Search

Background: Existing estimates of adolescent sexual and reproductive health (ASRH) behaviors may be a gross undercount given the sensitivity of this behavior in Indian culture. The objective of this study was to estimate ASRH behaviors in Rajasthan, India using direct questions and the best friend approach that seeks to reduce social desirability bias. Methods: We used population-based data of adolescents aged 15–19 in Rajasthan collected between September and December 2022. Data include whether the respondent and her closest female friend ever had a partner, ever had sex, ever used contraception, and were currently using contraception. We estimated respondent and best friend ASRH outcomes separately, overall and among unmarried adolescents for whom we anticipate social desirability bias is greatest. Results: The best friend approach performed well, with method assumptions largely met even before adjustments. Respondent and best friend estimates were similar among all adolescents except for current contraceptive use, which was higher for friends (though not significantly so). However, we observed large differences in ASRH behaviors between unmarried respondents and friends, with a significantly higher percentage of friends who ever had a partner (4.3% respondents, 11.6% friends), and a slightly higher percentage who ever had sex (2.4%, 3.8%) and who were currently using contraception (17.0%, 19.7% among those in need of contraception). Conclusions: We observed potential benefits of using the best friend methodology in estimating premarital sexual activity, but further work is needed to refine social network-based measures of sensitive adolescent behaviors in larger study samples to better understand ASRH needs. [ABSTRACT FROM AUTHOR]

Background: The world is not on track to meet the World Health Assembly (WHA) global target on Low Birth Weight (LBW). To estimate the prevalence and to identify the associated determinants of LBW among the newborns. Material and Methods: We conducted a cross-sectional study among the 364 mothers registered under the all government health facilities of Dadra & Nagar Haveli (DNH) during November 2021 to January 2022. Results: The prevalence of LBW was found to be 39%. On uni-variable logistic regression, live in relationship, caste, weight of mother, Body Mass Index (BMI), weight gain <5 kg in 2nd and 3rd trimester, high-risk pregnancy, complication present in previous pregnancy and preterm delivery, while on multi-variable logistic regression, weight gain <5 kg in 2nd and 3rd trimester (AOR 2, 95% CI 1.007-4.2) and having high-risk pregnancy (AOR 2, 95% CI 1.1-3.0) were found to be the significant predictors of LBW among the newborns. Conclusions: We conclude from the study that the prevalence of low birth weight among the newborn was high. There is a need to address maternal and child health issues like low birth weight, malnutrition and high-risk pregnancy under the RMNCAH+N program through various effective interventions. Future research should evaluate the feasibility of collaborative activities between RMNCAH+N program and the UNICEF in India. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension, the "Silent, Invisible killer" - is a modern day's universal epidemic. The adult populations in slum area are more vulnerable for hypertension as they are so busy in the fulfilment of even day to day basic needs and care, family commitments and economic stress. Aim and objectives: To estimate the prevalence of hypertension among the adults (25-44 years) and to study the effect of sleep on blood pressure levels. Methodology: The present cross-sectional study was carried among adults aged between 25 to 44 years residing in the slums of Meerut District. 30 Cluster Sampling technique was used. The slum was selected as a cluster unit. During the visit by house-to-house survey, members of the family were listed and eligible person were interviewed and examined. Data collected on a structured and pretested questionnaire. Results: Prevalence of hypertension among those who had sleep duration of >8 hours per day was 44.8% followed by 20.1% and 17.5% among those who had 7-8 hours and less than 7 hours of sleep time respectively. It was found that 24.2% monophasic sleep pattern follower were hypertensives while the prevalence was 19.4% in biphasic pattern. Conclusion: Majority (55.4%) had a sleep duration between 7-8 hours, followed by 33.9% and 10.7% with <7 hours and >8 hours of sleep time respectively. Majority (61.3%) of the study population were having monophasic sleep pattern, while 36.3% were biphasic and 2.4% were multiphasic. [ABSTRACT FROM AUTHOR]

Health related quality of life (HRQOL) is a multidimensional concept that encompasses the patient's perceptions of his or her physical, emotional, social, and cognitive functions. Despite DTC patients' long survival, HRQOL has been shown to be lower than in the general population. There is a scarcity of data on HRQOL in thyroid cancer in the Indian population and especially goiter endemic area. As a result, the authors conducted a health-related quality of life survey in patients managed at their center in Northern India's Sub-Himalayan region using two widely accepted questionnaires. Adults with differentiated thyroid cancer who had surgery with or without radio-iodine ablation and had recovered for at least 6 months were assessed using health quality of life surveys, the QLQ-C30 and QLQ-THY34 of the European Organization for Research and Treatment of Cancer Quality of Life Group. The survey was completed by 57 adults with a mean age of 45.64 ± 15.64 years. The average time between the survey and treatment was 13.3 ± 10.8 months. After surgery, the QLQ-C30 found a significant reduction in insomnia, appetite loss, constipation, diarrhea, and financial difficulties, whereas radio-iodine ablation significantly improved global health status. The QLQ-THY34 found a significant increase in symptoms such as voice concerns, hair problems, dry mouth, shoulder functioning, tingling, and worrying after surgery, with a significant improvement in swallowing and job impact symptoms. The surgical extent had no impact. The quality of life for people with differentiated thyroid cancer in goiter-endemic areas is similar to that of other areas. However, the limited number of subjects in the study warrants further large sample size longitudinal study to understand the exact Health-related quality of life in thyroid cancer in endemic area. [ABSTRACT FROM AUTHOR]

BACKGROUND: Professional rickshaw driving is a seemingly sedentary occupation and involves many risk factors for work-related musculoskeletal disorders (WMSD). OBJECTIVE: To assess the prevalence of work-related musculoskeletal disorders and its associated risk factors among professional rickshaw drivers. METHODS: 263 rickshaw drivers were voluntarily recruited from Aligarh, Uttar Pradesh, India. MSD symptoms in the past 12 months and last 7 days were assessed using a self-modified musculoskeletal questionnaire (Nordic Questionnaire). Chi-square tests and binary logistic regression were performed to analyze associations of MSD symptoms between study variables. RESULTS: 155 (58.9%) study participants reported MSD symptoms in past 12 months, in lower back (n = 126, 81.3%), leg (n = 122, 78.7%), neck (n = 106, 68.4%) and knee (n = 105, 67.7%); and 121 (46.1%) in last 7 days, in leg (n = 107, 88.4%), lower back (n = 102, 84.3%), neck (n = 89, 73.6%), upper back and knees (n = 87, 71.9%). Binary logistic regression showed relationship between working hours, seat and road condition, average load per ride, rickshaw ride duration, and standing driving with MSD symptoms among rickshaw drivers, especially in the lower back, leg/calf muscles, neck and knees. CONCLUSION: The results showed a high prevalence of MSD among all rickshaw drivers, with the neck, lower back, leg/calf muscles and knees being the most affected body parts. In order to avoid adverse effects on the occupational health of rickshaw drivers, ergonomic intervention training is necessary. [ABSTRACT FROM AUTHOR]

Background Factors causing postoperative discomfort after laparotomy are numerous and must be explored in depth. The postoperative distress may significantly affect the patient's state of well-being. Hence, the present study aims to assess the factors contributing to discomfort after laparotomy. Aim The aim was to assess and compare the discomfort between open and laparoscopic abdominal surgery. Objectives of the Study 1. To analyze the causes of patient's discomfort after abdominal surgery. 2. To compare the discomfort between open and laparoscopic abdominal surgery. 3. To determine the association between pain and selected variables among open and laparoscopic abdominal surgery. Materials and Methods An exploratory approach with a prospective observational design was adopted for this study. Using the purposive sampling technique, 100 patients were selected to open and 100 to laparoscopic abdominal surgery groups. Data were collected using demographic and clinical proforma and standardized postoperative discomfort inventory 6 and 24 hours after the surgery. The assessment focused on the study variables such as symptoms after the surgery and the factors contributing to the postoperative discomfort. Statistical Analysis The collected data were analyzed using descriptive and inferential statistics using the SPSS software version 20. Results Among 200 participants, most of the open (68%) and laparoscopic abdominal surgeries (42%) belong to 25 to 35 years of age. Also, 54% and 13% were diabetic in open and laparoscopic abdominal surgery groups, respectively. Most samples (56% in open and 68% in laparoscopic surgery) stayed 5 and 10 hours in postoperative ICU. In open and laparoscopic abdominal surgeries, pain is the primary (100%) cause of postoperative discomfort after 6 hours of surgery. Movement restriction is also the reason for significant discomfort both in open (98%) and laparoscopic (100%) abdominal surgeries. In contrast, pain (99% and 100%), movement restriction (92% and 95%), and abdominal distention (61% and 34%) were the major problems contributing to the patient's discomfort after 24 hours of both open and laparoscopic surgeries too. There was a significant difference in causes of patient discomfort between open and laparoscopic abdominal surgery after 6 hours (P < 0.05), except for discomfort related to IV drip (P = 0.852), constipation (P = 0.2), and chills (P = 0.6). Conclusion Even though pain is the major distressing factor both in open and laparoscopic surgeries, the current study highlights a few other factors that affect postoperative recovery. Nurses' attention to such distressing factors will fasten patients' recovery and quality of life after abdominal surgery. [ABSTRACT FROM AUTHOR]

Background: The end-of-life (EOL) decisions continue to be debated for their moral and legal standing. The acceptance of these decisions varies, based upon the perceptions and personal choices of the intensivists. Materials and methods: An online questionnaire-based survey was designed and circulated among the practicing intensivists via Indian Society of Critical Care Medicine (ISCCM) e-mail. Results: Out of 200 responses, 165 (82.5%) affirmed that EOL decisions are routinely undertaken in their intensive care units. The most prevalent reasons expressed for avoidance of EOL decisions are moral and ethical dilemmas and fear of litigation. There is notable variability in the practice of withholding (47.7%) vs withdrawal (3.5%) of therapies. A good proportion of intensivists follow do-not-intubate (91%) and do-not-resuscitate (86%) orders, whereas only 18% affirmed to be practicing terminal extubation. About 93% of the respondents acknowledged the use of monitoring toward the EOL, and 49% reported the use of preformatted documents. A meager 2% admitted to facing a medicolegal issue after taking an EOL decision. Conclusion: The survey establishes a general acceptance among the Indian intensivists regarding providing compassionate care to terminally ill patients, especially toward the EOL. The pattern of responses, however, indicates significant dilemmas and hesitancy with regard to the decision-making process. [ABSTRACT FROM AUTHOR]

Introduction: Clinical practice guidelines (CPG) exist for the management of non‐specific low back pain (LBP). The objective of this study is to evaluate if Indian physiotherapists' follow CPGs when treating patients with acute LBP. Methods: A cross‐sectional survey using an online questionnaire was used to collect demographic information, views, and opinion about acute LBP and CPGs, and management strategies of a clinical vignette presenting a patient with acute LBP. Results: Responses from 328 physiotherapists were included in this study. Eighty‐one percent of respondents indicated familiarity with CPGs for LBP and 75.3% (n = 328) respondents indicated that their intervention choices aligned with guidelines to at least some extent. Participants with post‐graduate and doctoral degrees were more accustomed to CPGs than those with bachelor's degrees (p < 0.01). There were significant differences in clinical practice (p < 0.01) between therapists who expressed familiarity with guidelines and those who were not, as well as those with and without post‐graduate and doctoral degrees. Conclusion: In general, the study showed adherence to guidelines; however, there were areas that did not align with established evidence, especially referral for radiology and use of electrical modalities. [ABSTRACT FROM AUTHOR]

Background: The widespread consumption of trans-fats across the world represents a worrying scenario, as it is directly responsible for coronary heart disease and related mortality. Recognizing its dangers, the WHO has set an agenda to eliminate trans-fats by 2023. In India, the Food Safety And Standards Authority ensures safe and wholesome food consumption. In light of the WHO's standards for the elimination of trans-fats, the FSSAI recently notified limits of trans-fatty acids to not more than 3% in all fats and oils by January 2021 and 2% by January 2022, as well as a limitation on all food products in which edible oils and fats are ingredients to not contain trans-fatty acids of more than 2% mass of total oils/fats in the product by January 2022. Objective: Given the need to eliminate the consumption of trans-fats, it is necessary to assess the implementation of trans-fat regulations in India in order to determine the current status of enforcement and suggest measures for improvement. Methods: Empirical research was conducted through a questionnaire to analyze India's current status and difficulties in enforcing trans-fat regulations. Results: Although all states have included compliance of trans-fat regulation in the agenda of the State Surveillance Plan but are facing some implementation challenges such as lack of lab infrastructure, lack of trained manpower, unsupportive FBOs, insufficient budget, lack of testing kits, and excluding proprietary food from compliance with trans-fat regulations. Further, all states have felt the need to develop a guideline/manual to facilitate enforcement of the trans-fat regulations. In light of this, the article has critically analyzed the legal framework for implementing trans-fat regulations in India to identify specific implementation challenges due to scattered regulations and recommend suggestive measures for developing the guidelines/ manual to facilitate effective implementation of the said regulation. [ABSTRACT FROM AUTHOR]

Background: Most patients infected with the COVID-19 virus may experience long-term effects from COVID-19 infection, known as post-COVID or long COVID conditions. Long COVID may last for weeks, months or years and may limit ones day to day activities and needs health care. Aim & Objective: To study the prevalence and risk factors of long COVID among the COVID-19 survivors of a rural area of Maharashtra. Methods and Material: A Community-based cross-sectional study was conducted in adult subjects residing in Chanai village from Maharashtra who have had a history of COVID-19 and have passed more than 3 months since the diagnosis from May 2022 to June 2022. The interview of the study participants was conducted with the help of a pre-designed, semi-structured questionnaire for data collection. Statistical Analysis: Data was analyzed using Microsoft Excel 2010, Open EPI-Info version 3.01 updated on 2013/04/06. Data was presented in tables, graphical format, frequencies and percentages and the statistical association was shown using the chi-square test. Results: The majority of participants were males (59%), from 19 to 39 years of age group (57%), having fever as presenting symptom (83%), with mild COVID (13%), and required hospitalization (53%). Long COVID was associated with the elderly age group, male sex (27.1%), severe COVID presentation (88.2%) after 12 weeks, and those required intubation (80%). Conclusion: The prevalence of long COVID was 17.5%. Determinants associated with long COVID were the elderly age group, male sex, severe COVID presentation and who required intubation. [ABSTRACT FROM AUTHOR]

Tuberculosis is known as one of the long-standing and dominating health problems affecting people and the extent further escalates in a developing country like India. A pre-evaluated feedback structured questionnaire was validated and adopted to get their quantitative data from 424 respondents. In the present study urban respondents (60.8%) gave affirmative responses regarding awareness of TB, especially with mobile media as their major source of information, followed by information from healthcare workers. Rural respondents were less expressed and deficient on knowledge of TB transmission and preventive methods. Prevention practices toward TB are claimed to be high in urban population because 79.48% believed that early diagnosis, prompt treatment and avoiding poor hygiene and crowded environment are effective strategies to cease the transmission of TB. Effective preventive and informative strategies should be employed in rural border areas to make up for the knowledge gap found among rural and urban populations in this study. [ABSTRACT FROM AUTHOR]

Background: Birth preparedness and complication readiness (BPCR) helps in improving the effective utilization of available maternal and newborn health care services through knowledge of danger sign, identifying birth place and attendant, means of transportation, managing fund for an emergency, birth companion and identification of blood donor. Aim: To find the association between socio-demographic characteristics and BPCR index indicators. Settings and Design: A cross-sectional study was conducted among the recently delivered and pregnant women in urban and rural areas of the Gandhinagar district of Gujarat. Methods and Material: Total 420 pregnant and recently delivered women from urban and rural areas were interviewed for study. A pretested semi-structured questionnaire was used to interview women at household setting. BPCR index is estimated by set of 7 quantifiable indicators and expressed in the percentage of women with specific characteristics. Results: Regarding ANC registration within 12th weeks of pregnancy and skilled birth attendant for delivery. Significant difference was observed with variable like APL/BPL status, education of women and their husband, parity and type of family. Conclusions: Hindu religion, APL economic status, higher education level, joint family, high parity and joint family were found important predictor of better BPCR practice. [ABSTRACT FROM AUTHOR]

Introduction: As reported by WHO, hypertension is the third 'killer' disease, accounting for one in every eight deaths worldwide. Many modifiable and non-modifiable risk factors are found to be associated with the disease. The present study aims to determine the role of dietary management and physical activity in the control of hypertension in a given population. Material and Methods: A cross-sectional study was conducted that. Study included all hypertensive patients (290) from the field practice area of a tertiary care institute. A self-constructed, pretested questionnaire was used to enquire about the socio-demographic factors and other risk factors associated with hypertension. The data was analyzed using SPSS 23 and valid conclusions were drawn by using the chi-square test. Results: Out of 290 patients, 204 (70.3%) were females and 86 (29.7%) were males. Univariate analysis identified decreased salt intake, decreased fatty food consumption, physical activity, stress management, and spiritual help as highly significant factors affecting hypertension. On multivariate analysis, physical activity, stress management and spiritual help were found to be significant. Conclusion: The study showed that physical activity, stress management and spiritual help were significantly associated with hypertension control among the elderly. Measures should be taken to create awareness about lifestyle modifications in the control of hypertension. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 patients have been reported to have systemic complications. Analyzing its effect on the endocrine system is essential to ensure women's reproductive health. Aim: This study aimed to determine the effect of COVID-19 disease on menstruation. Methods: It was a hospital-based cross-sectional study conducted from October 2021 to April 2022, using a validated questionnaire to collect the data. The study included females (15 to 49 years) who had confirmed COVID infection. Results: A total of 132 females participated in the study. For 29 (22%) patients presenting with menstrual cycle changes, most common change was prolonged cycle (14%). An increase in menstrual volume was reported by 12%, where as 35% of patients experienced more pain during menstruation. Menstrual irregularities were significantly higher in severe infection (p-value 0.04). Conclusion: There were transient changes in menstruation in COVID-19-infected patients, with a higher probability of menstruation abnormalities among severely infected patients. [ABSTRACT FROM AUTHOR]

Introduction: Pre-hypertension is a borderline health state of increased blood pressure (BP) that falls short of the measurable parameters at which surveillance and/or therapy would be required. The approach of identifying people "At Risk" of developing hypertension can be more cost-effective and feasible for applying lifestyle interventions. Objectives: The objective of the present study is to find the prevalence of pre-hypertensives and associated bio-socio-demographic factors Materials and Methods: A cross-sectional study was conducted among 1946 participants aged 19 years and more in the Doiwala block of Dehradun, Uttarakhand. Multistage sampling was used to arrive at desired sample size. A pre-validated, structured questionnaire was used for data collection. The questionnaire included information on the socio-demographic profile (age, sex, education etc.), awareness about hypertension and its associated risk factors. Statistical Analysis: The chi-square test was used to compare proportions and draw inferences. Results: 958 (49.2%) study participants out of a total 1946 were found to be pre-hypertensives. A statistically significant association was found between pre-hypertension and factors such as male gender, age, education, occupation and waist-hip ratio. (p<0.05) Conclusion: It is recommended that identification on the pre-hypertensive group and subjecting them to lifestyle modification could be a fruitful strategy for preventing them from becoming hypertensive. [ABSTRACT FROM AUTHOR]

Background: Due to rapid urbanization, there is an increase in population in slums often lacking access to basic health services. Objective: The purpose of this study was to assess the utilization of reproductive and child health services by recently delivered women and their children residing in catchment areas of urban PHCs, to evaluate their level of satisfaction and to determine the factors associated with utilization of these services by recently delivered women. Settings and Design: The study was conducted in the catchment areas of urban primary health centre of Lucknow. Methods and Material: A cross-sectional study was conducted among 320 women having children less than 24 months in the slums covered under selected U-PHCs, sampled through a multi-stage random sampling technique using a semi-structured questionnaire. Statistical analysis used: SPSS-26 and MedCalc software were used for data analysis. Results: Utilization of RCH services by recently delivered women from UPHC was 39%. About 24% of recently delivered women availed ANC services from UPHC and 56.7% utilized family planning services and 95.8% immunization services for children. Child care services for diarrhea and ARI were availed by 9.9 and 3.1% of women, respectively. Satisfaction regarding maternal care and immunization services was seen in 84 and 95.8% of women. Poor satisfaction regarding child care was seen in 56.5% of women. Conclusions: The utilization of RCH services was found to be poor in the study population. Most recently delivered women were satisfied with all services except child care. [ABSTRACT FROM AUTHOR]

Aims: The primary objective of the present study was to evaluate the economic burden of limited English proficiency (LEP) by estimating its direct, indirect, and intangible costs. A secondary objective was to assess the impact of variables on the economic burden. Design and Setting: A cross-sectional single-arm descriptive study conducted in a learning disability clinic in a public medical college in Mumbai. Subjects and Methods: The study cases (aged ≥8 years and ≤18 years) were recruited by non-probability sampling. A structured questionnaire was used to interview the parent to collect data related to direct and indirect costs. Intangible cost data were collected by documenting the willingness-to-pay value using the contingent valuation technique. Statistical Analysis Used: A multivariate regression model was used to assess the impact of predictor variables on the costs. Results: The direct, indirect, and intangible costs due to LEP were Indian Rupees (INR) 826,736, 3,828,220, and 1,906,300, respectively. Indirect costs comprised 82.2% of the total costs. Expenditure on tuition and remedial education comprised 39.86% and 14.08% of the indirect and direct costs, respectively. The average annual learning disability clinic costs were INR 2,169,146. The average annual total costs per student were INR 42,102. Higher socioeconomic status was predictive of increased "indirect costs", "total costs", and "intangible costs." Conclusion: LEP is a cost-intensive condition (indirect > intangible > direct costs). Non-medical costs are the costliest component of direct costs. Parental loss of earnings is the costliest component of indirect costs. [ABSTRACT FROM AUTHOR]

Background: The incidence of maternal morbidity and mortality gets reduced if antenatal care (ANC) is provided since it focuses on providing birth preparedness, good health maintenance measures, and awareness regarding pregnancy complications as well as danger signs. Methodology: The present study was conducted in the selected 10 villages in the Bahadarbad block of Haridwar, Uttarakhandw. 479 out of 580 pregnant women (who had visited Antenatal Health Camps), responded to the questionnaire thus, leading to a response rate of 82.8%. Most respondents, i.e. 96% (n=461), were 21-30 years old. Result: Out of 461 pregnant women, only 45% visited antenatal health camps and 58% were found anemic. The study also indicated that of the pregnant women who visited antenatal health camps during this period, more than 72% of women gave their previous birth in less than two years. Only 15% of women obtained complete ANC (4 visits) during the study period, just half of the previous year's coverage (31%) for the same duration. The study found that home deliveries increased significantly during the lockdown period. From April to June 2020, the percentage of home deliveries was 41% while from July to December 2020 it was 24%. Conclusion: The study suggested reduced utilization of ANC services during the pandemic and significant factors were women's age, residence, educational status, repurposing of maternity healthcare services, fear of COVID-19 transmission, and transportation disruptions. Thus, efforts should be taken to enhance maternal health services. [ABSTRACT FROM AUTHOR]

Background: Anti-retroviral therapy (ART) for HIV has changed a highly fatal disease to a chronic manageable condition. National technical guidelines by NACO say that adherence of >95%(optimal) is required for optimal viral load suppression which is a challenge both for the patient and the health system. Objectives: This study was conducted to determine the reasons for missed and lost to follow-up (LFU) cases and to assess the impact of the COVID pandemic on ART adherence. Settings and Design: Cross-sectional study conducted at ART center, Jhansi. Methods and Material: 357 patients were administered a self-designed questionnaire after taking informed consent to enquire about the reasons for missing doses and LFU and whether they missed treatment during the lockdown. Statistical analysis used: The results were expressed in frequencies and percentages and appropriate statistical tests were applied. Results: 72% HIV patients had optimal adherence and 6.7% were on second-line treatment. Out of 357 patients, 56 had missed treatment and 10 were LFU. The main reasons for the missing were run out of pills, busy with other things and being away from home. The number of episodes of missed and LFU increased during the pandemic. The main problems faced were lack of transport (24), fear of catching the disease (7), no money to hire a vehicle (5). Conclusions: Constant monitoring and handholding of those with suboptimal adherence is required. Travel allowance to such patients and regular counseling will help to ensure adherence. Long-term solutions include vocational rehabilitation and awareness programs to reduce stigma and discrimination. [ABSTRACT FROM AUTHOR]

Background: Lockdown measures are being implemented in several parts of the world to control the spread of novel coronavirus. This unprecedented crisis has significantly affected the lives of people in different ways. Aim: To understand the experiences and vulnerability to mental health problems during lockdown among the Indian population during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted using an online survey form circulated through various social media platforms from April 12 to May 3, 2020 containing self-reported questionnaires to collect lockdown related experiences and scales to assess anxiety (GAD-7) and depression (PHQ-9). A convenience sampling method was used. Results: 442 valid responses were received from different states of India. Statistical analysis revealed that one-third of the respondents suffered from some form of anxiety and depression during a lockdown. Less than 10% of them had severe levels of symptoms. The majority were males aged 18 to 45 years and private sector employees. Delivering essential services was involved with significant anxiety and depression. Availability of food and daily essentials was the most common problem. Difficulty in availing medicines and financial crisis were significant predictors of anxiety and depression. Worsening of interpersonal relationships was associated with higher levels of anxiety and depression. Conclusions: The study concluded that experiences during the lockdown and associated psychological outcomes are important factors to consider and appropriate preventive measures to be taken in case of any future lockdowns. [ABSTRACT FROM AUTHOR]

Introduction: Menstrual-related problems are one of the most common problems among adolescent girls and might adversely affect their performance in academic and other activities of daily life. Aims & Objectives: To determine the prevalence of school absenteeism among adolescent school girls during menstruation. To assess the restrictions which are imposed on adolescent school girls during menstruation. To evaluate the various factors associated with school absenteeism during menstruation. Methods: A study was conducted by carrying out a questionnaire and focus group discussion between October 2019-January 2020 in seven schools of Bangalore city after obtaining the assent and informed consent signed by their parents. Result: The mean age of the girls was 14.45 ± 1.71. The proportion of school absenteeism during menstruation was (30.25%). The majority (89.25%) of the students among the school absentees missed one day of school during menstruation. Among the school absentees, pain/discomfort was one of the main reasons for missing school, accounting for (69.42%). (46.25%) of the students were restricted from any kind of religious activities. Pain during menstruation, shame, fear of leakage, lack of toilet or water supply, lack of a place to dispose of sanitary pads and absence of a private place to manage periods were some factors that were associated with school absenteeism during menstruation. Conclusion: Considerably high school absenteeism among adolescent girls due to menstruation was noted in this study, highlighting the need for improved interventions that reach girls at a young age. [ABSTRACT FROM AUTHOR]

Background: College students appear more vulnerable in developing a dependence on the internet. Individuals with hikikomori are frequently reported to have social contact predominantly via the internet. Objectives: To find the prevalence of internet addiction, gaming addiction, hikikomori trait and insomnia amongst medical undergraduates and to study their association with various determinants. Methodology: The present cross-sectional study was conducted among first to final-year medical students studying at various medical colleges in Indian city from February to May 2021. Data collection was done after obtaining the ethical permission of the Institute. A total of 400 students who gave consent were sent an electronic questionnaire. Results: The mean age of study participants was 20 ± 1.58 years. Internet addiction was present in 189(47.2%) participants, gaming addiction in 128 (32%) students and hikikomori trait was found in 98(24.5%) students. There was a statistically significant association between different grades of insomnia and internet, gaming addiction, and hikikomori trait (< 0.0001) in the present study. Conclusion: Internet addiction was present in almost half of the medical students while gaming addiction was seen in nearly one third of the students. Male gender and hostel stay had a statistically significant association with internet addiction, gaming addiction, insomnia and hikikomori trait. [ABSTRACT FROM AUTHOR]

Background: Contemporary society has led to the increasing use of electronic equipment that is very much responsible for the burden of electronic waste (e-waste). E-waste contains very hazardous substance that harms health and environmental conditions. There is no delicate mechanism for the management of e-waste in Lucknow city, Uttar Pradesh. This study assessed knowledge, practice, and awareness of e-waste management among residents of this city. Material and methods: The study was conducted amongst users of electronic equipment living in the Lucknow City of Uttar Pradesh. The study was a cross-sectional descriptive study. Multi-stage random sampling was done for the selection of participants for the study. A predesigned and pretested questionnaire was administered in a single setting for all phases. The total optimum sample size is 700 individuals who participated in the study. Data were entered in MS Excel 2016 and descriptive statistics such as frequencies and percentages were calculated, applying the chi-square test for association using R-4.2.1 Statistical software. Aim and objectives: To assess the knowledge, attitude and practices regarding the management of electronic waste among users of electronic equipment residing in Lucknow city. Results: Only 37% of users are aware that e-waste adversely affects health. Only 34.3% of users knew that e-waste should be given to the seller or manufacturer for recycling while rest told that it should be stored at home, sold to a scrap dealer, or disposed with normal waste. 87.3% users are not aware about e-waste govt guidelines. In the current study electronic and print media like television, radio and news paper were not found to be source of information for e-waste disposal. Conclusion: Education regarding the ill effects of e-waste is essential for people and awareness of proper disposal of e-waste is the need of the hour. Electronic and print media as well as companies producing electronic equipment should play a significant role to awaken the respondent about the disposal of e-waste. [ABSTRACT FROM AUTHOR]

Background: Chronic viral hepatitis is a major global public health problem, an important cause of morbidity and mortality. We conducted this study to evaluate the behavioral risk factors of HBV infection and its association with HBsAg positivity among residents of Kaza sub-division of district Lahaul & Spiti in Himachal Pradesh. Material & Methods: The study was carried out by the Gastroenterology, Community Medicine, and Microbiology Department at Indira Gandhi Medical College Shimla at Kaza, a subdivision of Lahaul & Spiti. The cluster sampling technique was used to get the desired sample size of 4000. Forty clusters were chosen using a probability proportionate to size sampling method, and 100 research participants were added to each cluster using a simple random sampling method. The data was gathered using a pretested interview plan. A blood sample of 5 mL from each study participant was obtained, and its HBsAg content was examined. Results: In our study, 2.7% of the interviewed respondents' parents were positive for hepatitis B and 3.7% reported one positive family member. Injectable drug use was reported by 1.6 (68/4231). Among these users 8.8% (6/68) shared needles with other IDUs in last 12 months and 35.3% (24/68) used a common container to draw up drug solution. Sexual intercourse was reported to be experienced by 15.5 (655/4231) and 12.2% either did not disclose or were children. Out of those who ever experienced sexual/penetrative intercourse 38.3% (251/655) had reported it with someone else other than a spouse. Majority of these had two partners other than a spouse (30.3%; 76/251). Around 30% (195/655) reported of using a condom in their last intercourse. Body piercings or a tattoo from someone who doesn't sterilize his or her equipment, including local treatment from lamas, was prevalent among 16.3% of the population (689/4231). Acupuncture was taken as a remedy for any medical condition by 9% of participants. Regression analysis also revealed that one infected family member emerged as an independent factor associated with HBsAg positive test after adjusting for confounders. Conclusion: Our study provided much important information concerning hepatitis B risk factors in this tribal group. Health education about behavioral risk factors among this tribal population should be the main intervention that might help limit the spread of these blood-borne infections. [ABSTRACT FROM AUTHOR]

Background: Rabies is one of zoonotic viral disease, estimated to cause 59000 human deaths annually in over 150 countries, of which 20,000 are from India alone; about 40% of which are in children under the age of 15. Rabies though 100% fatal is preventable with post-exposure prophylaxis which includes wound washing, anti-rabies vaccination and rabies immunoglobulin. Objective: To describe the clinico-social profile of animal bite patients attending the anti-rabies clinic of BRD Medical College, Gorakhpur. Methodology: A cross-sectional study was conducted in the anti-rabies clinic of Nehru hospital, BRD Medical College, Gorakhpur from January 2022 to May 2022. Study participants were interviewed by using a pre-phrased, pre-designed and pre-tested questionnaire. Data regarding socio-demographic and clinical profile of the study participants following animal bite exposure was collected. Results: The total number of animal bite victims were 250, in which majority of them were males (76.77%) and highest percentage was of adult population (20-59 years). Maximum number of victims were from rural area (78.70%). 19.35% were working and 39.35% were students. 77.43% were category III bites and in 50.96% cases lower limb was the site of bite and dogs were responsible for 89.67% of the bites. 60.64% victims did not wash the wound properly before reaching the anti-rabies clinic. Conclusion: This study concludes that as majority of the animal bite victims were students and majority of victims were unaware about the importance of wound care, therefore a step can be taken to create awareness in various schools. [ABSTRACT FROM AUTHOR]

Background and Objectives: Students with borderline intellectual functioning ("slow learners") underperform in all school subjects. The primary objective of this study was to evaluate the parental-perceived health-related quality of life (HRQoL) of these students. Its secondary objective was to analyze the impact of sociodemographic variables on their HRQoL. Settings and Design: Cross-sectional single-arm questionnaire-based study was conducted in the learning disability clinic in a public medical college in Mumbai. Subjects and Methods: One hundred parents of slow learners aged 8 to 16 years were recruited by non-probability sampling. Their HRQoL scores were measured using the English DISABKIDS chronic generic module parent (proxy) long-version ("DCGM-37-P") instrument. Statistical Analysis: Multiple regression analysis was carried out for determining the "independent" impact that sociodemographic variables had on a poor facet and total score outcomes. Results: Clinically significant deficits were detected in 4 facets, namely: small deficit in "social inclusion"; medium deficits in "independence", "emotion", and "social exclusion"; and large deficit in "total score". Multivariate analysis revealed that: (i) being an only child predicted a poor "emotion" and "social exclusion" facet score outcomes (P = 0.039 and P = 0.024, respectively); (ii) being a female predicted a poor "social inclusion" facet score outcome (P = 0.022); and, (iii) studying in a single-gender school predicted a poor "limitation" facet score outcome (P = 0.020). Conclusions: Parents of slow learners perceive their psychosocial and total HRQoL to be significantly compromised. There is a need to evaluate the HRQoL of slow learners so that optimum rehabilitation can be facilitated. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of the Basic Neonatal Resuscitation Program (NRP) course and to evaluate the perceived utility of the skills acquired during the course., Methods: This cross-sectional survey aimed to assess the perceptions of participants who attended the Basic NRP course, comprising online video modules and offline workshops, across India. Data were collected between October 2023 and November 2023 for the courses held from May 2022 to April 2023, using a semi-structured questionnaire distributed electronically or via telecommunication., Results: Out of 10,000 participants approached, 6,066 responded which included nurses (60.4%), pediatricians (20%), and medical officers (19.7%). Majority were females (76.4%), in private healthcare (62.1%), with the highest participation from West Bengal (14.72%) among the different states. Satisfaction with online videos was reported as very high by 48.5% and reasonable by 51.5% and one participant reported dissatisfaction. Compared to private healthcare settings, exposure to labor room experience was lesser in government facilities (48.8% vs. 42.5%, P < 0.001). The overall functional equipment was greater in government set-ups compared to private facilities (49.8% vs. 45.2%, P = 0.001)., Conclusion: Participants reported improved neonatal resuscitation skills as well as opportunities and facilities to practice after Basic NRP course.

Background: Understanding the factors that influence medication adherence and the multidimensional aspects of quality of life in the elderly is of paramount importance in enhancing their overall well-being. Since geriatric patients usually suffer from multiple morbidities due to their declining age, the adherence towards their medications plays a very crucial role in their quality of life., Methodology: This cross-sectional study explores the intricate relationship between medication adherence and quality of life among 310 elderly patients at a single medical college and hospital. Participants completed the Morisky Medication Adherence Scale (MMAS-8) to assess medication adherence and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, which comprises four domains (physical health, psychological health, social relationships, and environment) to evaluate quality of life. Statistical analyses, including correlations, paired t-tests, ANOVA, and Backward Multiple Linear Regression, were employed to examine the relationships and differences among variables., Results: The findings indicate varying levels of medication adherence among participants, with a significant proportion exhibiting medium adherence (47.1%) and highlighting the need for interventions to address challenges in medication adherence among the elderly population. Notably, gender emerged as a significant factor influencing quality of life, with males reporting higher satisfaction across all domains compared to females. Medication adherence exhibited a significant correlation with the social relationships domain (DOM3) of the WHOQOL-BREF, underlining the importance of adherence in fostering positive social interactions., Conclusion: Our study revealed a significant association between medication adherence (MMAS- 8) and the quality of life (WHOQOL-BREF) among elderly patients. We also observed noteworthy gender differences in quality-of-life perceptions. It emphasizes the need for tailored interventions that consider medication adherence issues to enhance the overall quality of life among this vulnerable population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Khaiser et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Selfies have been defined as "a photograph that one has taken of oneself, and are a continuing growing trend among Millennials and Gen Z". Narcissism refers to a personality trait of an extraordinary self-awareness and adoration. Studies have shown a close relationship between selfie-taking behavior, narcissism and oral health. Hence, a study was conducted with aim of assessing correlations between perceived health, perceived oral health, selfie-taking behavior, narcissism and oral health behavior in an adolescent population., Methods: An analytical cross-sectional questionnaire study was designed using relevant literature for collating information on sociodemographic characteristics, frequency of dental visits, selfie-taking behavior and perceived oral health. Oral health examination was performed to assess decay and plaque using DMFT index and Plaque index. Narcissism was assessed using The Five-Factor Narcissism Inventory Short Form., Results: The study included a sample of 163 participants. The associations between selfies taken per day and perceived oral health was statistically significant (p value 0.047*). Binary logistic regression models were constructed, which were significant for perceived oral health and grandiose fantasy. Plaque Scores showed significant corelations between indifference, manipulativeness, thrill seeking and age. Step forward binary regression demonstrated a significant odds ratio for grandiose narcissism followed by selfie-taking behavior., Conclusion: This study revealed a correlation between perceived oral health and selfie-taking behaviour. Further studies are required to assess selfie-taking behaviour and oral health., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Prabhu P et al.)

Background: A specific phobia is an anxiety disorder that is characterised by persistent and excessive fear in the presence of the object of the phobia. Animal phobias are the most prevalent forms of specific phobia among humans. Fear of snakes (snake phobia) is present in non-human primates which suggests its evolutionary origins as the ability to detect the threat of snakes was critical for survival. Snake phobia is a critical factor in protecting snakes and mitigating snakebite burden. To date, only one standardised psychometric test [the Snake Questionnaire (SNAQ) developed in 1974] has been used to quantify snake phobia although this was not performed in snakebite-endemic countries. In this study, we aimed to determine snake phobia in India, where snakebites and resulting deaths, disabilities and socioeconomic impacts are high., Methodology/principal Findings: A modified version of the SNAQ (i.e. SNAQ12), which has previously demonstrated internal consistency, excellent reliability, and good discrimination between phobics and non-phobics in Europe was used in this study. SNAQ12 was developed both in English and Tamil and validated by testing on several individuals. Then, the final questionnaire was disseminated to members of the public through various methods including social media and in person through academic and clinical organisations. We received a total of 2032 responses, comprising 1086 [53.4%] males and 946 [46.6%] females, and these data were analysed to determine various aspects of snake phobia in the study population., Conclusions/significance: The results demonstrated good internal consistency in using SNAQ12 to determine the phobia amongst the tested population. The data suggests that males are more snake-phobic in all age groups than females in India, in contrast to previous research that suggested that females are usually more snake-phobic. No other critical factors contribute to snake phobia in this study population. The use of the SNAQ12 allowed us to easily discriminate between individuals with phobia and non-clinical controls. This tool can be used as part of the One Health approach to better understand the relationships between snake phobia and snakebites and their impact on the mental health and well-being of vulnerable populations., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Salim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Problem: Despite the recent introduction of midwifery services in India to improve maternal and newborn healthcare, there is limited research on women's perspectives on midwife-led care., Background: The Government of India initiated midwifery services guidelines in 2018 to improve the quality of care for pregnant women and newborns across the country. It is important to develop evidence-based strategies which can optimise the implementation of these new midwifery services., Aim: This study explored women's attitudes and beliefs towards the implementation of midwife-led care in two southern states of India., Methods: A convergent mixed methods design was employed using an online questionnaire and semi-structured online interviews. Quantitative data was analysed using descriptive statistics and qualitative analysis used a framework approach. Data from both sources were then integrated through merging techniques., Findings: A total of 307 women completed the online survey, and 23 participated in in-depth interviews. The study highlighted inadequate knowledge of midwife-led care among women. Despite this, 60 % expressed optimism about its benefits. Key factors to women's acceptance included better understanding outcomes, having trust in midwives, receiving respectful care, and having autonomy in decision-making. They also required midwife-led birthing units would be clean, accessible, and well resourced., Discussion: Most participants perceived midwife-led care as beneficial, valuing its skilled, responsive and compassionate services., Conclusion: Insights from this study have implications for the implementation of midwife-led care which should consider the informational needs, safety standards and cultural contexts of women and their families living in both urban and rural areas of India., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: This study was conducted to assess patients' outcome and satisfaction with the eye care received with telemedicine and physical consultation at a tertiary care hospital during and after the coronavirus disease 2019 (COVID-19) pandemic., Methods: A descriptive study was carried out on 6052 patients who consulted for eye illness at a tertiary care hospital between April 2020 and December 2022. An outcome scoring system was developed and validated for the assessment of patient outcome after providing treatment on telemedicine consultation and physical consultation. Outcome scores for various symptoms were compared pretreatment and posttreatment. Telehealth Usability Questionnaire (TUQ) was used through an online survey to assess patients' satisfaction with teleophthalmology services during the COVID-19 pandemic. An 18-item Patient Satisfaction Questionnaire (PSQ-18) was used to assess the same with physical consultation., Results: A total of 6052 patients were included in the study. Physical consultation group had 2485 patients (41.06%) and the telemedicine group had 3567 patients (58.93%). Male patients constituted 63.11% and females were 36.89%. There was a significant improvement in outcome scores for pain and redness in both physical and telemedicine consultation groups (P < 0.0001). All subgroups of TUQ had significantly high scores (including usefulness, ease of use and learnability, interface quality, interaction quality, and satisfaction and future use), except one subgroup (reliability). Uneducated patients were significantly more satisfied with telemedicine compared to educated patients (P = 0.044)., Conclusion: Majority of patients expressed satisfaction with teleophthalmology services. The recent pandemic paved the way for the future integration of telemedicine in ophthalmology, especially if virtual eye examinations attain a higher level of reliability., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

The usage of face mask has been encouraged globally to combat the COVID-19 pandemic. However, their improper disposal has begun to impact the environment. In the present study, face mask littering was assessed in sixteen stations across the beaches in Coromandel coast of South India for a period of four weeks. Moreover, an online questionnaire was recorded to evaluate the people's perception about face mask usage and littering. In terms of land use pattern, stations with both fishing and tourism activities had higher abundance of face mask littering when compared with exclusive fishing and tourism stations. The study also found that mask littering was higher in streets when compared to the beaches. Of 163 respondents, most of the respondents preferred using disposable single use masks and 39.9% of the respondents preferred to dispose of the face masks along with other wastes. The study highlights the lack of proper solid waste management, negligent littering, and the need for raising awareness, strategic intervention to control this menace., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Internationally, traditional medicine approaches are used to support humanised childbirth practices. Labour support issues in low- and middle-income countries (LMICs), include limited resources, staffing, and escalating pharmaceutical interventions. There is a strong interest in evidence-based acupressure programs, however, training and experience to implement them is limited. Maternity professionals at the Fernandez Foundation (FF) including associated hospitals in the Hyderabad region, India, sought training in acupressure to support humanised childbirth., Aims: To evaluate the implementation of the 'Acupressure for childbirth training program' at FF hospitals, up to 6-months post-training, including barriers and facilitators, as well as determining pregnancy and labour conditions for which the techniques are most useful., Methods: Pre- and post-training, and 6-month surveys, were distributed to participants., Results: Participants included a diverse group of 88 midwives, doulas, physiotherapists, educators and obstetricians. There were significant improvements in participant skills and knowledge, which persisted up to 6-months post-training (p<0.01). Participants indicated they were 'highly satisfied' with the training, and found it valuable, easy to implement, and reported extremely positive responses from women and support people. Facilitators to implementation included 'strategies and ideas', 'effectiveness of pain relief', and 'aiding labour progress'. Barriers included 'other staff and institutional challenges', 'needing more training', 'women's attitudes'., Conclusion: Acupressure training as part of a humanised approach to childbirth, demonstrates significant skill and knowledge gain, usefulness of training and skills, ease of implementation, and a highly positive reception within the clinical environment. Implementation of these practices should be widespread and supported by policy makers and clinicians., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The available limited literature and Centers for Disease Control data suggest that human papillomavirus (HPV) vaccination acceptance is lower among Asian Indians than the general population in the United States., Purpose: The purpose of the study was to determine the effects of health beliefs, subjective norms, acculturation, and demographics on HPV vaccination acceptance among Asian Indian parents., Methodology: Using a comparative descriptive cross-sectional study design, immigrant and first-generation Asian Indian parents of 9- to 16-year-old children were recruited ( N = 171). The survey comprised the Health Belief and Subjective Norms instrument and the Suinn-Lew Asian Self-Identity Acculturation Scale. The analysis included parametric and nonparametric tests., Results: Participants who expressed higher levels of perceived barriers were less likely to accept HPV vaccination (odds ratio [OR] = 0.47, p = .016). Spousal opinion negatively correlated with HPV vaccination acceptance (OR = 0.57, p = .006). However, subjective norms positively predicted HPV vaccination acceptance (OR = 1.69, p = .039). Participants who perceived that friends and family approved of the vaccination also had significantly higher rates of vaccination acceptance (OR = 11.99, p = .001)., Conclusions: The results revealed unique factors in the acceptance of HPV vaccination in Asian Indians that were not examined or understood before. The applied Health Beliefs and Subjective Norms theoretical framework suggested that perceived barriers, subjective norms, and the opinions of spouses, friends, and family predicted HPV vaccination acceptance., Implications: Educational interventions targeting providers, spouses, family, and community members with influential effects on parents may positively affect HPV vaccination acceptance. Providers should note that this population welcomes the provider's recommendations., Competing Interests: Competing interests: The authors report no conflicts of interest., (Copyright © 2024 American Association of Nurse Practitioners.)

Introduction: Systemic Lupus Erythematosus (SLE) warrants an early diagnosis and prompt management. Delay in diagnosis can result in repeated flares, permanent damage, and even death. There is a large variability in the time taken to diagnose SLE across the world. We undertook this study to determine the time taken for diagnosis of SLE in India and to identify the factors associated., Methods: Patients with SLE diagnosed within the previous 1 year as per Systemic Lupus Erythematosus International Collaborating Clinics criteria (SLICC) 2012 criteria were included in a cross-sectional multicentre questionnaire-based survey. Demographic profile, self-reported socioeconomic status as per Kuppuswamy classification of socioeconomic status (version 2022) (SES), and several healthcare related parameters including referral pattern were recorded. Median time taken for diagnosis was used to demarcate early or late diagnosis and associated factors were explored., Results: We included 488 patients with SLE from 10 rheumatology centres. The median time to diagnosis was 6 months Interquartile Range (IQR 3,14.7) and within 3 months in about one third [150(30.7%)]. Very early diagnosis ( < 1 month) was established in 78(16.0%) patients. The mean SLE Disease Activity Index (SLEDAI) at diagnosis was 10.28 + 7.24. In univariate analysis, an older age, lower SES, non-southern state of residence and larger family size were significantly associated with late diagnosis. In the multivariate analysis, higher SES (AOR 0.95, 95% CI: 0.92-0.98), multiple organ system involvement at initial presentation (AOR1.75 95%CI: 1.08-2.84) and place of residence in south Indian states (AOR1.92 95%CI: 1.24-2.97) had lesser odds of being associated with late diagnosis. Distance from the closest medical centre/professional did not influence the time to diagnosis. Majority of patients had first consulted a medical graduate (42.5%) or postgraduate doctor (48.2%), and referral to rheumatologist was largely done by postgraduate (65%) doctors. More than half of our patients (61%) self-finance their treatment., Conclusion: Median time to diagnosis of SLE was 6 months, 1/3rd being diagnosed within 3 months and 78(16.0%) with 1 month of symptom onset. Delay in diagnosis was noted in those belonging to lower socioeconomic strata and those with single organ disease. Distance to the health care facility did not influence time to diagnosis., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Access to assistive products (APs) is essential to maximising function, participation, and inclusion of persons with disabilities. Challenges to AP access in low- and middle-income countries include stigma, costs, supply, and rehabilitation capacity gaps. This study aimed to examine AT access in the context of a low-resource setting in rural South India. Objectives were to examine rehabilitation professionals' perceptions of AP needs, barriers and facilitators of AP provision, and AT knowledge., Methods: A descriptive study design with a 2-part online survey methodology was utilized. This study was conducted in April-September 2020 at a non-governmental organization (NGO) serving children and adults with disabilities in 3 districts of rural South India. Purposive sampling of NGO's multidisciplinary rehabilitation professionals (N=62) was used. The survey was developed based on WHO's Assistive Products List (APL). Barriers and facilitators were classified according to the principles of AT access. Analyses revealed acceptability, affordability, and availability as the top three barrier themes across disciplines, including poor acceptance by clients/families due to stigma, high AP costs, and a long waitlist for government-provided devices. Acceptability, affordability, and accessibility were the top three facilitator themes, including community awareness, availability of AP funding, client/family education, and AT service provision training., Impact: Our study identified key enabling strategies for AT access, aimed at reducing reported barriers. Enabling AP provision was determined to be multi-factorial, aimed at users/ families, service providers, organizations, communities, and policymakers. Local stakeholder groups are crucial to understanding challenges and opportunities to AP provision within a low-resource context.

Background: To explore the association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children., Methods: This hospital-based cross-sectional study included 453 children, aged 6-12 years. Two myopia participants were selected for each individual with the corresponding premyopia or emmetropia. All children underwent cycloplegic autorefraction and ocular biometric tests. The Children's Sleep Habits Questionnaire (CSHQ) and parental information on behavioral habits were used to assess the association of sleep parameters with myopia and premyopia using logistic regression models., Results: Both myopia and premyopia exhibited significant late bedtime, short sleep duration, early wakeup time on only weekdays, and longer weekend catch-up sleep than emmetropia children (p < 0.05). In multivariate analysis, late bedtime (more than 24:00 a.m.) on weekdays (Odds ratio, OR = 3.63, 95% CI [0.74, 8.68]) as well as on free days (OR = 1.04, 95% CI [0.02, 8.08]); and early wake-up time only on weekdays (5:00-6:00 a.m., OR = 2.16, 95% CI [0.24, 6.76] and 06:00-07:00 a.m., OR = 2.42, 95% CI [0.51, 8.44]) were associated with increased risk of myopia (all p < 0.05) but not premyopia. After adjusting the confounding factors, when each of the eight CSHQ subscale components was analyzed, only bedtime resistance, night waking, and daytime sleepiness scores were significantly associated with a higher risk for premyopia and myopia (p < 0.05)., Conclusions: The sleep quality components, including bedtime resistance, night waking, and daytime sleepiness, equally involve a higher risk for myopia as well as premyopia., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aims to analyze the prevalence and patterns of sensory processing deficits (SPD) in Indian children with spastic cerebral palsy (CP) using child sensory profile-2 (CSP-2) caregiver questionnaire. The authors surveyed 230 caregivers of children aged 3 to 14 y with spastic CP, using CSP-2. The difference in prevalence and distribution of SPDs among the CP subtypes and Gross Motor Function Classification System (GMFCS) levels was done. Overall prevalence of "Definite" (>2 SD) SPDs was 83%. Forty-seven percent had definite SPDs in more than one sensory subsection. Prevalence of definite SPDs was similar among the spastic CP subtypes. "Conduct" domain had more affection among hemiplegics and quadriplegics. "Avoiding" pattern was observed more in quadriplegics and "Seeking" pattern was observed less in diplegics. Severe GMFCS levels had more definite sensory processing deficits. SPDs are highly prevalent in children with spastic CP with unique patterns of affection among the spastic CP subtypes., (© 2024. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation.)

Purpose: Assistive technology for elderly are advancing, and this study aimed to analyse the Indian perspective on utilising assistive robot technology for aiding elderly individuals., Materials and Methods: A population-based survey was undertaken to collect data from three perspectives: Relatives of the elderly, Healthcare professionals and Elderly individuals. The survey gathered 389 responses. The responses are statistically analysed, and data is visualised with different plots for better understanding., Results: It is observed that the older people rate with less conviction on the use of technology when compared to the relatives and healthcare professionals. Out of the three target groups, the elderly individuals had the most correlating attributes to purchasing the robot. Also, healthcare personnel, relatives, and older people gave 82%, 63% and 55% affirmatives to the question on purchasing the robot, respectively. And the cost of the robot is preferred to be under 6 lakh rupees., Conclusions: Though the younger generation has more orientation towards technology, older people are skeptical about handling computer gadgets or robots. However, there are significant expectations and concerns expressed by three target groups such as conversational, navigational, reminder features, security and malfunction concerns.

Background: The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective., Methods: As a part of this cross-sectional, observational study, digital survey links were administered to 1,042 children and youth aged 5 to 17 (50.3% boys; 49.7% girls). Participants were recruited from 41 schools across 28 rural and urban regions in India. Children and youth provided information on various sociodemographic factors, perceptions of crime and air pollution, and peer support factors. MVPA data were collected using an adapted version of the IPAQ short-form questionnaire. The overall sample was stratified by age, gender, and location, resulting in a total of seven multiple linear regression models to assess the association between AST and MVPA., Results: Children and youth who engaged in AST were associated with higher MVPA than those who did not engage in AST ( β  = 18.020, 95% CI [5.890 to 30.149], p  = 0.004), after adjusting for age, gender, and location. In contrast, perceptions of high crime in the neighbourhood ( β  =  - 21.921, CI [-36.195 to -7.647], p  = 0.003) and perceptions of air pollution ( β  =  - 12.472, CI [-23.797 to -1.147], p  = 0.031) were associated with lower MVPA. Moreover, having active friends was associated with higher MVPA ( β  = 32.391, CI [9.264 to 55.518], p  = 0.006) than not having active friends. AST was significantly associated with higher MVPA in the boys, rural, and aged 13 to 17 models; however, this association was not statistically significant in the girls, urban, and aged 5 to 12 models., Conclusions: These findings highlight that promoting AST can potentially promote MVPA and contribute to mitigating the NCD burden among children and youth in India. Future policies and interventions should prioritize initiatives that promote AST, considering diverse sociodemographic factors, and addressing environmental challenges such as perceptions of crime and air pollution., Competing Interests: The authors declare there are no competing interests., (©2024 Katapally et al.)

Objectives: Strict social distancing and lockdown measures imposed to curb transmission during the early phase of the outbreak of the COVID-19 pandemic posed challenges to people's psychological wellbeing, limited access to social support, and disrupted routine mental health service delivery. In response, a consortium of mental health stakeholders from Goa, India launched the COVIDAV program, which provided pro-bono virtual psychiatric and counselling consultations across India through an online platform. This study describes the acceptability and feasibility of the program from the perspective of various stakeholders., Methods: Data were collected via a survey with clinicians who had volunteered on COVIDAV ( n = 40), in depth interviews of the clinicians ( n = 14), and focus group discussion with key collaborators ( n = 1). Process data were mapped at various stages during the online platform's development and use. The qualitative and quantitative data was analysed using thematic analysis and a descriptive analysis respectively., Results: Over 17 months, 63 clinicians conducted 2245 online sessions through the COVID platform, primarily accessed by youth across the country. The clinicians acknowledged the online platform's ability to enhance access and reduce stigma. Challenges included session time constraints, connectivity issues, and user interface inconsistencies that interfered with clients' accessibility to the services. High satisfaction rates amongst the service providers were reported, with 79.3% content with the service provision and 82.8% with pro bono contributions through the platform., Conclusions: This study illustrates the feasibility, flexibility, and applicability of a rapidly designed pro-bono online platform for delivering mental health care services through the collaboration of stakeholder groups in the mental health care, private, social, and governmental sector. Our findings highlight the potential of rapidly deployed digital platforms, developed via cross-sector partnerships, to meet mental health care needs during unprecedented global emergencies such as the COVID-19 pandemic.

Older adults are at risk of committing cognitive and decision-making errors due to the decline in cognitive functions. However, the understanding of the determining factors of cognitive errors among ageing adults is limited. In this study, we explored the role of various psychiatric factors, life satisfaction, and other socioeconomic, health and behavioural risk factors of committing cognitive errors among middle-aged and older adults in India. The study utilized the data from the experimental module of the Longitudinal Ageing Study in India (LASI) Wave-1 (2017-2018) with a sample of 12,754 adults aged 45 years and above. The cognitive error was measured using logical fallacies committed in the activity-based experiments. The study employed descriptive, bivariate statistics and multivariable logistic regression models to identify the factors associated with cognitive errors among the study participants. Depression (aOR = 1.28, 99%, CI: 1.16-1.41), life satisfaction (aOR = 0.99, 99%, CI: 0.98-1.00), and cognitive impairment (aOR = 1.13, 90% CI: 1.00-1.30) self-reported psychiatric) were significantly associated with higher odds of committing cognitive errors among the middle-aged and older adults. Also, ageing adults with low educational levels, functional limitations, sleep disturbances, smoking history, living in rural areas and belonging to scheduled tribes had a higher probability of committing cognitive errors. However, involvement in physical activity, reading habits and social interactions reduced the odds of cognitive errors among this sample. Mental health and well-being indicators, including depression, life satisfaction, cognitive impairment, and other health and behavioural health factors, determine cognitive errors among ageing adults. Programs and policies should be initiated to address these factors, reduce cognitive errors, and ensure active ageing., (© 2024. The Author(s).)

Background: Medical undergraduate students are often unaware of the managerial aspects of operating a healthcare facility. This leads to confusion and a sense of being lost when they assume administrative roles, highlighting the need for hospital management and leadership training. This prompted us to evaluate the needs of medical undergraduates concerning these crucial aspects., Methods: An exploratory study was conducted on 240 medical undergraduate students to assess the medical undergraduates' need to learn about hospital management and leadership training, their views about the importance and their self-perceived knowledge of the various elements of hospital management and leadership training. A meticulously validated questionnaire, comprising three essential parts, based on the Likert scale was effectively employed in the study. Part A asked students to evaluate the importance of 15 selected elements of hospital management and leadership training, ranging from not important to very important, in their role as a doctor. Part B required the students to assess their self-perceived knowledge levels on a scale from no knowledge to very adequate for the same 15 elements. Part C inquired about the students' opinions on including these topics in their curriculum and, if so, the appropriate timing., Results: Nearly 75% of the students felt that time management, stress management, and patient safety issues were very important for their role as doctor. Closely following these were communication/ public relation skills, hospital information system & record keeping, quality improvement/assurance, law, ethics & code of conduct. Only 25% of the students reported their self-perceived knowledge as very adequate for almost all the elements. For inclusion in the curriculum, the majority wanted to learn about these elements and throughout the course was the preferred timing., Conclusion: The students felt that hospital management and leadership training were pivotal for their roles as doctors. They expressed a lack of sufficient knowledge in these areas and the need for these important aspects to be included in their curriculum as a longitudinal course., (© 2024. The Author(s).)

Background: Violence against women is considered a fundamental violation of their human rights. According to the world health organization (WHO), one-third of women worldwide experience some form of intimate partner violence (IPV). This study aimed to investigate the relationship between dowry demand, perception of wife-beating, decision-making on work and household purchases and physical, sexual, and emotional violence against married adolescent girls in India by using a large dataset., Methods: Data from the Understanding the lives of adolescents and young adults (UDAYA) project survey were used in this study. The final sample size included 4893 married adolescent girls. Descriptive statistics and bivariate analyses were performed to examine preliminary results. Multivariate logistic regression analysis was used to analyze the associations between dowry demand, perception of wife-beating, decision-making and types of IPV., Results: The prevalence of emotional, physical, and sexual violence among married adolescent girls were 28.6%, 22.9%, and 26.1%, respectively. Approximately 44% of married adolescent girls have experienced some form of violence (emotional, physical, or sexual). The likelihood of experiencing violence was 3.64 times more likely among adolescent girls who reported that dowry was demanded by their in-laws than their counterparts [aOR: 3.64; CI: 3.05-4.35]. Moreover, married girls who justified wife-beating were more likely to face any violence than their counterparts [aOR: 1.56; CI: 1.28-1.90]. Similarly, adolescent girls whose work decisions were made by others had higher odds of experiencing any violence than those who decided their work themselves/jointly with others [aOR: 1.34; CI: 1.07-1.68]. The odds of any violence were higher among adolescent girls whose decisions on household purchases were made by others compared to those who decided to make purchases themselves or jointly with others [aOR: 1.37; CI: 1.09-1.71]., Conclusions: The findings revealed significant associations between dowry-demand, justification of wife-beating, decision making power and IPV among married adolescent girls, and suggest policies that help reduce violence related to the predominantly practiced dowry system in the country, and programs aimed at educating adolescent married girls about their rights against violence and empowering them to retain equal decision-making power within their families and reduce their vulnerability to domestic violence., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Srivastava et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: This study aims to assess the health worker absenteeism and factors associated with it in a high-focus district in Chhattisgarh, India., Background: Human resources for health are among the key foundations to build resilient healthcare systems. Chhattisgarh is a high-focus Indian state with a severe shortage of health care workers, and absenteeism further aggravates the shortage., Methods: This study was conducted as a mixed-methods study employing sequential explanatory design. Absenteeism was defined as the absence of health worker in the designated position without a formal leave or official reason in two different unannounced visits. A facility survey across all the public healthcare facilities in Jashpur district, Chhattisgarh, was conducted through random, unannounced visits employing a checklist developed based on Indian Public Health Standards. Twelve participants were purposively sampled and interviewed from healthcare facilities to explore factors associated with absenteeism. Survey data were analysed descriptively, and thematic analysis was employed to analyse qualitative interviews., Findings: Among all the positions filled at primary health centre level ( n = 339), close to 8% ( n = 27) were absent, whereas among the positions filled at community health centre level ( n = 285), only 1.14% ( n = 4) were absent. Absenteeism was not found in the district hospital. Qualitative interviews reveal that macro-level (geographical location and lack of connectivity), meso-level (lack of equipment and amenities, makeshift health facilities, doctor shortage, and poor patient turnover), and micro-level (unmet expectations) factors contribute to health worker absenteeism., Conclusion: Health worker absenteeism was more at PHC level. Systemic challenges, human resource shortages, and infrastructural shortcomings contributed to health worker absenteeism.

Objective: The primary objective of this study was to assess caregivers' perceptions of feeding practices (breastfeeding and complementary feeding) and diet diversity among children aged 12-59 months in a rural district of South India. The secondary objective was to identify potential predictors of these perceptions and diet diversity., Design: An analytical cross-sectional study was performed from March 2023 to May 2023., Setting: In a rural district of Tamil Nadu, South India., Participants: This study included 301 mothers/caregivers of children between 12 and 59 months of age in a rural district of Tamil Nadu. The research gathered demographic information from caregivers, including details such as age, educational background, occupation, relationship with the child and place of residence. Additionally, the caregivers' perspectives were evaluated through a questionnaire focused on breastfeeding/complementary feeding, and the diet diversity of the children was also assessed., Outcome Measures: The primary outcome was the perceptions of mothers/caregivers of children between 12 and 59 months of age about breastfeeding/complementary feeding practices, and the diet diversity of the children was measured. Additionally, predictors associated with these perceptions were evaluated through regression analysis., Results: In the present study, 188 (62.5%) and 179 (59.5%) of the participants had good perceptions of breastfeeding practices and complementary feeding practices, respectively. This binomial regression revealed that subjects with unstable occupations (adjusted OR=2.24, 95% CI 1.25 to 4.01), schooling (7.71, 95% CI 2.73 to 8.9) and higher education (38.32, 95% CI 4.63 to 316.85) had increased chances of having good perceptions of breastfeeding practices. Subjects with unstable occupations (0.23, 95% CI 0.06 to 0.85), stable occupations (0.13, 95% CI 0.04 to 0.51), schooling (0.43, 95% CI 0.25 to 0.74), higher education (0.15, 95% CI 0.04 to 0.50) and increased birth weights (2.54, 95% CI 1.35 to 4.78) had increased chances of having good perceptions of complementary feeding practices (p<0.05). This study revealed that 86.4% of the children had adequate diet diversity., Conclusion: The study revealed that most caregivers, particularly mothers, possess a strong understanding of breastfeeding and complementary feeding practices, with education and occupation exerting a notable influence. However, there is a crucial necessity to translate this knowledge into practical applications to effectively obtain feeding indicators., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Lifestyle diseases significantly contribute to the global health burden, with lifestyle factors playing a crucial role in the development of depression. The COVID-19 pandemic has intensified many determinants of depression. This study aimed to identify lifestyle and demographic factors associated with depression symptoms among Indians during the pandemic, focusing on a sample from Kolkata, India. An online public survey was conducted, gathering data from 1,834 participants (with 1,767 retained post-cleaning) over three months via social media and email. The survey consisted of 44 questions and was distributed anonymously to ensure privacy. Data were analyzed using statistical methods and machine learning, with principal component analysis (PCA) and analysis of variance (ANOVA) employed for feature selection. K-means clustering divided the pre-processed dataset into five clusters, and a support vector machine (SVM) with a linear kernel achieved 96% accuracy in a multi-class classification problem. The Local Interpretable Model-agnostic Explanations (LIME) algorithm provided local explanations for the SVM model predictions. Additionally, an OWL (web ontology language) ontology facilitated the semantic representation and reasoning of the survey data. The study highlighted a pipeline for collecting, analyzing, and representing data from online public surveys during the pandemic. The identified factors were correlated with depressive symptoms, illustrating the significant influence of lifestyle and demographic variables on mental health. The online survey method proved advantageous for data collection, visualization, and cost-effectiveness while maintaining anonymity and reducing bias. Challenges included reaching the target population, addressing language barriers, ensuring digital literacy, and mitigating dishonest responses and sampling errors. In conclusion, lifestyle and demographic factors significantly impact depression during the COVID-19 pandemic. The study's methodology offers valuable insights into addressing mental health challenges through scalable online surveys, aiding in the understanding and mitigation of depression risk factors., (© 2024. The Author(s).)

Objective: To investigate the prevalence of problematic internet use (PIU) among adolescents and determine the associated factors contributing to PIU., Methods: In April/May 2023, a cross-sectional study was conducted among adolescents studying in grades 9 to 12 in government and private non-residential schools in Western Tamil Nadu, India. Participants completed a semi-structured questionnaire assessing demographic characteristics, behavioral patterns, and internet usage. The Problematic and Risky Internet Use Screening Scale (PRIUSS) was employed to quantify PIU., Results: Out of 1795 participants, 398 (24.5%) were identified with PIU. Prevalence rates of PIU were similar between adolescents studying in English (n = 189; 25.4%) and Tamil medium (n = 209; 23.7%), with no significant differences based on gender [boys (n = 270, 25.4%) and girls (n = 121, 22.2%)]. Students possessing personal gadgets showed higher PIU [n = 287 (27%) Vs. n = 111 (20%)]. Specific risk factors for PIU identified students in English medium and scoring below 80% [OR (95%CI) 1.5 (1.1, 2.3); P = 0.029 ] and those with multiple gadgets at home [1.3 (1.01, 1.7); P = 0.04]., Conclusion: Adolescents have a high prevalence of PIU. Implementing school-based educational programs will mitigate excessive internet usage.

Background: Pregnancy is a known physiological phenomenon characterized by various changes in the body. The physical and physiological changes that occur during pregnancy may impact the body image which may lead to implications such as body image issues or poor eating habits among pregnant women. This study aimed to analyze the body image perception of pregnant women in their third trimester., Methods: This cross-sectional survey which involved the administration of a Multidimensional Body Self-Relations Questionnaire (MBSRQ), was conducted among pregnant women between 28 and 40 weeks of gestation in a tertiary care setting in Southern India. Descriptive statistics were used to report the demographic characteristics of the respondents. A one-sample t-test was used to analyze the difference between the present sample scores and the published norms of MBSRQ. Univariate Logistic Regression was done to find the association between the demographic variables and subdomains of MBSRQ., Results: The mean age of the respondents (n = 246) was 29.5 years, and the period of gestation was 33.4 weeks. With mean scores of subscales of MSRQ as reference values, a greater proportion of women had higher scores on appearance orientation (52.44%), health evaluation (56.91%), and illness orientation (55.28%). Respondents scored less on appearance evaluation (52.03%) and body areas satisfaction scale (50.41%). The study found that pre-pregnancy BMI, abdominal circumference, and weight gain during pregnancy were associated with appearance orientation, overweight preoccupation, and self-classified weight. Health evaluation was associated with weight gain and Instagram use, while moderate-intensity physical activity during pregnancy was associated with higher health orientation., Conclusion: Although pregnant women in our setting during the third trimester were oriented towards their appearance and considered themselves healthy and fit, almost half of the respondents reported dissatisfaction with their changing bodies and appearance. Self-reported physical activity status, body mass index, weight gain, level of education, use of Instagram app, and type of family were factors found to affect pregnant body image perception. Hence, we conclude that body image perception is affected during pregnancy, and healthcare professionals should be aware of this, and the factors associated with it while addressing the health of pregnant women., Clinical Trial Registration Details: The study was registered under the Clinical Trials Registry- India: CTRI/2023/08/056524. https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=89771&EncHid=39880.12369&modid=1&compid=19 ., (© 2024. The Author(s).)