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Background: Stunting, indicating chronic malnutrition in children, remains a pressing concern globally, especially in low- and middle-income countries. India, despite substantial efforts, continues to grapple with high rates of stunting, impacting child development and health outcomes. Understanding the multifaceted factors contributing to stunting is crucial for targeted interventions and policy formulation. Methods: This descriptive cross-sectional study was conducted in Balipatana, Khordha district, Odisha, India among 400 children. A survey employing structured questionnaires and WHO Anthropometric guidelines for data collection was used. Statistical analyses including Chi-square tests and logistic regression models were used to uncover significant associations. Results: The study revealed a stunting prevalence of 28% among children under five, with 7% severe and 21% moderate stunting. Regression analysis revealed key risk factors included low birth weight (1.5-2.5 kg), parental illiteracy, lower household income (Rs. 1000-15000), inadequate toilet facilities, and specific drinking water sources. Conclusion: The findings align with global concerns about stunting, emphasizing the complex interplay of socioeconomic and environmental factors. Interventions targeting parental education, household economic status, and improving sanitation and drinking water facilities are imperative. By addressing these factors, focused efforts can be made to reduce childhood stunting, ensuring a healthier future for the nation's children. [ABSTRACT FROM AUTHOR]

This document is a list of references from scientific articles that discuss the analysis and detection of diarrheagenic Escherichia coli (E. coli) strains in various regions and populations. The articles cover topics such as the prevalence, virulence genes, and antimicrobial resistance of E. coli strains associated with diarrhea and urinary tract infections in countries including Bangladesh, Vietnam, India, Iran, and Mexico. These references are valuable resources for researchers studying the epidemiology and characteristics of diarrheagenic E. coli strains in different settings. [Extracted from the article]

Background: Basic sanitation and waste management have always remained a central issue in India. The country launched its flagship sanitation program -- Swachh Bharat Abhiyan (SBA) (Clean India Mission) in 2014 to abolish open defecation and achieve universal sanitation coverage. Objective: This study aimed to examine barriers to toilet use and women's menstrual hygiene practices in relation to the availability of toilets among rural residents. Materials and Methods: Using a cross-sectional design and multi-stage sampling method, 120 households were selected from rural villages of the Mayurbhanj district of Odisha. Structured questionnaires and direct observation methods were used for data collection. Results: All the houses had SBA latrines, yet 25% population defecated outside. About 40% households reportedly never cleaned their toilets. Most menstruating women (86.2%) preferred to change their menstrual pads/cloths in their bedroom instead of bathrooms. Incomplete construction was reported as the major reason for not using toilets. Large family size and low caste were found to be other predictors of non-use of toilets. Rural women did not use toilets for menstrual purposes as they do not consider these places as clean and safe. Conclusion: This study clearly suggests that constructing toilets without adequate behaviour change interventions would not solve the problem of hygiene and sanitation in India, particularly in rural areas. There must be adequate monitoring of SBA scheme and utilization of funds for toilet usage. Development and implementation of suitable behaviour change strategies for toilet use in rural areas are essential to achieve the goal of open defaecation-free India. [ABSTRACT FROM AUTHOR]

Background: Maternal and child health (MCH) care is one of the essential routine healthcare services, which got affected during the coronavirus disease 2019 (COVID-19) pandemic. Modeled projections had anticipated an 8.3%-38.6% rise in maternal mortality from different countries globally. In view of limited studies pertaining to issues related to accessing MCH services in the event of a pandemic, this study was carried out on pregnant and postnatal mothers in Odisha, India. Methods: An explorative qualitative study through 36 in-depth interviews (IDIs) was conducted among 16 (44.4%) antenatal and 20 (55.5%) postnatal mothers in six of thirty districts of Odisha, India, from February to April 2021. The districts and blocks were randomly selected for better representativeness. The IDIs were conducted using a predesigned and pretested guide among mothers who had undergone delivery or availed of antenatal, postnatal, or child health services from October 2020 to April 2021. The IDIs were conducted till data saturation. The data were analyzed using MAXQDA software. Results: The average age of mothers was 27.6 (+/- 2.2) years. Among the participants, 16 (44.4%) were antenatal and 20 (55.6%) were postnatal mothers; 19 (52.8%) were primipara and 17 (47.2%) were multipara. The majority explained that they received enormous support including door-to-door services from the community health workers (CHWs) even during the difficult times of the pandemic. Reduced transportation facility and fear of contracting the infection were reasons behind the unwillingness to visit health facilities and preference for home delivery. Furthermore, the pandemic had physical, mental, social, and financial impacts among pregnant and postnatal women. Conclusion: The unprecedented COVID-19 pandemic has affected access to MCH services by antenatal and postnatal mothers. Health system preparedness and appropriate strategies including better community engagement and participation could avert such challenges in the future. [ABSTRACT FROM AUTHOR]

Context: Health literacy among school children is a priority to promote their health, hygiene, and nutrition behaviours and practices. Although in schools they learn from their peers and teachers, their domestic and social conditions also contribute to learning and adopting in practice. The level of health literacy is also influenced based on socio-demographic features. Aims: It is imperative to explore and understand the practices including existing gaps and challenges for future improvement. Methods and Material: A qualitative study consisting of 17 focus group discussions (FGDs) among students and teachers in six rural secondary schools was carried out in a rural block of the Cuttack district, Odisha. All FGDs were audio-recorded; transcribed and compiled data were imported into Atlas.ti for analysis. Results: An existing gap in health literacy and healthy practices with respect to hygiene and sanitation, nutrition, and diseases was observed. A low socio-economic status, inaccessibility to clean and safe drinking water, toilet facility, and nutritional food items were major factors preventing their health literacy and practice. Many schools have adopted measures such as poster presentation, practical teaching and demonstration, school play, and competitions at the school and in the community, which were found to be effective for creating awareness. Improving infrastructural facilities, ensuring availability of essential commodities, and having more health-promotional activities are required for improving health literacy and practice. Conclusions: There is an urgent need to improve the health literacy and practice among rural school children. Innovative practical-oriented education at schools and improved awareness among parents and community people would achieve better adherence to healthy practices. [ABSTRACT FROM AUTHOR]

Background: Health state valuation attempts to evaluate health states based on the perception of individuals. The values are used to derive disability weights (DWs) —an important metric for estimation of disability-adjusted life years and thereby calculation of the burden of diseases. Several studies have calculated DWs using different methods of valuation, however, very few have attempted to explore the underlying cause for assigning values to different health states. This study aims to document the perceptions, preferences, and social context in assigning DWs to given health states. Methods: A total of 42 community members and 21 service providers (from public and private sectors) across urban and rural Odisha and Telangana were interviewed between July to September 2018. A face-to-face in-depth interview and a rank ordering technique through card sort exercise was employed to explore reasons and perceptions of individuals in the context of health states using the thematic framework approach. Findings: Six themes emerged through analysis: awareness of the health state, nature of the disease, disease consequences, treatment-related issues, social implications, and case burden. Each theme captured an individual's reason for valuing one health state as different from the other, with differences and/or similarities between community members and service providers. Conclusion: Our study provides a comprehensive comparison between contrasting groups of individuals, thereby suggesting mere acceptance of 'experts' reasoning may not always suffice. Further research studies in the future need to be conducted for a better insight into the health perspective of a culturally diverse community. It can also help estimate the burden of disease for decision making and resource allocation in developing countries. [ABSTRACT FROM AUTHOR]

Background: Bibliometric analyses are an important tool for evaluating health research outputs in terms of their distribution, trends, contributors, focus, and funding sources. The transition from millennium to sustainable development goals has led to a gradual shift in the health policy, and possibly, research priorities of low‑income settings in the Empowered Action Group (EAG) states lagging in socioeconomic and health parameters, and also ranking low on innovations and research. In this study, we depict the recent trends, quantity, type, focus, and sources of health‑related research in the EAG state of Odisha, India. Methods: Peer‑reviewed published original research articles related to human health published between 1 January, 2011 and 31 December, 2020 and where the study population was the residents of Odisha, or the study site was in Odisha, exclusively or partially, were analyzed. The publication characteristics were tabulated, including the title, journal name, open access, date of publication, number of authors, designation of the authors, number of institutes involved, and name of the institute of the first author. The details of the study setting, study site, ethical clearance, and funding source were also analyzed. Results: The study identified 2,285 articles from database searches and included 666 articles after screening for bibliometric analysis. Most of the manuscripts had between three and six authors (43.5%). Two institutes from the state, the Regional Medical Research Center (ICMR‑RMRC) and Kalinga Institute of Industrial Technology (KIIT), together contributed to 22.4% of the published manuscripts. Nearly 45.9% of the studies were community‑based while 45.3% were hospital‑based. While most of the published work was on infectious diseases, the proportion came down with time. An overwhelming majority of the studies were observational and less than 10% were experimental in design. Conclusions: The analysis shows a substantial increase in the number of publications in this decade. Priority setting of healthcare problems, increased funding, and capacity‑building can give a much‑necessitated impetus to more quality‑ and evidence‑based research for aiding policy implementation and improvement of the overall health. [ABSTRACT FROM AUTHOR]

Objective: The objective of this review was to summarize and compare the estimates of diabetes among adults in community and hospital-based settings in Odisha, India. Introduction: Diabetes Mellitus (DM) is a major non-communicable disease as well as a risk factor. In a vast and diverse country such as India, where health is a state subject, regional synthesized and up to date estimates of DM burden is necessary for informed policy making. No such estimates are currently available for the state of Odisha. Materials and Methods: Peer-reviewed published original research articles related to prevalence DM in the state of Odisha published between 2011 and 2022 were retrieved from 4 medical databases and analysed. Study screening, selection, data extraction and critical appraisal was done by 2 independent review authors. Data synthesis and assessment of certainty of the evidence was done in meta-analysis of the results. Results: A total of 15 studies, that included 17339 participants, with overall good methodological quality were included in the review. The overall prevalence of DM among adults in the state of Odisha based on Community based surveys was 6.8% (95% CI: 2.3-13.4%). The prevalence in older adults aged 60 years or above is higher at 22.2% (95% CI: 8.6-39.9%). The prevalence in studies that relied on self-reported methods of screening was 4.8% (95% CI: 1.7-9.3%) as compared to those that diagnosed participants based on standard criteria (12.1%; 95% CI: 8.1-16.7%). Conclusions: We found a high prevalence of DM in the state of Odisha, which was higher than previously available national and regional estimates. This prevalence was much lower in community-based studies and in self-reported surveys pointing towards significant under diagnosis of hypertension in the state of Odisha and highlighting a need for a robust community-based screening program among adults in the state. [ABSTRACT FROM AUTHOR]

Purpose: To describe and validate the eye health program protocol of Dongria tribal community, a particularly vulnerable tribal group (PVTG) in Rayagada district, Odisha, India.Methods: The program would consist of three segments. At people's residences, trained community health workers (CHWs) will measure the vision and collect demographic data. In addition, vision technicians (VTs) will refract using a hand-held device and prescribe spectacles to people who improve to >6/12, N8. Others would be referred to the vision center (VC). At VC, the VT will perform a slit-lamp examination and re-refract. They would refer people with vision ≤6/12 to the secondary center (SC). At SC, referred people will receive a comprehensive eye examination and treatment. The ophthalmologist will assign the cause of blindness and visual impairment for people with visual acuity <6/12. The entire process was rehearsed in a pilot study.Results: The target population is approximately 10,000 people residing in 101 hutments on the hills of Rayagada district. The pilot study included 126 people. The mean age was 44 ± 18 years; 70% of the people were illiterate, and in this cohort, 97.6% (n = 123) had never worn spectacles. In the pilot study, 41% of the people had cataract, and 12% had pterygium. The agreements between optometrist versus VTs and between optometrist versus CHWs were good (k = ~0.8-1.0) in all eye conditions except for strabismus (k = ~0.56-0.65).Conclusion: The pilot study confirms the program modality, and when completed, it would help in the planning and resource allocation of Odisha PVTG eye care. [ABSTRACT FROM AUTHOR]

Introduction: India accounts for one-fourth of the global TB burden. The load of drug-resistant TB is of foremost attention and concern at international, regional, and national levels. As per estimates of TB burden in India in 2018, the MDR/RR-TB incidence was 1.30 lakhs. Objectives: Socioepidemiological status and clinical outcome of MDR TB patients in a teaching hospital in tribal area of southern Odisha from 2012-2020. Material and Methods: This is a retrospective observational study accepted by the Institutional Ethics Committee of this tertiary medical college & hospital to which the DRTB centre is attached with the agreement of the program administrators. Inclusion Criteria: Patients with >15 years of age, those patients with pulmonary and extrapulmonary tuberculosis with normal liver enzymes. Exclusion Criteria: Patients having abnormal liver enzymes before treatment, pregnant ladies and children <15 years of age. Results: A total of 40 MDR TB patients were included. The patients' mean age was 36.65 ± 11.75 years. 65% of the patients had BMI below 18.5 kg/m2. 17.5% of patients had comorbidities. Approximately 45% had successful treatment outcomes. Poor treatment outcome includes loss to follow-up in 22.5% and mortality in 12.5%. We did not find any treatment failure. Conclusion: Treatment success outcomes occurred in less than half of the cases. The main predictors of mortality among MDR-TB patients were the presence of comorbidities like anaemia, baseline leucocytosis or lymphopenia, hypoproteinaemia, HIV sero-positivity and smaller baseline BMI. [ABSTRACT FROM AUTHOR]

Purpose: To estimate seeing and other disabilities in a population cohort in a tribal district, Rayagada, in the Indian state of Orissa.Methods: A door-to-door survey was conducted to identify the disabilities. The vision was measured at the residence of the subject, and other disabilities were documented from the history obtained from the subject/household/neighbor. All people with seeing disabilities were reexamined in the community eye center (primary or secondary), and required treatment was given at no cost to the patients. People with other disabilities were transported to the public health facility for appropriate care and disability certification. The results were compared with the 2011 national census data.Results: A total of 147,699 people were enumerated, and 106,339 (72%) were examined over one year period, 2016-17. In this cohort, 47.3% (n = 50,320) were male and 27.5% (n = 29,215) were 40 years or older. We recorded systemic disease in 0.6% (n = 689) people; hypertension was two times higher than diabetes mellitus. Disability was identified in 2.8% (n = 3022). Common disabilities were seeing (46.7%; n = 1411), hearing (36.8%; n = 1112), mobility (10.4%; n = 315), and mental retardation (3.2%; n = 98). Dual sensory disability (seeing and hearing) was seen in 6.4% (n = 251), and it was higher in the older age group. Seeing and hearing disabilities were higher than the 2011 state (P =< 0.001) and national (P =< 0.001) disability census.Conclusion: The first population-based survey in Rayagada, Odisha (India) in 2017 showed a higher proportion of people with seeing and hearing disabilities. It calls for an appropriate service strategy. [ABSTRACT FROM AUTHOR]

Background: An occupational hazard is a growing concern for developing countries. The study aims to assess the pattern and the factors associated with morbidity of the steel plant workers and the usage of social security schemes among them. Materials and Methods: The cross-sectional study was conducted in two steel plants of the Angul district of central Odisha from May to August 2019. The steel plant workers were assessed for occupational hazard using a structured questionnaire and a physical examination was conducted. Chi-square test and binary logistic regression were used to find out the association. Results: Dust was the most common exposure followed by noise and heat. Myopia (26.7%), generalized weakness (19.0%), hearing impairment (19.0%), respiratory illness (15.9%), hypertension (11.0%), myalgia (10.2%), and peripheral neuropathy (9.1%) were the common morbidities among the steel plant workers. Exposure to dust, noise, vibration, chemicals, and year of exposure is the common determinants of morbidities. Only 63.5% of the study participants availed of different social-security schemes. Conclusions: Pre-placement examination, regular medical check-ups, and the use of proper safety measures during work can reduce the chance of morbidities. Authorities need to sensitize the workers to safety equipment and hazard-prone conditions and also regarding social-security schemes. [ABSTRACT FROM AUTHOR]

Background: Stillbirth rate has shown less or no improvement in developing countries. India was estimated to have the largest number of stillbirths globally in 2015. Systematic review of stillbirths is a strategy that helps in identifying gaps in the care of a pregnant mother, and is a useful and comprehensive indicator of the quality of maternity care. Objectives: The objective of this study was to assess the quality of maternal care, and factors causing stillbirth, and to provide some doable plans to reduce its incidence in the Odisha state. Materials and Methods: The stillbirth review was undertaken over 4-month timeline (August to November 2014) in ten high-priority districts (HPDs) of Odisha. It included development of tools, desk reviews, training of staffs, and data handling. The deaths were estimated from Annual Health Survey. It was compared to the estimated stillbirth of each district to get the underreporting/overreporting districts. A report was generated on stillbirth process indicators, and program indicators after completion of assessment. Results: In the selected HPDs of Odisha, 4689 stillbirths were observed during the study period. However, the labor room register stated the reason of death in only 408 cases (8.7%). Further, at the time of admission, a provisional diagnosis could be made for only 3038 (64.7%) cases, of which 11% diagnosed as safe delivery resulted in stillbirth. Conclusions: The present study could contribute to a larger extent to address some of the gaps in the stillbirth review process in Odisha. [ABSTRACT FROM AUTHOR]

Purpose: To measure the proportion of people with major ophthalmic and retinal disorders in the tribal and non-tribal people presenting to a community eye hospital in an Indian state with a sizeable tribal population.Methods: Hospital-based cross-sectional retrospective study of all new adult patients, examined between September 2015 and June 2020. A tribal was defined as per the Indian ethnic classification. Blindness and visual impairment were defined as per the WHO standards. Diabetes and hypertension were defined as per Indian standards. The proportion of common ophthalmic and retinal disorders between the tribal and non-tribal community were compared.Results: This cohort consisted of 76,166 people (45.8%; n = 34,869, tribal); 39.4% (n = 29,989; non-tribal 23.6% and tribal 15.8%) people had ophthalmic disorders. In the examined people 2.3% were blind (higher in tribal community 4.7% versus 0.8%; P < 0.001) and 8.4% had moderate-to-severe visual impairment (higher in tribal community 14.4% versus 4.4%; P < 0.001). Refractive error (64.4%; higher in non-tribal community, 77.3% versus 44.6%, P < 0.001) and operable cataract (23.9%; higher in tribal community, 40.9% versus 11.8%, P < 0.001) were the principal ophthalmic disorders. Retinal disorders were higher in non-tribal people (5.9% vs. 2.9%; P < 0.001), but the tribal group had higher proportion of retinitis pigmentosa (20% vs. 6.4%; P < 0.001) and lower proportion of diabetic retinopathy (8% vs. 40.7%; P < 0.001).Conclusion: : The health-seeking behavior of the tribal community in India is low. A tribal person in India apparently visits the hospital when vision is grossly affected. It calls for greater advocacy, increased access to healthcare, and a larger population-based study. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) causes several maternal and neonatal complications. Aims: This exploratory study was conducted to estimate the prevalence, determine the risk factors and morbidities among pregnant women. Methods: In this prospective study, 1557 pregnant women attending the Gyn. & Obs. clinic of a hospital in an urban area of Bhubaneswar were enrolled. Various socio-demographic factors and clinical profiles were assessed. We used a Glucometer for the diagnosis of GDM. Results: More younger pregnant women residing in slums, sedentary and overweight were having diabetes. A large percentage of pregnant women living in rural areas and slums visit the government hospitals as they are benefitted by the State govt.'s scheme, Mamata. Pregnant women residing in the urban areas prefer to go for ante-natal check-ups in private Nursing homes/Clinics owing to the crowd and prolonged waiting hours. In this study, body mass index (BMI) and family history of the pregnant women appeared to be the significant risk factors for the gestational diabetes. Out of 1557 pregnant women, 154 were having diabetes, the prevalence being 9.89%. This is low when compared to the studies reported from other regions of the country. Conclusions: Gluco-One is suitable for screening gestational diabetes using the optimal threshold capillary glucose level of 140 mg/dl. As the pregnant women find it difficult to come the next day just to collect the results, this facilitated in getting the test results promptly and appropriate consultation by Doctor the same day. Glucometer can be used for accurate screening of gestational diabetes mellitus. Pregnant women with screening values not normal were identified on the spot and followed up at regular intervals. Screening for diabetes among pregnant women would result in early case detection indirectly resulting in better outcomes of treatment and prevention of complications. [ABSTRACT FROM AUTHOR]

Purpose: To describe the prevalence of refractive error in school children in a tribal district, Rayagada, Odisha state, India.Methods: In a cross-sectional school eye health study, the students with diminished vision and other ocular abnormalities were referred for a further eye examination to the vision technicians after initial screening by the trained school teachers. The examination by vision technicians consisted of an external eye examination, photorefraction using a Spot screener and subjective correction. Those not improving with subjective correction were referred to the ophthalmologist for further examination.Results: The school teachers measured vision in 153,107 children; 5,990 students reached a vision technician. There was a near equal number of boys (50.06%) and girls (49.94%). The average age was 10.5 ± 2.63 (range: 5-15) years. The prevalence of refractive error was 9.7% (95% [CI]; 9.0-10.5%) in the vision technician-examined children. Myopia (4.9%) and astigmatism (5.4%) were more common than hyperopia (0.2%). The presenting visual acuity (PVA) was worse in children with hypermetropia (PVA 20/100-20/200 in 40% of children). Spherical equivalent of refractive error did not have a good correlation with age (R2 = 1.3); but increasing age was associated with increased risk of myopia (odds ratio 1.14; 95% CI 1.09-1.20; P < 0.001).Conclusion: The quantum of refractive error was close to other similar studies in India but the prevalence of myopia was relatively less. [ABSTRACT FROM AUTHOR]

Background: Poor documentation practices in labour rooms have been a challenge especially in resource limited countries. This hinders the efforts towards improving quality of maternal healthcare services. Little effort has been made on this regard in many countries including India. SWOT analysis on labour room documentation would be the first step in understanding the situation, barriers and to formulate strategies for improvement. Materials and Methods: Facility based cross-sectional study was carried out in five secondary health facilities of Cuttack district, Odisha, India. A qualitative method using in-depth interviews among 26 healthcare providers was adopted for data collection and inductive content analysis approach for analysis. Strategies like pioneering, positive, conservative and resistive were formulated under each of the three major components identified. Results: Three major components emerged were i) Adherence and completeness of labour room records and reports, ii) Status of the monitoring and supervision and iii) Utilization of labour room data. Improving knowledge and skill through training and supportive supervision, adopting computer-based application for data management, better coordination among supervisors and labour room staff, infrastructural strengthening for documentation and its security, making documentation a priority, more accountability would improve the documentation. Ensuring data analysis and interpretation, discussion in review meetings and regular monitoring and supervision will improve performance. Conclusion: Ensuring documentation of labour room records, regular quality monitoring and supervision, and analysis and interpretation of data are critical to improve labour room performance. Making it a priority and adopting the strategies will achieve the same, thereby better labour outcome. [ABSTRACT FROM AUTHOR]

The outcome of a retinopathy of prematurity (ROP) program initiated in five districts of Odisha over 3 years with partnerships between the government and non-government organizations was prospectively analyzed. The mentoring partners trained the district ophthalmologists and neonatal care providers; the program was handed over when the trainees were considered competent enough to diagnose and treat babies with ROP. During the project period (July 2016-June 2019), 3058 babies were examined; ROP was detected in 33.81% (n = 1034) and 5.06% (n = 159) babies required treatment. At the end of the project, ROP screening was possible in all five districts, and treatment was possible in three districts. ROP care nodal centers were built in one government medical college. To strengthen the initial gain, we recommend creating an Odisha Retinopathy of Prematurity (OD-ROP) steering committee with private-public partnerships to support the program and monitor its progress in other districts of Odisha. [ABSTRACT FROM AUTHOR]

Purpose: To explore the possibility of vitamin A deficiency (VAD) detection through School Sight Program (SSP) in a tribal district of Odisha, India.Methods: In a cross-sectional observational study, we tracked school children with ocular signs/symptoms of VAD to their villages. The ophthalmologist examined their under-5 siblings and other under-5 children in the village. Information pertaining to family belief and practices of food, water, sanitation, and the socioeconomic status of the family were collected.Results: The ocular features of VAD were detected in 207 of 4801 (4.3%) examined children. This included 70 children (mean age 11 ± 2.6 years) detected in the school, 22 siblings (mean age 3.2 ± 1.2 years) of these children detected at their home, and 115 children (mean age 3 ± 1.5 years) detected in their habitat. The average family size was 5.8 ± 2.02 and the birth order of the child with VAD was 2.3 ± 1.25. Most parents were farmer, living in asbestos-roofed house, depended on public underground water, and practiced open-air defecation. The distribution of VAD in 207 children was conjunctival xerosis (X1A = 207; 100% of VAD and 4.3% of all children), Bitot's spot (X1B = 169; 81.6% of VAD and 3.5% of all children), corneal scar (XS = 3; 1.4% of VAD and 0.06% of all children), and night blindness (XN = 35; 16.9% of VAD and 0.72% of all children).Conclusion: An opportunistic screening for detection of VAD through a SSP could be cost-effective and complement the existing strategy. [ABSTRACT FROM AUTHOR]

Introduction: Scrub typhus is a mite-borne bacterial infection of humans caused by Orientia tsutsugamushi that presents with prolonged fever unless suspected early. The aim of this study was to characterize the epidemiological factors and clinical clues in this region for early diagnosis. Materials and Methods: This study was a retrospective, observational study conducted in all diagnosed scrub typhus cases admitted to the pediatric ward of a tertiary care hospital in-between January 1, 2015 and December 31, 2016. One hundred and one patients admitted with IgM positive for scrub typhus over 2-year period were analyzed for the epidemiological factors and clinical features. Results: Male:female ratio is 1.4:1. The mean age of the patients in our cohort was 4.83 years, ranging from 0.25 to 14 years. Majority (79.2%) was from the rural area. Fever was present in all cases and about 81.19% of children presented with fever for >7 days. Other findings were hepatosplenomegaly (55.45%), respiratory problems (47.54%), abdominal symptoms (40.59%), eschar (26.74%), rashes (15.84%), altered behavior (9.9%) and lymphadenopathy (2.97%) of cases studied. Thrombocytopenia, elevated liver enzymes, and raised C-reactive protein (CRP) were found characteristically. Defervescence after starting doxycycline was within 3.26 ± 2.26 days. Conclusions: Scrub typhus can present in various ways but mostly with prolonged fever. Hepatosplenomegaly, eschar, third spacing, raised CRP, and thrombocytopenia are important clues for early clinical diagnosis. Increased awareness and heightened suspicion, especially in the light of increasing number of patients are required for timely treatment and prevention of complications. [ABSTRACT FROM AUTHOR]

Context: Partograph is a simple, effective and low-cost intrapartum monitoring tool that helps in early identification of complications if any and helps in prompt intervention to save the life of the mother and the newborn. There is limited study about its usage and challenges in plotting from India particularly Odisha. Aim: To determine the usage of partograph and explore the issues/challenges in its plotting at various levels of health facilities Settings and Design: A cross-sectional study was carried out from April to June 2018 in ten different public health facilities from two tribal districts of Odisha, India. Materials and Methods: Quantitative information from 1552 mothers using pre-tested epi-info questionnaire tool and qualitative information through 22 in-depth interviews among health care providers. Statistical Analysis Used: Quantitative data using Ms Excel 10 and IBM SPSS ver. 22 and qualitative data using the inductive content analysis method. Results: Partograph plotting was found in 48.7% (adherence) while its completeness was only 1.03%. Partograph plotting was significantly better at CHCs compared to DHH and SDH (P = 0.000). No significant association of partograph adherence was observed with the birth outcome, complications, referral status and type of delivery. Though majority health care providers knew the importance of the partograph, hardly they use it. The main reasons were increased workload, shortage of staff, cases arriving at a later stage and lack of monitoring from a higher level. Conclusions: On job training on partograph, regular monitoring and strict policy will improve the adherence and completeness in partograph plotting. [ABSTRACT FROM AUTHOR]

Aim and Objective: The aim of this study was to assess the oral hygiene status, oral hygiene practices, and periodontal health among brick kiln workers of Odisha. Materials and Methods: Four hundred and eight subjects (300 males and 108 females) between the ages of 22 and 65 years with mean age of 33.44 ± 2.34 years working in various brick kilns in the district of Khordha, Odisha, participated in the survey. Data were collected through personal interview and clinical examinations. Results: Overall prevalence of periodontal diseases among brick kiln workers was 86.27%. There was a statistically significant difference in the distribution of Community periodontal index (CPI) (P < 0.001) and loss of attachment score scores (P < 0.001). Periodontal disease was significantly associated with age, oral hygiene status, practices, and tissues abuse habits. Most of the workers were males (59%), in the age group of 30–40 years (40.69%), having only a primary level of education (75.98%) and were married (80.88%). Majority of the workers brushed their teeth once daily (78.9%) with toothbrush (51.5%) and used toothpaste (41.2%). Most of them were found to be consuming paan or gutkha as compared to cigarette or beedi smoking. Among the subjects with a CPI >2, higher prevalence of periodontal disease was seen in subjects older than 50 years of age (86.7%), those brushing once daily only (75.2%), brushing with finger (82.8%), with higher frequency and duration of consumption of tobacco and alcohol, and having a poor oral hygiene (85.5%). Conclusion: The survey among brick kiln workers revealed that the oral hygiene status was poor, they had ill-informed oral hygiene practices and most of them were suffering from periodontal disease. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) and thyroid dysfunction (TD) often present together and complicate each other at many levels. Methodology: In this prospective study, we determined the prevalence of TD among 700 patients with T2DM attending the diabetes clinic of a tertiary care hospital who were recruited. Various sociodemographic factors such as age, gender, marital status, literacy status, and habits and clinical profile were assessed. Results: In all, 68% of male and 31% of female patients were enrolled in this study. About 33.5% of males and 66.4% of females were found with TD. One hundred and fifty-two (21.7%) patients were having TD. Diabetes and TD were more common among females, with advancing age, 45–70 years, sedentary, overweight patients and having familial history. Twenty-five percent of the patients were having prehypertension. About 10.5% of the patients were suffering with hyperthyroidism and 9% were suffering from subclinical hyperthyroidism. Forty-two percent were suffering from hypothyroidism, while 36% had subclinical hypothyroidism. Ten percent had higher T3 hormone levels, 11% had higher T4 hormone levels, and 69% had increased thyroid-stimulating hormone levels. Three percent of patients with diabetes and TD were having cardiovascular diseases. Conclusions: Out of 700 patients with T2DM, 21% were having different kinds of TD. More females with advancing age and sedentary lifestyle were having TD. Screening for TD among diabetes patients could improve case detection and early treatment, indirectly leading to better thyroid-specific treatment outcomes and prevention of DM complications. [ABSTRACT FROM AUTHOR]

Context: Overweight and obesity has become a major contributor to global burden of chronic diseases and disability. Obesity among rural India is emerging as a major health problem because of change in lifestyle and food habits, thereby increases the risk of multiple morbid conditions among rural population. Aims: This study aims to find out the association of overweight/obesity with different socio-demographic factors and explore the co-morbidities among overweight and obese in a rural setting. Settings and Design: A cross-sectional study was done in a randomly selected primary health centre of Khurda district, Odisha for 4 months. Materials and Methods: This study was done among 183 patients aged >20 years with BMI >25 kg/m2 after taking their consent. Anthropometric measurements were done and data were collected using a semi-structured questionnaire. Statistical Analysis Used: Descriptive statistics such as proportion, mean and standard deviation were calculated and inferential statistics such as Chi-square test, univariate and multivariate regression was done using the SPSS version 20.0. Results: Mean age of participants was 45.7 (±13.8) years. About 93.4% were Grade II obese while 51.9% were at risk according to their waist–hip ratio. Around 53.6% of participants had multi-morbidity. Age, occupation and number of children were significantly associated with obesity. Morbidity was significantly associated with age, occupation, marital status and number of children. Increased grade in obesity the more is the probability of having morbidity. Conclusions: There is an urgent need to screen for obesity at rural health facility and early management for prevention from co-morbidities. [ABSTRACT FROM AUTHOR]

Background: There are limited data available on how the problem of alcohol use is detected in primary care setting in India. Particularly in Odisha, it has not been investigated yet. This study was conducted to determine the prevalence of drinking, drinking patterns, and quitting behavior among the male patients visiting a primary health‑care facility in a district of Odisha. Methodology: A cross‑sectional study was conducted among patients attending community health center (CHC), Buguda in the state of Odisha, India, from December 1, 2014, to February 31, 2015. Patients above 18 years of age, conscious, and willing to participate in the study were included in the study, while those with cognitive impairment and critically ill were excluded from the study. All eligible consecutive patients attending outpatient department of CHC were invited to participate while they came out after physician’s consultation. A pilot study was conducted prior to the study. Informed verbal consent from each patient was obtained before the interview. The study was approved by the Institutional Ethics Committee of Indian Institute of Public Health, Bhubaneswar. Results: A total of 431 patients were interviewed. Our study showed 38% (95% confidence interval [CI]: 33.5%–42.7%) of respondents were alcoholic and of those 60% (95% CI: 51.4%–66.5%) were hazardous drinkers. One in five patients had a history of alcoholics in their family, and a similar proportion of participants were heavy workers. Smokers were eight times (adjusted odds ratio [AOR] =7.56; 4.03–14.52) more likely to be alcoholics as compared to nonsmokers (P < 0.001), whereas the prevalence of alcohol drinking was four times (AOR = 3.94; 2.25–6.92) higher in smokeless tobacco users compared to nonusers. Conclusion: Focusing only on counseling and treatment services will not reduce the piling burden of alcohol use. It is important to target the environment that leads to such habits. [ABSTRACT FROM AUTHOR]

Introduction: Patient satisfaction is as important as is the care itself. When the patient has a disease like cancer it becomes even more important. A cancer patient not only suffers from the disease but also undergoes substantial mental trauma, agony, stress, uncertainty, and apprehension. There are limited studies in India eliciting patient's views on the quality of care being received by cancer patients. Methodology: A cross-sectional triangulation data transformation model mixed method design (Quant + Qual) was used to conduct the study between March and May 2015 among patients attending specialty hospitals providing oncology services in Odisha, India. The quantitative data were collected using, Patient Satisfaction Questionnaire-18 to assess satisfaction. The qualitative data were obtained through in-depth interviews using open-ended questionnaire. Results: The results showed that general satisfaction among the patients was 60%. The maximum score was obtained for the communication of doctors. The qualitative findings revealed that travel for distant places for minor illness, waiting period, and lack of services at the primary care facilities were reasons for patient's dissatisfaction. Conclusion: The study found that the patients were generally satisfied with the quality of services. However, more studies should be conducted including perceptions of the patients as well as the caregiver. [ABSTRACT FROM AUTHOR]

Background: Physicians constitute a considerable professional influential group; they may be most suited for tobacco use prevention and smoking cessation intervention among the growing tobacco using population. Methods: We assessed tobacco cessation knowledge and practice done by 91 physicians in two blocks of Khurda district by using modified version of survey instrument developed by Francisco G. Soto Mas. Statistical Package for Social Sciences (SPSS) 16 statistical software was used for the analysis. Results: The response rate was 75.83%, of which 77 (84.6%) were male. Study participants were in the age group 36-45 years. Nearly 13.2% of the respondents were active tobacco user. In tobacco-related practices, around 58 (62%) of participant physicians ask patients about tobacco use status always-frequently. More than (67) 70% of participant physicians advise their patients to quit tobacco but only 10-20% of study physicians assist them in referring to cessation programs. Seventy one (78%) of physicians felt providing counseling to patients using tobacco as their responsibility. Conclusions: The results indicate that physicians participating in this study do not meet the level of intervention recommended by National Tobacco Control Program. [ABSTRACT FROM AUTHOR]

This article examines the processes of change in a large lagoon system, and its implications for how commons can be managed as commons in the long run. We use two related concepts in our analysis of change: communization and decommonisation; ‘communization’ is understood as a process through which a resource gets converted into a jointly used resource under commons institutions that deal with excludability and subtractability, and ‘decommonisation’ refers to a process through which a jointly used resource under commons institutions loses these essential characteristics. We analyse various contributing issues and dynamics associated with the processes of communization and decommonisation. We consider evidence collected through household and village level surveys, combined with a host of qualitative and quantitative research methods in the Chilika Lagoon, the largest lagoon in India, and one of the largest lagoons in Asia. We suggest that in order to keep the Chilika commons as commons will require, as a starting point, a policy environment in which legal rights and customary livelihoods are respected. With international prawn markets stabilized and the ‘pink gold rush’ over, the timing may be good for a policy change in order to create a political space for negotiation and to reverse the processes causing decommonisation. Fishers need to be empowered to re-connect to their environment and re-invent traditions of stewardship, without which there will be no resources left to fight over. [ABSTRACT FROM AUTHOR]