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Background: The prevalence of Postpartum Depression in India varies from 6.8-21.5%. About 5% women reported persistent PPD symptoms even three years after childbirth. PPD increases the suicide risk among mothers. It not only affects the psychological health but also physical health & quality of life of mother. Maternal PPD affects the mother child bonding and also the child growth & development. Objective: To assess the long-term effects of post-partum depression on the mothers and the children at 1 year-5 years. Methodology: We have done a Cohort study with 290 mother-child dyads in both rural and urban area of Khordha, Odisha. Mothers were screened using EPDS for PPD at 6wk to 6 months after delivery. The outcome for mothers and children were assessed at one year to five years after delivery. Chronic depression was assessed with EPDS, confirmed by psychiatric evaluation and suicidality of the mother with SBQ-R; child anthropometric outcomes with WHO growth charts and development with Bayley Scale of Infant and Toddler Neurodevelopment. Results: Among the 62 mothers screened positive for post-partum depression, 18 (29%) were found to have Chronic depression and a significant association was found between post-partum and chronic depression (OR=11.25, CI- 4.60- 27.69, p-value

In this retrospective observational study, we have performed a comparative analysis of the demographic, clinical and epidemiological characteristics of the HCWs affected with SARS-CoV-2 infection during first two waves in India. The overall prevalence of SARS-CoV-2 infection among HCWs was found to be 15.24% (14.20–16.33) and 23.38% (22.14–25.65) during first and second waves respectively. The second wave showed an adjusted odds ratio of 0.04(0.02–0.07) and 2.09(1.49–2.93) for hospitalization and being symptomatic, respectively. We detected significantly higher level of C-reactive protein (CRP) among admitted HCWs during the second wave (5.10 –14.60 mg/dl) as compared to the first wave (2.00 – 2.80 mg/dl). Our study found the relative risk of SARS-CoV-2 reinfection among HCWs during the second wave to be 0.68 [0.57–0.82, p < 0.001)]. Although, the prevalence of SARS CoV-2 infection and risk of being symptomatic was higher during second wave, the risk of hospitalization was less when compared with the first wave. [ABSTRACT FROM AUTHOR]

Background: Iron-deficiency anemia among school-aged children is widespread in India. The efficacy of micronutrient and iron fortified school-served meals in reducing iron deficiency anemia has been demonstrated in randomized controlled trials in other parts of the globe. The current study evaluates its effectiveness in real-world Indian settings. Methods: Mid-day-Meal (MDM) programme provides free lunch to students of grades 1 to 8 in all public-funded Indian schools. An implementation research project fortified MDM of all public schools of 4 out of 8 sub-districts ("blocks") of Dhenkanal district of Odisha state with fortified rice kernel (FRK). All the schools of the other 4 blocks fortified with micronutrient powders (MNP)—both FRK and MNP containing equal amounts of supplementary iron and other micronutrients. Schools of 4 matched blocks of neighboring nonimplementing Angul district served as control. Cross-sectional representative samples of students were drawn from the 3 arms, before and after intervention (n = 1764 and n = 1640 respectively). Pre-post changes in anemia prevalence and hemoglobin levels were estimated in the sampled children using difference-in-difference analysis after controlling for inter-arm differences in socioeconomic status, and iron and deworming tablet consumptions. Results: Factoring in pre-post changes in control and adjusting for potential confounders, the proportion of children without anemia and mean hemoglobin improved by 1.93 (1.38, 2.24, P <.001) times and 0.24 (−0.03, 0.51, P =.083) g/dL in MNP; and 1.63 (1.18, 2.24, P =.002) times and 0.18 (−0.09, 0.45, P =.198) g/dL in FRK arms. Conclusions: Fortified MDM could effectively improve anemia status among Indian school-aged children under real-world conditions. [ABSTRACT FROM AUTHOR]

Objective. The aim of the study is to identify the normal vertical positions of sella (S) and nasion (N) points in subjects with a normal inclination of anterior cranial bases. Materials and Methods. Lateral cephalograms of 117 subjects who had a normal ∠SN-FH plane (7° ± 1°), ∠SN-palatal plane (9° ± 2°), ∠FH-palatal plane (1° ± 1°), and cranial base angles (131° ± 4°) were included in the study. Various linear and angular parameters and ratios were evaluated to determine the normal vertical positions of S and N points. An unpaired t-test was used to identify any significant differences between males and females. The P value of 0.05 was considered as the level of significance. Results. Among subjects with the normal inclinations of SN, FH, and palatal planes and cranial base angle, the mean values of ∠Ar-S-Ptm, ∠S-Ptm-Ar, and ∠S-Ar-Ptm were 59.38° ± 3.52°, 59.70° ± 3.21°, and 60.84° ± 3.56°, respectively, forming an almost equilateral triangle between S, Ar, and Ptm points. The mean values of ∠Ba-S-PNS, ∠S-PNS-Ba, and ∠S-Ba-PNS were 59.56° ± 3.17°, 59.72° ± 3.47°, and 60.76° ± 3.11°, respectively, forming another approximate equilateral triangle between S, Ba, and PNS points. The mean S-FH to N-FH ratio was 0.67 ± 0.06% for the whole sample, but it was significantly greater in males (0.69 ± 0.07%) compared to females (0.65 ± 0.06%) (P = 0.002). Conclusions. Two approximate equilateral triangles were formed between S, Ar, and Ptm points; and S, Ba, and PNS points in subjects with normal inclinations of SN, FH, and palatal planes and cranial base angle. The S-FH to N-FH ratio was an excellent guide to locating the normal vertical position of S and N points. [ABSTRACT FROM AUTHOR]

Behaviour change is an important aspect of the successful implementation of any national health program. Social behaviour change among end-user can be possible by imparting the right information in the right quantity to the right audience, at frequent intervals through the proper medium. Mass media, both electronic and print are considered useful modes to deliver all public health-related messages to the people. However, the key is to provide correct information to the media for dissemination. On the other hand, medical colleges have a depth of knowledge on technical know-how but reaching a larger population is quite challenging. Therefore, a team approach should be planned by establishing a partnership between media and medical colleges and then the social behaviour change can be achieved in the desired direction. In lieu of this novel partnership, the Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar had taken the initiative to bring together media personnel and faculty of medical colleges to chalk and roll out the behaviour change communication for nutrition interventions. This program was highly successful as the liaison helped disseminate the right information to the people. Also, the faculty and residents gained insight into dealing with media and thereby serving the community. [ABSTRACT FROM AUTHOR]

Caste, a stratifying axis of the Indian society, is associated with wealth and health. However, to what extent caste‐based health inequality is explained by wealth disparities, is not clear. Therefore, we aimed to examine the caste‐based differences in anaemia (haemoglobin < 11 gm/dl) and self‐reported sickness absenteeism in schoolchildren and the mediating role of economic disparity. Students (n = 1764) were surveyed from 54 government schools of Dhenkanal and Angul, Odisha state. Socioeconomic data, anaemia and absenteeism were recorded. The relative risks of anaemia among Scheduled Tribe (least advantaged) and Scheduled Caste (second least advantaged) students were 1.19 (95% CI: 1.08, 1.26) and 1.13 (1.03, 1.20), respectively, as compared to students of the most advantaged caste and that for sickness absenteeism were 2.78 (2.03, 3.82) and 2.84 (2.13, 3.78); p < 0.05, with marginal attenuation when controlled for inter‐caste economic disparities. Caste had an independent effect on anaemia and sickness absenteeism in school children, unexplained by inter‐caste economic disparities. [ABSTRACT FROM AUTHOR]

Background: India is the highest tuberculosis (TB) burden country accounting for one-fifth of the global incidence. It is estimated that, annually, 1.9 million cases are from India and about 0.8 million are infectious, new smear, positive pulmonary TB cases. The present study was a cross-sectional study conducted in a tertiary care hospital to determine the extent of delay in diagnosis and initiating the treatment after diagnosis in new smear, positive pulmonary TB patients attending a tertiary care hospital of Haryana during a 1-year period. Methods: A total of 204 patients were interviewed after being diagnosed as new sputum, positive TB (NSP-TB) by the treating doctor at the tertiary care hospital and re-interviewed at their home after initiation of anti-TB treatment. Chi-square test and analysis of variance (ANOVA) were used for statistical analysis. Results: More than half of the study patients delayed their first consultation with a health care system. The mean and median patient delay was 32.97 and 16 days, respectively. Lack of awareness of the disease was the leading cause for the patient delay. The mean duration of delay at peripheral health care provider was 60.46 days. The mean and median delay at tertiary care hospital was 8.35 and 4 days, respectively. Most of the patients delayed for diagnosis as per revised national TB control program (RNTCP) guidelines. The mean total delay in diagnosis was 75.71 days. Conclusions: There is an urgent need to scale up the information education communication activities to decrease the patient delay. Doctor at all level of health care need to be actively involved for subjecting the suspects to sputum examination at the earliest possible, as per RNTCP guidelines. [ABSTRACT FROM AUTHOR]

Objective: To study the utilization of health services by mothers during antenatal, natal and post-natal period under Janani Suraksha Yojna (JSY). Materials and Methods: This cross-sectional study was conducted in rural areas of two districts of Haryana as per the rate of institutional deliveries. A total of 48 sub-centers were selected by multistage random sampling. 1386 JSY beneficiary mothers were interviewed by house-to-house visits, after obtaining informed consent. Results: Majority 1216 (87.5%) of the study subjects were registered between 12-26 weeks of pregnancy whereas only 170 (12.3%) of them were registered within first 12 weeks. Around one-fourth of the mothers did not receive the recommended minimum three antenatal check-ups. The coverage of TT immunization was 92.1%. Majority 1253 (90.4%) of the deliveries were institutional. More than three-fourth of the home deliveries were conducted by trained dais and 15% of the home deliveries were conducted by untrained persons. Out of the 1253 institutional deliveries, 84.6% were conducted in Government institutions while 15.4% deliveries were conducted in Private hospitals. About two-third mothers received at least three post-natal care visits by the health functionaries. Discussion: Janani Suraksha Yojna is an ambitious scheme serving as a safe motherhood intervention under NRHM. It has been fairly successful in promoting institutional deliveries but the key components of Essential Obstetric Care i.e., early antenatal registration, minimum three antenatal care visits, three post-natal care visits still need strengthening. [ABSTRACT FROM AUTHOR]

Managing of radiotherapy department in many cancer centers in India has become very challenging during the COVID-19 pandemic. A radiotherapy center has to deal with multiple problems such as long treatment duration of each patient, high caseload on each radiotherapy machine, a limited number of qualified technical staff available, and equipment maintenance. For the department's smooth running, both the patient and healthcare worker must be safe from contacting COVID-19. A robust and planned strategy is required for prevention, screening, and awareness among all. To access our preparedness and evolve by gaining from other radiotherapy centers, a study was conducted using questionnaires and responses collected from different cancer centers in India., Competing Interests: None

Background: The monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat them in both public and private primary care facilities. The Government of India launched the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) in 2010 to strengthen health systems. We assessed availability of trained human resources, essential medicines and technologies for diabetes, cardiovascular and chronic respiratory diseases as one of the components of the National Noncommunicable Disease Monitoring Survey (NNMS - 2017-18)., Methods: NNMS was a cross-sectional survey. Health facility survey component covered three public [Primary health centre (PHC), Community health centre (CHC) and District hospital (DH)] and one private primary in each of the 600 primary sampling units (PSUs) selected by stratified multistage random sampling to be nationally representative. Survey teams interviewed medical officers, laboratory technicians, and pharmacists using an adapted World Health Organization (WHO) - Service Availability and Readiness Assessment (SARA) tool on handhelds with Open Data Kit (ODK) technology. List of essential medicines and technology was according to WHO - Package of Essential Medicines and Technologies for NCDs (PEN) and NPCDCS guidelines for primary and secondary facilities, respectively. Availability was defined as reported to be generally available within facility premises., Results: Total of 537 public and 512 private primary facilities, 386 CHCs and 334 DHs across India were covered. NPCDCS was being implemented in 72.8% of CHCs and 86.8% of DHs. All essential technologies and medicines available to manage three NCDs in primary care varied between 1.1% (95% CI; 0.3-3.3) in rural public to 9.0% (95% CI; 6.2-13.0) in urban private facilities. In NPCDCS implementing districts, 0.4% of CHCs and 14.5% of the DHs were fully equipped. DHs were well staffed, CHCs had deficits in physiotherapist and specialist positions, whereas PHCs reported shortage of nurse-midwives and health assistants. Training under NPCDCS was uniformly poor across all facilities., Conclusion: Both private and public primary care facilities and public secondary facilities are currently not adequately prepared to comprehensively address the burden of NCDs in India., (© 2021. The Author(s).)

Objective: To generate national estimates of key non-communicable disease (NCD) risk factors for adolescents (15-17 years) identified in the National NCD Monitoring Framework and, study the knowledge, attitudes and practices towards NCD risk behaviours among school-going adolescents., Design and Setting: A community-based, national, cross - sectional survey conducted during 2017-2018. The survey was coordinated by the Indian Council of Medical Research-National Centre for Disease Informatics and Research with 10 reputed implementing research institutes/organisations across India in urban and rural areas., Participants: A multistage sampling design was adopted covering ages between 15 and 69 years-adolescents (15-17 years) and adults (18-69 years). The sample included 12 000 households drawn from 600 primary sampling units. All available adolescents (15-17 years) from the selected households were included in the survey., Main Outcome Measures: Key NCD risk factors for adolescents (15-17 years)-current tobacco and alcohol use, dietary behaviours, insufficient physical activity, overweight and obesity., Results: Overall, 1402 households and 1531 adolescents completed the survey. Prevalence of current daily use of tobacco was 3.1% (95% CI: 2.0% to 4.7%), 25.2% (95% CI: 22.2% to 28.5%) adolescents showed insufficient levels of physical activity, 6.2% (95% CI: 4.9% to 7.9%) were overweight and 1.8% (95% CI: 1.0% to 2.9%) were obese. Two-thirds reported being imparted health education on NCD risk factors in their schools/colleges., Conclusion: The survey provides baseline data on NCD-related key risk factors among 15-17 years in India. These national-level data fill information gaps for this age group and help assess India's progress towards NCD targets set for 2025 comprehensively. Though the prevalence of select risk factors is much lower than in many developed countries, this study offers national evidence for revisiting and framing appropriate policies, strategies for prevention and control of NCDs in younger age groups., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The primary objective of National NCD monitoring survey (NNMS) was to generate national-level estimates of key NCD indicators identified in the national NCD monitoring framework. This paper describes survey study protocol and prevalence of risk factors among adults (18-69 years)., Materials and Methods: NNMS was a national level cross-sectional survey conducted during 2017-18. The estimated sample size was 12,000 households from 600 primary sampling units. One adult (18-69 years) per household was selected using the World Health Organization-KISH grid. The study tools were adapted from WHO-STEPwise approach to NCD risk factor surveillance, IDSP-NCD risk factor survey and WHO-Global adult tobacco survey. Total of 8/10 indicators of adult NCD risk factors according to national NCD disease monitoring framework was studied. This survey for the first time estimated dietary intake of salt intake of population at a national level from spot urine samples., Results: Total of 11139 households and 10659 adults completed the survey. Prevalence of tobacco and alcohol use was 32.8% (95% CI: 30.8-35.0) and 15.9% (95% CI: 14.2-17.7) respectively. More than one-third adults were physically inactive [41.3% (95% CI: 39.4-43.3)], majority [98.4% (95% CI: 97.8-98.8)] consumed less than 5 servings of fruits and / or vegetables per day and mean salt intake was 8 g/day (95% CI: 7.8-8.2). Proportion with raised blood pressure and raised blood glucose were 28.5% (95% CI: 27.0-30.1) and 9.3% (95% CI: 8.3-10.5) respectively. 12.8% (95% CI: 11.2-14.5) of adults (40-69 years) had ten-year CVD risk of ≥30% or with existing CVD., Conclusion: NNMS was the first comprehensive national survey providing relevant data to assess India's progress towards targets in National NCD monitoring framework and NCD Action Plan. Established methodology and findings from survey would contribute to plan future state-based surveys and also frame policies for prevention and control of NCDs., Competing Interests: The authors have declared that no competing interests exist.

Objective: The objective is to determine prevalence and risk factors for soil-transmitted helminth (STH) infection among school-going age children from slums of Bhubaneswar., Design: Cross-sectional observational study., Setting: Microbiology laboratory of a tertiary care hospital, Bhubaneswar, during May 1-October 30, 2015 (6 months) including 360 children of 3-15 years from two populated slums of Bhubaneswar, assuming STH prevalence - 50%, confidence interval 95% and 10% relative precision. Purposively sampling by house to house visit was adopted to collect stool samples along with risk factors through questionnaires from each child after written informed consent of parents/guardians., Materials and Methods: Direct saline mount and egg counting by Kato-Katz (KK) method for STH-positive samples was done., Results: STH prevalence was 13.3%, more in males (68.8%), and significantly high (62.5%. P < 0.05) in school-going children between 6 and 12 years of age. Predominant STH was Ancylostoma duodenale (56.2%), 15% of parents were illiterate, 80% of houses had toilets, 70% were washing hand with soap and using footwear. STH infection was much less (12.5%) in those practicing handwashing with soap. Fifty percent of children had STH infection even after receiving deworming within the past 6 months. More egg counts - 216 eggs/gram of feces were found in 29 cases by KK method. Entamoeba histolytica (56.5%) was predominant among non-STH infections., Conclusion: STH prevalence of Bhubaneswar slums was minimum (13.3%), school-going children of 6-12 years were more affected and handwashing habit with soap was the key factor to prevent STH infection. The proportion of participants having toilet facility and using footwear regularly had no role in STH prevention., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Tropical Parasitology.)

Background: Hepatitis C is a global public health problem. As many as 12 million people may be chronically infected in India and most are unaware of it., Aims: To determine the incidence of hepatitis C in the Ratia block of the Fatehabad district, Haryana, India., Method: This cross-sectional study was carried out by house-tohouse visits over 2 weeks. After obtaining written consent, a blood sample was drawn from suspected cases by a laboratory technician maintaining all necessary safety precautions and sterilization., Results: Of the samples, 1,630 (22.3 per cent) were found to be positive for hepatitis C by ELISA, 253 (15.5 per cent) patients were previously hepatitis C positive, and adults (21-60 years) were affected maximally (70.0 per cent)., Conclusion: The study emphasises the need for public awareness campaigns at various levels and prevention of HCV infection. It also suggests the need to develop and strengthen evaluation methodology for the Integrated Disease Surveillance Project (IDSP).