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Introduction The effects of COVID-19 infection persist beyond the active phase. Comprehensive description and analysis of the post COVID sequelae in various population groups are critical to minimise the long-term morbidity and mortality associated with COVID-19. This analysis was conducted with an objective to estimate the frequency of post COVID sequelae and subsequently, design a framework for holistic management of post COVID morbidities.Methods Follow-up data collected as part of a registry-based observational study in 31 hospitals across India since September 2020–October 2022 were used for analysis. All consenting hospitalised patients with COVID-19 are telephonically followed up for up to 1 year post-discharge, using a prestructured form focused on symptom reporting.Results Dyspnoea, fatigue and mental health issues were reported among 18.6%, 10.5% and 9.3% of the 8042 participants at first follow-up of 30–60 days post-discharge, respectively, which reduced to 11.9%, 6.6% and 9%, respectively, at 1-year follow-up in 2192 participants. Patients who died within 90 days post-discharge were significantly older (adjusted OR (aOR): 1.02, 95% CI: 1.01, 1.03), with at least one comorbidity (aOR: 1.76, 95% CI: 1.31, 2.35), and a higher proportion had required intensive care unit admission during the initial hospitalisation due to COVID-19 (aOR: 1.49, 95% CI: 1.08, 2.06) and were discharged at WHO ordinal scale 6–7 (aOR: 49.13 95% CI: 25.43, 94.92). Anti-SARS-CoV-2 vaccination (at least one dose) was protective against such post-discharge mortality (aOR: 0.19, 95% CI: 0.01, 0.03).Conclusion Hospitalised patients with COVID-19 experience a variety of long-term sequelae after discharge from hospitals which persists although in reduced proportions until 12 months post-discharge. Developing a holistic management framework with engagement of care outreach workers as well as teleconsultation is a way forward in effective management of post COVID morbidities as well as reducing mortality.

Objectives This study provides insights on the impact of a targeted intervention (TI) programme on behaviour change among injecting drug users (IDUs) in India. Methods This paper examined the data from the Integrated Biological and Behavioural Surveillance 2014–2015 for IDUs in India. Logistic regression was performed to understand the factors (TI programme services) that affected injecting risk behaviours by adjusting for covariates. Propensity score matching was conducted to understand the impact of the TI programme on using new needles/syringes and sharing needles/syringes in the most recent injecting episode by accounting for the covariates that predicted receiving the intervention. Results Participants who received new needles and syringes from peer educators or outreach workers were 1.3 times (adjusted odds ratio, 1.29; 95% confidence interval [CI], 1.09 to 1.53) more likely to use new needles/syringes during most recent injecting episode than participants who did not receive needles/syringes. The matched-samples estimate (i.e., average treatment effect on treated) of using new needles in the most recent injecting episode showed a 2.8% (95% CI, 0.0 to 5.6) increase in the use of new needles and a 6.5% (95% CI, −9.7 to −3.3) decrease in needle sharing in the most recent injecting episode in participants who received new needles/syringes. There was a 2.2% (95% CI, −3.8 to −0.6) decrease in needle sharing in the most recent injecting episode among participants who were referred to other services (integrated counselling and testing centre, detox centres, etc.). Conclusions The TI programme proved to be effective for behaviour change among IDUs, as substantiated by the use of new needles/syringes and sharing of needles/syringes.

Background/Objectives: Studies globally have documented the impact of COVID 19 on maternal and newborn health services. This study assesses the impact of COVID-19 on essential maternal and child health (MCH) services in India based on the national Health Management Information System (HMIS). Methods: Present retrospective study used secondary data analysis upon the routinely collected data accessed from Health Management Information System. Microdata on maternal and newborn indicators was extracted for all states between April and June during 2019, 2020 and 2021. Relative change for each indicator were taken into consideration for the year 2020 and 2021; with respect to the outcomes in 2019. Results: Compared to 2019, antenatal care registrations saw a decline in all states for both periods in 2020 and 2021 except for Sikkim, Telangana, Maharashtra and Andhra Pradesh. Similarly, the relative changes in 2019 pertaining to the proportion of pregnant women provided with emergency obstetric care for pregnancy complications registered a decline in all states except for Himachal Pradesh, Telangana and Arunachal Pradesh. There was a decreasing trend noted in institutional deliveries in 2020 and 2021 among all major states. However, an increasing trend was seen in the number of immunization sessions held among all major states. Conclusion: The study demonstrates a disruption in service delivery during the lockdown period in the first wave and the peak of the second wave. Further qualitative studies need to be undertaken to generate evidence for maintaining continuum of care during a pandemic situation.

Abstract An article published in this journal analyses the deficiencies in the data of interventional drug trials registered with Clinical Trials Registry - India. We wish to rebut some of the inferences and highlight the pitfalls of a purely automated analysis of registry data as posited by the authors.

Objective: To understand food safety knowledge, perceptions, and practices of adolescent girls. Design: Focus group discussions (FGDs) with 32 groups selected using stratified random sampling. Setting: Four South Indian states. Participants: Adolescent girls (10-19 years). Phenomena of Interest: Food safety knowledge, perceptions, and practices. Analyses: FGDs were audio recorded, transcribed, and manually coded by topic. At each stage of coding and analysis, reports were read independently by 3 researchers. Results were presented according to 4 food safety topics: concept of safe food; home-cooked food or outside food; packaged food products and food labels; and previous exposure to food safety education. Results: Subjects confused the concept of nutrition with food safety. They were checking food labels, but they were not aware of quality symbols like ISI (Bureau of Indian Standards), FPO (Fruit Products Order), and AGMARK (Agriculture Marking and Grading Act); trusted more in brand names/expensive packaged food; were less careful about snack food safety. Receiving food safety information through school health education was preferred. Conclusions and Implications: Adolescent girls are not aware of food quality standards. Awareness needs to be raised on permitted food additives concerning which foods can use them. Children should be familiarized with quality symbols on food labels. (Contains 2 tables.)

Calorie counting mobile apps claim to assist in weight management by helping users monitor their diets and track activity. This study assessed quality and effectiveness of popular calorie counting apps in weight management and behaviour change. Top 20 apps were selected from Google Play store and their quality was assessed using a 55-point scoring scale on attributes like standards used, content accuracy, user interface and sources of database. The mean (±SD (standard deviation)) quality score was 36.95 (±5.65). The calorie and activity recommendations were compared with standards and over 65 per cent apps over/underestimated calorie intake. To assess effectiveness, 60 young volunteers were recruited and divided into two groups. The intervention group (n = 30) was asked to use one of the top 3 apps for 8 weeks. Pre- and post-comparisons were made with the control group (n = 28). No significant difference was noted in anthropometry or food consumption. There was increasing trend (13.33%) in physical activity in the intervention group. [ABSTRACT FROM AUTHOR]

Objective: To study consumer knowledge and use of food labels.Design: A cross-sectional study employing both quantitative and qualitative methods. Intercept interviews were conducted with 1832 consumers at supermarket sites selected using a stratified random sampling procedure. This information was triangulated with twenty-one focus group discussions.Setting: New Delhi and Hyderabad, two metro-cities from north and south India.Subjects: Adolescent (10-19 years), adult (20-59 years) and elderly (≥60 years) consumers.Results: While the national urban literacy rate is 84 %, about 99 % of the study participants were educated. About 45 % reported that they buy pre-packaged foods once weekly and about a fifth buy them every day. Taste, quality, convenience and ease of use are the main reasons for buying pre-packaged foods. Although 90 % of consumers across the age groups read food labels, the majority (81 %) looked only for the manufacturing date or expiry/best before date. Of those who read labels, only a third checked nutrition information and ingredients. Nutrient information on labels was not often read because most consumers either lacked nutrition knowledge or found the information too technical to understand. About 60 % read quality symbols. A positive association was found between education level and checking various aspects of food labels. Women and girls concerned about 'fat' and 'sugar' intake read the nutrition facts panel.Conclusions: The intention of promoting healthy food choices through use of food labels is not being completely met. Since a majority of people found it difficult to comprehend nutrition information, there is a need to take up educational activities and/or introduce new forms of labelling. [ABSTRACT FROM AUTHOR]

The purpose of this analysis was to combine evidence from parallel and cross-over randomized controlled trials to assess the impact of iodine fortified foods on urinary iodine concentration (UIC) in children. A structured search for studies on iodine intervention studies on MEDLINE, Pro Quest, and the Cochrane Library from Jan, 1990 to Dec, 2012 was carried out. Carry-over effect was estimated by general linear model. We explored two methods to pool continuous outcomes in a meta-analysis by combining parallel and cross-over trial designs. The standard mean difference was calculated for net change in UIC. Fixed or random-effects models were used to summaries fortified food response data. Meta-regression and covariate meta-analysis were performed to explore the influ-ence of confounders on the net pooled effect on UIC. The overall pooled estimate, which combined parallel with cross-over trials in the absence of carry-over effect of UIC from 9 studies, showed a significant increase in the fortified group compared with the control group (n=3448; standard mean difference=2.02 μg/L; 95% CI: 1.30, 2.73; I2=99%, τ2=1.81, p<0.01). Meta-regression analysis indicated that dose of the feeding was positively related to the effect size (regression coefficient=0.014; 95% CI: 0.003, 0.026; p<0.019). The net pooled effect size after removing the confounders was 1.59 (95% CI: 0.953, 2.23) μg/L. There was an association between intakes of io-dine fortified foods and UIC in children. These results suggest that we can combine parallel with cross-over trials for meta-analysis for nutrients such as iodine when absorption is high. [ABSTRACT FROM AUTHOR]

The potential allergenicity of Bar, Barnase, and Barstar recombinant proteins expressed in genetically engineered mustard for pollination control in plant breeding was evaluated for regulatory review. To evaluate the potential allergenicity of the Bar, Barnase and Barstar proteins amino acid sequence comparisons were made to those of known and putative allergens, and search for published evidence to the sources of the genes using the AllergenOnline.org database. Initial comparisons in 2012 were performed with version 12 by methods recommended by the Codex Alimentarius Commission and the Indian Council of Medical Research, Government of India. Searches were repeated with version 15 in 2015. A literature search was performed using PubMed to identify reports of allergy associated with the sources of the three transgenes. Potential open reading frames at the DNA insertion site were evaluated for matches to allergens. No significant sequence identity matches were identified with Bar, Barnase or Barstar proteins or potential fusion peptides at the genomic-insert junctions compared to known allergens. No references were identified that associated the sources of the genes with allergy. Based on these results we conclude that the Bar, Barnase and Barstar proteins are unlikely to present any significant risk of food allergy to consumers., (Copyright © 2015 Elsevier Ltd. All rights reserved.)