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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that occurs during the developmental period and affects overall cognitive, emotional, social, and physical health. Comprehensive screening for ASD can assist in diagnosis and intervention planning. The primary aim of this study was to develop and validate a screening tool for ASD based on the diagnostic guidelines of the International Classification of Diseases (ICD-11). The Social-Emotional Rating Scale for Autism Spectrum Disorder (SERA) was validated with 504 participants, including healthcare professionals who have worked with individuals with ASD and parents/primary caregivers of children with ASD. A confirmatory factor analysis on 78 participants with ASD and 27 participants without ASD indicated a good fit for the data. As an intervention planning tool, the developed SERA appears promising for identifying a person's social-emotional functioning level in line with autistic characteristics. [ABSTRACT FROM AUTHOR]

Objectives: To develop a tool to assess pre-writing skills of 2-5 y old children in India., Methods: The tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10 th , 25 th , 50 th , 75 th , 90 th ). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10 th -90 th age-percentile bars., Results: The final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings., Conclusions: A 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established., (© 2023. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation.)

Background: Obstructive sleep apnea (OSA) is reported in a high proportion of cardiac surgical patients, up to 73%. STOP-BANG is a validated questionnaire for screening of outpatients for OSA with high sensitivity. There is sparse literature from India regarding the prevalence of OSA in preoperative cardiovascular patients and the utility of screening tools.Aims: We sought to study the utility of the STOP-BANG questionnaire as a screening tool for OSA in cardiovascular patients validating it with ambulatory level 3 polysomnography.Materials and Methods: It was a prospective study where consecutive patients getting admitted for coronary artery bypass surgery (CABG) from August 2017-February 2019 were recruited. All the patients were screened with the STOP-BANG questionnaire. 53 patients underwent overnight level 3 polysomnography using Apnea-Link. Correlations were made between clinical symptoms, STOP-BANG score, and OSA severity, measured using Apnea hypopnea index (AHI).Results: We had 120 patients(103 males) with a mean age 60 years. Snoring was the most common sleep complaint. Our cohort had a high prevalence of vascular risk factors (DM 72.3%, hypertension 59.2%, dyslipidemia 60%) and 11.7% were obese (BMI >30). The median STOP-BANG score was 3 (IQR 2) with 83 having scores ≥3. Median AHI was 5.6 with AHI ≥5 in 28 patients and AHI 15 or above in 14 patients. Among the clinical parameters, arousals with respiratory difficulty at night, higher neck circumference, and tonsillar hypertrophy showed a significant association with PSG-proven OSA.STOP-BANG scores 3 or above had a sensitivity of 75% in predicting OSA.Conclusions: Our study shows that in cardiovascular patients less symptomatic for sleep complaints, the STOP-BANG questionnaire is a useful screening tool for OSA in outpatient settings. Among clinical parameters, airway narrowing and neck circumference can predict OSA. [ABSTRACT FROM AUTHOR]

Objective. Preservation of cognition is essential for good quality life. Epileptic pathological processes and pharmacotherapy are thought to be responsible for the cognitive dysfunction (CDF) in persons with epilepsy (PWE). Regular monitoring of persons on antiepileptic drugs (AED) for CDF is recommended. P300, an attention dependent event related potential (ERP), is known to be abnormal in PWE. The value of P300 in monitoring cognitive functions has not been tested prospectively. Material and methods. PWE not exposed to AED in preceding 6 months were recruited and prescribed one of the three common AEDs i.e. carbamazepine, phenytoin and valproate. Subjective tests of cognition-MoCA, Trail making test, Paragraph memory tests, Stroop test in addition to P300 ERP were administered before initiating AED and repeated after three months on the prescribed AED. The significance of the change in the scores of cognitive tools and P300 latency was ascertained by paired t-test. Outcome. Thirty eight PWE (females 18, mean age mean = 22.89±9.39 yr) qualified the inclusion criterion. The values of P300 latency and deployed subjective tests of cognition at two data collection points were compared with the clinical profile of the patients. Performance of the patients deteriorated on all the cognitive batteries after exposure to AED (mean 107.84±19.2 days). The deterioration was independent of education level, type of AED and seizures. Prolongation of P300 latency from baseline was seen in 30 of 38 patients (78.94%). The sensitivity of P300 for picking cognitive dysfunction was 80.64% taking MoCA scores as a reference. Conclusions. Attention along with several other domains of cognition is affected adversely with AED exposure. The P300 could be useful for monitoring cognitive adverse effects of AED in PWE. [ABSTRACT FROM AUTHOR]

Background: Frailty is a major challenge for healthcare systems in ageing societies. This dynamic state of health is a reflection of reduced reserve in various organ systems and enhanced vulnerability to stressors. Research in this area of geriatrics and gerontology is limited in low- and middle-income countries (LMICs) like India. This study is directed at development of a culturally appropriate and validated assessment scale for frailty among older Indians. Methods: After extensive review of the literature on existing scales, a preliminary draft scale was formed. This draft was pre- and pilot-tested to check feasibility and modified accordingly. The final scale was validated on 107 older adults by confirmatory factor analysis and was named the Frailty Assessment and Screening Tool (FAST). The Fried's frailty phenotype was also administered on the same 107 older adults and scores of both were co-related. Suitable cut-off scores were found for frail and pre-frail older adults. Results: The final version of the FAST consisted of 14 questions pertaining to 10 domains. It has good reliability. Cronbach's alpha co-efficient was 0.99; test–retest reliability was 0.97 and validity by confirmatory factor analysis was adequate. The Kaiser–CMeyer–Olkin (KMO) of sampling adequacy was 0.699, and Bartlett's test of sphericity was significant (χ2 = 353.471, p < 0.001). FAST scores had a cut-off of ≥ 7/14 for frail and ≥ 5/14 for pre-frail elderly. Conclusion: The FAST is a validated tool with good psychometric properties. It is expected that it will be helpful in screening pre-frail and frail older adults in India and other LMICs and guide in clinical decision making for intervention. [ABSTRACT FROM AUTHOR]

Introduction: Autism is included as a certifiable disability in the Indian Rights of Persons with Disability Act, 2016. The Indian Scale for Assessment of Autism (ISAA), developed by the Government of India and mandated for certifying disability, is a detailed instrument that needs trained mental health experts and takes time to administer. The current project was planned to develop a simple, easy to use screening tool based on the ISAA to identify possible cases in the community. Methods: The project is planned in three phases. During the first phase, data collected during the development of the ISAA (N = 433/436 children with autism) will be used to identify questions answered as frequently, mostly, and always. During the second phase, the psychometric properties of the screening tool based on these items will be evaluated among research participants recruited from hospitals and special schools (n = 100). In the third phase, the screening questionnaire will be administered in the community (n = 500). Results: The most frequently answered questions will be selected for inclusion in the proposed screening tool. The number of items in the screening tool will be kept as few as possible, with yes or no responses Discussion: Indian Autism Screening Questionnaire (IASQ) will be tested as a screening version of ISAA, which can be used by community health workers, teachers, or school counselors. The IASQ will not provide a diagnosis of autism. A positive screening result should be followed by a thorough assessment by a trained specialist. Analyzing the psychometric properties of the test can help ensure cost-effective screening of the community to identify autism. [ABSTRACT FROM AUTHOR]

Introduction: The awareness and knowledge on bleeding disorders is generally poor among the rural population. Accredited Social Health Activists (ASHAs) serve as the facilitators between the rural community and the health care system. Training of ASHAs in screening of rural population for early identification of bleeding disorders can enable prompt referral, timely detection and management of bleeding disorders. Aim: The aim of the study was to evaluate the effectiveness of an ASHA training programme for identification of suspected bleeding disorder cases. Methods: A population‐based, cross‐sectional survey was implemented by 586 Accredited Social Health Activists (ASHAs) in rural Udupi district, who underwent a structured training programme on identification of bleeding disorders. A survey record book with a screening tool on assessment of bleeding symptoms was given to each ASHA. The screening tool consisted of symptoms related to bleeding disorders and family history of bleeding disorders. Using the screening tool, ASHAs carried out a door‐to‐door survey. After screening, those who reported with bleeding symptoms were referred by the ASHAs to the investigator, who conducted further assessment. A detailed bleeding history was documented and bleeding symptom assessment was carried out using bleeding assessment tool (BAT) at the haemophilia treatment centre. Further coagulation assessments were carried out as per the treatment centre protocol. This paper highlights the evaluation of an ASHA training programme on identification of individuals with bleeding symptoms in the rural population. Results: A total of 586 trained ASHAs surveyed a population of 318 214 in rural Udupi district. Out of the 124 cases reported by ASHAs, 29 bleeding disorder cases were identified; haemophilia (A and B) was the most commonly found bleeding disorder 22 (75.8%), followed by von Willebrand disease (vWD) 3 (10.3%) and 4 (13.8%) immune‐mediated thrombocytopenic purpura (ITP), with an overall prevalence of 2.2/10 000 population. Conclusion: Training ASHA health care workers, who are the most important link between the community and health services, resulted in increased awareness among the public for the early detection of bleeding disorders. [ABSTRACT FROM AUTHOR]

Background & objectives: Several studies have been conducted in India to determine the prevalence of learning disabilities in school children which has been reported to be 3-10 per cent among students population. The present study was conducted to find out prevalence of specific developmental disorder of scholastic skills in students of classes VII to XII and to find out feasibility of screening tool in Chandigarh, India. Methods: A cross-sectional study on school students was carried out in two phases. The students were drawn from classes VU to XII from 10 schools of Chandigarh, India. Details of academic performance of all the students was taken, subjectively from class teachers and objectively from the marks obtained in the last academic session. In phase I, 2402 students were assessed. In phase II, 108 students were randomly selected for evaluation for assessing sensitivity and specificity of screening proforma for teachers. A total of 124 students from phase I and all students in phase II were assessed in detail. Tests of intelligence (Malin's Intelligence Scale for Indian Children and Standard Progressive Matrices), and NLMHANS Index for specific learning disability (SLD) battery were administered. Results: A total of 38 students were found to be having specific developmental disorder of scholastic skills in phase I, that gave a prevalence of 1.58 per cent. Majority had mixed type of errors on SLD battery. There were more boys diagnosed with specific learning disability. Teacher's screening instrument had high sensitivity (90.385) and specificity (94.68). Interpretation & conclusions: The findings of our study conducted in community, showed that specific learning disability was not identified even till later age. The screening instrument thus could be used by teachers to suspect students with specific learning disability. [ABSTRACT FROM AUTHOR]

Problem: Several biomarkers have been studied to predict spontaneous preterm birth, including salivary progesterone. However, due to limited studies, the utility of this biomarker remains controversial. This study synthesized the available literature and determined the role of salivary progesterone as a potential biomarker for preterm birth., Method of Study: All studies reporting the levels of salivary progesterone among pregnant women with reported birth outcomes were obtained from Ovid Medline, Scopus, CINAHL, and Cochrane Central Register of Controlled Trials from inception to January 10, 2022. A review of titles and abstracts was done independently by three reviewers. The quality of the studies was assessed using the Newcastle-Ottawa scale. Meta-analysis was performed in R v.4.1.3 using the "meta" package., Results: Five studies involving 861 pregnant patients from Egypt, India, Iraq, and the US were included in this meta-analysis. The random-effects model showed that salivary progesterone level after the 28th week of gestation was significantly different between patients with term and preterm birth (standardized mean difference [SMD]: 1.99; 95% confidence interval [CI]: .44-3.54) with a high degree of heterogeneity (I 2  = 96%, P < .001). Based on the results of this meta-analysis, women with term birth had higher level of salivary progesterone after the 28th week of gestation than those with preterm birth., Conclusion: In conclusion, the study results suggest that low salivary progesterone level after the 28th week of gestation is significantly associated with preterm birth. This study also highlights the use of saliva samples for monitoring sex steroid hormones throughout pregnancy., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Influenza A (H1N1) hit the headlines in recent times and created mass hysteria and general panic. The high cost and non-availability of diagnostic laboratory tests for swine flu, especially in the developing countries underlines the need of having a cheaper, easily available, yet reasonably accurate screening test. Aims: This study was carried out to develop a clinical feature-based scoring system (CFSS) for influenza A (H1N1) and to evaluate its suitability as a screening tool when large numbers of influenza-like illness cases are suspect. Settings and Design: Clinical-record based study, carried out retrospectively in post-pandemic period on subject's case-sheets who had been quarantined at IG International Airport's quarantine center at Delhi. Materials and Methods: Clinical scoring of each suspected case was done by studying their case record sheet and compared with the results of RT-PCR. RT-PCR was used to confirm the diagnosis (Gold Standard). Statistical Analysis: We calculated sensitivity, specificity, positive and negative predictive values of the clinical feature-based scoring system (the proposed new screening tool) at different cut-off values. The most discriminant cut-off value was determined by plotting the ROC curve. Results: Of the 638 suspected cases, 127 (20%) were confirmed to have H1N1 by RT-PCR examination. On the basis of ROC, the most discriminant clinical feature score for diagnosing Influenza A was found to be 7, which yielded sensitivity, specificity, positive, and negative predictive values of 86%, 88%, 64%, and 96%, respectively. Conclusion: The clinical features scoring system (CFSS) can be used as a valid and cost-effective tool for screening swine flu (influenza A (H1N1)) cases from large number of influenza-like illness suspects. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is a developmental disability and is of public health importance. It affects not only the child and the family. It also has direct and indirect cost implications on the nation that are incurred in providing health care, support for education, and rehabilitative services. There is a lack of evidence-based estimate of the population prevalence of ASD in India. Therefore, this systematic review was aimed at determining the prevalence of ASD in the Indian population., Materials and Methods: We conducted a systematic review and meta-analysis of the published studies evaluating the prevalence of ASD in the community setting. A search within the published literature was conducted from different databases (PubMed, OvidSP, and EMBASE). The analysis of data was done using STATA MP12 (StataCorp, College Station, TX, USA)., Results: Four studies were included in this systematic review. Of the four included studies, one had studied both urban and rural populations, and the other three had studied the urban populations only. The study from the rural setting showed a pooled percentage prevalence of 0.11 [95% confidence interval (CI) 0.01-0.20] in children aged 1-18 years; and, four studies conducted in the urban setting showed a pooled percentage prevalence of 0.09 (95% CI 0.02-0.16) in children aged 0-15 years., Conclusion: The scarcity of high-quality population-based epidemiological studies on ASD in India highlights an urgent need to study the burden of ASD in India. The proper acquisition of data related to the prevailing burden of ASD in India would lead to a better development of rehabilitative services in our country., Competing Interests: None

Screening for psychiatric morbidity helps to identify disease, enable initiation of treatment and intervention to reduce mortality and suffering from psychological problems. There is a dearth of such scales in India and South East Asia. The present work aims to develop and validate the NIMHANS screening tool for psychological problems in Indian context. 754 (229 normal subjects and 525 clinical subjects) were taken from the community and in-patient and out patient psychiatric setting of the hospital. Socio-demographic datasheet and the newly developed tool were administered on them. Split half reliability of the tool was .84. Score of 12 & 24 and above indicated presence of psychiatric distress in normal and clinical group respectively. Discriminate validity developed with sensitivity of .76 and specificity of .82. The NIMHANS screening tool for psychological problems has a utility in screening out psychiatric distress in the community., (Copyright © 2014 Elsevier B.V. All rights reserved.)