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Background: Food insecurity is a major public health problem worldwide. In India, there are limited food insecurity assessment studies using a conventionally accepted method like the Food Insecurity Experience Scale (FIES), developed by the Food and Agricultural Organization (FAO). This study aims to measure food insecurity using the FIES and explore its determinants and association with body mass index (BMI) among Indian adults. Methods: In a cross-sectional study, we used FIES to measure food security in a sample of 9005 adults residing in North and South India. Using questionnaires, socio-demographic factors, dietary intake and food security data were collected. The dietary diversity scores (FAO-IDDS) and food insecurity scores (FAO-FIES) were calculated. Body size was measured and BMI was calculated. Results: The mean age of the study participants was 52.4 years (± 11.7); half were women and half resided in rural areas. Around 10% of the participants reported having experienced (mild or moderate or severe) food insecurity between October 2018 and February 2019. Dietary diversity (measured by FAO's Individual Dietary Diversity Scores, IDDS) was low and half of the participants consumed ≤ 3 food groups/day. The mean BMI was 24.7 kg/m2. In the multivariate analysis, a lower IDDS and BMI were associated with a higher FIES. The place of residence, gender and wealth index were important determinants of FIES, with those residing in South India, women and those belonging to the poorest wealth index reporting higher food insecurity. Conclusion: Food security is understudied in India. Our study adds important evidence to the literature. Despite having marginal food insecurity, high prevalence of low diet quality, especially among women, is disconcerting. Similar studies at the national level are warranted to determine the food insecurity situation comprehensively in India and plan appropriate policy actions to address it effectively, to attain the key Sustainable Development Goals (SDG). [ABSTRACT FROM AUTHOR]

Background: With visceral leishmaniasis (VL) incidence at its lowest level since the 1960s, increasing attention has turned to early detection and investigation of outbreaks. Methods: Outbreak investigations were triggered by recognition of case clusters in the VL surveillance system established for the elimination program. Investigations included ascertainment of all VL cases by date of fever onset, household mapping and structured collection of risk factor data. Results: VL outbreaks were investigated in 13 villages in 10 blocks of 7 districts. Data were collected for 20,670 individuals, of whom 272 were diagnosed with VL between 2012 and 2019. Risk was significantly higher among 10–19 year-olds and adults 35 or older compared to children younger than 10 years. Outbreak confirmation triggered vector control activities and heightened surveillance. VL cases strongly clustered in tolas (hamlets within villages) in which > 66% of residents self-identified as scheduled caste or scheduled tribe (SC/ST); 79.8% of VL cases occurred in SC/ST tolas whereas only 24.2% of the population resided in them. Other significant risk factors included being an unskilled non-agricultural laborer, migration for work in a brick kiln, living in a kuccha (mud brick) house, household crowding, habitually sleeping outside or on the ground, and open defecation. Conclusions: Our data highlight the importance of sensitive surveillance with triggers for case cluster detection and rapid, careful outbreak investigations to better respond to ongoing and new transmission. The strong association with SC/ST tolas suggests that efforts should focus on enhanced surveillance in these disadvantaged communities. [ABSTRACT FROM AUTHOR]

COVID-19 has emerged as global pandemic with largest damage to the public health, economy and human psyche.The genome sequence data obtained during the ongoing pandemic are valuable to understand the virus evolutionary patterns and spread across the globe. Increased availability of genome information of circulating SARS-CoV-2 strains in India will enable the scientific community to understand the emergence of new variants and their impact on human health. The first case of COVID-19 was detected in Chambal region of Madhya Pradesh state in mid of March 2020 followed by multiple introduction events and expansion of cases within next three months. More than 5000 COVID-19 suspected samples referred to Defence Research and Development Establishment, Gwalior, Madhya Pradesh were analyzed during the nation -wide lockdown and unlock period. A total of 136 cases were found positive over a span of three months that included virus introduction to the region and its further spread. Whole genome sequences employing Oxford nanopore technology were generated for 26 SARS-CoV-2 circulating in 10 different districts in Madhya Pradesh state of India. This period witnessed index cases with multiple travel histories responsible for introduction of COVID-19 followed by remarkable expansion of virus. The genome wide substitutions including in important viral proteins were identified. The detailed phylogenetic analysis revealed the circulating SARS-CoV-2 clustered in multiple clades including A2a, A4 and B. The cluster-wise segregation was observed, suggesting multiple introduction links and subsequent evolution of virus in the region. This is the first comprehensive whole genome sequence analysis from central India, which revealed the emergence and evolution of SARS-CoV-2 during thenation-wide lockdown and unlock. [ABSTRACT FROM AUTHOR]

Objective: Despite a reduction in maternal mortality in recent years, a high rate of anaemia and other nutrient inadequacies during pregnancy pose a serious threat to mothers and their children in the Global South. Using the framework of the WHO–Commission on Social Determinants of Health, this study examines the socioeconomic, programmatic and contextual factors associated with the consumption of iron and folic acid (IFA) tablets/syrup for at least 100 d (IFA100) and receiving supplementary food (SF) by pregnant women in India. Design: We analysed a nationally representative cross-sectional survey of over 190 898 ever-married women aged 15–49 years who were interviewed as part of the National Family Health Survey (NFHS) conducted during 2015–16, who had at least one live birth preceding 5 years of the survey. Setting: All twenty-nine states and seven union territories of India. Participants: Ever-married women aged 15–49 years. Results: Less than one-third of women were found to be consuming IFA100, and a little over half received SF during their last pregnancy. The consumption of IFA100 was likely to improve with women's education, household wealth, early and more prenatal visits, and in a community with high pregnancy registration. Higher parity, early and more prenatal visits, contact with community health workers during pregnancy, belonging to a poor household and living in an aggregated poor community and rural area positively determine whether a woman might receive SF during pregnancy. Conclusions: Continuous monitoring and evaluation of provisioning IFA and SF in targeted groups and communities is a key to expanding the coverage and reducing the burden of undernutrition during pregnancy. [ABSTRACT FROM AUTHOR]

Low birth weight (LBW) is defined as birth weight less than 2.5 kg. LBW infants remain at a relatively higher risk of mortality than those with normal birth weight. This is still a major public health problem in developing countries like India. Data from the third round of the National Family Health Survey were used for this study. The multivariable logistic regression model demonstrated a significant association between the reporting of birth weight, and education level and financial status. Furthermore, as the rate of parity increased, the odds for reporting of birth weights decreased in the northern, central and eastern regions of India. [ABSTRACT FROM AUTHOR]

The human gut microbiome contributes to a broad range of biochemical and metabolic functions that directly or indirectly affect human physiology. Several recent studies have indicated that factors like age, geographical location, genetic makeup, and individual health status significantly influence the diversity, stability, and resilience of the gut microbiome. Of the mentioned factors, geographical location (and related dietary/socio-economic context) appears to explain a significant portion of microbiome variation observed in various previously conducted base-line studies on human gut microbiome. Given this context, we have undertaken a microbiome study with the objective of cataloguing the taxonomic diversity of gut microbiomes sampled from an urban cohort from Ahmedabad city in Western India. Computational analysis of microbiome sequence data corresponding to 160 stool samples (collected from 80 healthy individuals at two time-points, 60 days apart) has indicated a Prevotella-dominated microbial community. Given that the typical diet of participants included carbohydrate and fibre-rich components (predominantly whole grains and legume-based preparations), results appear to validate the proposed correlation between diet/geography and microbiome composition. Comparative analysis of obtained gut microbiome profiles with previously published microbiome profiles from US, China, Finland, and Japan additionally reveals a distinct taxonomic and (inferred) functional niche for the sampled microbiomes. [ABSTRACT FROM AUTHOR]

Sexual diamorphism can provide information on behavioral and ecological characteristics of extinct species. Sexual diamorphism is predominantly done by long bone, pelvis and skull, but hyoid bone least notable bone for sex determination. In present study 100 adult hyoid bone, out of 72 male and 28 female hyoid bone, remove from corpse and buried in soil, examined using discriminant function analysis (IBM SPSS20). Age of deceased ranged from 18 years to 90 years, four discriminant function were tested and was obtained, Discriminant Function = 2.563 mlgrclt + (-0.265) mlgrcrt + 1.761 dislessc - 11.398, Cut off score was (-0.296), 76% accuratelly classified in to their groups. Crossvalidated results showed correct classification in 74% of the cases were correctly classified. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) provides that India will have the fastest rate of rise in deaths attributable to tobacco in the first two decades of the twenty first century. There are strong evidences that smoking behavior is related to social factors. Taste and smell also influence the inclination to smoke where exciting sensory organs in the lips, mouth and throat provide sensations of touch, taste and irritation. It has been suggested that high negative mood variability is a risk factor for future smoking escalation and that its mood stabilizing effects may reinforce and maintain daily cigarette use among youths. Cigarette smoking is the largest modifiable risk factor and reason for male and female infertility and several other disorders (like: for pregnancy, respiratory disorder, diabetes, tuberculosis, coronary heart disease and during substance abuse treatment). Epidemiological status in India an estimated 65% of all men and 33% of all women use some form of tobacco. Tobacco consumption continues to grow in India at 2-3% per annum, and by 2020. It is predicted that it will account for 13% of all deaths in India. Interventions to aid smoking cessation are among the most important treatments such as nicotine replacement therapy and non nicotine replacement therapy like antidepressants drugs that can be offered to smokers to improve their current and future health and reduce the risk of premature death. Recent treatment with new technologies like use of electronic cigarettes, devices that deliver a nicotine-containing vapor, has increased rapidly across the country and globally. The proliferation of smart phones used in novel ways to promote smoking cessation. New possibilities for using mobile phones as tools for health promotion Smart phones are being used in novel ways to promote smoking cessation. The approach to smoking cessation and adherence to the U.S. public health service's 2008 clinical practice guidelines for treating tobacco use and Dependence. It is recommended that current apps be revised and future apps be developed around evidence-based practices for smoking cessation. [ABSTRACT FROM AUTHOR]

Objective. To assess the prevalence of oral potentially malignant disorders and to determine the potential risk factors for its development in Indian population. Materials and Methods. This cross-sectional study was carried out on 1241 individuals in Indore, Madhya Pradesh. A questionnaire was designed to record information about sociodemographic characteristics, oral hygiene practices, dietary habits, and risk factors for oral potentially malignant disorders. Oral mucosal lesions were examined by a skilled person. Results. The overall prevalence of oral potentially malignant disorders was found to be 13.7% with oral submucous fibrosis (8.06%) found to be more common and erythroplakia (0.24%) found to be least prevalent. Results of Logistic Regression analysis showed that males (OR = 2.09, P value < 0.0001) who were ever consumers of tobacco (OR = 2.06, P value = 0.030) and areca nut chewing (OR = 2.64, P value = 0.004) were more likely to develop oral potentially malignant disorders compared to never consumers. Diabetic (OR = 2.21, P value = 0.014) and underweight individuals (OR = 2.23, P value = 0.007) were more likely to suffer from oral potentially malignant disorders. Conclusion. The study reinforces the association of tobacco and areca nut consumption with oral potentially malignant disorders. An association of oral potentially malignant disorders with diabetes and BMI was confirmed by this study. [ABSTRACT FROM AUTHOR]

Justification: Severe acute malnutrition (SAM) is a major public health issue. It afflicts an estimated 8.1 million under-five children in India causing nearly 0.6 million deaths. The improved understanding of pathophysiology of SAM as well as new internationally accepted growth charts and newer modalities of integrated intervention have necessitated a relook at IAP recommendations. Process: A National Consultative Meeting on Integrated Management of Severe Acute Malnutrition was held in Mumbai on 16th and 17th October, 2010. It was attended by the invited experts in the field. Extensive discussions were held as per the program. The participants were then divided into six groups for detailed discussions. The groups deliberated on various issues pertaining to the task assigned and presented recommendations of the groups in a plenary session. The participants made a list of recommendations after extensive discussions. A Writing Committee was formed and was entrusted with the task of drawing a Consensus Statement on the basis of these Recommendations. After multiple deliberations, the following Consensus Statement was adopted. Objectives: To critically evaluate the current global evidence to formulate a consensus among stakeholders regarding diagnosis and management of SAM. Recommendations: An integrated management of malnutrition is likely to yield more dividends. Thus, management of SAM should constitute an important component of Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program. Determination of SAM on the basis of Z-scores using WHO Growth charts is considered statistically more appropriate than cut-offs based on percentage weight deficit of the median. Considering the fact that many children with SAM can be successfully managed on outpatient basis and even in the community, it is no more considered necessary to advise admission of all children with SAM to a healthcare facility. Management of SAM should not be a stand-alone program. It should integrate with community management therapeutic programs and linkages with child treatment center, district hospitals and tertiary level centers offering inpatient management for SAM and include judicious use of ready-to-use-therapeutic Food (RUTF). All sections of healthcare providers need to be trained in the integrated management of SAM. [ABSTRACT FROM AUTHOR]

Not much is known about disease prevalence, treatment outcomes, trained manpower, programs, and patients' awareness of diseases from South Asia, compared with the Western world. While other aspects are improving, the quantitative evaluation of awareness of diseases is lagging. Compared with other diseases, the situation for mental health disorders and addiction is worse. While no single study can fully quantify all aspects of awareness, a good starting point is to understand if increasing the number of mental health facilities is beneficial by understanding people's perception toward the likelihood of contracting various diseases, their preferred approach to treatment, and their perception of whether there are enough current facilities. We surveyed over 8000 families across several states of India and asked if they would treat a particular problem at home, visit a local healer, seek religious council, or go to a modern hospital for treatment. Our questions also included non-medical options to assess how likely people are to avoid trained medical help. We also asked people about their perceived likelihood of a family member ever suffering from (1) diarrhea, (2) high fever, (3) alcoholism, and (4) schizophrenia and other mental health problems. We reversed the order of diseases in our questions for a fraction of the population to evaluate the effect of order of questioning. Finally, we asked, if people feel they have enough local healers, religious places, general hospitals, de-addiction centers, and mental health facilities. Despite the taboo around mental health, many people claimed that their family members were unlikely to contract mental health or addiction problems, people recognized the severe paucity of mental health facilities and de-addiction centers. This raises hope for improving the mental health situation in India. We also found a significant relation between education levels and choices people make, underscoring the positive role education has in improving mental health. [ABSTRACT FROM AUTHOR]

Background Vaccination is considered as the most cost effective method for preventing infectious diseases. Low grade fever is a known adverse effect of vaccination. In India, it is a common clinical practice to prescribe paracetamol either prophylactically or therapeutically to manage fever. Some studies have shown that paracetamol interferes with antibody responses following immunization. This manuscript reports the outcome of a post hoc analysis of data from a clinical trial of a pentavalent vaccine in Indian infants where paracetamol was not used or was used either as prophylaxis or for treatment of fever. Methods Pre and post vaccine antibody levels against Diphtheria, Tetanus, Pertussis, Hepatitis B, Haemophilus influenzae type B were assessed in no paracetamol and paracetamol groups. The paracetamol group was further divided into prophylactic and treatment groups. Results Similar rates of seroprotection/seroresponse for anti-D, anti-T, anti-wP, anti-PT, anti-HBs and anti-PRP were observed in all the groups. There was no clear tendency for difference in percentage seroprotection/seroresponse and geometric mean (GM) titers in any of the groups. Conclusion The study found no evidence that paracetamol usage either as prophylactic or for treatment impact immunological responses to DTwP-HepB-Hib combination vaccine. [Clinical trial registry of India (study registration number CTRI/2012/08/002872 )]. [ABSTRACT FROM AUTHOR]