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Background: The study aimed to estimate the magnitude of nomophobia, prevalence and degree of depression, anxiety and stress; the relationship between nomophobia and different mental health status; and also finding the correlates of nomophobia among undergraduate medical students. Methodology: This descriptive cross-sectional study was undertaken in Murshidabad Medical College during September-November 2023, among a calculated sample of 222 undergraduate medical students selected through stratified random sampling. A self-reported English questionnaire comprising background characteristics, smartphone use related characteristics; and validated nomophobia questionnaire (NMP-Q) and depression, anxiety and stress scale (DASS) were used to collect the data. Data were analyzed using SPSS 20.0. Results: Among the study participants 13.1%, 72.1% and 14.8% had mild, moderate and severe nomophobia respectively. The prevalence of depression, anxiety and stress were 54.5%, 69.4% and 37.4% respectively. Multivariable binary logistic regression revealed that students aged less than 21 years (AOR: 6.088; 95% CI: 2.053- 18.055), students belonging to joint family (AOR: 6.836; 95% CI: 2.392-19.537) and daily average time spent on smartphone more than 5 hours (AOR:5.314; 95% CI: 1.919-14.721) were at higher risk of developing severe nomophobia. Correlation analysis revealed depression was significantly correlated with Nomophobia (Spearman rho:0.200, p value:0.003). Conclusion: Nomophobia is quite prevalent among medical students with varying degree of severity. Mental health status specially depression is correlated with nomophobia. Findings suggests the need for supporting the holistic well-being of medical students through proper health education strategies and workshops on mental health.

Background: Menstrual hygiene management (MHM) encompasses use of hygienic absorbents, appropriate frequency of changing, genital hygiene and disposal. Inadequate facilities at school pose a formidable barrier for MHM. Objective: To assess the practices related to MHM and their correlates among school going adolescent girls aged 15-19 yrs and explore the enablers and barriers of MHM from the participant’s perspective. Methodology: This concurrent mixed method study with cross-sectional design and phenomenological approach for quantitative and qualitative part respectively, was undertaken in public schools of Berhampore Municipality, Murshidabad district during September-November’23. The quantitative study was contemplated among 204 eligible participants selected through multistage random sampling. Data on background variables and variables related to MHM were collected with a predesigned, pretested self-administered questionnaire and analyzed with SPSS.20. For qualitative component, In-Depth Interviews (IDI) were done on purposively selected eight participants, representing different schools and age groups. IDIs were transcribed in verbatim and thematic analysis was done. Results: All participants used sanitary pads; 53.9%, 17.64% and 20.5% changed pads at appropriate frequency (four times/day), cleaned external genitalia (thrice/day) and disposed in covered bins respectively. Only 11.3% had favourable MHM (at least 3 correct practices out of 4). Maternal education [(OR:3.44; (1.28-9.27)]and occupation [(OR:7.01; (2.23-21.99)], socio economic status [(OR:5.66;(1.52-21.02)], access to continuous water supply [(OR:15.40;(4.38-54.10)] and disposal facilities[(OR:2.88;(1.15-7.22)] were significantly associated with MHM. On thematic analysis major enablers explored were conducive home environment, communication with parents, access to hygienic absorbents and access to washrooms with water supply at school; lack of access to hygienic washrooms and proper disposal facility at school, long duration of school and limited communication were identified as barriers for MHM. Conclusion: Among the school girls in this area unfavourable MHM was alarmingly high, surfacing multiple factors amenable to change by ensuring access to proper services/facilities and communication about MHM.

Background: Tuberculosis preventive treatment (TPT) among close contacts of Tuberculosis (TB) cases is a globally accepted strategy. India targeted elimination of TB by 2025 and started implementing TPT among all household contacts. This intervention needs evaluation in different areas and population groups for effective outcome. Objectives: We aimed to assess the extent of TPT coverage and adherence; ascertain the reasons for non-initiation and non-adherence; and to determine the socio-demographic and programmatic correlates of coverage. Methodology: We conducted a descriptive cross-sectional study during September-November 2023 in a block of Murshidabad district, West Bengal. A sample of 301 eligible household contacts (HHC) of ‘index cases’ (microbiologically-confirmed drug-sensitive pulmonary TB) registered in TB unit of the block during October’22 to March’23 were the study subjects. For child contacts (

Background: Type 2 diabetes is a major public health challenge. Indian Diabetes Risk Score (IDRS), a simple and cost-effective tool consisting of two modifiable (waist circumference, physical activity) and two non-modifiable risk factors (age, parental history) for diabetes, can be easily applied in mass screening programmes. Opportunistic screening for diabetes among individuals aged = 30 years is being done under the programme for Prevention and Control of Non-communicable Diseases. Objective: To assess the risk of type 2 diabetes mellitus using IDRS, coverage of screening services for diabetes through the primary health care delivery system and to identify their correlates. Methodology: : A descriptive, cross-sectional study was conducted in a block of Murshidabad district, West Bengal during September to November 2023 among permanent residents aged = 30 years on a calculated sample of 300 selected through multi-stage sampling. Required data were collected by interviewing the study subjects using pre-designed, pre-tested schedule including IDRS, reviewing medical records and measuring waist circumference. Analysis was done using SPSS-20. Results: Among 300 participants, 40.7% had high risk; 54% and 5.3% had moderate and low risk of diabetes respectively according to IDRS. In multivariable analysis, age =35 years (AOR 18.10, 95% CI 5.07-64.66), female gender (AOR 2.36, 95% CI 1.40-4.00) and being in joint family (AOR 3.53, 95% CI 1.77-7.04) were significant correlates for high-risk category according to IDRS. Only 67% were screened for diabetes within last six months, of which 89% were through primary health care delivery system. Screening status varied significantly by age group (OR 3.81, 95% CI 1.98-7.35) and IDRS risk categories (OR 1.72, 95% CI 1.06-2.80). Conclusion: Alarmingly substantial proportion of people in the area are at high/moderate risk of diabetes coupled with low opportunistic screening coverage, which highlights the need for intensive behaviour change communication and stronger service delivery.

Background : Fine needle aspiration cytology (FNAC) may be diagnostic in candidates with indeterminate solitary pulmonary nodules (SPNs) suspicious of bronchogenic carcinoma. Aims : The study was performed to evaluate the usefulness of computed tomography (CT)-guided FNAC in our centre. Materials and Methods : All the cases had a strong clinical suspicion of lung cancer, negative bronchoscopy, negative sputum cytology for malignant cells and acid fast bacilli. A thorough radiological evaluation was made to rule out primary malignancy elsewhere. Results : A total of 94 patients were studied in one year. May-Grόnwald-Giemsa stain was used for the smears. The cytological diagnosis was correlated with clinical-radiological follow-up and biopsy to arrive at a final diagnosis. The procedure had a high sensitivity and specificity. Chi-square test was used to calculate statistical significance. Tumor of more than three centimeter and immediate cytological assessment significantly increased the yield. Review of slides added two cases of malignancy that were missed initially. There were very few complications. Conclusions : CT-guided FNAC was an accurate and safe procedure for SPNs.

The COVID-19 pandemic created a challenge for providing assistive technology (AT) and rehabilitation services, with many service providers implementing telehealth service provision for the first time. The objective of this study was to explore the experiences of people accessing and providing AT and rehabilitation services during the pandemic and to assess the implementation of telehealth service delivery at an assistive technology and rehabilitation center in India. A mixed-methods design, combining analysis of clinical data and semi-structured interviews, was utilized. A descriptive analysis of demographics and clinical characteristics of service users accessing services through telehealth, or in-person mode was completed. In addition, service users were interviewed to explore their experiences of accessing services during the pandemic. Service providers were also interviewed to gather their opinions on telehealth service delivery during the pandemic. Findings showed that telehealth was an alternative tool in the pandemic for continuing to deliver services in a low-resource setting. However, not all types of services could be successfully delivered via telehealth. There are barriers to the delivery of telehealth services that need to be considered and addressed to allow successful implementation, and it is important to consider that telehealth consultations are not suitable for all service users. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Tuberculosis (TB) and malnutrition are epidemiologically interrelated two major public health problems in India. Food security also influences nutritional status. This aspect needs evaluation in diverse geographical areas. This study aimed to assess the level of food security, nutritional status and correlates among adult TB patients in a block of Murshidabad, West Bengal. Methods: This cross-sectional study was undertaken in the Nabagram block of Murshidabad district during April–July 2023. All adult (≥18 years) patients registered under the Tuberculosis Unit of the block during a reference period of 6 months (October 2022–March 2023) were considered study subjects. Eighty such eligible participants recruited randomly were interviewed with a pre-designed schedule for socio-demographic and programmatic characteristics. Household food security was measured using a validated U.S. Household Food Security Survey Module. Anthropometric measurements were taken, and nutritional status was determined based on body mass index. Statistical Package for the Social Sciences (SPSS) version 26 was used for analysis. Results: Among 80 TB patients, 51% were underweight and 20% were severely underweight. The majority (90%) of them had high or marginal food security, and 10% had low or very low food security. On multivariable logistic regression, Hindu religion (adjusted odds ratio (AOR): 6.74, 95% confidence interval (CI): 2.12–29.39), presence of any chronic morbidity (AOR: 11.61, 95%CI: 2.71–49.78) and receipt of dietary counselling by a health worker (AOR: 7.25, 95%CI: 1.22–43.13) appeared as predictors of underweight. Conclusions: Underweight among TB patients is quite prevalent in the area, and few programmatic interventions are influencing factors. This underscores the importance of nutritional counselling services and the universal provision of Poshan benefits. [ABSTRACT FROM AUTHOR]

Background: The prevalence of adolescent hypertension is on the rise due to multiplicity of certain risk factors, like obesity, unhealthy dietary behaviour, physical inactivity, tobacco use, alcohol addiction, and academic stress. The present study aimed to estimate the prevalence of elevated blood pressure and hypertension among adolescent school children and identify the factors influencing it. Methods: The present observational, cross-sectional study was conducted in two higher secondary schools in a block of Murshidabad district, West Bengal, from February to April 2021. The subjects included 15 to 19-year-old school students. Multistage random sampling method was used for selecting a sample size of 183 adolescent school children. Data were obtained by interviewing the study participants, measurement of blood pressure and anthropometric measurements. Chi-squared test and binary logistic regression were used for bivariate and Multivariable data analysis, respectively, with P<0.05 as the level of significance. Results: The mean of Systolic Blood Pressure and Diastolic Blood Pressure were 115.02+10.853 and 71.52+8.484 mm of Hg, respectively. The overall prevalence of elevated blood pressure and adolescent hypertension was 21.3% (95% CI 15.4-27.2). The prevalence was significantly higher among those with paternal education of above middle school (AOR=1.803, P=0.011), high socioeconomic status (AOR=3.16, P=0.02), and high Body Mass Index for their age (AOR=11.474, P<0.0001). Smart phone use (P=0.03) and family history of hypertension (P=0.029) were also found to significantly influence elevated blood pressure among the subjects in bivariate analysis. Conclusions: Measurement of blood pressure, as a part of school health programme, should be given priority with emphasis on physical activity at school, health promotion to avoid unhealthy diet, and restricted smart phone use. [ABSTRACT FROM AUTHOR]

Background: Biomedical waste become hazardous if it is not segregated, treated and disposed properly and poses a serious health problem to health care workers as well as to the community. Objectives: To assess the knowledge, attitude and practice about biomedical waste management among the health care workers posted in primary health care facilities in a district of West Bengal. Methods: This cross-sectional study was conducted in subcentres, bedded and non bedded primary health centres (PHC) selected by multi stage random sampling. Thus six PHCs and 14 subcenres were chosen. Study population included doctors, nurses, pharmacists, lab technicians, health supervisors, Auxiliary Nurse Midwives and housekeeping staff. Study techniques included interview of the study participants and practice of was observed by an observation check list. Results: Knowledge and attitude of the study participants were satisfactory about biomedical waste management, but practice was seen to be very poor. Nurses were seen to be more knowledgeable than other categories of staff. Training and vaccination status were poor. The median knowledge, attitude and practice score had no significant association with age or years of experience of the study participants. Conclusion: Repeated training and sensitization workshops should be organized for increasing knowledge and attitude of the health care workers and repeated monitoring is required to improve practice. All the HCWs should be vaccinated properly with Hepatitis B vaccination and tetanus toxoid. [ABSTRACT FROM AUTHOR]

Context: Nationwide lock down imposed due to Covid 19 might bring about various social problems, constraints in availing essential services, difficulty in taking care of morbid elderly persons and inaccessibility to health care which can lead to stress. Aims: To identify social problems among adult Indian residents during lockdown period, to assess perceived stress among them and to identify the factors associated with it. Settings and Design: The study was conducted through the online platform using a google form among adult residents of India. Perceived stress was assessed by Perceived Stress Scale 10. Statistical Analysis Used: Data were analysed using SPSS version 16.0., using chi square, Odd's Ratio and binary logistic regression. Results: One fourth of the respondents faced economic problem, 11.7% of them had experienced some sort of violence and worsening of familial relationship. The problems encountered in seeking care were chi square test due to non availability of transportation facilities and health services. Overall 80.78% of the respondents were observed to have moderate and high levels of perceived stress. Multivariate analysis revealed single marital status, owing a debt and experiencing violence had 1.62, 1.8 and 9 times higher odds of having moderate to high perceived stress. Violence was identified as its chief correlate. Conclusions: The present study found negative economic and social consequences on the Indian population and also posed an enormous psychological stress due to sudden lock down in pandemic situation. [ABSTRACT FROM AUTHOR]

Purpose: There is a lack of trained rehabilitation professionals, especially in the small towns and rural areas of low and middle income countries. In India, a cadre of mid-level rehabilitation workers, the Rehabilitation Therapy Assistants (RTAs), are being trained by Mobility India, a Non-Governmental Organisation (NGO). This paper aims to assess impact of their training and experiences after the training. Method: Data were collected from 3 different initiatives connected with the trained RTAs: an impact assessment of their training; interviews with RTAs during an evaluation; and a survey of 188 RTAs trained between 2002 and 2019. Results: RTAs were shown to have good skills to provide rehabilitation interventions in the field and are appreciated by clients and other stakeholders. Most of the RTAs work for NGOs in CBR programmes, and in private hospitals and clinics. There does not seem to be a role for them in government services in most countries. The number of trained RTAs remains small in spite of the large needs. This may be due to lack of an accreditation system for RTAs and the low priority given to rehabilitation services in general in some countries. Conclusions: The results provide useful information to strengthen RTA training courses. Training RTAs to provide rehabilitation services in smaller towns and rural areas of low and middle income countries can have a good impact through CBR programmes. However, this impact remains circumscribed to small areas where NGOs are active. Changes are needed in health systems for the inclusion of mid-level rehabilitation workers in primary health care services. [ABSTRACT FROM AUTHOR]

Purpose: People with intellectual disabilities are deeply affected by health inequity, which is also reflected in their access to and use of assistive technology (AT). Including the perspectives of adults with intellectual disabilities and their caregivers, together with the views of local health professionals, suppliers of AT and policy-makers, this paper aims to provide an overview of factors influencing access to AT and its use by people with intellectual disabilities in Bangalore, a southern region of India. Method: Face-to-face interviews were conducted with 15 adults with intellectual disabilities (ranging from mild to profound) and their caregivers, and with 16 providers of AT. This helped to gain insight into the current use, needs, knowledge, awareness, access, customisation, funding, follow-up, social inclusion, stigma and policies around AT and intellectual disability. Results: Access to AT was facilitated by community fieldworkers and services to reach out and identify people with intellectual disabilities. Important barriers were stigma, and lack of knowledge and awareness among parents. Factors related to continued use were the substantial dependence on the care system to use AT, and the importance of AT training and instructions for the user and the care system. Conclusion and Implications: The barriers and facilitators related to AT for people with intellectual disabilities differ from other populations in need. The findings of this study can be used to inform and adjust country policies and frameworks whose aim is to improve access to AT and enhance the participation of people with intellectual disabilities within their communities. [ABSTRACT FROM AUTHOR]

Background: Murshidabad in West Bengal is considered as an endemic district for arsenic contaminated ground water. Iron is also a common inorganic material present in ground water which have ill effects on the body if beyond permissible limits. The present study was conducted to find out the level of arsenic and iron in the water samples in Government run institutions in one block of Murshidabad district. Methodology: In this descriptive observational study, water sample reports of 26 Government run institutions in an arsenic affected block were analysed. WHO and Bureau of Indian Standard permissible and acceptable values of both materials were considered for analysis. Results: As per Indian standards, only 26.9% of water samples in the study block were within acceptable limits for arsenic. If WHO recommended international standards were considered then more than 80% water samples were not safe as drinking water. In case of iron, only 7.7% water samples were within desirable limit as per Indian standards. While considering both arsenic and iron, only 1 water sample was seen to be within desirable limit. Conclusion: In spite of ongoing arsenic mitigation activity in West Bengal the arsenic level was found to be above permissible level in the Govt run tube wells. Awareness generation for repeated testing of arsenic, use of arsenic removal method at household level and use of safe water for both drinking and cooking at community level should be stressed upon. [ABSTRACT FROM AUTHOR]

India's achievements in the field of health have been less than satisfactory and the healthcare delivery at the village level is constrained by lack of healthcare infrastructure, lack of doctors, lack of supply-chain and lack of appropriate monitoring of the existing healthcare infrastructure. This paper describes an innovative and low cost health care infrastructure that can be rapidly rolled out to provide basic healthcare using tele health services. It consists of a standard shipping container converted to a Micro Health Centre (referred to as μHC). It is connected to medical personnel through Internet, to bring much needed preliminary healthcare to those in need and provisions for medical equipments being directly linked to the μHC health cloud. The objective is to equip the Micro Health Centre with basic diagnostic equipments that can be operated by paramedics or interns, along with specialist medical personnel providing expert interventions through remote medical consultation. It can have a network connectivity varying from 256 KBPA (via satellite) to 2 MBPS (via leased line). Furthermore it can be easily transported to remote rural areas as all supply-chains such as trucks, trains, roadways etc are aligned to handling shipping containers. The solution has been rolled out in North India on a research basis. As this healthcare infrastructural solution is easy to transport and rapidly deployable thus it is well suited for war torn areas as well as areas affected by natural disasters. [ABSTRACT FROM AUTHOR]