborns was higher in mothers with late ANC registration, <4 ANC visits, chronic medical conditions, infection during pregnancy, PIH, anemia, consuming tobacco, exposure to second hand smoke, LSCS/Assisted delivery, in female newborns', current pregnancy birth order number more than 2, in pre term newborns' and mothers with bad obstetric history. Conclusion: Create awareness and adoption of suitable family planning methods. Need to do early (within 12 weeks) ANC registration with minimum four ANC visits for better pregnancy outcome. Effective tracking and suitable intervention provided to improve current pregnancy outcome. Health care professional should pay special attention to high-risk pregnancy. Develop social culture in such a way that females are neither addicted nor exposed to any tobacco containing products in their life. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies highlight the negative impact of social isolation and involvement in leisure activities on enhanced well‐being of individuals. However, there is dearth of evidence on relationship between social isolation and leisure activities on cognitive abilities and depression of older adults in the Indian context. The paper reports the impact of social isolation and leisure activities on cognitive functioning and depression of older adults. Methods: Data were collected from the Longitudinal Ageing Study of India (LASI), and 63,806 participants aged 45 years or above were considered for the study with adherence to the exclusion criteria. Multivariate analysis was carried out to analyse the group‐based differences. Results: Social isolation (F = 102.09, p < 0.01; η2 = 0.09) and leisure (F = 224.54, p < 0.01; η2 = 0.07) had a statistically significant impact on the cognition and depressive symptoms of participants. Socially isolated older adults with little involvement in leisure activities had the worst cognitive functioning (M = 32.76, SD = 4.41), whereas middle‐aged adults who were actively involved in leisure activities and experienced the least social isolation exhibited the best cognitive functioning (M = 32.76, SD = 4.41). However, leisure and age as independent factors did not have a significant impact on depression. Conclusion: Socially isolated participants, irrespective of age, and involvement in leisure activities exhibit poor cognitive functioning and are more likely to suffer from depression as compared to their counterparts. The findings of the study can be used to design intervention strategies aimed at reducing social isolation by incorporating leisure activities to ensure the optimal functioning of middle‐aged and older adults. Key points: Socially isolated older adults with least involvement in leisure activities reported the worst cognitive functioning.Socially isolated participants reported a positive association with depressive symptomatology.Both middle‐aged and older adults who engaged in leisure activities reported better cognitive functioning as compared to their counterparts who did not engage in any form of leisure activities.Leisure as an independent factor is not significantly associated with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: In India, the prevalence of overweight among adolescents is on the rise, setting the stage for an increase in metabolic syndrome (MS). This paper presents the national prevalence of MS in adolescents in India. Methods: A nationally representative data of adolescents (10–19 years) from the Comprehensive National Nutrition Survey was used. MS was defined based on the NCEP–ATP III criteria for adolescents. Bivariate analysis was used to report socio-demographic differentials in prevalence and to assess interstate variability. Multivariate logistic regression model was constructed to measure the association between socio-demographic characteristics and prevalence of MS. Census data from 2011 was projected to 2017 to calculate burden. Results: The prevalence of MS was 5.2% among adolescents. 11.9%, 15.4%, 26.0%, 31.9% and 3.7% had central obesity, high blood pressure, hypertriglyceridemia, low HDL-cholesterol and high fasting glucose, respectively. The prevalence was higher among males (5.7% vs. 4.7%, adjusted odds ratio (AOR): 1.3, 95% confidence interval [CI]: 1.0, 1.6), those residing in urban areas (7.9% vs 4.2%, AOR: 1.4, 95% CI: 1.1, 1.8), and from wealthier households as compared to their counterparts (8.3% vs. 2.4%, AOR: 3.4, 95% CI: 2.1, 5.5). There was wide interstate variability in the prevalence of MS (0.5% – 16.5%). In 2017, 14.2 million adolescents had MS in India. Conclusions: The prevalence of MS among adolescents in India is low and clustered in urban areas and richer households. Early prevention interventions promoting a healthy lifestyle, especially in high prevalence areas, are needed to keep MS from becoming a public health issue. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies. Design: A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam. Sample: This paper presents diabetes data of adults ≥30 years enrolled from the community cohort. The interviews were conducted with 997 participants at their residence. Measurement: Random blood glucose was assessed for each participant using a finger prick test. Results: The overall prevalence of diabetes was 30.1%, of which 4.1% of participants had undiagnosed diabetes. Among those with diabetes, 86.3% were aware of their diagnosis; among those aware, 86.5% were on treatment. Among those on treatment for diabetes, 54% achieved controlled blood sugar. Conclusion: The challenge in diabetes management is controlling the blood glucose levels of people who adhere to treatment. Younger employed females from lower-income quartiles have the highest risk. The study also raises questions about quality and strategies for medication compliance. The findings inspire future research on care needs, policies, and program responses to reduce the diabetes disease burden. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to understand the recent trends and correlation of tobacco use and factors associated with an attempt to quit smokeless tobacco (SLT) use among adults from Northeast India. Methods: We used data from two rounds of the cross-sectional Global Adult Tobacco Survey. The paper applied proportion test statistics to examine the change in the prevalence of tobacco use between the two periods. Binary logistic regression was applied to determine the associated risks of tobacco use. Results: Prevalence of SLT use among adults increased significantly by 3.9% from 2009-10 to 2016–17. In the same period, the prevalence of smoking had declined by 2.4%. Increase in use of SLT use was more prominent among women and illiterate adults, rural and poor households, while a decrease in prevalence of smoking was observed among adults. A significant proportion of educated people, students, and homemakers, reported that they had quit smoking; however, the proportion of attempts to quit SLT had increased significantly among older adults, rural residents, and those with low education levels. Conclusions: Actions involving the community, youth, women, the less educated and poor adults are necessary to encourage them quit SLT use and smoking in the north-eastern states of India. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is an important nutritional disorder with major public health importance. In India, anemia prevalence among adult males was 25.0% (NFHS-5, 2020-2021). Being rich in iron and other micronutrients camel milk might decrease the nutritional anemia prevalence. The objective was to determine the prevalence of anemia among adult male camel milk consumers (CMC) versus nonconsumers in rural Rajasthan. Materials and Methods: A community-based study was conducted among 30 CMC adult male. All the participants meeting the eligibility criteria were recruited. The same numbers of non-CMC (NCMC) adult males were recruited with respect to similar age, sex, and residence. After obtaining informed consent a semi-structured interview schedule containing sociodemographic, dietary characteristics were introduced to all participants in June 2013. The participants were assessed for their hemoglobin (Hb) level from fingertip capillary blood using the Cyanmet Hb method as suggested by Dacie and Lewis. The prevalence of anemia in each group was compared. Data were entered into Microsoft Excel version 2013 and analyzed in Stata version 13. Results: The prevalence of anemia was more (26.6%) among nonconsumers than CMCs (16.6%). There was a significant difference between these groups (P < 0.001). The mean (standard deviation) Hb (g/dL) level of the male in the CMC and NCMC categories was found to be 13.0 (0.99) and 12.22 (1.51) in adult males, respectively. This difference was statistically significant (P = 0.021). Conclusion: The prevalence of anemia among CMC adult males was lower than nonconsumers with relatively higher levels of Hb in the former group. Future studies are recommended for further inference. [ABSTRACT FROM AUTHOR]

Context: Over the past three decades, there has been a significant rise in the prevalence of noncommunicable diseases (NCDs) globally, accompanied by a relative decline in communicable diseases. Aims: With this background, the research was planned to determine the prevalence of acanthosis nigricans (AN) or skin tags (STs) in the study population and to examine the relationship between the presence of AN and ST with commonly used indicators such as waist-to-height ratio (W/Ht.), Indian Diabetes Risk Score (IDRS), and body mass index for predicting the risk of NCDs. Settings and Design: This cross-sectional study was done at a health facility in Lucknow (India). Methodology: Consecutive sampling was employed to select 152 apparently healthy adults as the participants. Data collection involved administering a questionnaire and conducting anthropometry using standardized methods. Visual inspection was conducted to identify AN or ST on the common sites. Statistical Analysis Used: Data entry was done in Microsoft Office Excel, followed by data analysis using SPSS. To test the association between variables "significance of difference of mean," Chi-square test, logistic regression analysis, and estimation of Kohen's kappa were used. A "P" value was considered statistically significant at <0.05 level. The sensitivity and specificity of AN and ST were also estimated in predicting the risk of NCDs. Results: The prevalence of AN was 19.08% (95% confidence interval [CI] = 12.76%–25.40%), while the prevalence of STs was 28.29% (95% CI = 21.05%–35.53%). AN showed a sensitivity of 22.4% and specificity of 96.3% with W/Ht. ratio as the standard, and a sensitivity of 26.44% and specificity of 90.77% with IDRS as the standard. ST exhibited a sensitivity of 32.0% and specificity of 88.89% with W/Ht. ratio as the standard, and a sensitivity of 37.93% and specificity of 84.62% with IDRS as the standard. Conclusion: AN and ST can be used as simple and time-saving tools in screening protocols for (NCDs). Further research is desirable to validate the findings. [ABSTRACT FROM AUTHOR]

Background: Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity. Material and Methods: Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant. Results: Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively). Conclusion: Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet. [ABSTRACT FROM AUTHOR]

CONTEXT: Pottery is defined as clay that has been fashioned into the desired shape and then dried to reduce its water content before being fried or baked to fix its form. The artisans living in traditional societies are normally influenced by their environment as well as by their myths, legends, rituals, ceremonies, festivals, social organization, and cultural norms which are reflected in their creations. The poor environmental conditions and the lack of protective equipment in these pottery workshops are key contributing factors to the development of these occupational diseases. Most pottery industries are small- to medium-scale industries and have longer and irregular working hours, a higher percentage of elderly employees, limited opportunities for health education or health inspection, and insufficient health promotion facilities compared with large companies. These factors are considered to play an important part in the development of occupational diseases and some nonspecific diseases such as psychosomatic, cardiovascular, and locomotor diseases among pottery workers. Traditional pottery making has its unique method of potter-work where it demands prolonged squatting without back support for hours which can develop musculoskeletal disorders (MSDs). AIMS: The study aimed to estimate the prevalence of work-related musculoskeletal disorders (WRMD) among traditional pottery makers at selected places in Bengaluru. SETTINGS AND DESIGN: A cross-sectional study was conducted in two rural communities of Bengaluru. One hundred and ten traditional pottery makers were randomly selected. MATERIALS AND METHODS: Subjects were screened for work-related musculoskeletal disorders (WRMD) using the Nordic Musculoskeletal Questionnaire, following which the pottery makers who reported low back pain (LBP) were screened for the severity of disability using the Modified Oswestry LBP Disability Questionnaire (M-OSW). The results obtained were statistically analyzed using SPSS 25.0. RESULTS: The result showed the highest prevalence of MSDs in the lower back, the findings of this study confirmed the work-related stress on traditional pottery makers. In the present study, the highest prevalence of musculoskeletal disorder was found in the lower back, of which had trouble in the last 12 months, 56.36% were having trouble during the last 7 days, and 19.09% were prevented from doing normal activities during the last 12 months. The prevalence of MSDs during the last 12 months revealed that the maximum of them, i.e., 24.54%, were having pain in the lower back. The present study also found MSDs prevalent in the hip joint and knee joint due to the occupational need to complete the work on prolonged squatting. CONCLUSIONS: This study concluded that prolonged work exposure and awkward work postural demand increase the incidence of MSD among traditional pottery makers in Bengaluru. [ABSTRACT FROM AUTHOR]

CONTEXT: Flatfoot is a common foot condition that can be classified into flexible or rigid flatfoot. It is more prevailing among young children, adolescents, and adults. There has been an association seen between flatfoot and increased weight; however, the research is more focused on the prevalence of flatfoot in younger children. AIMS: The purpose of the present study is to report the prevalence of the flexible and rigid flatfoot and its association with body mass index (BMI) among adolescents. SETTINGS AND DESIGN: One-hundred adolescents including both males and females were included from Sri Guru Harkrishan Public School, Amritsar. Parental consent was obtained through the process of informed consent. The height and weight of subjects were measured using a standard apparatus. SUBJECTS AND METHODS: Obesity was calculated by BMI. Flatfoot assessment was done using the Staheli index and plantar arch index (PAI), and flatfoot severity was graded with the Denis method. A relationship between BMI and flatfoot was observed. STATISTICAL ANALYSIS USED: Statistical analysis was done using the SPSS 15 version statistical program for Microsoft Windows. The statistical analysis employed included calculating the average, standard deviation, cumulative percentage, conducting a t-test, and performing Pearson's correlation test. The probability value P ≤ 0.05 was statistically significant. RESULTS: Fourteen percent of participants had left flatfoot, and 8% had right flatfoot. Further, left and right flatfoot types were also analyzed, and it was found that 12% of participants had flexible flatfoot on the left, and 5% had it on the right. The results showed a positive correlation between BMI and the right foot (r = 0.222, P = 0.026), indicating that as BMI increases; the right PAI also increases. However, there was no significant correlation between BMI and left foot (r = 0.111, P = 0.273). CONCLUSIONS: This study found a low prevalence of flexible and rigid flatfoot among adolescents; however, a positive correlation between BMI and flatfoot was found, indicating that individuals with higher BMI may be at increased risk for flatfoot. The findings of this study suggest that flexible flatfoot is common among adolescents, whereas rigid flatfoot is rare. [ABSTRACT FROM AUTHOR]

Background: Nursing profession requires strength and resilience not just physically, but emotionally as well which requires them to adapt in stressful situations that they are often exposed to in their work environment. Objective: To determine the prevalence and associated factors of emotional intelligence (EI) and occupational stress (OS) among the nursing professionals from selected tertiary care hospitals in Bangalore, India. Methods: This was a multi-centric, cross-sectional study done among nurses with more than 1year of work experience and they were randomly selected from four tertiary care hospitals in Bangalore. The EI and OS were assessed using the Emotional intelligence scale (EIS) and Occupational Stress Index (OSI). Data was collected, both online and offline, owing to the ongoing COVID-19 pandemic. The data was analyzed using SPSS v21.0 to calculate the mean, associations, and regression. Results: Out of the total 294, the mean age of the study participants was 27±4.92years. A total of 75 (25.5%) nurses had poor EI and 245 (83.3%) had moderate OSI. None of the participants had high OSI. There was a significant association between the severity grades of EI and OSI (P = 0.010) and a binary logistic regression showed that those staff with high EI had a lesser odd (OR 0.531, 95% CI 0.282-0.999) of developing occupational stress as compared to those with low EI. Conclusion: EI plays a significant role in reversing the effect of one's occupational stress. Thereby, the training curriculum should include skills and measures of resilience to facilitate their EI improvement. [ABSTRACT FROM AUTHOR]

Background: Adolescents are at risk of various psychosocial problems, due to pressure from parents, educational agencies, peers, and society. Often, it is not recognized and goes unnoticed. There is an immense need to screen this group for early detection and proper management. Aim: The aim of this study was to assess the prevalence of psychosocial problems among adolescents and to determine their risk factors. Methodology: The study employed a nonexperimental, exploratory, cross-sectional research design with a quantitative approach. Using a two-stage random sampling technique, a total of 2030 adolescents from 37 schools were chosen. The data collection tool for study participants consisted of three parts: (a) A sociodemographic proforma, (b) a pediatric symptom checklist-youth report, and (c) a checklist for assessing determinants of psychosocial problems. Results: Three hundred five (15.02%) of the 2030 respondents had significant impairment to internalizing problems, 350 (17.24%) to attention deficit problems, and 378 (18.62%) to externalizing problems. Pediatric symptom checklist scores and academic performance showed a moderately positive correlation. There is a significant association between psychosocial problems and adolescent characteristics at a P = 0.05 level of significance. Conclusion: Adolescents have a high prevalence of psychosocial problems such as anxiety and attention deficit. Periodic screening, counseling, and referral to psychotherapy can help to lessen the severity of the condition and improve psychosocial well-being. [ABSTRACT FROM AUTHOR]

The Indian national tuberculosis (TB) prevalence survey conducted during 2019–2021 revealed a 31% TB infection (TBI) burden among individuals above 15 years of age. India has an ambitious plan of eliminating TB by 2025, 5 years ahead of the global agenda, thus focusing on the burden of TBI and management of TBI with TB preventive treatment (TPT) is of utmost importance in achieving the same. States in India adopt different models of implementation of testing and treating the TBI. Some of the states select subcontracting agencies to provide end-to-end TPT and some do adopt the in-house mechanism using the existing health system in providing the same. Moreover, the "Programmatic Management of TPT in India" guideline prioritizes population group for TPT based on elevated risk of progression from infection to TB disease or increased likelihood of exposure to TB disease. Given the background, we propose two models of implementation of TBI diagnosis using interferon-gamma release assay and treatment; one using a subcontracting agency and the other one using the existing health system machinery to test and treat the TBI. [ABSTRACT FROM AUTHOR]

The National Mental Health Survey 2016 (NMHS 2016) was a large epidemiological study, one of its kind, conducted by the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru to overcome the shortcomings of the previous surveys. The detailed report of the study is available in two parts- 'mental health systems' and 'prevalence, pattern and outcomes'. Though done comprehensively, there are some inevitable limitations. The private sector, a substantial health care provider in the country was not a participant in the survey. Though MINI version 6.0 is a standard and structured instrument, it does not cover many commonly encountered mental illnesses like somatoform disorders. Further, the methodology of the survey makes it difficult for an accurate calculation of the prevalence of individual major psychiatric disorders. The survey has been appraised using a standard checklist for prevalence studies. The detailed qualitative data has not been shared in the report. The contribution of the traditional indigenous systems of healthcare and accessibility of services in rural areas have not been elaborated. Thus, the need for a comprehensive and culturally sensitive assessment tool, involvement of the private sector, and enhancing funding provision to improve the infrastructure are emphasized as future directions for the subsequent phases of the survey. [ABSTRACT FROM AUTHOR]

The National Mental Health Survey of India (NMHS) was a ground-breaking nationwide study that harnessed a uniform, standardized methodology blending quantitative and qualitative approaches. Covering data from 12 states across diverse regions, its mission was to gauge the prevalence of psychiatric disorders, bridge treatment gaps, explore service utilization, and gauge the socioeconomic repercussions of these conditions. This initiative provided pivotal insights into the intricate landscape of mental health in India. One of the analyses planned for NMHS data was to undertake a logistic regression analysis with an aim to unravel how various sociodemographic factors influence the presence or absence of specific psychiatric disorders. Within this pursuit, two substantial challenges loomed. The first pertained to data separation, a complication that could perturb parameter estimation. The second challenge stemmed from the existence of disorders with lower prevalence rates, which resulted in datasets of limited density, potentially undermining the statistical reliability of our analysis. In response to these data-driven hurdles, NMHS recognized the critical necessity for an alternative to conventional logistic regression, one that could adeptly navigate these complexities, ensuring robust and dependable insights from the collected data. Traditional logistic regression, a widely prevalent method for modeling binary outcomes, has its limitations, especially when faced with limited datasets and rare outcomes. Here, the problem of "complete separation" can lead to convergence failure in traditional logistic regression estimations, a conundrum frequently encountered when handling binary variables. Firth's penalized logistic regression emerges as a potent solution to these challenges, effectively mitigating analytical biases rooted in small sample sizes, rare events, and complete separation. This article endeavors to illuminate the superior efficacy of Firth's method in managing small datasets within scientific research and advocates for its more widespread application. We provide a succinct introduction to Firth's method, emphasizing its distinct advantages over alternative analytical approaches and underscoring its application to data from the NMHS 2015--2016, particularly for disorders with lower prevalence. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence and determinants of cardiometabolic disease (CMD), and the factors associated with healthcare utilisation, among people with CMD. Methods: Using a cross-sectional design, 11,657 participants were recruited from randomly selected villages in 3 regions located in Kerala and Andhra Pradesh from 2014 to 2016. Multivariable logistic regression was used to identify factors independently associated with CMD and healthcare utilisation (public or private). Results: Thirty-four per cent (n = 3629) of participants reported having ≥1 CMD, including hypertension (21.6%), diabetes (11.6%), heart disease (5.0%) or chronic kidney disease (CKD) (1.6%). The prevalence of CMD was progressively greater in regions of greater socio-economic position (SEP), ranging from 19.1% to 40.9%. Among those with CMD 41% had sought any medical advice in the last month, with only 19% utilising public health facilities. Among people with CMD, those with health insurance utilised more healthcare (age-gender adjusted odds ratio (AOR) (95% confidence interval (CI)): 1.31 (1.13, 1.51)) as did those who reported accessing private rather than public health services (1.43 (1.23, 1.66)). Discussion: The prevalence of CMD is high in these regions of rural India and is positively associated with indices of SEP. The utilisation of outpatient health services, particularly public services, among those with CMD is low. [ABSTRACT FROM AUTHOR]

Social determinants of malnutrition play a significant role in dictating the course of malnutrition outcomes in any population. Sustained efforts to optimize these determinants are indispensable to sustainable changes in the status of nutrition of the affected population. Despite the efforts undertaken, such a high prevalence of child malnutrition in India defies logic. Multiple causes of child mortality exist. Malnutrition accounts for 69% of these underfive deaths in India losing up to US$3.5 trillion loss per year, globally. Understanding the social determinants of malnutrition and its impact on child health is crucial to formulate sound and equity-based policies and interventions yielding fruitful outcomes. The situation has further worsened due to the COVID 19 pandemic. The paper emphasizes gaining cognizance of the grim and longstanding issues of malnutrition, its social determinants, and existing interventions to curb the issue. [ABSTRACT FROM AUTHOR]

The advantages and uses of folklore herbs have been acclaimed and executed from ancient times in India. The use of these Folklore remedial herbs for therapeutic applications is contributing to maintenance of human health. The ancient literature, i.e., Ayurveda and Unani, also describes the global usage of herbal medicine for treatment, and its formulation's concoction for prevention of various diseases. Ehretia laevis is a conventional therapeutic herb from ancient times, frequently designated as Khandu Chakka by local people in Maharashtra. E. laevis leaves are used in the treatment of skin infections, fungal infections, mouth blisters, eczema, cuts and wounds, diabetes, asthma, fever and joint pain etc. The leaf of this plant contains abundant therapeutically beneficial secondary metabolites besides primary metabolites. This paper describes antimicrobial sensitivity of E. laevis leaf (fresh and dried) acetone and ethyl alcohol (95%) soxhlet extract and dried leaf dimethyl sulphoxide (DMSO) extract (prepared after from evaporation of acetone in dried leaf acetone extract) against isolated oral microbial flora i.e., Streptococcus spp, Staphylococcus aureus and Candida spp. Amoxicillin in dimethyl sulphoxide was also tested for antimicrobial sensitivity. The result revealed that E. laevis fresh leaf ethyl alcohol and acetone extract and dried leaf acetone and DMSO extract was efficacious against isolated oral microbial flora. The extracts showed positive results for flavonoids and tannins. The results showed the antibacterial and antifungal potential of this folklore plant, particularly against S. aureus and Candida spp., which are microorganisms that are becoming resistant against most therapeutic drugs. This use of this folklore herb requires further study on pharmacological drug formulations. And it can also be used in herbal products i.e., toothpastes, mouthwash etc. [ABSTRACT FROM AUTHOR]

Changing family structure from joint to nuclear posits a challenge among older people. Increasing prevalence of nuclear family promotes household headship among older adults but leaves them vulnerable as they have to live alone at older ages. Therefore, the study aims to estimate the trends and determine the factors associated with household headship among older adults from 1992-93 to 2015–16. The analysis of this paper is based on four rounds of the National Family Health Survey, which were conducted during the periods between 1992-93, 1998–99, 2005–06, and 2015–16, respectively. The study carried out bivariate and multivariate analysis to observe the association between outcome and independent variables. Results found that household headship among older adults had increased from 59.5% in 1992–93 to 67.8% in 2015–16. Further, the study found a rise in the proportion of nuclear families and household headship among older adults from 1992-93 to 2015–16. In older ages, household headship was more among older women than older men. The likelihood of household headship among older adults in a joint family is low as compared to household headship in a nuclear family. While the rise in household headship among older adults may be attributable to a variety of socio-economic influences, it has been noted that household headship among older adults has varied between men and women and by type of family structure. Moreover, there was a clear relationship between headship and wealth status of a household. [ABSTRACT FROM AUTHOR]

Domestic Violence (DV) during the antenatal period has major effects on the mother and pregnancy outcome and is associated with stress and mental health problems. The paper aims to examine the association of DV with stress and depression (S&D) during the first trimester of pregnancy attending antenatal care (ANC) at the Lok Nayak (LN) hospital, a tertiary healthcare hospital in New Delhi, India and address the response of the women. A mixed method was used to gain an in-depth understanding of the participants. A total of 921 women were screened from November 2018 to March 2020 using standard tools for the presence of incidents of DV and S&D. 517 pregnant women with up to 20 weeks of pregnancy who met the inclusion criteria and came to receive ANC at the facility were considered. The prevalence of DV in various forms (psychological, physical and sexual) during pregnancy (49.5%), stress (82%), and depression (33%) have an association that reflects the importance of acknowledging both of them as having a significant implication for the health of pregnant women in India. Analysis suggest that women who experienced DV during pregnancy are 4.9 times and 5.3 times more likely to suffer from stress and depressive symptoms than non-victims of DV respectively. The strong association reinforces the need to conduct routine screening during pregnancy to identify and respond to women with DV and S&D. [ABSTRACT FROM AUTHOR]

Background High-risk pregnancies (HRP) place women and their offspring at the highest risk for morbidity and mortality. Maternal and medical risks increase pregnancy risk and complications during pregnancy and childbirth. Here, we reported the current prevalence of high-risk pregnancies among Indian women, which is defined through various factors such as maternal, lifestyle, medical, current health risk and adverse birth outcomes. Methods This is a cross-sectional study based on secondary data from India's National Family Health Survey-5 (NFHS-5). A total of 23853 currently pregnant women were considered for analysis after considering the inclusion and exclusion criteria. The prevalence and contributing factors of high-risk pregnancies were estimated using descriptive statistics and logistic regression, respectively. Results The prevalence of high-risk pregnancies among Indian women was 49.4%, with 33% of women having a single high-risk, and 16.4% having multiple high-risk pregnancies. Notably, pregnant women from Meghalaya and Manipur states had 67.8% and 66.7% with one or more high-risk factors, respectively. About 31.1% of women had short birth spacing, and 19.5% of women had adverse birth outcomes during the last birth. Logistic regression analysis showed that women with no education (adjusted odds ratio (AOR)=2.02; 95% confidence interval (CI)=1.84-2.22) and the poorest wealth quintile (AOR=1.33; 95% CI=1.04-1.29) had significantly higher odds of having HRP than those with higher education and the highest wealth quintile, respectively. Conclusions Nearly half of all pregnancies in India have one or more high-risk factors, which is a matter of concern, and the risks were higher among the vulnerable population such as no educated, poorest groups etc. The leading high-risk factors such as short-birth spacing, adverse birth outcomes, and caesarean deliveries should be addressed through the health policy and programmes. [ABSTRACT FROM AUTHOR]

Background Undiagnosed diabetes is a significant public health concern in India, considering the accumulative burden of diabetes and its long-term complications. We have estimated the prevalence and factors associated with undiagnosed diabetes in India. Methods We used data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21) to estimate undiagnosed diabetes prevalence aged under 50 (15-49) years. A log-binomial model with survey-adjusted Poisson regression was used to estimate the prevalence risk ratio (PR) between undiagnosed diabetes and various factors. Multinomial logistic regression analysis was performed to examine the factors associated with diagnosed diabetes (vs. healthy) and undiagnosed diabetes (vs. healthy). All the analyses were survey-weighted and stratified by gender and reported with 95% confidence intervals. Results The prevalence of diabetes for individuals aged 15-49 years was found to be 4.90% (4.80 to 5.00%) from the NFHS-5. Among them, the proportion of individuals with undiagnosed diabetes was 24.82% (24.07 to 25.59%), with higher among males (28.82% (26.45 to 31.30%)) than females (24.22% (23.44 to 25.01%)). The overall prevalence of undiagnosed diabetes was 1.22% (1.18 to 1.26%), with a higher prevalence among males (1.60% (1.46 to 1.76%)) than females (1.17% (1.13 to 1.21%)). Individuals who are middle-aged (45-49), have a higher body mass index (BMI), and are in a lower wealth index group, or live in the southern regions of India are at a higher risk of being undiagnosed for diabetes. Conclusion One in every four having diabetes is undiagnosed. The study highlights the need for public health interventions to improve diabetes screening and access to health care, particularly among middle-aged individuals, and those with higher BMI, as well as addressing lifestyle and dietary factors. The findings also reveal disparities in diabetes burden among population subgroups in India, underscoring the need for targeted efforts. [ABSTRACT FROM AUTHOR]

Purpose: This study on spatial analysis of child labour in India is a macro level analysis on child labour using the census data, 2011 of Government of India. The population census which is conducted once in 10 years only provides district level data on work-force distribution. The study has spatial analysis of child labour in the age group of 5–14 years in India. To assess the magnitude of the children in the labour force, district level data of Census 2011 has been used in the study. The study has made an attempt to identify the districts where there is high level of children in the labour force. This paper aims to estimate the magnitude and trends of children's workforce participation using the census data as it is the only data base, which is available at the district level since 1961 onwards. The study has made an attempt to identify the clustering of child labour across districts in India and how child labour is clustered by different background characteristics. Design/methodology/approach: The study has used ArcGIS software package, GeoDa software and local indicator of spatial association test. Findings: The findings of study reveal that the proportion of rural, total fertility rate (TFR) and poverty headcount ratio is positively associated, whereas female literacy and the pupil-teacher ratio are negatively associated with child labour. It suggests that in the hot-spot areas and areas where there is a high prevalence of child labour, there is need to increase the teacher's number at the school level to improve the teacher-pupil ratio and also suggested to promote the female education, promote family planning practices to reduce TFR in those areas for reducing the incidences of child labour. Research limitations/implications: The study also recommends that the incidences of child labour can be controlled by a comprehensive holistic action plan with the active participation of social workers. Practical implications: The promulgation of effective legislation, active involvement of judiciary and police, political will, effective poverty alleviation and income generation programmes, sensitisation of parents, corporates and media can play effective role in mitigating the incidences of child labour in India. To achieve the sustainable development goals (SDGs) adopted by world leaders in 2015 to eradicate child labour in all its forms by 2025. Social implications: The study aims to achieve the SDGs adopted by world leaders in 2015 to eradicate child labour in all its forms by 2025. Originality/value: The study is purely original and there are no such studies in Indian context by using the latest software. [ABSTRACT FROM AUTHOR]

Objective: To investigate the trends and patterns of the cancer burden among the elderly in different regions of India at a subnational level. Methods: Data were extracted from the Global Burden of Disease (GBD) Studies India Compare 2019. Prevalence rate, disability‐adjusted life years (DALY), and annual percentage change techniques were used to analyze data. Results: The three age groups with the highest prevalence of cancer were those aged 60–64 years, 65–69 years, and 70–74 years. In 2019, The prevalence of cancer among the elderly ranged from 7048.815 in Karnataka to 5743.040 in Jharkhand. Kerala has the most significant annual percentage change in the cancer prevalence rate of 0.291 between 1990 and 2019. The highest DALY rate was observed among individuals aged 80–84 years in 2019. That year, the DALY rate among the elderly was 8112.283 in India. The top five cancers with higher DALY rates among the elderly in India in 2019 were tracheal, bronchus, and lung cancer (908.473), colon and rectum cancer (752.961), stomach cancer (707.464), breast cancer (597.881), and lip and oral cavity cancer (557.637). Conclusion: Elderly individuals demonstrated a higher vulnerable to cancer compared to other age groups. There is a need for state‐specific government intervention to minimize the risk of cancer among the elderly due to the heterogeneity in the burden of cancer across Indian states. [ABSTRACT FROM AUTHOR]

Leukoplakia is a white mucosal thickening and perhaps undermining change in the oral mucosa transcendently found in tobacco users. Since the tobacco utilization is extensively higher with the indigenous groups in the Asia Pacific locale, the current examination implicated the prevalence of tobacco consumption and leukoplakial lesions and the relationship between the two. This cross-sectional study was conducted through six tribal hamlets of Chithalayath Forest range at Wayanad district of Kerala, South India. Leukoplakia screening was led by a senior consultant on the basis of a visual investigation and pathological evaluation was not done. An organized questionnaire was utilized to gather data on demographic details and tobacco usage status and frequency. The prevalence of clinical oral lesions among tobacco users and non users was determined using statistical analysis. Clinical oral leukoplakia was diagnosed in 27 (8.5%) subjects among the 317 individuals screened. The prevalence of lesions was considerably higher among tobacco consumers in comparison with non users (11 vs. 3.7%). Also, the tobacco chewers group had a higher percentage of leukoplakia. Another significant finding of this study is that the incidence of provisional leukoplakia was observed to be comparatively high among the most frequent tobacco consumers 15 (65.2%) in comparison with 8 (34.8%) in the frequent and nonfrequent users. Prevalence of abusive habits and clinical oral leukoplakial was substantial among the tribes. The cause and effect relationship and dose-response were also shown to have a significant association. [ABSTRACT FROM AUTHOR]

OBJECTIVES: In India, despite the high prevalence of vitamin B12 (vit B12) deficiency, the current public health policy focuses solely on iron and folic acid supplementation as a measure to prevent anaemia. Vit B12 is an important cofactor for enzymatic reactions related to DNA synthesis, folate, and cell metabolism. While folate deficiency has been acknowledged in not only the prevention of neural tube defects and other adverse pregnancy outcomes, the effects of low vit B12 status have not been well defined. It is becoming recognized that there is a much higher prevalence of B12 deficiency than earlier suspected, and more of its effect on maternal and fetal health is being reported. The current study was planned as an observational study to correlate the effects of vit B12 deficiency with respect to various feto-maternal outcomes. STUDY DESIGN: In this prospective cohort study a total of 300 antenatal women were screened for vit B12 levels in the late first trimester and were followed up to find out co-existent folic acid deficiency, development of pregnancy complications like anemia, gestational hypertension/pre-eclampsia, fetal growth restriction (FGR), second-trimester abortions, gestational diabetes mellitus (GDM) and preterm deliveries. RESULTS: It was found that most of the women with low B12 levels were vegetarian and had co-existent folic acid deficiency. They had a statistically significant increase in the incidence of anemia, preeclampsia, gestational diabetes, (small for gestational age) SGA/FGR, and preterm births. CONCLUSION: The study suggests that low levels of vit B12 increase the likelihood of adverse fetomaternal outcomes. Further research involving larger sample sizes is necessary to confirm these findings and determine if vit B12 supplementation should be included in pregnancy nutritional supplements, especially in vegetarian women. [ABSTRACT FROM AUTHOR]

Background: Vitamin A deficiency (VAD) and Anemia are important public health nutritional problems in India. Objective: To assess nutritional status and prevalence and correlates of undernutrition, anemia, and VAD among children. Materials and Methods: A community-based cross-sectional study was carried out adopting systematic random sampling. Information on socio-demographic particulars was collected and 20 µL blood was collected for hemoglobin and free-flowing drop on Whatman filter paper for Vitamin A estimation. Hemoglobin was estimated using indirect cyanmethemoglobin and Vitamin A by high-pressure liquid chromatography. Nutritional status was assessed using the WHO Child Growth Standard. Results: The overall prevalence of anemia and VAD was 68% and 59%, respectively, while underweight, stunting, and wasting was 30%, 55%, and 11%, respectively, among under 5 year children. Stepwise logistic regression analysis revealed no significant association of anemia and VAD with any sociodemographic variables, while the odd of stunting was four times higher among children of mothers engaged in labor and two times among children from low-income group, while underweight was two times higher among children from households not having sanitary latrine. Exclusive breastfeeding was observed to be associated with undernutrition among infants. Conclusions: Anemia, VAD, and stunting were high among children. Low intakes of green leafy vegetables and milk and milk product may be the reasons for the higher prevalence of anemia and VAD. There is a need to strengthen supplementation of iron and folic acid tablets and Vitamin A and also public distribution system. [ABSTRACT FROM AUTHOR]

Introduction: Mental health issues were neglected in India. However, coronavirus disease 2019 (COVID-19) had raised the importance of mental health. Hence, this study aimed to determine the prevalence of awareness and utilization of the mental health services provided by primary care centers during the COVID-19 pandemic. Methods: This community-based cross-sectional study was conducted among individuals aged 18 years and above in selected primary health center (PHC) service areas, Karnataka, South India. The sample size was 388. A semi-structured questionnaire was used to collect the information. Results: The mean (standard deviation [SD]) age of the participants was 42.7 (±15.37) years and 76% were female. The prevalence of awareness was 47% (95% confidence interval [CI] 41.8%–52.0%), and only 1% (95% CI 0.8%–2.6%) had utilized the mental health services through PHCs during COVID-19. About 82% (95% CI 78.0%–85.8%) were willing to avail the mental health services through PHCs. No formal education (adjusted prevalence ratios [APR] = 7.33, 95% CI 1.81–29.60, P = 0.005) and current psychological distress (APR = 2.99, 95% CI 2.08–4.30, P = 0.00) were significantly associated with unwillingness to avail care from PHCs. Conclusion: The awareness and utilization of mental health services through primary care centers were poor in the community. Strategic measures must be implemented through the mental health program to improve the utilization of the services. [ABSTRACT FROM AUTHOR]

Background: Minority social status determined by religion, caste and tribal group affiliations, are usually treated as independent dimensions of inequities in India. This masks relative privileges and disadvantages at the intersections of religion-caste and religion-tribal group affiliations, and their associations with population health disparities. Methods: Our analysis was motivated by applications of the intersectionality framework in public health, which underlines how different systems of social stratification mutually inform relative access to material resources and social privilege, that are associated with distributions of population health. Based on this framework and using nationally representative National Family Health Surveys of 1992–93, 1998–99, 2005–06, 2015–16 and 2019–21, we estimated joint disparities by religion-caste and religion-tribe, for prevalence of stunting, underweight and wasting in children between 0–5 years of age. As indicators of long- and short-term growth interruptions, these are key population health indicators capturing developmental potential of children. Our sample included Hindu and Muslim children of < = 5 years, who belonged to Other (forward) castes (the most privileged social group), Other Backward Classes (OBCs), Schedule Castes (SCs) and Schedule Tribe (STs). Hindu-Other (forward) caste, as the strata with the dual advantages of religion and social group was specified as the reference category. We specified Log Poisson models to estimate multiplicative interactions of religion- caste and religion-tribe identities on risk ratio scales. We specified variables that may be associated with caste, tribe, or religion, as dimensions of social hierarchy, and/or with child growth as covariates, including fixed effects for states, survey years, child's age, sex, household urbanicity, wealth, maternal education, mother's height, and weight. We assessed patterns in growth outcomes by intersectional religion-caste and religion-tribe subgroups nationally, assessed their trends over the last 30 years, and across states. Findings: The sample comprised 6,594, 4,824, 8,595, 40,950 and 3,352 Muslim children, and 37,231, 24,551, 35,499, 1,87,573 and 171,055 Hindu children over NFHS 1, 2, 3, 4, and 5, respectively. As one example anthropometric outcome, predicted prevalence of stunting among different subgroups were as follows- Hindu Other: 34.7% (95%CI: 33.8, 35.7), Muslim Other: 39.2% (95% CI: 38, 40.5), Hindu OBC: 38.2 (95%CI: 37.1, 39.3), Muslim OBC: 39.6% (95%CI: 38.3, 41), Hindu SCs: 39.5% (95%CI: 38.2, 40.8), Muslims identifying as SCs: 38.5% (95%CI: 35.1, 42.3), Hindu STs: 40.6% (95% CI: 39.4, 41.9), Muslim STs: 39.7% (95%CI: 37.2, 42.4). Over the last three decades, Muslims always had higher prevalence of stunting than Hindus across caste groups. But this difference doubled for the most advantaged castes (Others) and reduced for OBCs (less privileged caste group). For SCs, who are the most disadvantaged caste group, the Muslim disadvantage reversed to an advantage. Among tribes (STs), Muslims always had an advantage, which reduced over time. Similar directions and effect sizes were estimated for prevalence of underweight. For prevalence of wasting, effect sizes were in the same range, but not statistically significant for two minority castes-OBCs and SCs. Interpretation: Hindu children had the highest advantages over Muslim children when they belonged to the most privileged castes. Muslim forward caste children were also disadvantaged compared to Hindu children from deprived castes (Hindu OBCs and Hindu SCs), in the case of stunting. Thus, disadvantages from a socially underprivileged religious identity, seemed to override relative social advantages of forward caste identity for Muslim children. Disadvantages born of caste identity seemed to take precedence over the social advantages of Hindu religious identity, for Hindu children of deprived castes and tribes. The doubly marginalized Muslim children from deprived castes were always behind their Hindu counter parts, although their differentials were less than that of Muslim-Hindu children of forward castes. For tribal children, Muslim identity seemed to play a protective role. Our findings indicate monitoring child development outcomes by subgroups capturing intersectional social experiences of relative privilege and access from intersecting religion and social group identities, could inform policies to target health disparities. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to understand the complex relationship between maternal complications and women's characteristics in India. Methods: The present study builds structural equation modeling (SEM) using the data from the National Family Health Survey round 4 (2015–16) and includes 190, 898 women who had given their last birth during 5 years preceding the survey. Based on eight questions related to maternal complications, the SEM constructed two latent variables – complications during pregnancy (PREGCOMP) and delivery (DELCOMP). Results: Result shows that prolonged labor was highly prevalent (42%) among women, followed by vaginal bleeding (34%) and swelling in legs, body or face (32%). Women from affluent households (β = −0.02 for each‐middle, richer and richest quantile), with higher education (β = −0.02), timing when they received first ANC (β = −0.003) and women who received full ANC (β = −0.01) had a lower risk of PREGCOMP. However, consanguineous marriage (β = 0.01) was positively related to PREGCOMP. Further, women with PREGCOMP (β = 0.20), rural residents (β = 0.02), having exposure to mass media (β = 0.01), and who had facility delivery (β = 0.04) were at high risk of DELCOMP. Women with pregnancy complications are more likely to have delivery complications. [Correction added on 27 November, after first online publication: The statement "who received full antenatal care (ANC) (β = −0.05)" has been removed.] Conclusion: Socioeconomic and demographic factors significantly affect both the latent variables. This study concludes that the use of intensive healthcare services reduces health complications. The paper recommends early visits and full ANC checkups to reduce pregnancy complications. [ABSTRACT FROM AUTHOR]

To review the available evidence about the prevalence and determinants of antenatal common mental disorders (antenatal CMDs) among women in India. We searched Ovid Medline, Embase and Psyinfo systematically from date of inception to Oct. 31, 2019 for publications in English language on the prevalence of antenatal CMDs and their determinants among women in India. All study designs were included. Quality was assessed with Standard Quality Assessment Criteria for Evaluating Primary Research Papers. We performed a meta-analysis using a random effects model. Twenty-seven studies involving 7780 women were analysed. There was a high degree of heterogeneity ((I2 = 97.53%). Publication bias [Egger bias = 0.65 (95% CI: 0.36;.94)] was evident. The overall pooled estimate of the prevalence of antenatal CMDs was 21.87% (95% CI: 17.46; 26.29). Significant risk factors reported in the 18 studies which examined them were negative reaction of husband or in-laws to the dowry, difficult relationship with husband/in-laws, lack of support or experiencing violence perpetrated by an intimate partner and preference for or feeling pressured to have a male child. Protective factors were having more education and being employed, having a supportive husband and opportunities for recreation during pregnancy. Antenatal CMDs are highly prevalent among women in India. There is an urgent need for locally developed policies and programmes for mental health promotion during pregnancy, preventive and early intervention for antenatal CMDs among women to be integrated into maternity care in India. [ABSTRACT FROM AUTHOR]

William J. Niblock (WJN), an Assistant Surgeon at the Madras General Hospital (MGH), published a paper 'Cancer in India' (2 pages of text and 3 pages of tables) in the Indian Medical Gazette in 1902. He appears to have been a popular surgeon in Madras who surgically treated mouth cancers, testicular filariasis, and calcareous stones in the liver, gall bladder, and kidney. His 'Cancer in India' article is a compilation of numerical data of different cancers recorded in MGH from 1892 to 1901 mostly, and from 1896 to 1901 occasionally. In this article, WJN refers to cancers of different internal organs and external parts. He attributes the mouth cancers to constant chewing of 'betel' (the betel quid), which he explains as giving rise to leukoplakia, forerunner of buccal carcinoma. He supplies many, easily comparable, paired tables. These tables are made of raw numbers about the diverse human populations living in Madras, such as the Indians (Hindus and Muslims), Europeans, and Eurasians (Anglo-Indians) extracted from the 10-year records of MGH. None of the tables has been analyzed statistically. Nevertheless, he supplies the total numbers of admissions into MGH, which serve usefully as denominators in this study; occasionally, he presents data as percentages. Despite the lack of parametric statistical analysis, WJN's article, written in 1902, impresses as a useful contribution, because it provides a cross-sectional view of cancer incidence in Madras, particularly in defiance of Saldanha's supposition that cancers do not manifest in dark-skinned people, such as Indians. [ABSTRACT FROM AUTHOR]

Background: Often obesity and hypertension are bracketed with developed countries, urban locations, and affluent societies. Yet, there is a recent secular trend in rising adiposity and cardiovascular risks, even in rural locations in developing countries like India. Objectives: Our study aimed to assess the prevalence of obesity and hypertension among the Chakhesang adults, emphasizing the association between body mass index (BMI) and blood pressure (BP) traits and their socio-demographic correlates. Methods: A crosssectional study was conducted among the Chakhesang adults of Nagaland. The total sample comprises 209 participants (102 females and 107 males) aged 18-50 years. BMI was classified according to the classification given by WHO for adult Asians. Whereas BP traits were classified based on the Joint National Committee (JNC) protocols. Results: The overall prevalence of overweight and obesity was 42.6% and 13.4%, respectively, while systolic and diastolic hypertension was prevalent at 22.5% and 28.2%, respectively. Results of the linear regression depicting the relationship between BMI and BP traits presented significant figures. Further, the multivariate multiple regression (MMR) analyses yielded a positive association of sex, age, occupation, and income with BMI and BP traits. In contrast, education was found to have a negative impact on both BMI and BP. Conclusion: The prevalence of overweight/obesity and hypertension in this tribal community is relatively high for a rural setting. Socio-economic changes pertaining to occupation shift and adoption of modern lifestyle are the causal factors for high cases of obesity and hypertension among the Chakhesang adults. [ABSTRACT FROM AUTHOR]

Background: The emergence of drug-resistant tuberculosis (DR-TB), a challenging health condition to treat, poses serious problems for public health in India. Unfavorable socioeconomic conditions, limited access to healthcare and insufficient diagnostic tools all increase vulnerability. Comorbidities also make it more difficult to treat TB and promote the development of DR-TB. Objectives: The primary goal of this review study was to focus particularly on the DRTB epidemic in India. Our understanding of DR-TB will be expanded as a result of this study, which will also make it easier to develop focused interventions and public health regulations to deal with this problem. Methods: A meticulous systematic literature review was carried out using a wide range of electronic databases from around the world, including reputable sources. Results: The prevalence of DR-TB is rising over time. The main factors contributing to the disease's rising prevalence are genetic changes in Mycobacterium tuberculosis, and the appearance of comorbidities in TB patients. In contrast, these elements impair immunity, increase the likelihood of side effects from treatment, and promote the spread of DR-TB. Conclusion: To address the problems brought on by DR-TB, the TB epidemic necessitates a thorough, multi-sectoral approach. Initiatives for targeted public health education and awareness are essential to lowering the prevalence of DR-TB and improving general health outcomes in India. [ABSTRACT FROM AUTHOR]