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Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Sudden cardiac death (SCD) is a leading cause of mortality worldwide and, in recent years, has become an urgent public health concern in low- and middle-income countries (LMICs). Data from LMICs, however, remains limited. As such, the aim of this article is to systematically review the current literature on the incidence of SCD in LMICs to inform policymakers and identify potential research gaps. A search of PubMed and Embase was utilized to capture the targeted condition, outcome, and setting. Only peer-reviewed cohort studies in LMICs reporting SCD incidence estimates in the general population of individuals aged ≥1 year were eligible for selection. Papers providing incidence data for specific types of SCD, including sudden coronary death or death from sudden cardiac arrest, were also included. After deduplication, 1941 citations were identified and screened. Seven studies representing four countries--Cameroon, China, India, and Iran--met the criteria for inclusion and were considered in our analysis. The crude incidence rate for SCD ranged from 19.9 to 190 cases per 100,000 person-years, while ageadjusted rates ranged from 33.6 to 230 cases per 100,000 person-years. There was notable variability in methods utilized to ascertain SCD cases. These findings suggest that the incidence of all-cause SCD in LMICs and may exceed that of high-income countries; however, observed disparities may be partly attributable to differences in case ascertainment methods. Additional research is needed to better understand the true incidence of SCD in developing countries. It is crucial that future studies across regions utilize standard diagnostic criteria and methodology for identifying SCD, which would provide a framework by which to compare outcomes between settings. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) recommends the requirement of human resource for health (HRH) stands at 44.5 skilled health workers per 10,000 population. WHO recognizes India as one of the countries which has HRH crisis. Karnataka, a southern state in India, has the highest number of medical colleges yet faces the shortage of specialists in the public hospitals. We conducted desk review to understand the HRH crisis, particularly the medical specialists in India. Simultaneously, we conducted secondary research to explore the initiatives taken by the Government of Karnataka (GoK) to mitigate the shortage of medical specialists in the rural areas. GoK scaled up the National Board of Examination in Medical Sciences (NBEMS) postgraduate and super-speciality courses such as Diplomate of National Board (DNB), Diploma, and Doctorate of National Board (DrNB) in district hospitals (minimum 250--500 bedded) and taluk hospitals (minimum 100 bedded) by utilizing the existing resources. Karnataka is the first state in India to expand the NBEMS (DNB and Diploma) courses in taluk hospitals and to begin DrNB courses in district hospitals. The paper documents the process of implementation of the NBEMS courses at district and taluk hospitals of Karnataka, which has supported in strengthening these hospitals in the state. [ABSTRACT FROM AUTHOR]

Introduction: Mid-upper arm circumference (MUAC) measures the arm muscle and fat area. The use of MUAC as a screening measure for assessing undernutrition has the following advantages; it makes use of a simple equipment, is easy to carry at the field sites, and requires minimal training. In India, "mid-upper arm circumference" is widely used and accepted in many nutritional programs. Objectives: This study was conducted with the primary objective to compare different anthropometric parameters of children and to validate the usefulness and limitations of MUAC to screen out undernourished children. Subject and Methods: Anthropometric measurements were recorded for all the anganwadi centers of the selected sub-center that comes under the field practice area of our department. The measurements like weight, height, MUAC were done according to the standard guidelines as per WHO, and further, calculations were done with the help of "Anthro software 3.2.2." Comparisons were done between categorization of MUAC tape and Weight-for-Height Z-scores (WHZ), and hence, the sensitivity and specificity of the MUAC tape to screen the malnourished child were found out. Results: Sensitivity of MUAC to categorize a child in red/yellow was only 9.03%, negative predictive value (NPV) was 40.75%, specificity came 95.10%, and positive predictive value was 73.68% on taking WHZ as the gold standard. Conclusion: MUAC has a limited role in screening out an undernourished child (red/yellow category), whereas it has a good role in screening healthy children (green category). [ABSTRACT FROM AUTHOR]

Background: Women's empowerment, a precondition of sustainable development, is a multidimensional and complex concept, often described with three interrelated components: resources, agency, and achievement. There is no universal construct for women's empowerment; rather, it has been assessed based on the context. It had been hardly explored in rural West Bengal. Objectives: This study was formulated to construct a women's empowerment index (WEI), in rural West Bengal, and assess the reliability of the index. Methods: A community-based cross-sectional study focusing on Women's Empowerment, Child Health and Nutrition (WE-CHANT) was conducted in a community development block in West Bengal. Mother (of reproductive age)--child (6--59 months) pairs were recruited from 20 villages by two-stage sampling (n = 268). Mothers were interviewed. Exploratory factor analysis (EFA) with oblique rotation was conducted with 25 measurement variables to construct the WEI. The internal consistency was assessed with Cronbach's alpha, item-rest, average inter-item, inter-domain, and domain-to-index correlation. Results: A 12-item (factor loading ≥0.40) WEI comprising three domains--decision-making power, attitude toward gender-based violence (GBV), and social independence--was constructed with acceptable internal consistency (Cronbach's alpha = 0.747). The multidimensionality of the index was also observed. Conclusion: A concise agency-based WEI was constructed, where decision-making power was explored as the major domain. This index in the context of rural West Bengal could be further utilized to assess women's empowerment and elicit its association with resources and achievements. [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]

Evidence for reducing cardiovascular and renal events with sotagliflozin is uncertain among type 2 diabetes mellitus (T2DM) patients. To gather more evidence, this meta-analysis assesses the beneficial effects of sotagliflozin, a dual sodium--glucose cotransporter 1 and 2 inhibitor, in reducing the cardiovascular and renal events in diabetic patients with or without chronic kidney disease (CKD). Scopus, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed were the databases used to search. The studies published from January 1, 2018, to January 30, 2022, were considered. The eligibility of studies was assessed independently. The data were collected in a modified Cochrane data extraction form. The included studies' quality was assessed with the Cochrane risk-of-bias tool. The quality of evidence for renal and cardiovascular outcomes was evaluated using GRADEpro software. The number of events of urgent visits to the hospital and requiring hospitalization was reduced (RR: 0.73; 95% CI: 0.69, 0.78; P value <0.00001). The mortality rate because of cardiovascular events was decreased with sotagliflozin (RR: 0.73; 95% CI: 0.67, 0.80; P value <0.00001). Patients taking sotagliflozin had a drastic decline in the number of deaths due to stroke and non-fatal myocardial infarction. Yet, there is no difference between the groups in terms of changes in mortality due to other causes or the glomerular filtration rate (GFR). Sotagliflozin demonstrated effectiveness in reducing the mortality rate related to heart failure and cardiovascular events when the dose was increased from 200 mg to 400 mg. Despite this, evidence is still needed to prove the renal protective action. [ABSTRACT FROM AUTHOR]

Intellectual disability (ID) is a public health challenge affecting communities worldwide. ID is characterized by impaired physical and cognitive functioning and less engaged in physical activities. The objective of this study was to assess the impact of adaptive yoga practices on cognitive and motor abilities in the subjects with ID. Sixty-six subjects with mild and moderate IDs were purposively selected and randomly divided into experimental and control groups, with 33 subjects in each group. One month of adaptive yoga module was provided to the experimental group. To assess the impact of the yoga intervention, Functional Reach Test (FRT), Wall Toss Test (WTT), Finger Tapping Test (FTT), Sit-- Reach Test (SRT), and Six Letter Cancellation Test (SLCT) were administered. The experimental group showed a statistically significant improvement with P < 0.05 across all the parameters, whereas the control group could not observe a significant improvement. Based on the results, this study concludes that "one month of adaptive yoga module" delivered impact and helped to improve the dynamic balance, eye--hand coordination, neuro-motor function, spinal flexibility, and selective attention in ID-afflicted subjects. [ABSTRACT FROM AUTHOR]

Background: Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans. Material and Methods: Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers' families. Results: Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population. Conclusions: The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation. [ABSTRACT FROM AUTHOR]

Background: Menstruation is a natural, physiological process experienced by all adolescent girls and women. The reproductive age group is the largest and most susceptible to various health and illness-related risk factors. This study aims to find the prevalence of satisfactory menstrual hygiene management (MHM) among women of reproductive age group and we also want to explore the cultural practices and beliefs related to menstruation and barriers to satisfactory MHM. Material and Methods: This study was conducted in rural field practice areas of Department of Community and Family Medicine, AIIMS, Rishikesh including 271 participants; women of reproductive age group using a mixed method study design (sequential quan--qual). Quantitative data were collected by household surveys and government schools using a validated structured questionnaire. Descriptive statistics were used to analyze the data. Focus group discussions (FGD) were conducted to have insights about understanding menstrual hygiene and barriers to satisfactory hygiene practices. Results: It was found that only 70 (29.6%) participants adhered to satisfactory menstrual hygiene practices. The age group of 20--24 years had a higher proportion compared to other groups. Through FGD, the main themes derived were practices related to menstruation (maintenance of personal hygiene), daily activities (physical and mental problems during menses), and barriers faced (cultural, economic, privacy concerns, and shyness). Conclusion: The prevalence of satisfactory menstrual hygiene practices was very low only 29.6%, which is a cause of concern; either Taboos associated with menstruation, socio-cultural, economic barriers, or lack of awareness related to menstrual hygiene in the community can be contributing factors for low prevalence. [ABSTRACT FROM AUTHOR]

Background: Social and community participation are major indicators to assess the adequacy of treatment and rehabilitation in patients with spinal cord injury (SCI). This study examined the relationship between functional independence, level of disability, and social and community participation among people with SCI in India. Materials and Method: In this cross sectional study, 110 persons with SCI, aged 18 years and above participated in a community setting, in Karnataka, India. Spinal Cord Independence Measure Version III-self-reporting (SCIM III-SR), Craig Handicap Assessment and Reporting Technique (CHART), and WHO Disability Assessment Schedule 2.0 (WHODAS) were the clinical outcome measures. Spearman's correlation and stepwise multiple linear regression were done to determine association and identify the factors determining the community participation of people with SCI. Results: CHART physical independence had a positive correlation with SCIM self-care (R = 0.446) and SCIM mobility (r = 0.434). CHART cognitive independence (R = -0.38) and CHART mobility (R = -0.396) had a weak correlation with WHODAS. SCIM self-care and SCIM mobility (R² = 0.34) were determinants of CHART cognitive independence. SCIM respiratory and sphincter management and SCIM self-care (R² = 0.327) were determinants of CHART mobility. Conclusion: Self-care and mobility of people with SCI determine their ability to successfully reintegrate into the community, warranting a comprehensive community rehabilitation program. [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]

Background: COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels. Material and Methods: The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box-Jenkins approach was used to estimate future air pollution data points using time series data analysis. Results: The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin. Conclusion: The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health. [ABSTRACT FROM AUTHOR]

Introduction: Safe disposal of feces is ensured when it is deposited into a toilet, whereas unsafe disposal of child's feces plays a crucial role in disease transmission and environmental pollution. These areas are overlooked by many sanitation promotion interventions. Objective: To determine the effect of positive deviance (PD) approach on safe disposal of child's feces among households who owned a toilet. Materials and Methods: A community-based quasi-experimental study was conducted in the four field practice villages of the Urban Health Training Center, Villupuram, for 18 months. Households who owned a toilet and had a child less than 5 years old were included. After IEC clearance, information was collected from a representative sample of 100 households before intervention and another 100 households after intervention. PD approach was applied for 6 months to promote safe disposal practices in the study villages. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 24). The Chi-square test was used to determine the significance of difference between baseline and endline data. The effect size was calculated to estimate the magnitude of difference between baseline and endline data. Results: Before intervention, only 3% of households disposed the feces into a toilet, while after intervention, almost 38% of households disposed in the toilet (χ² = 37.39; df = 1; P = 0.001). The effect size (Cramer's V) was found to be 0.43. Conclusion: PD approach demonstrated considerable improvements in safe disposal of child's feces in rural settings. Further, to sustain the behavior change, frequent reinforcement of key messages at frequent intervals needs to be emphasized. [ABSTRACT FROM AUTHOR]

Background: One of the most important aspects of women's well-being and welfare is RSH (reproductive and sexual health). Reproductive health is not an exception to the threat that CCC (climate change and climate crisis) poses to numerous facets of public health. Firstly, the present review seeks to identify the influence of climatic changes, natural disasters, and climate-driven migration on RSH. Secondly, to identify knowledge gaps regarding the same. Material and Methods: Two databases (Scopus and PubMed) were scanned using Boolean operation. The literature search aimed to find records pertaining to topics of RSH and climate change. Using the PRISMA-ScR method, records were screened and shortlisted based on established inclusion criteria. This literature search was carried out in November 2022. In the shortlisted records, preference for the comprehensive review articles was given. Results: The present review is based on 38 records that collectively revealed that climate crisis and natural disasters have many negative impacts on female reproductive health. These effects are observed in different phases of life, ranging from teenage to menopause. The unique strength of the present review is that it draws a relationship between female reproductive health and the direct as well as indirect effects of the CCC. The available literature about LMICs is predominantly confined to drought, flood, and earthquake. Disasters like tsunamis, cyclones, and avalanches remain unexplored. Conclusion: From the available literature, it is quite evident that CCC has an adverse effect on a woman's reproductive life as well as a bearing on future generations' health. Filling these knowledge gaps is pivotal for designing more effective disaster and health policies. Policymakers should take into consideration these detrimental effects while designing health schemes and policies for females. [ABSTRACT FROM AUTHOR]