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Background: Stroke survivors and their caregivers have numerous and diverse educational needs, many of which are unmet because of inadequate training from healthcare professionals. As stroke recovery and rehabilitation can continue for years post-stroke, it is critical that stroke survivors are provided with and have access to a range of support options and evidence-based information. Website-based education programs (WEP) have been adopted in recent years to manage health problems. The present pilot study aims to evaluate the effect of WEP on activities of daily living (ADLs) and the fear of falls among sub-acute stroke survivors. Methods: A total of 16 eligible post-stroke survivors were recruited from multiple study settings across Surat City of Gujarat state in western India and were randomly assigned using a lottery method to either the experimental group (n = 8) receiving WEP or the control group (n = 8) receiving conventional physiotherapy for 4 weeks. Outcome measures were the Indian Stroke Scale (ISS), Modified Barthel Index (MBI), and Falls Efficacy Scale-International (FES-I). Results: Both groups showed statistically significant improvements in all outcomes but the experimental group showed more significant improvements in ADLs and fear of falls among sub-acute stroke survivors (p < 0.05). Conclusion: WEP for sub-acute stroke survivors is an effective intervention. It improves the performance of ADLs for stroke survivors and helps in better fall management indicating that web-based education programs shall be implemented on a regular basis to improve patient care. [ABSTRACT FROM AUTHOR]

Introduction: Primary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India's Chhattisgarh state. Methods: We conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care. Results: On an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population's health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure. Conclusion: HWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population's acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to determine the impact of problematic mobile phone use on negative mental health outcomes among nursing students in India, highlighting the necessity for targeted interventions and support mechanisms to enhance the overall well‐being and adaptability of future healthcare professionals. Methods: A cross‐sectional survey was conducted in three randomly selected nursing colleges in South India, employing validated and standardized tools such as the Mobile Phone Problematic Use Scale, Patient Health Questionnaire, Insomnia Severity Index Scale, Satisfaction with Life Scale and Rosenberg Self‐Esteem Scale. Results: The study included 402 nursing students with an average age of 20.47 years, revealing a 39% prevalence of severe problematic mobile phone usage. Positive correlations were observed between mobile phone problematic use and age, depression and insomnia. Additionally, strong negative correlations were found between satisfaction with life and self‐esteem. Depression and satisfaction with life served as chain mediators in the impact of self‐esteem on problematic mobile phone use, and both self‐esteem and satisfaction with life negatively predicted problematic mobile phone use. Conclusion: The study highlights a prevalent issue of problematic mobile phone use among nursing students, indicating a pressing need for timely intervention, as it correlates with depression, sleep insomnia, low self‐esteem and life dissatisfaction. Summary statement: What is already known about this topic? Over the last decade, using mobile phones has been prevalent among today's children and young people, coinciding with an increase in poor mental health in this population.Problematic mobile phone use may consist of various issues, including addiction/dependence, financial troubles, risky use (i.e. while driving) and restricted use (i.e. in prohibited places).From an epidemiological standpoint, prevalence rate estimates vary widely and there is little research and understanding regarding the aetiology of problematic and addicted mobile phone usage, particularly its progression. What this paper adds? The prevalence of severe problematic mobile phone use among nursing students is very high and needs immediate attention.There is a negative impact of mobile phone use on the mental health outcomes of nursing students.Positive life satisfaction and self‐esteem are protective variables that negatively predict problematic mobile phone use, while their influence is mediated by a chain reaction involving reduced depression, emphasizing the interconnected psychological dynamics. The implications of this paper: Further research is needed on the influencing factors of problematic mobile phone use and interventions to prevent mobile phone addiction among nursing students.The influence of mobile phone use on the mental health outcomes of nursing students can affect their clinical practice and productive life therefore the appropriate policies should be implemented.Implementation of short and rapid counselling services for the nursing students by the nurse educators should incorporate into the curriculum to achieve a better quality of nurses. [ABSTRACT FROM AUTHOR]

Objective: Despite generating huge employment opportunities and profitable business, fishing is considered a dangerous occupation due to challenging weather conditions and exposure to unhealthy occupational factors and lifestyles, which contribute to various health issues. However, few studies have examined the health status of shrimp cultivators. Consequently, this study aims to estimate the age group-wise burden of non-communicable diseases (NCDs) among shrimp cultivators. Methods: Simple random sampling was employed for collecting data. The sample size was 357 shrimp cultivators. Disability-adjusted life years (DALY) and relative risk (RR) methods were used to measure the burden of NCDs among shrimp cultivators. This study reported the burden of NCDs per 100,000 shrimp cultivators. Results: The top five prevalence of NCDs per 100,000 shrimp cultivators were mental disorders (85,434), musculoskeletal diseases (26,325), digestive diseases (9,803), diabetes (5,882), and cardiovascular diseases (4,481). DALY per 100,000 shrimp cultivators was 33,407.59, while at the national level, it was 24,775.99 per 100,000 people across all age groups. The RR of NCDs among shrimp cultivators in terms of DALY was 1.35, indicating a 0.35 times higher burden of NCDs among shrimp cultivators than at the national level. The largest RR of NCDs was found among shrimp cultivators aged 15–49 years (1.85), followed by 50–69 years (1.09). The highest percentage changes in the burden of NCDs among shrimp cultivators, resulting from changes in the methods of estimating DALY, was observed in the age group of 70 years and above (−48.36%) followed by 15–49 years (−46.08%) and 50–69 years (−40.33%) when compared to the baseline method of estimating DALY without utilizing age weightage and discount rate. Conclusions: Focus should be given to improving the lifestyle and occupational factors of shrimp cultivators to mitigate the burden of NCDs. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the feasibility, acceptability and preliminary efficacy of a standardized nurse delivered mobile phone intervention to improve adherence to antiretroviral treatment and clinical outcomes. Methods: Feasibility and acceptability of the phone intervention was assessed with rates of eligibility, completed visits, and attritions. Intervention fidelity was assessed by checking recorded calls and feedback. Efficacy was assessed using a randomized controlled trial in which 120 women living with HIV and psychosocial vulnerabilities, were randomized to Treatment as Usual (TAU = 60) or TAU plus the mobile phone intervention (N = 60). Trained basic nurses delivered the theory-guided, standardized mobile phone intervention for mental health issues and psychosocial risk factors to improve antiretroviral treatment (ART) adherence and retention in care and improve clinical outcomes. Blind raters performed the assessments at 6, 12 and 24 weeks post-randomization. Results: Adherence diminished over time in the TAU only group, while it was sustained in the TAU Plus group, only dropping at 24 weeks after the intervention had been discontinued. Among participants with depressive symptoms (CESD ≥ 16), the intervention had significant improvement in adherence rates (p < 0.01), psychological quality of life (p < 0.05) and illness perception (p < 0.05) compared to those in the TAU only group. Greater improvements of quality of life subscales were observed in the TAU Plus group among participants with less psychological vulnerability (PSV < 2). HIV RNA was not significantly different between the groups at week 24. Conclusions: The mobile-delivered counseling intervention was feasible and acceptable and shows promise among women living with HIV and psychosocial vulnerabilities in rural South India. Trial Registration: ClinicalTrials.gov Identifier: NCT02319330 [Registered on: December 18, 2014]. [ABSTRACT FROM AUTHOR]

Worldwide, the mortality due to SARS-CoV-2 has been inclined to around 68 million by the end of January 2023. Many people lost their family members due to the virus attack or its comorbid complications. Mourning the loss of a loved one is a painful time, but the ability to handle this stress may vary from person to person. It could be a result of their personality traits and inner capabilities, such as self-efficacy. This study aimed to understand the role of personality traits and self-efficacy on the resilience of bereaved individuals. Convenience sampling was employed to recruit a total of 237 participants who had lost loved ones to COVID-19 (father, mother, grandfather, grandmother, uncle, aunt, and distant relatives). After explaining the objective of the study and taking informed consent, they were administered using brief resilience scale, a big five personality inventory, and general self-efficacy questionnaire. Self-efficacy and resilience were found to have a positive correlation, while neuroticism and resilience had a negative correlation. In addition, the mediation analysis revealed that self-efficacy acted as an important mediator between personality traits (Openness, agreeableness, conscientiousness, and neuroticism) and resilience. Individuals with strong self-efficacy were able to return to their usual state more quickly than those with low self-efficacy, as indicated by the results. However, attributes such as openness, agreeableness, and conscientiousness, together with self-efficacy, might enhance resilience. Therefore, the study strongly suggests incorporating self-efficacy into the design of therapeutic programs for coping with bereavement. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal issues at work have an influence on daily life, productivity, and quality of life. Musculoskeletal issues that go untreated can result in severe damage and function loss, which can limit participation, cause financial loss, and add to the rising burden of illness in the world. Objective: The purpose of this study was to find the effect of occupational therapy rehabilitation program in occupational therapy students with work related musculoskeletal disorder. Study Design: Quasi-experimental, pilot study design was chosen for the research Methods: The study employed a quasi-experimental study design. Thirty occupational therapy students aged 20-25 years were recruited through convenience sampling after a prevalence check where 30 students reported 54 musculoskeletal problems. A total number of participants (n= 30) received occupational therapy rehabilitation program. Standardised Nordic musculoskeletal questionnaire (SNMQ) and Numeric pain rating scale (NPRS) were administered to Pain and work related musculoskeletal disorder for all the participants. Result: It revealed that there was a statistically significant difference in pre-test and post-test with numeric pain rating scale (t=10.625, p=0.000). There was a significant difference in percentage in 7 days component of SNMQ. There was no statistical difference with post-test of score of 12 months component of SNMQ. Conclusion: Occupational therapy rehabilitation program is effective for reducing Musculoskeletal disorder or discomfort in occupational therapy students. [ABSTRACT FROM AUTHOR]

Background: School teachers perform numerous tasks that contribute to low back pain and affect their activities of daily living, social and vocational abilities. Low back pain is multidimensional in nature constituting physical, psychological and social components. Psychosocial variables pose as an obstacle to rehabilitative recovery and have a role in development of chronicity, these factors are often neglected in the rehabilitation process, the present study integrates psychosocial factors with musculoskeletal factors and utilises a rehabilitation program that focuses on overall recovery. Objectives: This study aims to find effective treatment for psychosocial variables and examines the physical and psychosocial changes that occur in school teachers suffering with CLBP when they receive occupational therapy augmented with psychosocial intervention. The intervention targets anxiety, perceived stress, and self-efficacy. Methodology: The study sample consisted of 60 school teachers, half of the sample was enrolled for occupational therapy intervention and other half for occupational therapy intervention augmented with psychosocial treatment techniques. Results: At post-treatment participants in the occupational therapy augmented with psychosocial treatment group showed significant difference in measures of anxiety, perceived stress and self-efficacy, pain intensity, pain severity, pain disability and 5-minute walk test distance compared to participants who received occupational therapy treatment only. The two groups did not differ significantly in finger-to-floor test. Conclusion: The findings of the study suggest that augmenting psychosocial variables is beneficial to personenvironment factors of disability and result in better rehabilitation outcomes in terms of both psychosocial variables as well as pain related variables. [ABSTRACT FROM AUTHOR]

Background of the Study: Low back pain is one of the most common health problem and 80% of people experiences low back pain in their lifetime. Majority of low back pain is due to the muscle imbalance. Muscle imbalance occurs due to shortened or lengthened in structure and it leads to injury which causes changes in motor programming. Objectives: To compare the effects of Muscle Energy Technique, Positional Release Technique and Conventional Therapy on improving pain, range of motion and functional ability in patients with mechanical low back pain. Subjects and Methods: Twenty four patients of complaining of mechanical low back pain participated in the study. Patients were randomly allocated using computer generator software into three groups: group A which received Muscle Energy Technique, group B which received Positional Release Technique and group C which received Conventional Therapy. Treatment sessions were given three times per week for three weeks. Patients were assessed before and after treatment using Numerical Pain Rating Scale(NPRS),Modified Oswestry Disability Index (MODI), and Modified Schobers Test to assess pain severity, functional ability, and range of motion of lumbar spine respectively. Results: Based on this statistical analysis, Group A showed better statistically significance in NPRS,MODI and ROM mean values as compared to Group B and C. Hence alternate hypothesis is accepted and null hypothesis is rejected. This we conclude that Muscle Energy Technique is more beneficial compared to Positional Release Technique and Conventional Therapy group. Conclusion: Muscle Energy Technique and Conventional therapy group shows significant improvement on Pain and Lumbar Extension Range of Motion compared to Positional Release Technique, whereas there was no significant difference in MODI on Muscle Energy Technique, Positional Release Technique and Conventional therapy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Professional driving requires long hours of work, uncomfortable seats, negotiating rough terrain and highways, and possibly minor repairs and other auxiliary transportation duties. Heavy vehicle drivers driving vehicles such as trucks, bulldozers, etc. due to such working structures are more prone to various musculoskeletal disorders (MSDs) and pain, which is of great concern. OBJECTIVES: In the present study, it is planned to investigate possible ergonomic risk factors such as age, weight, driving exposure, seat suspension systems, lifting heavy weights causing MSDs in drivers of various heavy vehicles. The results of the study are expected to help drivers reduce the risk of MSDs. METHODS: For the present study, the Nordic questionnaire on musculoskeletal disorders was modified and standardized and was administered to the 48 heavy vehicle drivers randomly selected to collect the data. RESULTS: The analysis divulged that over the past 12 months, lower back pain (LBP) emerged as the most dominant pain experienced by 56% of drivers, followed by knee pain (KP) (43%) and neck pain (NP) (39%) respectively. The prevalence of shoulder pain (SP) was observed to be much lower than in previous literature. The logistic regression model further revealed that increasing age, poor suspension system and poor body posture were significantly associated with lower back pain. Additionally, a poor suspension system and lifting heavy weights had significant effect on the drivers' knee pain. CONCLUSION: The results demonstrated the evident necessity for ergonomic consideration in vehicle designing and ergonomic training for heavy vehicle drivers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Textile-sizing mill workers are exposed to various hazards in the sizing units during their working hours and are at risk of acquiring lung impairments due to the usage of sizing chemicals in the sizing process. OBJECTIVE: The main aim of this study is to assess the influence of cotton dust and sizing agents on lung function and breathing difficulties among Indian textile sizing mill workers. METHODS: This cross-sectional study was carried out at a textile-sizing mill from August 2022 to September 2022. A modified questionnaire based American Thoracic Society's standard was used to assess respiratory symptoms among sizing mill workers and the pulmonary function test was conducted Spirometry. The chi-square test was used to find the difference between respiratory symptoms and the t-test was used to find the difference between spirometric parameters. RESULTS: Textile sizing mill workers showed significant (P < 0.0001) decline in peak expiratory flow rate, forced vital capacity (FVC), ratio of FEV1 and forced vital capacity, and forced expiratory volume in 1 s (FEV1). There was an association between symptoms and duration of exposure to pulmonary abnormality. Sizing mill workers showed a significant decline in lung functions and an increase in pulmonary symptoms. As the service duration of exposure in terms of years increased, respiratory symptoms increased and spirometric abnormality also increased. CONCLUSION: This study confirms that sizing agents such as polyvinyl alcohol (PVA), emulsifier, wax, carboxymethyl cellulose (CMC), and starch used in sizing mills are also responsible for respiratory illness and lung impairment among textile workers. [ABSTRACT FROM AUTHOR]

Background Patient rights are basic rules of conduct between patients, medical care providers, and the institutions and the people supporting them. Patient Right Education program provides an opportunity to improve nurses knowledge about patient rights. It fosters communication between patients and nurses, which helps achieve patient satisfaction and reduce the number of violations cases of patient's rights in the hospital. This study aims to find the effectiveness of patient rights education programs among nurses. Materials and Methods A quasiexperimental approach and one group pretest posttest design were adopted for this study. One hundred subjects were selected through a convenient sampling technique in the selected tertiary Hospital, Mangaluru, Karnataka, India. A pretest was conducted on the first day using a structured knowledge questionnaire, and the patient rights education program was conducted for the participants on the same day. The posttest was conducted on the 7th day after the education program. Results Among 100 nurses, the posttest knowledge score (9.67 + 1.67) regarding patients' rights was more than the pretest knowledge (7.43 + 1.67) score. The paired t -test showed that the calculated p -value was 19.381, more than the tab value of 1.98. Hence, it was found that the program effectively improved the knowledge by showing the difference in mean knowledge score at a 5% significance level. For item-wise comparison, McNemar's test was used, and there was an improvement in 50% of patient rights items. Conclusion This study concluded that nurses need a proper awareness system about patient rights for nurses in hospital settings. [ABSTRACT FROM AUTHOR]

Introduction Cancer is the most leading cause of death globally. Fatigue and poor quality of sleep are the common side effects of cancer treatment that lead to poor quality of life. There is a need of complementary therapy, which can help to minimize the side effects of cancer treatment and boosting relaxation. Warm water foot submerged technique helps to relieve fatigue and improve the quality of sleep; hence, quality of life can be improved. This study was conducted to assess effectiveness of warm water foot submerged technique on the level of fatigue, quality of sleep, and quality of life among patients with cancer. Materials and Methods A quasi-experimental pretest and post-test control group research design was adopted to conduct the study in oncology ward of selected hospital. Sixty-eight participants were recruited using a nonprobability purposive sampling technique and allocated to intervention and control groups. Data was collected using multidimensional fatigue inventory, Groningen sleep quality scale, EORTC QLQ-C30. The control group received normal routine care and the intervention group received warm water foot submerged technique that was given for 15 minutes two times per day for 5 consecutive days. Results Warm water foot submerged technique showed a significant difference in level of fatigue (p < 0.05), quality of sleep (p < 0.001), and quality of life (p < 0.001) in the intervention group. There was no significant difference in control group. Conclusion This study showed that the warm water foot submerged technique is effective in reducing the fatigue and improving the quality of sleep and quality of life among patients with cancer. Thus, this study was found to be effective. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are rising rapidly in low- and middle-income countries, leading to increased morbidity and mortality. Reducing sedentary behavior (SB) and increasing physical activity (PA) offer numerous health benefits. Workplaces provide an ideal setting for promoting SB/PA interventions; however, understanding the barriers and enablers is crucial for optimizing these interventions in workplace environments. Methods: Nested within a cluster randomised controlled trial (the SMART-STEP trial), the present study employed in-depth interviews with 16 office workers who have completed 24 weeks of two distinct (technology assisted and traditional) workplace SB/PA interventions. Using a deductive analysis, semi-structured interviews were administered to explore the barriers and enablers to the SB/PA interventions at individual, interpersonal and organisational level using the socio-ecological model. Results: Several individual (poor goal setting, perceived health benefits & workload, attitude, intervention engagement), interpersonal (lack of peer support) and organisational (task prioritisation, lack of organisational norm and material or social reward) barriers were identified. Indian women engaged in desk-based office jobs often find themselves burdened with intense home and childcare responsibilities, often without sufficient support from their spouses. A primary concern among Indian office workers is the poor awareness and absence of cultural norms regarding the health risks associated with SB. Conclusions: Raising awareness among workplace stakeholders—including office workers, peers, and the organization—is crucial before designing and implementing SB/PA interventions in Indian workspaces. Personalized interventions for Indian female office workers engaged in desk-bound work are warranted. [ABSTRACT FROM AUTHOR]

Introduction: Academic incivility in students has the potential to undermine the learning process because it affects both the perpetrator and the educator. This results from the reduced trust between students and faculty resulting in a reduction in productivity, thereby impeding the learning process. Objectives: The study was conducted to understand the perception and factors contributing to academic incivility among undergraduate nursing students. Methods: A descriptive cross-sectional survey was conducted. A total of 250 undergraduate nursing students studying in three nursing colleges in India participated in the study. A convenience sampling approach was used to recruit the participants. A 13-item Uncivil Behavior in Clinical Nursing Education (UBCNE) tool was used to collect the data. Results: The study found that 7.56% of the sampled nursing students always indulged in uncivil behavior, 9.51% of them often indulged in uncivilized activities, while 20.06% of them reported sometimes indulging in uncivil behavior. This means that 37.45% of the nursing students sampled engaged in some forms of uncivil behavior. In contrast, the study found that 62.55% of the nursing students never indulge in uncivilized activities. The contributing factors of academic incivility were the academic setting, the student's academic preparation, the teacher's attitude, emotional disturbance, substance abuse, cultural issues, and social issues. There was no significant association between the demographic variables and the level of perception on academic incivility among nursing students at p <.05. Conclusion: It is important to understand the perceptions and factors that predispose students to engage in uncivil behavior given the prevalence of this educational challenge. Corrective strategies are needed to educate the perpetrators about the ill effects of their actions. [ABSTRACT FROM AUTHOR]

Background: Circadian rhythms are crucial for physiological functioning, and they vary among people. There are three distinct chronotypes: morning, evening, and neither type. Morning types experience their highest level of activation during the early part of the day and tend to be more conscientious and focused on achieving their goals. Evening types, on the other hand, reach their peak performance during the latter portion of the day and exhibit a higher level of intelligence. University class schedules may occasionally clash with evening-type individuals' circadian preferences, potentially impacting their academic performance in comparison to their morning-type peers. Therefore, this study was done to investigate if morningness-eveningness can affect college students' academic performance as sleeping late or sleep deprivation can lead to disease in the young population. Materials and methods: A sample of 100 collegiate students aged 18–30 years were recruited via convenience sampling from Jamia Hamdard, Delhi, and informed consent was obtained from the subjects. The morningness-eveningness questionnaire (MEQ) was used to assess students' chronotype, and the mean of the last three academic years percentage was used to assess the academic performance of the students. Results: The total academic performance score was better in the morning category (75.53 ± 7.28) as compared to the evening (66.42 ± 10.08) and intermediate (73.72 ± 6.46) categories. There was a low degree of positive correlation between total academic performance and TMEQ (total morning-evening questionnaire) score (ρ = 0.204). Conclusion: The academic performance of morning chronotype students was better than that of evening chronotype students. [ABSTRACT FROM AUTHOR]

Background: In India, twenty-five percent of women who menstruate are unable to utilize sanitary methods, and even among those who have access, there are multiple obstacles to achieving proper menstrual hygiene management. The consequences of inadequate menstrual health may extend to affect a girl's socialisation, empowerment, overall well-being, and even survival. Objectives: To estimate the prevalence of unmet menstrual practice needs and its determinants among college going women in Coimbatore district, India. Methodology: A questionnaire based analytical cross-sectional study was conducted among 3144 college going women from October 2022 to January 2023. Menstrual Practice Needs Scale (MPNS-36) was used to collect data regarding the unmet needs and their mean scores were compared across socio-demographic variables, menstrual knowledge, and the choice of hygiene material. Results: The mean (SD) age of the study population was 19.3 (1.8) years. The prevalence of unmet menstrual practice needs was 62.8% with a mean (SD) MPNS score of 1.8 (0.4). The total MPNS score was low for those currently residing in rural or having a rural hometown. The unmet need was better for those residing in-campus of the educational institute and having educated parents. The socioeconomic class and presence of a personal income also influenced the total MPNS scores significantly (p < 0.05). Menstrual talks with friends before puberty and with friends and family after puberty improved the MPNS scores. Regarding menstrual hygiene methods, modern menstrual methods (MMM), disposable and bio-degradable materials had a lower unmet need. Marital status, freedom to manage expenses, pre-pubertal menstrual talks with family, and total number of family members did not influence the scores of MPNS. Multivariate regression analysis showed that maternal education, menstrual talks with family after puberty, and type of menstrual hygiene method including its disposability were independent predictors of total MPNS scores. Conclusion: Addressing unmet menstrual practice needs among college-going women in Coimbatore district necessitates a multifaceted approach encompassing education, access to affordable and sustainable menstrual products, and destigmatization efforts. [ABSTRACT FROM AUTHOR]

The smartphone has become a popular device, especially among young adults, with its significance highlighted during the COVID-19 lockdownwhen online classes became necessary for college students. This research aimed to evaluate the prevalence of smartphone use and its impact on healthrelated behaviors reported by college-going students in North India. Due to the pandemic, data collection was conducted through a Google form, and a questionnaire was used to gather information on various parameters. The Food Frequency Questionnaire assessed the frequency of food group consumption, while the validated Smartphone Addiction Scale--Shorter Version measured smartphone addiction. A total of 142 participants aged 18 to 24 years, including 59% female and 41% male participants from Delhi-NCR, were recruited using convenience sampling. The findings revealed a smartphone addiction prevalence of 41%. Statistically significant associations were found between smartphone use and sleep quality (p < .001), body mass index status (p = .016), and sedentary behavior (p < .001). Notably, smartphone screen time (p < .001) and stress levels (p = .028) correlated significantly with smartphone addiction based on the Smartphone Addiction Scale--Short Version score. This study highlights the significant prevalence of smartphone addiction (41%) among college students, which is associatedwithadverseeffectsonsleepquality, physical activity, and stress levels. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to determine the relationship between (a) stuttering impact and trust in the health care system and (b) stuttering impact and trust in physicians among persons who stutter in India. Method: This quantitative study utilized cross-sectional electronic surveys to assess the experiences of 118 adults who stutter in India. The surveys queried (a) stuttering impact, (b) trust in the health care system, and (c) trust in physicians. Results: Stuttering impact is strongly negatively associated with trust in the health care system (r = -.940, p = .0001, R2 = .885) and strongly negatively associated with trust in physicians (r = -.941, p = .0001, R2 = .885). Controlling for age, gender, and income does not affect these relationships. Conclusions: The strongly significant associations found in this study between stuttering impact and trust call attention to how interrelated stuttering experiences are with trust in health care. Speech-language pathologists around the globe may wish to discuss how stuttering might affect health care experiences with their clients who stutter to build rapport, to advocate for people who stutter, and to better support their health professional colleagues. [ABSTRACT FROM AUTHOR]

Background and objective: Prolonged standing is one of the significant contributors to chronic venous insufficiency (CVI) in industry workers. Yoga is proven to be an effective therapy in treating occupational hazards. The current study aimed to investigate the effect of yoga on CVI among industry workers. Methodology: Male workers (n = 100) from machinery manufacturing industries in Bangalore meeting the inclusion and exclusion criteria were recruited for the study. The yoga group received a specifically designed yoga module for 6 days a week for 12 weeks, and the control group was offered lifestyle suggestions. Plasma homocysteine was used as the primary outcome variable, whereas Venous Clinical Severity Score, ankle brachial pressure index (ABPI), ankle and calf circumference, CVI questionnaire, and Chalder fatigue scale were assessed as secondary variables at baseline and the end of 12 weeks of intervention. Results: Eighty-eight participants (yoga = 43, control = 45) completed the study. A one-way analysis of covariates (ANCOVA) was used to determine the significant differences between groups in the post-values. A significant difference was found between groups in plasma homocysteine (partial eta squared = 0.34, p < 0.001). All variables, except for ABPI, calf circumference, and ankle circumference, had shown statistically significant differences between the yoga and control groups after 12 weeks of intervention, with moderate to high effect sizes. There were no significant adverse events associated with the intervention. Conclusions: Yoga practices can reduce the symptoms of CVI along with vascular inflammation as indicated by reduced plasma homocysteine. Overall, yoga practices are found to be safe and efficacious for managing CVI. IEC Reference Number: RES/IEC-SVYASA/184/2021 Trial Registration Number (If Clinical Trial): CTRI/2021/02/030944 [ABSTRACT FROM AUTHOR]

Purpose: To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India. Methods: This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant's anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling. Results: Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework. Conclusion: UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage. [ABSTRACT FROM AUTHOR]

Background: Longitudinal incision is the commonly used incision for entry into the submucosal space during peroral endoscopic myotomy (POEM) for esophageal motility disorders. Transverse incision is another alternative for entry and retrospective data suggest it has less operative time and chance of gas-related events. Methods: This was a single-center, randomized trial conducted at a tertiary care hospital. Patients undergoing POEM for esophageal motility disorders were randomized into group A (longitudinal incision) and group B (transverse incision). The primary objective was to compare the time needed for entry into the submucosal space. The secondary objectives were to compare the time needed to close the incision, number of clips required to close the incision, and development of gas-related events. The sample size was calculated as for a non-inferiority design using Kelsey method. Results: Sixty patients were randomized (30 in each group). On comparing the 2 types of incisions, there was no difference in entry time [3 (2, 5) vs 2 (1.75, 5) min, p = 0.399], closure time [7 (4, 13.5) vs 9 (6.75, 19) min, p = 0.155], and number of clips needed for closure [4 (4, 6) vs 5 (4, 7), p = 0.156]. Additionally, the gas-related events were comparable between the 2 groups (capnoperitoneum needing aspiration—5 vs 2, p = 0.228, and development of subcutaneous emphysema—3 vs 1, p = 0.301). Conclusion: This randomized trial shows comparable entry time, closure time, number of clips needed to close the incision, and gas-related events between longitudinal and transverse incisions. Registration number: CTRI/2021/08/035829. [ABSTRACT FROM AUTHOR]

Background: Soil-transmitted helminth infections (STHs) in pregnancy have been linked to maternal anemia, low birth weight, and adverse perinatal outcomes. STH includes Ascaris lumbricoides, hookworm, and Trichuris trichiura. However, conflicting evidence exists regarding these effects. Hence, we aimed to assess the association of STH infections with perinatal outcomes. Methods and Materials: A community-based cohort study was conducted among pregnant women in primary care settings in Puducherry, South India, during December 2019 to April 2021. Stool samples were collected for STH screening and confirmed using polymerase chain reaction. Information on perinatal outcomes and hemoglobin levels were extracted from case records. The association of pre-term birth, low birth weight, anemia, and miscarriages with STH infection was analyzed using the Chi-square test. Results: Among the 650 women enrolled, 58 (8.9%) had one of the STH infections. At the time of recruitment, 336 (52.0%) women had anemia. Twenty-four women (3.7%) had miscarriages, 14 (2.2%) had pre-term birth, and 65 (10.4%) had low-birth-weight (LBW) babies. All 14 pre-term babies had LBW, and out of 65 LBW, 40 were in mothers with anemia. Incidence of LBW, pre-term deliveries, and anemia were higher in women with STH than in those without STH (LBW: 12.3% vs 10.2%, P = 0.62; pre-term: 3.5% vs 2.1%, P = 0.5; and anemia: 54.4% vs 51.85, P = 0.7). Conclusion: Though the incidence of anemia, LBW, and pre-term delivery was higher in women with STH infections compared to those without STH, we did not find any significant association between the presence of STH infections and perinatal outcomes. [ABSTRACT FROM AUTHOR]

Background: Antiretroviral therapy (ART) has transformed the life of PLHIV with a longer life expectancy. The rising coexistence of noncommunicable diseases (NCD)s especially type 2 diabetes mellitus (DM) and hypertension (HTN) among PLHIV (people living with HIV) is much more complicated and demanding for the health system, patients, and their families. To document the current status of type 2 DM and HTN among known diabetic/hypertensive PLHIV attending ART center, tertiary care hospital of South Gujarat. Materials and Methods: A mixed method study (cross-sectional survey followed by qualitative in-depth interview) was conducted among 184 PLHIV on ART with history of Type 2 DM and/or Hypertension who were registered and availing services from ART center, tertiary care hospital. Convenient sampling technique was used. All the participants were interviewed using pre-designed, semi-structured questionnaire, during their routine visits. In -depth interview (IDI) has been conducted to explore the delivery of NCD services at ART Centre. Results: Out of 184 PLHIV on ART, the most common co-morbidities were Type 2 DM (46.2%), HTN (39.13%), and 14.67% had both. Among total 184 participants, 64.1% were males and 35.9% were females. Only 22.3% of participants were availing treatment services for the above at tertiary care hospital. The study results showed a range of findings involving ART adherence, BMI, RBS, and BP measurements were included. IDI results described the NCD service delivery at ART Center. Conclusions: Study results suggest that the services received by PLHIV with NCD require an overhauling. Routine monitoring and strengthening of existing services should be focused to upgrade the quality and continuum of the care provided to PLHIV with NCD. [ABSTRACT FROM AUTHOR]

Background: Infertility is globally prevalent and India accounts for 25% of the global burden, but it is still a neglected reproductive health issue. To estimate the prevalence of infertility, its determinants, perception and challenges faced by couples from the peri-urban area of Ahmedabad City. Materials and Methods: A community-based cross-sectional study was conducted in peri-urban areas of Ahmedabad City. For quantitative data collection, 689 couples were selected through probability proportion-based sampling (PPBS). Data was collected through a questionnaire during (1) phase I for socio-demographic details of the community and identification of eligible couples, (2) phase II for assessing the presence of infertility and its risk factors along with the assessment of depression and anxiety, and (3) phase III for Clinicosocial profiling of all infertile couples (detected during second phase). Some of these women were involved in qualitative components to know the perceptions, challenges, etc. faced while seeking infertility treatment. Result: Study population of 917 families (n = 3891) yielded 689 women of reproductive age group (RAG) with a period prevalence of 7.4% (5.5%-9.4%); separately being 3.5% and 3.9% for primary and secondary type respectively. Socio-demographic determinants like age, education, occupation, addiction, and lifestyle-related illnesses like diabetes and hypertension exhibited no significant association with infertility. However, asthma, mental illnesses, and hormonal diseases like polycystic ovarian disease (PCOD) were associated and exhibited a significant association with infertility. Preventable risk factors like reproductive tract/sexually transmitted infections (RTI/STI) showed a significantly positive association with infertility. Conclusion: The period prevalence of infertility was 7.4%, with the secondary type being more common. Asthma, mental illness, RTI/STI and age at menarche showed significant association. Screening and treatment for RTI/STI can prevent complications like infertility. Stigma associated with infertility and lack of treatment facilities in the government sector makes it difficult to deal with and neglected health problems. [ABSTRACT FROM AUTHOR]

To compare the changes in outcomes of balance and postural control after balance training exercise and gaze stability exercise in the elderly population with fall risk. After the screening process, 44 subjects were randomized into three groups: Experimental Group A (Balance training exercises, BTE); Experimental Group B (Gaze stability exercises, GSE), and Control Group C (Fall prevention education only). The outcome measures were center of pressure (COP) range, COP sway, reaction time, proprioception, static balance, Clinical Test for Sensory Interaction in Balance (CTSIB), and Short Falls Efficacy Scale (SFES). The pre and post-data were recorded at baseline and after 8 weeks. The normality of the distribution was assessed using the Shapiro-Wilk test. Demographic data and baseline measures were compared using one-way ANOVA considering group as between factor and mixed model ANOVA was used to find out the group effect and time effect and time × group interaction effect. Statistical significance was indicated if p ≤ 0.05. GSE had significant changes only in CTSIB 4 whereas BTE had significant changes in CTSIB 4, 5, and 6. COP range showed a significant time effect in the front direction (p = 0.02). For proprioception, there was a significant time effect in the left (p = 0.018) and right direction (p = 0.005), whereas changes in front and back directions were found to be insignificant. SFES showed a significant time effect (p < 0.001), group effect (p = 0.21), and time × group interaction effect (p < 0.001). Balance training exercises may be a more effective form of intervention to improve balance and postural control in the elderly population. [ABSTRACT FROM AUTHOR]

Background: The Test of Mastication and Swallowing Solids (TOMASS) is a reliable tool for assessing chewing and swallowing in healthy adults, using commercially available crackers. TOMASS‐Children (TOMASS‐C) is the paediatric version of TOMASS. Objective: The present study aimed to establish normative data for TOMASS‐C using a validated regional commercial cracker among healthy individuals aged between 6–20 years of India. Methods: 327 healthy individuals between 6–20 years were recruited in a cross‐sectional study design following a convenient sampling procedure. Participants consumed one validated regional cracker and the procedure was video recorded. Data were stratified according to age groups (6–7, 8–9, 10–13, 14–17 and 18–20 years) and sex (boys and girls). Two Speech Language Pathologists independently analysed the video recordings to derive discrete bites, masticatory cycles, swallows and total swallow time indices. Using them, time/swallow, masticatory cycles/bite, swallows/bite and time/bite were calculated. Results: All parameters of TOMASS‐C had moderate to good (0.6–0.85) test–retest reliability and moderate to excellent (0.69–0.99) inter‐rater reliability at p >.000. Younger participants took more bites, chewed more times and swallowed more frequently with longer chewing and swallowing time. Boys exhibited a lower number of swallows, shorter swallow time and reduced total masticatory time at p >.05. Additionally, girls demonstrated fewer bites and chewing cycles compared to boys at p >.05. Conclusion: TOMASS‐C using a validated regional cracker was feasible and reliable. Normative data established for healthy boys and girls between 6–20 years offers much‐needed quantitative data to objectively delineate individuals with and without chewing and swallowing solid food difficulties. [ABSTRACT FROM AUTHOR]

Background: A novel COVID-19 has spread worldwide and created a big threat for the public and their daily life. Due to its rapid transmission and the mortality rate, governments across the world had created many restrictions such as social isolation which leads to economic crisis that also leads to the source of fear, stress, anxiety, and mood conditions and negatively affects people's mental health (Praveen et al., 2021). Although the initiatives were prepared, the coronavirus may also cause mental defects. These defects also affected the medical students, since they were the backbone and the future of public health, hence the study would describe the quality of well-being by different domains. Materials and Methods: The study was designed by the questionnaire based on the World Health Organization Quality of life-BREL, Subjective Well-Being Inventory (SWBI), and Beck Anxiety Inventory (BAI) research tool. A total of 288 students were participated in the study. Results: A total of 288 medical students were participated in the study, according Cronbach Alpha method, all three domains had obtained a value of above 0.7, and the descriptive analysis showed the highest score of about 67.12 with physical activity. According to the BAI, 84% of medical students with low anxiety, the study also investigates the quality of well-being and compared with gender, with religion, with family type, place of living, religions, and among family's monthly income. The results of the study were statistically defined, and it has a significant relationship with environment and SWBI. Conclusion: The quality of well-being was assessed on medical students and the study revealed that there is no impact with gender, religion, year of study, and family's monthly income. Although the study also revealed that the mean score of social well-being is high with physical activity and considerably low with psychological and environmental activity. [ABSTRACT FROM AUTHOR]

Background and Objectives: Health literacy (HL) is the degree to which individuals have the ability to access, understand and use health-related information and thus enable them to make health-related decisions. Thus accessing health-related information, understanding the available information and using those in their daily life determines HL of the individual. Addressing problematic health literacy can help to reduce health inequities in the community. Knowing the adequacy of HL is preliminary step towards it. The study aims to assess the HL status and its associated factors. Materials and Methods: A community-based cross-sectional study was conducted to assess HL among adults aged 18 to 64 years residing in the rural area of Singur using the tool HLS-EU-Q47 from October 2020 to November 2022. Two-stage random sampling was done among 15 selected villages under the field practice area. Data was analyzed using Microsoft Excel & IBM SPSS v. 16. Results: The median age of the study participants was 40(29.0 - 49.0) years. Adequate HL was found in 11.7% of the participants and 88.3% had problematic/inadequate HL. HL was found to be significantly associated, at 95% confidence interval, with the age of the study participants, years of schooling, employment status, being decision-makers of the family, and presence of healthcare workers in the family. HL was found to be adequate in the healthcare domain and inadequate in other domains. Conclusion: HL was found to be problematic/inadequate in majority of the study participants. Strategies to strengthen health literacy should be adopted with more emphasis on younger adults. Health-promoting schools are one of the initial steps to achieve the same. Healthcare professionals should disseminate health promotion interventions among the general population to improve the HL of the community. [ABSTRACT FROM AUTHOR]

Dyslipidemia is a critical risk factor for cardiovascular disease. This study investigated the impact of 500 mg of spilanthol (SA3X) supplementation on lipid profiles in men with dyslipidemia using a randomized, parallel-group, placebo-controlled design. A total of 279 male participants were randomly allocated to one of four groups: SA3X without exercise, placebo without exercise, SA3X with exercise, and placebo with exercise. After a one-month control period, participants received SA3X capsules or placebo for three months. The exercise groups undertook standardized weight-lifting exercises four times weekly. Lipid profiles, biochemical parameters, and anthropometric measurements were monitored throughout and after the intervention. Both SA3X groups exhibited significant reductions in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) compared to the placebo groups. By day 90, the SA3X-no-exercise group showed a 16.78 % decrease in TC, while the SA3X-plus-exercise group demonstrated a 52.87 % decrease compared to placebo. Significant reductions in TG and LDL-C were noted at days 60 and 90 (p=0.01 and p=0.03, respectively). The SA3X-plus-exercise group also exhibited decreased random blood sugar levels at days 60 and 90 compared to placebo-plus-exercise. Moreover, decreases in C-reactive protein, creatine kinase, and serum creatinine levels were observed. SA3X supplementation, particularly when combined with exercise, effectively improved lipid profiles and various health markers in men with dyslipidemia. Adverse events, primarily taste disturbance, were mild. These findings suggest SA3X may be a promising adjunctive therapy for managing dyslipidemia, emphasizing its potential cardiovascular health benefits and supporting further investigation. CTRI/2021/05/033694; May 2021. [ABSTRACT FROM AUTHOR]

Objectives To estimate the level of physical activity among geriatric population, to determine the motivating factors for being active and identifying barriers that prevent participants from engaging in physical activity. Methods A community-based cross-sectional study was carried out at one of the wards within Ahmedabad city following multi-stage random sampling. The calculated sample size was 230. A pre-designed, validated, short version International Physical Activity Questionnaire (IPAQ) and Behaviour Regulation in Exercise Questionnaire (BREQ-3) were used for data collection by personal interview. From selected sampling-frame, geriatric people residing in every 5th household were interviewed after obtaining oral informed consent following simple-random sampling. Results Of total 230 study participants, 67 (29.13%) were physically active (cumulative for Category 2 and Category 3), while the remaining 163 (70.87%) were found physically inactive (i.e., minimally active [Category 1]). Motivational scores, particularly in identified regulation, showed higher median scores across subdomains of the BREQ-3. Amotivation exhibited a strong negative correlation with physical activity, while intrinsic regulation displayed a strong positive correlation. Conclusion More than two-third of study participants were physically inactive. Level of educational status, type of previous occupation involved, presence of addiction, BMI, electronic device usage duration per day and presence of chronic illness were statistically significant determinants to decide involvement of elderly people in category of physical activity. Amotivation, external and introjected regulation had negative correlation with physical activity, while intrinsic regulation and RAI (Relative Autonomy Index) showed positive correlation with physical activity. None of the behavioural regulators had statistically significant association with category of physical activity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health care professionals (HCPs) working on the frontlines of health care emergencies/pandemics often experience elevated anxiety, stress and reduced quality of sleep. Yoga is a mind-body practice that has been proven to effective in improving physical and mental health. OBJECTIVE: To evaluate the effectiveness of integrated Yoga intervention on mental health measures and sleep quality among HCPs working during the COVID-19 pandemic. METHODS: This quasi-experimental study was conducted on 110 HCPs, including Doctors and nursing staff, with an age range of 20 to 65 years who were recruited through a convenience sampling method and assigned to a Yoga group (n = 55) or a control group (n = 55). The Yoga group received a weekly one-hour Yoga session followed by a 30-minute self-practice three times a week at home for one month. The control group followed routine activity. Heart rate (HR), Blood Pressure, stress measures (Perceived Stress and visual analogue Scale for Stress), COVID-related anxiety, Sleep Quality, Quality of life and Preservative Thinking were assessed before and after the intervention. RESULTS: A significant decrease in stress measures, COVID-19-related anxiety and fear, and perseverative thinking was noticed in the Yoga group. Sleep quality and quality of life also improved significantly. The control group showed no significant change. At one month, the Yoga group showed significantly greater improvement in stress measures, COVID-19-related anxiety and fear, perseverative thinking, sleep quality and quality of life compared to the control group. CONCLUSION: Yoga practice during the public health crisis would help reduce anxiety and stress and improve sleep among HCPs. Further randomized controlled trials are warranted. [ABSTRACT FROM AUTHOR]

Background/Objectives: The current study compared Self-Figure drawings from Thai and Indian adolescents to assess the cross-cultural applicability of a child abuse assessment tool. The research aims to understand the extent to which distinctions or similarities arise in Self-Figure drawings among adolescents from two culturally similar yet distinct backgrounds characterized by differences in religious affiliations, socioeconomic contexts, and political environments. Methods: Employing a mixed-methods approach, the study utilized quantitative measures, including the Traumatic Events Checklist (TEQ-5) and Medical Somatic Dissociation Questionnaire (MSDQ), alongside a qualitative analysis of Self-Figure drawings. Ethical approval was obtained with waived informed consent, and a convenience sample of 386 adolescents aged 13–18 years (193 from Thailand [M = 14.8, SD = 1.73; 135 females (69.9%) and 58 males (30.1%)], and 193 from India [M = 15.2, SD = 1.64; 135 females (69.9%) and 58 males (30.1%)]), who reported experiencing child abuse, participated in the study by completing questionnaires and drawing themselves. Results: The analysis revealed that Thai adolescents had higher MSDQ scores, while Indian adolescents exhibited more prominent pictorial indicators. Indian participants reported experiencing a broader range of event types, whereas Thai adolescents predominantly depicted verbal or emotional abuse. Variations in pictorial indicators were found significant, except for hair, cheek or chin, omitted legs or feet, and omitted eyes. Conclusions: These findings contribute to the understanding of how cultural factors influence adolescents' self-representations through drawing. The differences in pictorial indicators highlight the nuanced variations within similar cultures, emphasizing the cultural specificity of self-expression. [ABSTRACT FROM AUTHOR]

BACKGROUND: The World Health Organization (WHO) in their 2018 guidelines favored a noninterventional approach toward the labor process. The active phase of labor will be initiated when the cervix is 5 cm dilated and during obsoleted use of a 1 cm/hour cervical dilation rate as a diagnostic test for abnormal birth outcomes. OBJECTIVES: The aim of the study is to compare an active interventional labor management approach to a noninterventional labor management approach in nulliparous parturient women in terms of need of intervention, mode of birth, and maternofetal outcome. METHODOLOGY: This randomized control study was conducted at a rural tertiary care hospital for a period of 1.5 years. Nulliparous low-risk pregnant women presenting in latent labor were randomly allocated into two groups on the basis of cervical dilation and labor intervention. WHO 2014 guidelines with partograph were followed in group 1, and 2018 WHO guidelines with labor care guide were followed in group 2. RESULT: Both the groups were comparable with age, parity, and Bishop score at the time of admission. The incidence rates of intervention in the active first stage of labor in group 1 and group 2 were 31% and 10% with an odds ratio of 0.192 (95% confidence interval [CI] [0.079, 0.466]), and the rates of lower segment cesarean section in both the groups were 17.6% and 5.8%, respectively. The odds ratio with 95% CI for postpartum hemorrhage and neonatal intensive care unit admission in group 1 compared with group 2 was 0.313 [0.061, 1.610] and 1.057 [0.143, 7.832], respectively. CONCLUSION: This study showed that the shifting of the active first-stage threshold by 1 cm and letting labor progress at its natural pace significantly reduced the need for intervention and affected the fetal and maternal outcome positively. [ABSTRACT FROM AUTHOR]

Background: The Common Risk Factor Approach (CRFA) is one of the methods to achieve medical-dental integration. CRFA addresses shared risk factors among major Non-communicable Diseases (NCDs). This study aimed to explore the perspectives of dental and medical practitioners concerning CRFA for managing NCDs and periodontal diseases and to create and validate a tool to evaluate the Knowledge, Attitude, and Practice (KAP) of medical and dental practitioners in relation to utilization of CRFA for management of NCDs and Periodontal diseases. Methods: This research employed a concurrent mixed-method model and was carried out from January 2021 to February 2022, focusing on medical and dental practitioners in South India. In the qualitative phase, online interviews were conducted with dental and medical practitioners, recorded, and transcribed. Thematic analysis was applied after achieving data saturation. In the quantitative phase, a KAP questionnaire was developed. The sample size was determined by using the G power statistical power analysis program. A sample size of 220 in each group (dentists and medical practitioners) was estimated. Systematic random sampling was used to recruit the potential participants. The data obtained through the online dissemination of KAP tool was analysed and scores were standardized to categorize the KAP. Results: Qualitative thematic analysis identified four major themes: understanding of common risk factors, risk factor reduction and disease burden, integrating CRFA into clinical practice, and barriers to CRFA. In addition, thematic analysis revealed seventeen subthemes. For the quantitative phase, standardization was applied to a 14-item KAP questionnaire for medical practitioners and a 19-item KAP questionnaire for dental practitioners. The total KAP score for medical practitioners in the study was 21.84 ± 2.87, while dental practitioners scored 22.82 ± 3.21, which indicated a high level of KAP regarding CRFA. Meta integration of qualitative and quantitative data identified eight overarching themes: four were concordant, three were discordant, and one theme provided the explanatory component. Conclusion: The study's structured, validated questionnaire showed that both medical and dental professionals had a high knowledge of CRFA. However, they were not appreciably aware of the risk factors that are shared between NCDs and periodontal disease. Both groups were interested in the idea of using CRFA in integrated medical and dental care. [ABSTRACT FROM AUTHOR]

Background: Wild food plants (WFPs) play an important role in the traditional dietary habits of various indigenous communities worldwide, particularly in mountainous regions. To understand the dynamics of food preferences, cross-cultural studies on food plants should be conducted across diverse ethnic groups in a given area. In this context, the current study investigated the use of WFPs by seven different cultural groups in the Kashmir Himalayan Region. In this area, people gather wild plants and their parts for direct consumption, traditional foods, or sale in local markets. Despite this reliance, documentation of the food system, especially concerning WFPs, is notably lacking. Hence, our research aimed to document WFPs, along with associated traditional ecological knowledge, and identify major threats to their long-term sustainability in Division Muzaffarabad. Methods: Through a comprehensive approach involving questionnaires, interviews, focus groups, and market surveys, we gathered data from 321 respondents. PCA was performed to analyze threats and plant use using "factoextra" in R software. Origin Pro was used to create a chord diagram, while R software was used to generate a Polar heat map. Additionally, a Venn diagram was created using Bioinformatics software. Results: The study included 321 informants, of whom 75.38% were men and 24.61% were women. In total, 113 plant taxa from 74 genera and 41 botanical families were reported. Polygonaceae and Rosaceae accounted for the majority (17 species each), followed by Lamiaceae (7 species). Leaves were the most used part as food sources (41.04%), followed by fruits (33.33%). Most of the species are consumed as cooked (46.46%) and as raw snacks (37.80%). A total of 47 plant species were collected and cooked as wild vegetables, followed by 40 species used as fruits. This study is the first to describe the market potential and ecological distribution of WFPs in the study area. Cross-comparison showed that utilization of WFPs varies significantly across the region and communities, including their edible parts and mode of consumption. Jaccard index (JI) value ranged from 5.81 to 25. Furthermore, the current study describes 29 WFPs and 10 traditional food dishes that have rarely been documented in Pakistan's ethnobotanical literature. Climate change, invasive species, expansion of agriculture, and plant diseases are some of the most significant threats to WFPs in the study area. Conclusions: The older age group has more knowledge about WFPs compared to the younger generation, who are not interested in learning about the utilization of WFPs. This lack of interest in information about WFPs among the younger generation can be attributed to their limited access to markets and availability of food plants in the study area. Traditional gathering of food plants has been reduced in younger generations during recent years; therefore, it is crucial to develop effective conservation strategies. These efforts not only safeguard indigenous flora, food knowledge, and cultural heritage, but they also contribute to food security and public health by utilizing local wild foods in the examined area. [ABSTRACT FROM AUTHOR]

Background: Kerala, a southern state in India, is known to be atypical due to its high literacy rate and advanced social development indicators. Facing competition from a dominant private healthcare system, recent government health system reforms have focused on providing free, high-quality universal healthcare in the public sector. We carried out an analysis to ascertain the initial impacts of these measures among 'hard to reach groups' as part of a larger health policy and systems research study, with a focus on public sector health service utilisation. Methods: We conducted Focus Group Discussions (FGDs) among identified vulnerable groups across four districts of Kerala between March and August of 2022. The FGDs explored community perspectives on the use of public healthcare facilities including enablers and barriers to healthcare access. Transliterated English transcripts were coded using ATLAS.ti software and thematically analyzed using the AAAQ framework, supplemented with inductive code generation. Results: A total of 34 FGDs were conducted. Availability and cost-effectiveness were major reasons for choosing public healthcare, with the availability of public insurance in inpatient facilities influencing this preference. However, accessibility of public sector facilities posed challenges due to long journeys and queues. Uneven roads and the non-availability of public transport further restricted access. Gaps in acceptability were also observed: participants noted the need for the availability of special treatments available, reduced waiting times for special groups like those from tribal communities or the elderly mindful of their relatively greater travel and need for prompt care. Although quality improvements resulting from health reform measures were acknowledged, participants articulated the need for further enhancements in the availability and accessibility of services so as to make public healthcare systems truly acceptable. Conclusion: The 'Kerala Model of Development' has been applauded internationally for its success in recent years. However, this has not inured the state from the typical barriers to public sector health care use articulated by participants in the study, which match global evidence. In order to deepen the impact of public sector reforms, the state must try to meet service user expectations– especially among those left behind. This requires attention to quality, timeliness, outreach and physical access. Longer term impacts of these reforms – as we move to a post-COVID scenario - should also be evaluated. [ABSTRACT FROM AUTHOR]

Background: India is deemed the "Diabetes Capital," with over 100 million people suffering from this deadly disease. The disease is a lifestyle disorder and significantly impacts the quality of life. Thus, the study assesses the lifestyle factors and quality of life (QoL) among people suffering from Type 2 Diabetes (T2D). Materials and methods: A cross-sectional study was conducted among 100 T2DM participants aged 18–65. Data were collected from Diabetic Clinics across Pune City using the Modified Diabetes Quality of Life Questionnaire, having seven domains with 17 questions. Perceived Stress Scale (PSS) and International Physical Activity Questionnaire (IPAQ) were used to assess Stress and Physical Activity. Purposive and snowball sampling techniques were used to collect data. The data was entered and cleaned in Microsoft Excel and analysis was done using SPSS v23. Descriptive and inferential analysis was computed. Results: 60% of the participants were males with a mean age of 43.30 ± 10.89 years. The mean age of women was 50.17 ± 10.13 years. The mean HbA1c of males and females was 7.98 ± 1.41 and 7.83 ± 1.25, respectively. 83% have moderate stress, while 11% have low stress. Only 11% were found to be physically active. The average QoL score of the participants was 63.4 ± 11.2, non-significantly higher in males than in females (64.9 ± 11.03 vs 61.0 ± 11.22). Domain assessment of QoL showed statistical significance among general health (p = 0.002) and energy fatigue (p = 0.015), with males having better general health than women, and energy levels were better in females than males. However, no significance was seen between the genders in physical function, emotional well-being, and role limitation. A statistical significance for energy fatigue (p = 0.031) was observed when QoL was assessed across the disease duration. Conclusion: Due to a sedentary lifestyle and increased stress, the glycemic profile of the participants was uncontrolled, which negatively impacted their quality of life. Thus, a holistic approach to managing diabetes will be more beneficial in improving the quality of life. [ABSTRACT FROM AUTHOR]

Background: Birth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors. Methods: A community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text. Results: The study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27–5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34–12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92–12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39–3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08–3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14–16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39–0.97) were less likely to respond. Conclusion: The present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended. [ABSTRACT FROM AUTHOR]

Background: Non-specific lower back pain (NSLBP) is prevalent among female police officers, influenced by genetic factors, aging, and occupational risks such as heavy lifting. This study evaluates a 6-week program combining core strengthening and hip mobility exercises to alleviate NSLBP. Objective: To assess the effectiveness of core strengthening and dynamic hip mobility exercises in reducing NSLBP among female officers. Methods and Material: The study involved 40 female officers aged 25-55 with NSLBP lasting at least 6 weeks using simple random sampling technique. Participants were randomly assigned to Group A (control) or Group B (experimental). Group B underwent a 6-week core strengthening and hip mobility exercise regimen, with pain intensity (NPRS) and low back disability (ODI) measured before and after. Results: Group B exhibited significantly lower pain intensity (3.5 ± 1.147 vs 7.3 ± 0.9234) and reduced low back disability (13.6 ± 2.909 vs 28.65 ± 2.207) compared to Group A. Conclusions: The study revealed that among female officers with NSLBP, core strengthening and hip mobility exercises proved more effective than traditional exercises in alleviating pain and reducing low back instability [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus vaccine is effective in preventing cervical cancer and is especially recommended for girls above nine years of age. Understanding the level of awareness and attitude of the target population towards the HPV vaccine is imperative to create awareness where necessary. Aim and Objectives: To assess the baseline knowledge, attitudes, and behaviours concerning HPV vaccine among adolescent school girls in urban area, and to investigate the impact of health education on these parameters. Study design: Quasi-experimental Study setting: Secondary school in Pune city Target population: Adolescent girls Methods and Material: Calculated sample size was 200. A school was chosen randomly. All the willing female students from 8th-10th standards were enrolled. Awareness about HPV infection and vaccination, attitude and practices were assessed at the baseline and two weeks after the health education intervention, using a self-administered structured questionnaire. Results: Initially, only 2.5% had heard about the HPV vaccine and none had received it. Following health education, the proportion of students who correctly answered the questions regarding the HPV vaccine, diseases prevented and who can take the vaccine increased significantly by 94%, 71.5% and 72% respectively. Positive attitude regarding the risk of HPV infection and age for vaccination improved significantly by 78.5% and 48% respectively. Vaccine seeking behaviour improved significantly by 17.5%. Conclusions: Adolescent school girls had poor baseline knowledge and attitude regarding the HPV vaccine and health education significantly improved the same. [ABSTRACT FROM AUTHOR]

Introduction: Breastfeeding is crucial for infant health, yet challenges persist in promoting early initiation and exclusive breastfeeding, particularly among marginalized communities like the KOL tribe in Uttar Pradesh. This study aimed to understand breastfeeding practices among the KOL tribe and identify factors influencing these practices. Methods: A mixed-methods approach was employed, involving quantitative data collection through pre-designed questionnaires and qualitative in-depth interviews with KOL tribe mothers. Sampling included random selection, and data analysis was conducted using SPSS for quantitative data and QDA minor lite software for qualitative data. Results: Socioeconomic challenges were prevalent among the KOL tribe, with most women being illiterate and engaged in manual labour. Breastfeeding practices varied, including delayed initiation, reliance on cow/goat milk, and misconceptions about colostrum Health care utilization was limited, with home deliveries common due to family incompliance. Despite challenges, community support for breastfeeding was reported, and mothers felt comfortable breastfeeding in public. Conclusion: The study underscores the influence of socio-economic factors, cultural beliefs, and limited awareness on breastfeeding practices among the KOL tribe. Targeted interventions focusing on education, community engagement, and improving healthcare access are crucial for promoting optimal breastfeeding practices and improving infant health outcomes in marginalized communities. [ABSTRACT FROM AUTHOR]

Background: HIV/AIDS remains an international public health concern causing enormous morbidity and mortality. Although antiretroviral therapy (ART) has improved the outlook for patients living with HIV/AIDS (PLWHA), many still face psychosocial challenges that negatively impact their quality of life (QOL). HIV related perceived stigma and social support have a bearing on their QOL. Aims and Objectives: To assess the QOL of PLWHA attending an ART centre in Jammu, India and to assess the role of perceived stigma and social support in predicting QOL in this population. Material and Methods: This cross-sectional study was conducted at the ART centre of Government Medical College, Jammu for 8 months. A sample of 300 PLWHA was selected using a convenience sampling strategy. Data was collected using questionnaires assessing socio-demographic profile, QOL (POZQOL), perceived stigma (12-item short version of the HIV stigma scale), and perceived social support (MSPSS). Results: Mean scores for various domains of QOL i.e. Psychological, Social, Health concerns and Functional were 10.79±3.76, 10.18±3.70, 8.81±3.16 and 10.76±3.35 respectively. Perceived Stigma and social support were found to be significantly correlated with all QOL domains. Conclusion: QOL of PLWHA was enormously influenced by various socio-demographic factors, stigma, and perceived social support. Targeted interventions to reduce stigma, strengthen social support systems can improve QOL for PLWHA. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the efficacy and safety of individualized homeopathic medicines (IHMs) in treating hemorrhoids compared with placebo. Design: This is a double-blind, randomized (1:1), two parallel arms, placebo-controlled trial. Setting: The trial was conducted at the surgery outpatient department of the State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh, India. Subjects: Patients were 140 women and men, aged between 18 and 65 years, with a diagnosis of primary hemorrhoids grades I–III for at least 3 months. Excluded were the patients with grade IV hemorrhoids, anal fissure, and fistula, hypertrophic anal papillae, inflammatory bowel disease, coagulation disorders, rectal malignancies, obstructed portal circulation, patients requiring immediate surgical intervention, and vulnerable samples. Interventions: Patients were randomized to Group 1 (n = 70; IHMs plus concomitant care; verum) and Group 2 (n = 70; placebos plus concomitant care; control). Outcome measures: Primary—the anorectal symptom severity and quality-of-life (ARSSQoL) questionnaire, and secondary—the EuroQol 5-dimensions 5-levels (EQ-5D-5L) questionnaire and EQ visual analogue scale (VAS); all of them were measured at baseline, and every month, up to 3 months. Results: Out of the 140 randomized patients, 122 were protocol compliant. Intention-to-treat sample (n = 140) was analyzed. The level of significance was set at p < 0.05 two tailed. Statistically significant between-group differences were elicited in the ARSSQoL total (Mann–Whitney U [MWU]: 1227.0, p < 0.001) and EQ-5D-5L VAS (MWU: 1228.0, p = 0.001) favoring homeopathy against placebos. Sulfur was the most frequently prescribed medicine. No harm or serious adverse events were reported from either of the groups. Conclusions: IHMs demonstrated superior results over placebo in the short-term treatment of hemorrhoids of grades I–III. The findings are promising, but need to be substantiated by further phase 3 trials. Clinical Trial Registration Number: CTRI/2020/03/024342. [ABSTRACT FROM AUTHOR]

Background and aims: Smokeless tobacco (ST) use in South Asia is high, yet interventions to support its cessation are lacking. We tested the feasibility of delivering interventions for ST cessation in South Asia. Design: We used a 2 × 2 factorial design, pilot randomized controlled trial with a duration of 26 weeks, including baseline and follow‐up (6, 12 and 26 weeks) assessments. Setting: Two primary health‐care facilities each in Dhaka (Bangladesh) and Karachi (Pakistan) and a walk‐in cancer screening clinic in Noida (India) took part. Participants: Adult daily ST users willing to make a quit attempt within 30 days. Of 392 screened, 264 participants [mean age: 35 years, standard deviation = 12.5, 140 (53%) male] were recruited between December 2020 and December 2021; 132 from Bangladesh, 44 from India and 88 from Pakistan. Interventions: Participants were randomized to one of three treatment options [8‐week support through nicotine replacement therapy (NRT, n = 66), a behavioural intervention for smokeless tobacco cessation in adults (BISCA, n = 66) or their combination (n = 66)] or the control condition of very brief advice (VBA) to quit (n = 66). Measurements Recruitment and retention, data completeness and feasibility of intervention delivery were evaluated. Biochemically verified abstinence from tobacco, using salivary cotinine, was measured at 26 weeks. Findings Retention rates were 94.7% at 6 weeks, dropping to 89.4% at 26 weeks. Attendance in BISCA pre‐quit (100%) and quit sessions (86.3%) was high, but lower in post‐quit sessions (65.9%), with variability among countries. Adherence to NRT also varied (45.5% Bangladesh, 90% India). Data completion for key variables exceeded 93% among time‐points, except at 26 weeks for questions on nicotine dependence (90%), urges (89%) and saliva samples (62.7%). Among follow‐up time‐points, self‐reported abstinence was generally higher among participants receiving BISCA and/or NRT. At 26 weeks, biochemically verified abstinence was observed among 16 (12.1%) participants receiving BISCA and 13 (9.8%) participants receiving NRT. Conclusions: This multi‐country pilot randomized controlled trial of tobacco cessation among adult smokeless tobacco users in South Asia demonstrated the ability to recruit and retain participants and report abstinence, suggesting that a future definitive smokeless tobacco cessation trial is viable. [ABSTRACT FROM AUTHOR]

Background: Pregabalin, approved for various medical conditions, has shown increasing misuse potential globally. However, limited research exists on pregabalin dependence in India. This study aimed to investigate the prevalence and characteristics of pregabalin dependence among individuals seeking substance use disorder (SUD) treatment in North India. Methods: A cross-sectional, analytical study was conducted on patients enrolled between August 2022 and July 2023 at an academic institution-based addiction treatment center. Case records of patients with pregabalin dependence were retrieved and compared with controls with opioid dependence but no history of pregabalin use. Results: Among 3766 registered patients, 135 had pregabalin dependence (prevalence: 3.58 per 100 registered patients). Pregabalin-dependent patients were male, with a median usage duration of eight months and a median daily dose of 1200 mg. Most had concurrent opioid dependence, primarily heroin, used via the injection route. The odds of pregabalin dependence among those with opioid dependence were significantly higher than those with other substance dependence (OR 1.44, 95% CI 1.13-1.85). Reasons for pregabalin use included opioid craving reduction, sedation, and euphoria. Patients with pregabalin dependence were more likely to have lower socioeconomic status (P < 0.0001) and urban residence (P = 0.032), an earlier age of substance use initiation (P = 0.02) and treatment seeking (P < 0.0001), and a higher co-occurrence of psychiatric disorders (P = 0.007) and less occurrence of alcohol dependence (P = 0.03). Conclusion: Findings underscore the need for heightened awareness, screening, and intervention efforts targeting pregabalin misuse within SUD treatment. Further research should focus on longitudinal studies to elucidate pregabalin dependence's trajectory. [ABSTRACT FROM AUTHOR]

Background: Risk and protective factors play crucial roles in shaping problem behavior, substance use, and mental health outcomes among adolescents. The study aims to examine the risk and protective factors and their association with emotional and behavioral problems among school-going tribal adolescents in Meghalaya, India. Methods: This study employed a cross-sectional design, utilizing a simple random sampling method to select schools from the Ri-Bhoi district (Nongpoh town) and East Khasi Hills district (Shillong cantonment area) of Meghalaya. A total of 450 students participated in the survey, out of which 300 students belonged to tribal ethnicity. The study focused on school-going adolescents with tribal ethnicity, aged 13-19 years, encompassing both genders (male and female). Participation in the study required both parental consent and the adolescent's assent. The Communities That Care Youth Survey (CTC-YS) and the Strength and Difficulty Questionnaires (SDQ), scale were administered. Results: The findings highlighted significant risk factors including laws and norms favorable to drug use, community disorganization, poor family management, and low school commitment. Protective factors such as opportunities for prosocial involvement were evident across all domains. Family conflict, family history of antisocial behavior, and parental overcontrol were significant contributors (P < 0.05) to total difficulty scores. Among individual risk factors, "Interaction with anti-social peers" (P = 0.009) and "Intentions to use substance" (P = 0.021) had significant associations with higher difficulty scores. The overall prevalence of mental health problems, as indicated by the total difficulty score, was 31.3% among school-going tribal adolescents. Conclusion: The high prevalence of mental health problems, especially among tribal adolescents, underscores the urgent need for targeted interventions. By addressing these factors, policymakers and stakeholders can work toward fostering healthier outcomes for tribal adolescents in Meghalaya and similar communities. [ABSTRACT FROM AUTHOR]

Background: With the primary objective of addressing the disparity in global surgical care access, the College of Surgeons of East, Central, and Southern Africa (COSECSA) trains surgeons. While sufficient operative experience is crucial for surgical training, the extent of utilization of minimally invasive techniques during COSECSA training remains understudied. Methods: We conducted an extensive review of COSECSA general surgery trainees' operative case logs from January 1, 2015, to December 31, 2020, focusing on the utilization of minimally invasive surgical procedures. Our primary objective was to determine the prevalence of laparoscopic procedures and compare this to open procedures. We analyzed the distribution of laparoscopic cases across common indications such as cholecystectomy, appendicitis, and hernia operations. Additionally, we examined the impact of trainee autonomy, country development index, and hospital type on laparoscopy utilization. Results: Among 68,659 total cases, only 616 (0.9%) were laparoscopic procedures. Notably, 34 cases were conducted during trainee external rotations in countries like the United Kingdom, Germany, and India. Gallbladder and appendix pathologies were most frequent among the 582 recorded laparoscopic cases performed in Africa. Laparoscopic cholecystectomy accounted for 29% (276 of 975 cases), laparoscopic appendectomy for 3% (76 of 2548 cases), and laparoscopic hernia repairs for 0.5% (26 of 5620 cases). Trainees self-reported lower autonomy for laparoscopic (22.5%) than open cases (61.5%). Laparoscopy usage was more prevalent in upper-middle-income (2.7%) and lower-middle-income countries (0.8%) compared with lower-income countries (0.5%) (p < 0.001). Private (1.6%) and faith-based hospitals (1.5%) showed greater laparoscopy utilization than public hospitals (0.5%) (p < 0.001). Conclusions: The study highlights the relatively low utilization of minimally invasive techniques in surgical training within the ECSA region. Laparoscopic cases remain a minority, with variations observed based on specific diagnoses. The findings suggest a need to enhance exposure to minimally invasive procedures to ensure well-rounded training and proficiency in these techniques. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate how workplace bullying mediates between workplace conflict and employee silence (acquiescent, quiescent, and pro-social silence). Data was collected from 430 employees of service-sector companies (IT and ITES). Structural equation modeling using bootstrap technique was applied for data analysis. The findings of this study confirm that workplace bullying partially mediates the relationship between workplace conflict and the three types of employee silence. The implications of this research work are beneficial for organizations in order to fathom the silence behavior of employees that arises due to conflict and bullying at workplace. Management should discourage any signs of conflict, curb bullying, and at the same time encourage the employees to raise their voices against their problems in a formal way. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mercury (Hg) is a toxic heavy metal with multiple uses in various medical devices. Hg is used in dentistry as a restorative material. Such use creates significant exposure to dental practitioners. Hence, it is important to assess the risk created by Hg use in healthcare. OBJECTIVE: To quantify airborne Hg vapour exposure and Hg levels in dental healthcare workers, and determine the association of various symptoms and diseases to Hg exposure. METHODS: Air monitoring of Hg vapours were conducted in dental clinics and amalgam rooms. Urine samples were collected from occupationally exposed dental healthcare workers and urine Hg levels were measured. A cross-sectional health survey was conducted in 23 healthcare units of Delhi to determine an association between Hg exposure and various health effects. RESULTS: Hg vapour concentration ranged from 0.96μg/m3 to 15μg/m3, the highest concentration was recorded in the amalgam room (15μg/m3). Urine Hg levels in healthcare workers (0.51±0.17μg/L) were higher than the control (0.29±0.05μg/L). A cross-sectional health survey revealed a significant prevalence of confusion, forgetfulness, muscle spasm, and tremors by the respondents. CONCLUSION: Hg concentration in dental clinics may hover above the prescribed safe levels posing a definitive health risk to healthcare workers. Urinary Hg measurements did not reveal an excess of body burden except in one case. Since Hg bio accumulates, it is probable as these workers grow older, they may end up with a higher body burden of Hg that may lead to a variety of adverse health outcomes. [ABSTRACT FROM AUTHOR]