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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]

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]

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]

Background: Evidence of hysterectomy in India is limited mainly due to lack of information in large-scale nationally representative health surveys. In 2015–16, the fourth National Family Health Survey (NFHS-4) – a cross-sectional survey – collected for the first time direct information on hysterectomy and self-reported reasons for undergoing the procedure among women in the reproductive age group. This paper examines the prevalence and determinants of hysterectomy in India among women aged 30–49 years in 29 states and seven union territories (UTs) of India using the NFHS-4 dataset. Methods: Percentage weighted by sampling weights was used for estimating the prevalence of hysterectomy. The paper used crosstabulations and percentage distributions to estimate the prevalence of hysterectomy across different socioeconomic backgrounds and reasons for undergoing hysterectomy respectively. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy. Results: In India as a whole, 6 % of women aged 30–49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs (from a minimum of 2% in Lakshadweep to a maximum of 16% in Andhra Pradesh). A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector except in the northeast region. Years of schooling, caste, religion, geographic region, place of residence, wealth quintiles, age, parity, age at first cohabitation, marital status, and body mass index of women were found to be the sociodemographic determinants statistically associated with hysterectomy in India. The reasons reported frequently for hysterectomy were excessive menstrual bleeding/pain (56%), followed by fibroids/cysts (20%). Conclusion: The percentage and likelihood of undergoing hysterectomy are relatively high among women from older age groups (45–49), those who reside in rural areas, those without schooling, those who are obese, those having high parity, those with a low age at first marriage, and those who reside in the eastern and southern parts of India. The policy implication of these findings is that the reproductive health program managers should ensure regular screening and timely treatment of the problems resulting in hysterectomy. [ABSTRACT FROM AUTHOR]

Background: During the last century, Kerala witnessed drastic mortality reduction and high improvement in longevity. This achievement is often compared with that of developed countries. However, how far the early advantages in mortality reduction have further enhanced in Kerala remains unknown. In most developed countries, advanced stage of mortality reduction and further increase in longevity was achieved mainly due to the mortality shift from adult and older ages to oldest ages (Olshansky and Ault 1986). Objectives: Considering the lack of comprehensive study on the change in longevity in Kerala, this study focuses on discovering (i) the historical time-periods that provided the biggest gain to life expectancy and also the beneficiaries (by age group and sex) and (ii) the contributions of major groups of causes of death in mortality reduction and consequent improvement in longevity. Methodology and data: The study uses the methodology proposed by Olshansky and Ault in 1986. It used methods such as Temporary Life Expectancy (TLE), Annual Relative Change in TLE, Decomposition of changes in longevity among different age groups (gender and spatial) and causes of deaths, for the analysis. It used data from various sources such as Census, Civil Registration System (CRS) and Directorate of Health Services (DHS), as well as survey data from Sample Registration System (SRS) and Medically Certified Causes of Deaths (MCCD) for this study. Finding and conclusion: The study found that overall mortality dramatically declined in the state in the recent decades. Younger ages have contributed the most for this reduction. Therefore, further mortality reduction is possible in adult and early old ages. However, the contribution of these ages to life expectancy was lower than that of youngsters until 1991-2000 especially among males. This may indicate a slow progress towards the advanced stage of epidemiological transition characterized by high prevalence of non-communicable diseases. The paper concludes that although the health issues of infants, children, and mothers in the reproductive age group, are effectively addressed through various policies in Kerala, the state needs to focus more on the health problems of adults, especially males. [ABSTRACT FROM AUTHOR]

Highlights • Elderly being married, acquiring resources and, practicing higher social action enjoy higher degree of social capital. • Elderly with higher degree of social capital are seen to experience better quality of life and healthy aging. • Social capital is signifcanly associated to lowering functional limitation, depression among eldelry. • High access to psychological resources regarding controlling important things in life put profound impact on the quality of life. • Emerging need to highlight the component of social capital in framing policy for elderly in India. Abstract Background Lacuna in contemporary Indian academic research highlights the need to investigate the component of social capital and health outcome among elderly individuals in Indian context. Study endeavors to investigate prevalence of health indicators: self-rated good health(SRH), functional limitation, depression and quality of life(QoL) and the illustrative effects of social capital on elderly health outcome and QoL. Methods Nationally representative cross-sectional data from WHO Study on global AGEing and adults health (SAGE) India 2007 is used. Individuals aged 50+ are included where logistic regression is used to estimate the effect of social capital along with other co-founders on SRH, functional limitation, and depression. Linear regression model is used to analyse evaluates the impact of social capital with other co-founders on QoL among elderly. Results The multivariate analysis shows that SRH is associated with age, female, those having education, higher social-action with strong trust, safety and higher psychological resources. Depression among elderly is significantly related to age, gender, education level, higher wealth, strong sociability. QoL is inversaly related to age, gender, being muslim. A positive association of QoL is observed with higher education, having wealth, and strong social capital component like currently married, civic engagement, social-action, trust solidarity,and strong psychological resources. Conclusion The paper presents evidence that social capital significantly associated with SRH, lower depression, better functional health and higher quality of life. Hench forth policy makers should construct social policy where elderly feel safe and trusty surrounding, that can involved them into main stream as a productive resource of society. [ABSTRACT FROM AUTHOR]

Anaemia control programmes in India are hampered by a lack of representative evidence on anaemia prevalence, burden and associated factors for adolescents. The aim of this study was to: (1) describe the national and subnational prevalence, severity and burden of anaemia among Indian adolescents; (2) examine factors associated with anaemia at national and regional levels. Data (n = 14,673 individuals aged 10–19 years) were from India's Comprehensive National Nutrition Survey (CNNS, 2016–2018). CNNS used a multistage, stratified, probability proportion to size cluster sampling design. Prevalence was estimated using globally comparable age‐ and sex‐specific cutoffs, using survey weights for biomarker sample collection. Burden analysis used prevalence estimates and projected population from 2011 Census data. Multivariable logistic regression models were used to analyse factors (diet, micronutrient deficiencies, haemoglobinopathies, sociodemographic factors, environment) associated with anaemia. Anaemia was present in 40% of girls and 18% of boys, equivalent to 72 million adolescents in 2018, and varied by region (girls 29%–46%; boys 11%–28%) and state (girls 7%–62%; boys 4%–32%). Iron deficiency (ferritin < 15 μg/L) was the strongest predictor of anaemia (odds ratio [OR]: 4.68, 95% confidence interval [CI]: [3.21,6.83]), followed by haemoglobinopathies (HbA2 > 3.5% or any HbS) (OR: 2.81, 95% CI: [1.66,4.74]), vitamin A deficiency (serum retinol <20 ng/ml) (OR: 1.86, 95% CI: [1.23,2.80]) and zinc deficiency (serum zinc < 70 μg/L) (OR: 1.32, 95% CI: [1.02,1.72]). Regional models show heterogeneity in the strength of association between factors and anaemia by region. Adolescent anaemia control programmes in India should continue to address iron deficiency, strengthen strategies to identify haemoglobinopathies and other micronutrient deficiencies, and further explore geographic variation in associated factors. Key messages: The Comprehensive National Nutrition Survey (CNNS) 2016–2018 is the only nationally representative survey to measure haemoglobin, haemoglobinopathies, biomarkers of micronutrient deficiencies, diet and social factors in Indian adolescents aged 10–19 years.Using CNNS data, we found that 28.5% of adolescents (girls: 39.6%, boys: 17.6%) were anaemic, with variation by region or state.Our prevalence estimates translate to 72 million adolescents being anaemic, with Uttar Pradesh having twice as many anaemic adolescents as any other state.Iron deficiency, haemoglobinopathies, vitamin A deficiency and zinc deficiency were associated with an increased risk of anaemia; these associations may vary subnationally. [ABSTRACT FROM AUTHOR]

Objectives: This paper investigates severe partner perpetrated burn (SPPB) in India and associated social correlates.Methods: Data are from the National Family Health Survey (NFHS-3), a cross-sectional nationally representative household-based survey. Age, wealth index, education, urban/rural status, region, in-law violence, parental abuse, father abuse of mother, presence of a son, and age at marriage were examined for relationships with SPPB. Models with two reference groups were created (women without intimate partner violence; women with other non-burn intimate partner violence). Logistic regression analyses were computed.Results: Prevalence of SPPB was 1.00% (n=429). When compared to women with no intimate partner violence (IPV), greater wealth and rural status were protective of SPPB, but having a father who abused the participant's mother increased odds of SPPB over three times. When compared to women who had experienced IPV, presence of a son was protective of SPPB, as was not living in the South. Similarities between models included increased odds of SPPB associated with in-law violence and younger age at marriage.Conclusions: SPPB was associated with measures that impacted odds of its occurrence. Prevention efforts should consider these and other cultural factors. [ABSTRACT FROM AUTHOR]

Background  Various risk factors for tumors such as smoking, alcohol consumption, diet, and radiation, etc., were already identified. ABO blood group antigens are also present on epithelia, endothelia, and neurons. Recent evidence suggested the role of ABO antigens in the pathogenesis of certain malignancies. Materials   and Methods A retrospective observational study was conducted in a tertiary care neurosurgical center in North India from January 2016 to December 2018. The hospital information system was used to obtain patient information while the blood center information system was used to collect blood group information. Brain tumors were majorly divided into cavernoma, glioma, meningioma, neuroma, pituitary adenoma, schwannoma, and others. Results  We found a total of 1,970 patients with brain tumors admitted during our study period. Most patients had glioma (33.55%), followed by pituitary adenoma (20.05%) and neuroma (2.23%). B blood group individuals had more prevalence of cavernoma, glioma, meningioma, pituitary adenoma, schwannoma, and others followed by O, A, and AB. Only association of O blood group with neuroma tumor was found statistically significant. Conclusions  Our patient population had blood group distribution similar to our general population and no significant association was observed by blood group antigens and brain tumors. Although neuroma was significantly associated with blood group O but the prevalence of neuroma in our patient population is very low hence large sample study is required to draw a firm conclusion regarding this association. [ABSTRACT FROM AUTHOR]

Objectives: Current tobacco use (CTU) and secondhand smoke (SHS) exposure among older adults in India (≥60 years) are prevalent in India and indicate the importance of addressing associated factors. Methods: Pooled Global Adult Tobacco Survey India 2009–2010 and 2016–2017 data (n = 17,299) for older adults examined prevalence of CTU and SHS exposure at home and/or in public places and associated socioeconomic and demographic correlates. Results: CTU among older adults in India was 44.6%, and SHS exposure at home and public places were 20.0% and 30.0%, respectively. Men, younger age-group, rural, lower education, lower wealth index, and lower knowledge were independently associated with CTU. Men, rural, lower education, lower wealth index, CTU, and lower knowledge were independently associated with SHS exposure at home. Men, younger age, and rural residence were associated with SHS exposure in public places. Conclusion: CTU and SHS exposure among older adults in India suggest targeted interventions to address associated social and demographic factors. [ABSTRACT FROM AUTHOR]

Multiple micronutrient deficiencies (MNDs) co‐exist, often because of poor intakes and adversely impact health. Habitual diets were assessed in 300 school children (6–17 years old) recruited from two government schools by simple random sampling. Probability of adequacy (PA) for 11 micronutrients and mean probability of adequacy (MPA) was calculated. Haemoglobin, plasma ferritin, folic acid, vitamin B12 and C‐reactive protein were estimated. Descriptive statistics and regression analysis were used to estimate magnitude and factors associated with MNDs. The contribution of fortified foods and/or supplements in addressing inadequacies and excessive intakes was modelled. The PA ranged from 0.04 for folate to 0.70 for zinc, and the MPA was 0.27. Prevalence of anaemia (53%), iron deficiency (57%; ID), iron deficiency anaemia (38%; IDA), folate deficiency (24%) and B12 deficiency (43%) was high. Dietary inadequacy of iron, zinc and a low MPA was associated with anaemia and IDA. Inclusion of double fortified salt (DFS), fortified rice (FR) or iron folic acid (IFA) supplements individually in habitual diet reduced probability of iron inadequacy significantly from 82% to ≤13%. Inclusion of DFS and FR simultaneously led to disappearance of iron inadequacy, but risk of excessive intake increased to 16%. Inclusion of DFS, FR and IFA together increased risk of excess iron intake to 40%. Nevertheless, intakes of folate and B12 remained inadequate even with FR and/or IFA. These results indicate a high risk of dietary MNDs in children and suggest need for more systematic intake measurements in representative sample and adjustment of iron dosages to avoid excessive intakes. [ABSTRACT FROM AUTHOR]

Background: Recognizing the need for good quality, scientific and reliable information for strengthening mental health policies and programmes, the National Mental Health Survey (NMHS) of India was implemented by National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, in the year 2015–2016. Aim: To estimate the prevalence, socio-demographic correlates and treatment gap of mental morbidity in a representative population of India. Methods: NMHS was conducted across 12 Indian states where trained field investigators completed 34,802 interviews using tablet-assisted personal interviews. Eligible study subjects (18+ years) in households were selected by a multi-stage, stratified, random cluster sampling technique. Mental morbidity was assessed using MINI 6. Three-tier data monitoring system was adopted for quality assurance. Weighted and specific prevalence estimates were derived (current and lifetime) for different mental disorders. Mental morbidity was defined as those disorders as per the International Statistical Classification of Diseases, Tenth Revision Diagnostic Criteria for Research (ICD-10 DCR). Multivariate logistic regression was conducted to examine risk for mental morbidity by different socio-demographic factors. Survey was approved by central and state-level institutional ethical committees. Results: The weighted lifetime prevalence of 'any mental morbidity' was estimated at 13.67% (95% confidence interval (CI) = 13.61, 13.73) and current prevalence was 10.56% (95% CI = 10.51, 10.61). Mental and behavioural problems due to psychoactive substance use (F10–F19; 22.44%), mood disorders (F30–F39; 5.61%) and neurotic and stress-related disorders (F40–F48; 3.70%) were the most commonly prevalent mental morbidity in India. The overall prevalence was estimated to be higher among males, middle-aged individuals, in urban-metros, among less educated and in households with lower income. Treatment gap for overall mental morbidity was 84.5%. Conclusion: NMHS is the largest reported survey of mental morbidity in India. Survey estimated that nearly 150 million individuals suffer from one or the other mental morbidity in India. This information is to be used for planning, delivery and evaluating mental health programming in the country. [ABSTRACT FROM AUTHOR]

Background: Contraception is a key component of sustainable development, empowering women, reducing the risk of maternal and child mortality and promoting economic growth. It is part of the Sustainable Development Goals agenda, where the aim is to achieve universal access to sexual and reproductive health. Our objective was to evaluate trends and inequalities in modern contraceptive prevalence, and according to the type of modern contraceptive, in 11 low- and middle-income countries that are partners of the Family Planning 2020 initiative. Methods: Analyses were performed using 62 Performance Monitoring and Accountability 2020 (PMA2020) surveys from 11 countries. Forty surveys were nationally representative, while 22 had regional coverage. Regional surveys were analyzed separately, totalizing 15 geographies from 11 countries. We described trends on modern contraceptive prevalence, and its subtypes (short- and long-acting reversible contraceptives, and permanent methods), by calculating absolute average annual changes. Absolute inequalities on the prevalence of modern contraceptives were assessed for the most recent survey of each geography using the slope index of inequality, and according to wealth, education and age. Results: The overall prevalence of modern contraception increased in most geographies analyzed, reaching a 7.2 percentage points increase per year in Lagos, Nigeria. This increase was mostly influenced by the long-acting reversible contraceptives, which increased in 73% of the geographies. Although the largest share of modern contraception is represented by short-acting reversible contraceptives, these are reducing and giving space for the long-acting methods. The exception was Rajasthan, India, where the permanent methods accounted for 70% of the modern contraception share, and their prevalence was almost 40%. Inequalities were identified in favor of richer, older and better educated women. Conclusions: Out of the 15 geographies analyzed, 11 demonstrated an increase in overall modern contraceptive use – mainly driven by the uptake of long-acting reversible contraception. However, even in the groups with the highest prevalence, modern contraceptive use was at most 60% in most geographies. So, we are far from reaching the desired universal coverage proposed by the Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Hysterectomy is one of the major public health issues today. In India, women's attitudes toward menstruation may be a significant driver in seeking hysterectomy. Therefore, we attempted to study the prevalence, associated factors and reasons for hysterectomy among 540,671 ever-married women aged 15–49 years, using data from the National Family Health Survey (NFHS-4) conducted during 2015–16 in India. Univariate, bivariate and multivariate analyses were conducted. These analyses revealed that the prevalence of hysterectomy was 4.1%. The prevalence was highest in the southern region and lowest in the north-eastern regions of India. Results of multivariate models indicated that high parity (odds ratio [OR] 2.84; 95% confidence interval [CI] 2.52–3.19), high body mass index (OR-1.43; 95% CI 1.35–1.51), older age, early age at first cohabitation, and illiteracy were positively associated with hysterectomy. Excessive menstrual bleeding was the leading reason for hysterectomy in this sample. Hysterectomy has exhibited an upward trend over the years. This may exert adverse effects on the physical, socio-psychological and reproductive health of women. Therefore, it is essential to promote high-quality prevention and treatment choices for women, rather than permanent but potentially inappropriate solutions such as hysterectomy. [ABSTRACT FROM AUTHOR]

India is the home of more than 253 million adolescents, which account for almost 21% of the country's population. In the recent past, there has been a rise in the prevalence of mental illness and maladaptive behaviours among adolescents living in slum populations, which are increasing at an alarming rate in many developing countries, mainly due to rural–urban migration, are characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. This neglected population has become a major reservoir for a broad spectrum of adverse health conditions. Studies on the mental health status among adolescents in India are relatively scarce. The main objective of the study was to estimate the prevalence of mental health disorder and its determinants among adolescents in slum settings in Lucknow, India; by using GHQ-12. The study used cross-sectional primary data which was collected in 2015–2016 from the adolescents living in various slums of Lucknow city. About 590 adolescents whose parents gave consent to participate were included in the study. Descriptive statistics, Chi square test and ordered logistic regression analysis (OLR) technique were used to assess the mental health. Reliability of GHQ-12 was assessed before performing the analysis which was found to be 0.79. Approximately, 33% of adolescents were found to suffer from severe level of mental disorder. The results of this study depicts that adolescents of age 12–15 years had more severe mental health problems compares to 16–19 years of adolescents. Females were more likely to suffer from severe mental health problems compared to moderate/normal mental health problems (OR 1.72; p < 0.001). Odds of severe mental health problems was significantly higher among Muslims (OR 1.66; p < 0.001) than Hindus. Thus, it was found that age, gender, education, caste, household economic status, media exposure and religion to be significantly associated with mental health problem. Government should provide a wide range of adolescent friendly health services (clinical, mental, nutritional, including counselling) in these slums for a better adolescent health outcome. [ABSTRACT FROM AUTHOR]

Objectives: The present study was designed with the objective to study the prevalence of depression and anxiety symptoms among adolescents and to explore the association of these disorders with Body Mass Index. Settings and Design: School setting and Cross-Sectional study design. Participants: 546 adolescents, aged 13-15 years, studying in public schools (n=5) in Delhi (Purposive sampling). Methods and Material: Anthropometric measurements: Height of the subjects was measured using a stadiometer in cm (to nearest 0.5cm). Weight was assessed using TANITA's Body Fat Monitor (UM-076). After gathering height and weight data, BMI (kg/m2) Z scores were calculated and classified into four categories: Underweight, Normal weight, Overweight and Obesity based on WHO's growth standards for BMI for age cutoffs. Mental Health Assessment: For this purpose, we used the Child Behavior Checklist (CBCL) for ages 6-18 years; parent report version. Results: A V shaped curve (trend) was observed between the association of depression and anxiety scores in four BMI categories; with majority of the malnourished adolescents having higher scores for depression and anxiety symptoms. It was interesting to note that any deviation from normal weight, either underweight or overweight/obese was significantly associated with depression (p = <0.001) and anxiety (p = <0.001) scores. Conclusions: The study emphasizes the association between body weight and depression and anxiety symptoms among adolescents studying in public schools of Delhi. It adds to the growing body of research in the area of nutritional psychiatry which needs to be promoted for the prevention and management of these disorders through a healthy diet. [ABSTRACT FROM AUTHOR]

Background: Injuries are considered as an emerging public health problem in India. Globally every year, injuries kill more than 5 million people, and by 2020, injuries will be the third-leading cause of death and disability worldwide. The study aimed to assess the prevalence and characteristics of nonfatal home injuries among the elderly in Tamil Nadu. Methodology: A cross-sectional analytical study was conducted among 1139 elderly (60 years and above), sampled from three districts of Tamil Nadu, India. Probability proportional to size sampling technique was used for sampling; a pretested questionnaire was used to collect the data. Results: Prevalence of nonfatal home injuries among elderly within the past 1 year was 14.6% (12.5–16.7 at 95% confidence interval), (n = 1003), among those injured, 94.5% were unintentionally injured and 5.5% were of intentional nature. When classified according to the types of injuries, majority of them had fall injuries (6.7%) followed by minor domestic injuries (5.4%), animal-related injury (0.2%), burn injuries (1.1%), road traffic injury (0.4%), and suicide attempt (0.8%). Majority of the respondents were in the age group of young-old, 60–69 years of age (84%), and there was more number of males (55%) in the study. Conclusion: The study reveals that nonfatal home injuries among elderly are an emerging public health problem, unintentional injuries contribute to the majority of the injuries, fall was the single largest contributor for all injuries among elderly. [ABSTRACT FROM AUTHOR]

Background. Tobacco smoking is a global epidemic among adults and increases the risk of different diseases, and premature deaths. Objectives. This study attempts to investigate and estimate the prevalence and risk factors of tobacco smoking among adults in India. Material and methods. This study utilized cross-sectional data from the nationally representative 2017 Global Adult Tobacco Survey. Chi-square analysis was used to show the association between tobacco smoking and risk factors. Binary logistic regression was used to determine the risk factors of tobacco smoking based on p-values and odds ratio along with confidence interval. Results. The overall prevalence of tobacco smoking was 12.84% (Male: 25.01%, Female: 2.63%). The highest prevalence of tobacco smoking was in Meghalaya (35.04%) and the lowest in Goa (3.07%). Genderwise, the highest prevalence of tobacco smoking was 57.27% in Meghalaya for males and 7.27% in Manipur for females. This study found that 16 out of 19 covariates were significantly (p < 0.001) associated with tobacco smoking. Age, region, gender, education, religion, marital status, wealth index, number of living persons, and presence of smoking persons were found to be highly significant (p < 0.001) risk factors. Adults from 46-60 years, north east region, no education, daily wage/casual labourers and self-employed, non-Hindu, married. Poorest, presence of smoking persons, and no knowledge about smoking cause strokes had significantly higher risk of tobacco smoking. Conclusions. Tobacco smoking remains one of the major causes of diseases, deaths and economic losses. This recent realistic evidence will help policy makers to make policy for reducing tobacco smoking in India, as well as different states. [ABSTRACT FROM AUTHOR]

Background: Smoking, alcohol consumption and chewing of tobacco affect the health of people as well as the socioeconomic structure of families, communities and eventually the nation. This study assesses the prevalence of substance use among municipal solid waste workers of Mumbai. Methods: To conduct the study, information was collected from 540 municipal workers of Mumbai with regard to substance use as well as their socioeconomic and occupational characteristics. To draw inferential statistics, the data was processed through multivariate logistic regression (MLR) and ordered logistics regression (OLR). Results: Multivariate regression suggests that waste loaders and street sweepers are significantly more likely to smoke, consume alcohol and chew tobacco with reference to the comparison group. Workers with more working years and morbid health status are significantly more likely to get involved with substance use. The results of OLR reveal that municipal waste workers are significantly more likely to consume alcohol on a daily basis (β = 0.220, p < 0.001). Conclusion: Socioeconomic characteristics significantly contribute in increasing the risk of substance use among workers. Workers defend their habit of substance use by considering it as a mechanism for coping with the filthy nature of their occupation. Evidence-based preventive measures need to be developed in order to reduce substance use among municipal solid waste workers. [ABSTRACT FROM AUTHOR]

Aim: Adaptive functioning develops throughout early childhood, and its limitation is a reflection that the child has developmental or emotional problems or even mental retardation. Little is known about the adaptive functioning or developmental status of slum children. The present cross-sectional study was undertaken during the year 2014 to assess the status of adaptive functioning among girl children aged between 3 and 9 years residing in slum areas of Bhubaneswar and to explore the factors associated with poor adaptive functioning.Methods: Stratified multi-stage cluster random sampling technique was used to select the study population; 256 mother-child pairs from 256 households in selected slum areas were studied. Demographic information was collected, and adaptive functioning was assessed using the modified Vineland Social Maturity Scale. Univariate and multivariate analyses was carried out using Statistical Package for Social Sciences (SPSS) version 21.Results: One-fifth (54, 21%) of the girls sampled had poor adaptive functioning, and 44 (17%) had poor cognitive functioning. Multivariate analysis revealed that the age of the child, parents' education, presence of stunting in children and attending school/early childhood centre were strong predictors of adaptive functioning in slum children.Conclusion: One-fifth of girls from slums are developmentally vulnerable; parental education, stunting and early childhood education or exposure to schooling are modifiable factors influencing children's adaptive functioning. Health, education and welfare sectors need to be aware of this so that a multi-pronged approach can be planned to properly address this issue in one of the most disadvantaged sections of the society. [ABSTRACT FROM AUTHOR]

An oral health survey was conducted in 829 individuals in different age groups in Ballabhgarh, Haryana, India, to estimate the prevalence of Dental caries and Periodontal diseases. A survey tool was modified from WHO's STEPwise approach to surveillance and Oral Health Assessment form 2013 from recently released WHO Oral Health Survey: Basic Methods (5th Edition) keeping in mind the South East Asian region. Out of 28 villages, six villages were randomly selected. A random list of study participants (Age-sex specific) was generated from the pooled list of these 6 villages. Local health workes helped in inviting the specific subjects to one centralized location within each village/ locality. The subjects were examined by trained dental surgeons and recordings were done by trained assistants. The prevalence of dental caries in 5-7 year, 12-15 year, 35-44 year and 65-74 year was 33.2%, 31.3%, 64.9% and 50.1% respectively. The prevalence of Periodontal Disease in 35-44 year and 65-74 year found to be 65.2% and 90.4% respectively. Only 37 participants had mucosal lesions, of which leukoplakia and tobacco pouch keratosis was seen in majority. Using the adopted tool, the prevalence of dental caries was found to be highest in 35-44 year (64.9%) age group and the prevalence of periodontal disease was found to be high in 35-44 year (65.2%) age group and highest in 65-74 year (90.4%) age group. Oral health promotion efforts are required to prevent oro-dental diseases in the studied population. [ABSTRACT FROM AUTHOR]

Background: The prevalence of gastro-esophageal reflux disease (GERD) varies widely around the world. This study aimed to investigate the prevalence and risk factors of GERD in a general population of southern India.Methods: An interview-based observational study was carried out in southern India during 2010 and early 2011 using a GERD questionnaire (GerdQ). In total 1072 participants were enrolled using a multi-stage cluster sampling method. Presence of GERD was defined as a score of ≥ 8. Logistic regression models were used to derive odds ratios (ORs) with 95 % confidence intervals (CIs).Results: The prevalence of GERD was 22.2 % (238/1072) in southern India, and was more common among older subjects and men. Overweight and obese subjects had a dose-dependent increased risk of GERD, compared to those with body mass index less than 25 (multivariate-adjusted OR = 1.4, 95 % CI 1.0-2.0; OR = 2.3, 95 % CI 1.3-4.1, respectively). People residing in urban community were more vulnerable to GERD than those in rural community (multivariate-adjusted OR = 1.8, 95 % CI 1.3-2.5). Similarly, those with a lower educational level appeared to have an increased risk of GERD. Further, those with a habit of pan masala chewing were more likely to develop GERD compared with those abstained from the habit (multivariate-adjusted OR = 2.0, 95 % CI 1.2-3.2).Conclusions: GERD is highly prevalent in southern India. Increasing age and BMI, an urban environment, lower educational level, and pan masala chewing appear to be risk factors of GERD symptoms for the studied population. [ABSTRACT FROM AUTHOR]

Background: Childhood anemia is highly prevalent worldwide. Improving the hemoglobin level of preschool age children could yield substantial benefits in cognitive and psychosocial development and overall health. While evidence-based recommendations for reducing childhood anemia in high anemia prevalence countries are available, there is no experimental evidence of community centered education and counseling programs, as a route to improved acceptance of iron supplements, demonstrating beneficial effects on anemia outcomes. We report on the evaluation protocol of a complex educational intervention led by the community lay health worker (LHW) and delivered to mothers of 12-59-month-old anemic children living in and visiting village day care centers in a large district of southern India.Methods and Design: The study is designed as a cluster randomized controlled trial. The intervention is based on the social cognitive theory and aims to promote among mothers, anemia awareness, dietary modifications to increase iron intake in the child, and recognition of the need for enhanced adherence to supplemental iron in the anemic child. From 270 eligible villages in the study area, a sample of 60 villages will be randomized to intervention [n = 30] or to treatment as usual [n = 30] of the study. LHWs in the intervention arm will be trained to administer the following intervention components to mothers of anemic children: 1] monthly distribution of Iron and folic acid (IFA) supplements to mothers of anemic children, and 2] five monthly counseling sessions of mothers of anemic children covering: a] anemia awareness education b] IFA adherence counseling and assessment, c] dietary modification to improve iron intake, and d] hygiene and sanitation. LHWs in the control arm will distribute IFA to mothers of anemic children as in the intervention arm but will not provide monthly education and counseling support. The primary outcome is the difference between the two experimental groups in anemia cure rates of children found to be anemic at baseline. Secondary outcomes, assessed as differences between all participants in both experimental groups, are: change in mothers' knowledge regarding anemia; 24 hour dietary iron intake; net improvement in individual hemoglobin values; serum ferritin; and the difference in overall cluster level childhood anemia prevalence. All outcomes will be measured 6 months after the start of the intervention. Multilevel linear and logistic regression models will be used to analyze differences between intervention and control groups in outcome variables.Discussion: This trial is designed to evaluate the effectiveness of an intervention intended to improve anemia cure rates in anemic children living in villages of Chamarajnagar, Karnataka a large district in south India. The extensive study of secondary endpoints will be used to identify possible weak points in the compliance to intervention delivery and uptake. This evaluation is one of the few large randomized trials evaluating the impact of an education and counseling intervention to reduce childhood anemia prevalence.Trial Registration: This trial was registered with ISRCTN.com (identifier: ISRCTN68413407) on 17 September 2013. [ABSTRACT FROM AUTHOR]

Introduction: Road accidents are associated with numerous problems each of which needs to be addressed separately [1]. Accidents, therefore, can be studied in terms of agent, host and environmental factors and epidemiologically classified into time, place and person distribution [2]. Objectives: 1.To assess the prevalence of RTAs coming to hospital and 2.To know the epidemiological factors related to RTAs and associated prevalence in hospital based study. Methodology: This cross sectional study was conducted at SMSR, Gr Noida, in 2012. The study group consisted of all the RTA victims reporting to casualty in the last one year. The victims of the accidents were interviewed on a pretested semi structured performa. Results: In that one year period total number of reported accident cases was 144. The age groups of the study subjects were between 13-65 years. Out of total study subjects, only 16 were female. Again out of the total accident cases 45% were attended by police and of all injured, 45.8% were driver by occupation (7% without driving license). Among these drivers, 11% were not attentive during driving because of various reasons. Ambulance services had reached in 46.5% cases. Fracture was the most common type (60%) of injury among all types of injuries. Among the applicable population only 33% wore helmet or seat belts. Conclusions: Only half of the total accident cases were attended by police and again only half of them received ambulance services. One third injuries were because of not wearing seat belt and helmets. [ABSTRACT FROM AUTHOR]

Aim To determine the prevalence and predictors of potentially inappropriate medications ( PIM) prescribing in elderly inpatients using the modified American Geriatrics Society ( AGS) updated Beers criteria 2012 and comparing it with the Beers criteria 2003. Methods The prospective observational study was carried out between September 2011 and May 2012 at a public teaching hospital. Elderly inpatients aged ≥60 years were included. Multivariate logistic regression analysis was used to determine the predictors of PIM prescribing. Results The results were based on data of 502 patients; more than half (60%) were males and 66% were aged between 60-69 years with a mean (standard deviation [ SD]) of 68 (7) years. Mean ( SD) number of diagnoses and medications were three (1) and nine (4), respectively. A total of 81 (16%) patients were prescribed with at least ≥1 PIM according to modified AGS updated Beers criteria 2012, compared with 11% according to Beers criteria 2003. On multivariate regression, important predictors for PIM prescribing were found to be age ≥80 years (odds ratio [ OR] 2.46, 95% confidence interval ( CI) 1.27-3.12; P = 0.03), male sex ( OR 1.35, 95% CI 1.06-1.84; P = 0.03), more than three diagnoses ( OR 2.47, 95% CI 1.59-3.39; P = 0.04), ≥6 medications prescribed ( OR 1.16, 95% CI 1.02-1.35; P = 0.03) and ≥10 days of hospital stay ( OR 1.59, 95% CI 1.09-2.31; P = 0.02). Conclusions The results show that PIM prescribing is common among hospitalized elderly Indian patients. It is feasible to reduce this practice through the provision of appropriate unbiased information to healthcare professionals. Geriatr Gerontol Int 2014; 14: 251-258. [ABSTRACT FROM AUTHOR]

Objectives: To examine the impact of a large-scale HIV prevention programme for female sex workers (FSW) in Karnataka state, south India, on the prevalence of HIV/sexually transmitted infections (STI), condom use and programme coverage.Methods: Baseline and follow-up integrated biological and behavioural surveys were conducted on random samples of FSW in five districts in Karnataka between 2004 and 2009.Results: 4712 FSW participated in the study (baseline 2312; follow-up 2400), with follow-up surveys conducted 28-37 months after baseline. By follow-up, over 85% of FSW reported contact by a peer educator and having visited a project STI clinic. Compared with baseline, there were reductions in the prevalence of HIV (19.6% vs 16.4%, adjusted odds ratio (AOR) 0.81, 95% CI 0.67 to 0.99, p=0.04); high-titre syphilis (5.9% vs 3.4%, AOR 0.53, 95% CI 0.37 to 0.77, p=0.001); and chlamydia and/or gonorrhoea (8.9% vs 7.0%, AOR 0.72, 95% CI 0.54 to 0.94, p=0.02). Reported condom use at last sex increased significantly for repeat clients (66.1% vs 84.1%, AOR 1.98, 95% CI 1.58 to 2.48, p<0.001) and marginally for occasional clients (82.9% vs 88.0%, AOR 1.22, 95% CI 0.89 to 1.66, p=0.2), but remained stable for regular partners (32%). Compared with street and home-based FSW, brothel-based FSW were at highest risk of HIV and STI, despite high levels of reported condom use.Conclusions: This large-scale HIV prevention programme for FSW achieved reductions in HIV and STI prevalence, high rates of condom use with clients and high rates of programme coverage. Improved strategies to increase condom use with regular partners and reduce the vulnerability of brothel-based FSW to HIV are required. [ABSTRACT FROM AUTHOR]

A descriptive study was conducted to determine the extent of vision loss among the individuals of 45 years and above and to identify the individuals who were at risk for developing vision loss and its complications in a village of Udupi district, Karnataka, among 100 subjects. Overall prevalence of vision loss was 2%. 4 male had the high risk for vision loss and 78 and 18 subjects had moderate and low risk respectively. With regard to occupation 3 subjects among the high risk group were in the group of gate keeper, watchman, coolie, domestic servant and mason and all of them belonged to Hindu religion and the income was between Rs.2500 to 4999 and majority were non vegetarians. 22 subjects had hypertension, 12 subjects had diabetes mellitus, 30 subjects had cataract, 93 subjects had long sight/short sight, 40 subjects had watering of the eye, 39 subjects had eye injury, 9 subjects were constantly exposed to sunlight, 38 subjects viewed lunar/ solar eclipse, 33 subjects had injury to the head, 22 subjects had rheumatoid arthritis, 33 subjects had family history of diabetes, 35 subjects had family history of hypertension, 26 subjects had family history of blindness, 25 subjects had family history of eye disorders. Habit of alcohol consumption was present in 42 subjects, 33 subjects had habit of smoking, 67 subjects had habit of taking snuff and 78 subjects had habit of chewing tobacco. And 55 subjects were taking medications for different illness. It is established that there is an association between vision loss and age and there is also a significant relationship between risk status and visual impairment. [ABSTRACT FROM AUTHOR]

Background: Diabetic foot is one of the most significant and devastating complication of diabetes. The objective of this study was to assess the prevalence of diabetic foot syndrome (DFS) and the associated risk factors among people with diabetes mellitus. Methods: A community based cross-sectional study was carried out among 620 subjects with diabetes mellitus (DM) in rural areas of Udupi district. The Michigan Neuropathy Screening Instrument was used to identify peripheral neuropathy. Ankle brachial index was used to identify peripheral arterial disease (PAD). Subjects with diabetic foot syndrome were classified according to the International Working Group on Diabetic Foot (IWGDF) classification system. Results: The overall prevalence of DFS was 51.8%. Among them 31.3, 11.9 and 8.5% belonged to category 1, 2 and 3 respectively. Multivariate logistic regression analysis showed advancing age, low socio-economic status, sedentary physical activity and longer duration of DM were significant independent correlates of DFS. Conclusion: The overall prevalence of DFS was high among the study population; hence the screening for foot complications should start at the time of diagnosis of diabetes integrated with sustainable patient education at primary care level by training of health care providers at primary care level. [ABSTRACT FROM AUTHOR]