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Background: Despite the increasing integration of competency-based education in medicine, there remains a significant gap in effectively assessing educational outcomes, underscoring the urgent need for designed assessment blueprints that accurately reflect both curriculum content and competency standards in Community Medicine for undergraduate students. This study, conducted across the All-India Institute of Medical Sciences (AIIMS) network, develops a summative assessment blueprint aimed at standardizing evaluations in medical education across diverse geographic locations in India., Methods: Twenty-five experts from 10 All India Institutes of Medical Science were invited via email and contributed for summative assessment for a theory paper. Each week, the study lead team sent an online form containing 25 topics. A total of 269 topics were selected to be included in the blueprint development. An Impact and Frequency score was obtained for each topic, with a score between 1 and 3 for both its "Impact (I)" and "Frequency" (F)., Results: The overall response rate was 71%. "Principle of epidemiology" (14.7%) had the most weight, followed by "Epidemiology of communicable disease" (13.4%) and "National Health Program" (10%). These three chapters constituted more than one-third of the total weight of the summative assessment (theory). 20 out of 24 (83%) chapters have moderate-to-good interrater reliability., Conclusions: The blueprint developed in this study is intended to serve as a guideline for setting question papers and aims to enhance objectivity, uniformity, and validity in assessment construction. While it provides a structured approach within the AIIMS network, its broader applicability may be limited, suggesting that its effectiveness in other educational contexts remains to be validated. Continued research is encouraged to explore its utility across diverse educational settings., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Context: Each year, about 21 million girls aged 15-19 in developing regions experience pregnancy, posing significant challenges for their health, well-being, and economic stability due to its vast impact., Aim: To identify the risk factors contributing to teenage pregnancy as compared to Pregnancy in pregnant women in the rural area of the Khordha district with the assessment of their knowledge and, health-seeking behaviour (Contraception and STDs) among teenage and adult pregnant women in the study area., Settings and Design: Hospital-based case-control study conducted at Bhubaneswar's Community Health Centre., Material and Methods: The study, conducted from April to July 2022, recruited 138 participants using consecutive sampling and interviewed them using a pretested semi-structured questionnaire., Statistical Analysis: Chi-square and logistic regression assessed association and strength., Results: Factors contributing to teenage pregnancy include education below high school (AOR = 2.46; 95%CI 0.89-6.79), SC and ST caste (AOR = 2.34; 95%CI 0.94-5.82), having more than three siblings (AOR = 4.45; 95%CI 1.53-12.96), and lack of communication about sexual issues (AOR = 2.84; 95%CI 1.25-6.39). Awareness of contraceptive methods was 34.8% among cases and 56.5% among controls ( p = 0.02). Regarding STD awareness and symptoms, 15.2% of cases and 42.4% of controls were knowledgeable and experienced symptoms ( p < 0.01)., Conclusions: This study suggests that factors such as lower education, minority caste, having more than three siblings, and lack of communication about sexual issues contribute to early pregnancy. These findings could enhance existing ARSH platforms by integrating regular engagement and sensitization efforts., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background: 44% of infants under 6 months of age worldwide are only adequately breastfed. It is also found that only 41.6% of women breastfeed their child within one hour of birth and less than 50% of women continue breastfeeding up to 2 years. This study was conducted to assess the prevalence of early initiation of breastfeeding practice, to explore the knowledge and practices about breastfeeding among lactating mothers, and to find the effect of breastfeeding on the nutritional status of the child., Materials and Methods: A hospital-based study was conducted among 160 lactating mothers of infants below six months of age presenting to the immunization clinic at AIIMS Bhubaneswar. A semi-structured questionnaire based on the CDC breastfeeding questionnaire was administered to assess the knowledge and practice. The nutritional status of the infant was assessed by plotting the weight for age and length for age of the infant in the WHO growth charts., Results: 102 (75%) of mothers had initiated breastfeeding within the first hour of delivery. Adequate knowledge and practice of breastfeeding was present only in 4 (2.5%) and 3 (1.9%), respectively. It was found that 13.75% of women were using formula feed. The prevalence of underweight and less than normal length was 40% ( n = 64) and 34.37% ( n = 55) among infants, respectively., Conclusion: This study emphasizes the importance of awareness among lactating mothers about the hindmilk, appropriate practice, and to find its effect on the nourishment of the children., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Aims This study aimed to assess the quality of life (QoL) of older adults in rural Odisha, India, exploring its multidimensional nature across physical, psychological, social, and environmental domains. The impact of depression and various sociodemographic factors on QoL was also investigated. Methods The research was conducted in the Tangi block of Khordha district, Odisha, encompassing 468 older adults. The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire, Geriatric Depression Scale (GDS-15), and sociodemographic questionnaire were used in data collection. Sampling employed a multistage approach, with statistical analysis utilizing Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY), including t-tests for normally distributed data and the Mann-Whitney U test for non-normally distributed data. Results The QoL of older adults in rural Odisha showed variability, with physical and social domains exhibiting relatively positive scores compared to psychological and environmental domains. Depression significantly impacted all QoL dimensions, with the most profound effect observed in global QoL and global health. Sociodemographic factors such as employment, substance use, elder abuse, adverse life events, and poverty were identified as significant determinants of global QoL. Additionally, recreational activity, elder abuse, education, and employment significantly affected all QoL domains. Conclusions This study reveals the complex landscape of QoL of older adults in rural Odisha. The findings emphasize the need for comprehensive interventions targeting mental health, social support, and environmental conditions to enhance the overall well-being of this population. Policymakers and healthcare professionals should consider these multidimensional factors to develop effective strategies for improving the QoL of older adults in similar contexts., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Antony et al.)

Introduction: The untied funds at sub-centers provided flexibility for local action at block and down below levels. Effective utilization of untied fund can strengthen the healthcare. So, our study aims at assessing the knowledge of health workers, male/female (HWF/M), and effectiveness of utilization of untied funds at the sub-center (SC) level., Material and Methods: A mixed method (cross-sectional study and qualitative study) was conducted at Tangi Block, Khordha district, Odisha, in the year 2020. Health workers, male and female in sub-centers, and local stakeholders were interviewed using a structured interview schedule. The tool comprises financial records, a semi-structured questionnaire, and an in-depth interview guide. Universal sampling was adopted. For the cross-sectional study, 24 health workers were male/female, and for the qualitative study, all local stakeholders and 24 health workers female/male were interviewed. The study was conducted as a part of an academic program, and ethics approval was approved by AIIMS Bhubaneswar Institute Ethics Committee., Results: Seven out of 24 sub-centers did not spend any money, with a median unspent amount of 4260 INR (Q1-0, Q3-17300). As many as 36.8% of sub-centers had a delay of 9 months to get the untied fund, which significantly affected the utilization of funds. 37% of HWF/M utilized the fund inappropriately. None of the health workers had complete knowledge regarding the appropriate usage of untied fund. Communication gap, multiple engagements, non-cooperation from officials, delay in technical processing, and irregular Garam Sabha meetings were found to be barriers., Conclusion: Our study found out under-utilization of money in untied fund. Communication gap, non-cooperation form village leaders, poor knowledge, overburdened health workers, improper reporting, and lack of felt need were found to be barriers for prompt utilization., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Community Medicine.)

Sediment contamination jeopardizes wetlands by harming aquatic organisms, disrupting food webs, and reducing biodiversity. Carcinogenic substances like heavy metals bioaccumulate in sediments and expose consumers to a greater risk of cancer. This study reports Pb, Cr, Cu, and Zn levels in sediments from eight wetlands in India. The Pb (51.25 ± 4.46 µg/g) and Cr (266 ± 6.95 µg/g) concentrations were highest in Hirakud, Cu (34.27 ± 2.2 µg/g) in Bhadrak, and Zn (55.45 ± 2.93 µg/g) in Koraput. The mean Pb, Cr, and Cu values in sediments exceeded the toxicity reference value. The contamination factor for Cr was the highest of the four metals studied at Hirakud (CF = 7.60) and Talcher (CF = 6.97). Furthermore, high and moderate positive correlations were observed between Cu and Zn (r = 0.77) and Pb and Cr (r = 0.36), respectively, across all sites. Cancer patients were found to be more concentrated in areas with higher concentrations of Pb and Cr, which are more carcinogenic. The link between heavy metals in wetland sediments and human cancer could be used to make policies that limit people's exposure to heavy metals and protect their health., (© 2023. The Author(s).)

Aims and Objective: The development of a nation depends on well-nourished individuals. A country's economic independence also depends on adequate food supply for all sections of its population and the proper selection of the right kinds of food, called nutritional literacy. This review will show the transition of dietary selection and practices across India over the last two decades and its impact on health., Materials and Methods: We conducted a literature search to review the evidence of the last two decades. The literature search was done using the PubMed search engine and the MeSH words "Nutrition Literacy, Dietary Practices, Diet Transition, Nutrition transition, India and Food pattern." Evidence from the last two decades was collectively reviewed, and observations on the transition in nutrition literacy were summated., Results: The literature search revealed 18 articles, out of which 13 articles were included in this review based on inclusion-exclusion criteria. Nine were review articles, and five were cross-sectional studies. The studies done over the last two decades on nutrition culture revealed that most of the studies related to transition have been done during the second decade of the twenty-first century. Most have found that the shift has been happening more among the urban poor and rural rich people. Indian diets have diversified and shifted away from cereals towards processed food., Conclusion: It was found that there is a shift in feeding preferences in diet-deprived sections in India. The findings are similar in rural and urban areas where the poor fall prey to the food fads, make poor nutrition choices, and gradually develop chronic ailments. Such a transition over the years clearly shows that a malnourished child, having faulty feeding practices, becomes prey to the triple burden of hidden hunger, lack of nutrition, and repercussions of chronic non-communicable diseases, including dental ailments., Competing Interests: None., (Copyright: © 2023 Journal of International Society of Preventive and Community Dentistry.)

Background Non-adherence to medication represents a modifiable risk factor for patients with type 2 diabetes mellitus (T2DM). Identification of patients with poor adherence can have a significant impact on clinical and socio-economic outcomes in the management of diabetes. This study aimed to assess medication adherence and its associated factors among patients with T2DM attending a non-communicable disease (NCD) clinic in a rural community health centre (CHC) in eastern India. Methods The study was a facility-based study that included 207 study participants with an age greater than 18 years. A structured questionnaire was used to collect data on socio-demographic characteristics, health-seeking behaviour, self-care practices, risk factors, clinical information on diabetes, prescription practices, and medication practices. The Hill-Bone Medication Adherence Scale (HB-MAS) has been used to assess medication adherence among study participants. Results The study found that the medication adherence rate among the study participants was 67.1%. On multivariate analysis, subjects with social insurance (adjusted odds ratio (AOR) = 2.73, 95% confidence interval (CI) = 1.01-7.38, p-value = 0.047), current smoking status (AOR = 5.47, 95% CI = 1.55-19.23, p-value = 0.008), anxiety (AOR= 3.52, 95% CI= 1.62- 7.61, p-value= 0.001), polypharmacy (AOR= 3.79, 95% CI= 1.25- 11.45, p-value= 0.018), and using alternative medicine (AOR= 5.82, 95% CI= 1.58 - 21.39, p-value= 0.008), were found to have a significantly higher chance of non-adherence. On the other hand, patients practising regular physical activity (AOR = 0.31, 95% CI= 0.12-0.79, p-value = 0.015) and with deprescription (AOR = 0.12, 95% CI= 0.03-0.47, p-value = 0.002) were found to have less chance of non-adherence as compared to their counterparts. Conclusion The study highlights the need to identify patients with poor medication adherence and develop interventions according to their requirements through a holistic approach. The study contributes to the existing literature on medication adherence among diabetes patients in rural healthcare settings in eastern India., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Mishra et al.)

Metals are micropollutants that cannot be degraded by microorganisms and are infiltrated into various environmental media, including both freshwater and marine water. Metals from polluted water are absorbed by many aquatic species, especially fish. Fish is a staple food in the diets of many regions in the world; hence, both the type and concentration of metals accumulated and transferred from contaminated water sources to fish must be determined and assessed. In this study, the heavy metal concentration was determined and assessed in fish collected from freshwater sources via published literature and Estimated Daily Intake (EDI), Target hazard quotient (THQ), and Carcinogenic Risk (CR) analyses, aiming to examine the metal pollution in freshwater fish. The fish was used as a bioindicator, and Geographic information system (GIS) was sued to map the polluted regions. The results confirmed that Pb was detected in fish sampled at 28 locations, Cr at 24 locations, Cu and Zn at 30 locations, with values Pb detected ranging from 0.0016 mg kg -1 to 44.3 mg kg -1 , Cr detected ranging from 0.07 mg kg -1 to 27 mg kg -1 , Cu detected ranging from 0.031 mg kg -1 to 35.54 mg kg - 1 , and Zn detected ranging from 0.242 mg kg -1 to 103.2 mg kg -1 . The strongest positive associations were discovered between Cu-Zn (r = 0.74, p < 0.05) and Cr-Zn (r = 0.57, p < 0.05). Spatial distribution maps depicting the consumption of fish as food and its corresponding Pb and Cr intake revealed a higher incidence of both carcinogenic and non-carcinogenic health concerns attributed to Pb and Cr in the region with populations consuming the fish., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

In recent years, C-glycosides have emerged as significant building blocks for many naturally occurring alkaloids and pharmaceutically active drug molecules. Therefore, significant efforts have been devoted to the construction of structurally important C-glycosidic linkages in carbohydrate compounds. Herein, we have summarized the recent developments of diverse synthesis of C-glycoside core between the time period from 2019 to 2022 focusing on different catalytic strategies, such as (i) transition-metal, and (ii) metal-free catalytic approaches. Further, the transition metal catalyzed C-glycosylations have been categorized into four sub classes: (a) metal based C-H activation, (b) cross-coupling reaction, (c) glycosyl radical intermediate-based process, and (d) Others., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Various studies revealed that adolescent girls have limited knowledge pertaining to sexual and reproductive health (SRH). The current study assessed the effectiveness of SRH education among adolescent girls in urban areas of Odisha, India., Methods: The study design was a cluster randomized trial, where the clusters composed of eight Odia (regional language) medium government girls' high schools in Bhubaneswar, the capital city of the state of Odisha, India. For the selection of study participants, adolescent girls who were studying in the ninth and tenth standards were recruited from each school. Eight schools were randomized through restrictive randomization at a 1:1 ratio, with four schools each in the intervention and control arm. Baseline and end-line assessments were done using a pre-tested, semi-structured questionnaire. Following baseline assessment, an intervention was given with the help of handbooks developed by the study authors to the schools in the intervention arm. Outcomes included change in knowledge, attitude and practices pertaining to SRH., Results: In our study at baseline, there were a total of 790 students, where 469 (59.4%) students were in the intervention arm, and 321 (40.6%) students were in the control arm. At baseline, only 282 (60.1%) in the intervention arm and 171 (53.3%) in the control arm were aware that physical bodily changes due to puberty were normal. After the intervention, there was a statistically significant increase in knowledge in intervention group 367 (94.8%) (p-value < 0.001). Most students used sanitary pads as absorbent, 97.2% in the intervention group and 98.4% in the control group. However, after the intervention, the use of other absorbents reduced to zero in the intervention group with a statistically significant difference (p < 0.05). The number of students having awareness on different methods of contraception increased from 51 (10.9%) to 337 (87.1%) in the intervention arm (p < 0.001), and of those having awareness on STIs/RTIs increased from 177 (38.2%) to 371 (96.1%) in the intervention group (p < 0.001)., Conclusion: From our study, there is a significant proportional change in knowledge, attitude, and practices pertaining to SRH. Our study recommends policymakers and program managers for the implementation of comprehensive SRH in the regular school curriculum. Trial registration CTRI/2021/01/030490, registered on January 15, 2021. Prospectively registered at https://ctri.nic.in/Clinicaltrials/login.php., (© 2023. The Author(s).)

CoWIN (Covid Vaccine Intelligence Network) is a web-based platform owned and operated by the Government of India for facilitating COVID-19 vaccination of the citizens. This project is considered a tremendous success, apparent from the sheer number of hassle-free and successful COVID-19 vaccinations. We believe that the CoWIN system is an ideal platform for capturing all the vaccine-related data in the Universal Immunization program (UIP) as well as providing an all-inclusive vaccine certificate in digital format. Advantages and challenges of upscaling the CoWIN system to include UIP and a vision statement of how this can be achieved are discussed in this article. We also enlist the state-level solutions currently in use for digital immunization records, which can serve as case studies for upscaling the CoWIN system., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Community Medicine.)

The world's population is aging rapidly, and the epidemiological transition has led to increased mental disorders worldwide. Geriatric depression is masked by multiple comorbidities or the natural process of aging. Our study aims to estimate the prevalence of geriatric depression and find the risk factors associated with geriatric depression in rural Odisha. The study was a multistage cross-sectional study conducted in the Tangi block, district Khordha, Odisha, from August 2020 to September 2022, among 520 participants selected by probability proportional to size sampling. From the selected participants, eligible 479 older adults were interviewed using a semi-structured interview schedule, Hindi Mini Mental Scale, Geriatric Depression Scale-15, and Hamilton Depression Rating Scale. The step forward multivariable logistic regression was used to assess the associated factors of depression among older adults. Among our participants, 44.4% (213) of older adults were depressed. Substance abuse in family members [AOR: 16.7 (9.1-30.9)], history of elder abuse [AOR: 3.7 (2.1-6.7)], physical dependency [AOR: 2.2 (1.3-3.6)], and financial dependency [AOR: 2.2 (1.3-3.6)] are significant independent risk factors associated with geriatric depression. Living with children [AOR: 0.33 (0.18-0.59)] and recreational activity [AOR: 0.54 (0.34-0.85)] are significant protective factors of geriatric depression. Our study found that geriatric depression is highly prevalent in rural Odisha. Poor quality of family life and physical and financial dependency was found to be the most significant risk factor for geriatric depression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Antony, Parida, Behera and Padhy.)

Background: Acceptance of vaccines has been on a decline in recent times, with vaccine hesitancy being listed as one of the top 10 global health threats. This study analysed vaccine hesitancy and belief towards vaccination among caregivers of children aged below 5 years., Methods: In this cross-sectional study, 196 caregivers of children aged 6 months to below 5 years who had attended an immunization clinic at a tertiary care institute of Eastern India from March to May 2019 were surveyed. Consecutive sampling was used to recruit eligible study participants. The survey assessed the attitudes of parents towards childhood vaccination by using the Vaccine Hesitancy Scale and their beliefs towards vaccination. Univariate analysis was performed to assess the association of various sociodemographic factors with vaccine hesitancy., Results: Among the caregivers, most (48%) mothers were aged 26-35 years, literate and homemakers. Vaccine hesitancy was observed in 9.18% of the participants. Only the age of the child was significantly associated with vaccine hesitancy. Nearly half (48.5%) of the participants were concerned about the serious adverse effects of vaccines, and a third (30.6%) agreed that newer vaccines are associated with higher risks than the older ones. Caregivers felt that vaccines are no longer required for uncommon diseases., Conclusion: Concerns regarding vaccine hesitancy are prevalent even among caregivers attending a tertiary care institute. Thus, additional studies are required to assess hesitancy in urban, rural, remote and inaccessible areas. Policymakers ought to conduct periodic assessments and implement necessary remedial measures for the long-term sustenance of the benefits of the national immunization programme., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s), 2023.)

India approved COVID-19 vaccine called Covaxin, developed by the Indian Council of Medical Research and Bharat Biotech Ltd. The primary objective of the study was to estimate the effectiveness of Covaxin in preventing breakthrough SARS-CoV-2 infection in healthcare workers (HCWs). A test-negative matched case-control study was conducted among HCWs of tertiary care hospital in Eastern India. Any HCW who tested positive for COVID-19 using RT-PCR during April and May 2021 was taken as the case. The HCWs who tested negative for COVID-19 by RT-PCR were considered as controls after matching with the date of testing and profession of the cases. Vaccination data were collected from the institution's vaccine database and recall. In case of discrepancy, it was confirmed from the CoWIN portal (cowin.gov.in). The sample size was 670 participants (335 pairs). Conditional logistic regression models were used to calculate the adjusted odds ratio for breakthrough SARS-CoV-2 infection. Vaccine effectiveness was calculated using the following formula: VE = (1-aOR) × 100%. Sensitivity analysis was done for effectiveness of Covaxin, excluding Covishield vaccination. The mean age of participants was 29.1 years (SD = 7.1), and the majority were males (55.2%). Among the study participants, 60% were completely vaccinated, 18.51% were partially vaccinated, and 21.49% were unvaccinated. After adjusting for age, gender, type of household and past history of COVID-19 disease in conditional logistic models, the vaccine effectiveness was 22% (aOR 0.78, 95% CI: 0.52-1.17; p = .233). Sensitivity analysis with Covaxin showed an effectiveness of 29% (aOR 0.71, 95% CI: 0.47-1.08; p = .114) for preventing breakthrough SARS-CoV-2 infection.

Introduction: COVID-19 has affected the quality of life of all age groups. Medical education during the pandemic shifted to online mode due to lockdown restrictions. The stress felt by medical students during the pandemic has been studied less. The current study aimed to assessed the stressors and de-stressors for undergraduate medical students during the COVID-19 pandemic., Materials and Methods: A cross-sectional online survey was conducted for the undergraduate medical students of a tertiary care institute of eastern India. A total of 307 medical students were included in the study by convenient and snowball sampling. A self-designed semi-structural questionnaire was created as a Google form and circulated among the students between September and October 2020. A combination of purposive and snowball sampling was adopted. Responses regarding stressors and de-stressors were recorded on a Likert scale. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. Categorical variables were presented as percentages and descriptive statistics were performed., Results: A total of 307 students responded and 64.5% of them were men and 35.5% were women. 47.6% of the students experienced stress due to changes brought about by COVID-19. Risk of parents getting infection (63.2%), fear of not easily returning home (53.1%), lack of clinical exposure (52.7%), and financial impact (47.9%) were the major stressors perceived by the students. Connecting with family and friends through social media (47.5%), gaming (45.0%), online streaming platform (51.2%), spending time with family members (54.4%) were the coping strategies adopted by these students., Conclusion: Higher level of psychological stress perceived by the undergraduate students needs psychological intervention. Academic revamp and adaptation of coping strategies are required for the medical under-graduates., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Community participation is one of the founding pillars of primary health care. However, due to various reasons, we are yet to achieve complete integration of this component into the health system functioning in India. The objective of our study was to do a formative assessment of community participation in a rural healthcare setting by adopting participatory learning action (PLA). technique. The study participants included frontline health workers and members from local governing institutions of rural areas. The study design is qualitative in nature with a participatory approach. A number of three PLA techniques have been used as a part of this study to recognize available resources for community participation, address its barriers and facilitators, and finally devise a time-line-based action plan. Based on the this, a conceptual framework for community participation pertaining to the rural healthcare system has been developed. This study highlights the importance of understanding the psychosocial aspects of community participation among various stakeholders involved in rural health care. Lessons learned from this PLA study will be helpful in the integration of community-based participatory approach within grassroot level healthcare planning and service delivery., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Mishra, Singh, Parida, Pradhan and Nair.)

The study aimed to assess the adverse events following COVID-19 vaccine (Covaxin) immunization at a tertiary care institution and also assess the predictors of the adverse events following immunization (AEFI). The prospective observational study was conducted in a tertiary care institute among the Covaxin beneficiaries between June 28 and September 6, 2021. A total of 1826 participants were assessed for any local or systemic adverse events after seven days of vaccination. A telephonic interview was conducted, and the beneficiaries were assessed according to the adverse event grading. A total of 1826 participants were assessed for AEFI, and 544 (29.8%) reported at least one of the AEFI. No severe adverse events were reported, and about 1.6% had moderate AEFI. Pain at the injection site (14.6%), fever (9.7%), and myalgia (5.9%) were the common adverse events reported by the participants. AEFI incidence was higher in the first dose (38.1%) when compared to the second dose (26.4%), and this finding was significant with a p < 0.001. The major factors associated with AEFI were female sex, history of an allergic reaction, presence of comorbidities, acute infection in the past 3 months, and intake of chronic medications. Precaution needs to be taken while vaccinating individuals having allergies, comorbidities, acute infection in the last 3 months, and individuals on chronic medication., (© 2022 Wiley Periodicals LLC.)

Objectives: To find the prevalence of COVID vaccine hesitancy amongst people of Odisha and reasons for the same., Design: Observational Study., Setting: Outpatients, inpatients, and attenders in tertiary health centers in Khorda, Tangi, and Mendhasal, Odisha, India; online data via google forms from people across the state., Duration of Study: April to June 2021., Participants: Convenience sampling of 450 adults aged between 18 and 60., Main Outcome Measure: Willingness to get vaccinated against COVID-19., Results: Hesitancy rate stands at 12.7%, with 5.7% in the urban setting and 20.9% in rural (CI 95%, P = 0.000), 3.1% amongst males and 25.4% females (CI 95% P = 0.000), and 42.6% amongst the homemakers. Main reasons for vaccine hesitancy include lack of knowledge about efficacy,fear of side effects, and testing positive despite taking the vaccine., Conclusions: The near tripling of the hesitancy rates indicates a probable hindrance in stopping the spread of the infection. Family physicians have a significant role in alleviating the myths, counseling people, and managing adverse events., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Family Medicine and Primary Care.)

Background: The prevalence of elder abuse in various parts of the world has been reported between 2.2 and 90.4%. According to some studies conducted in India, elder abuse prevalence ranges between 9.6 to 61.7%. Yet, elder abuse is an underreported issue. Most available evidence shows the involvement of close family members and caregivers in the abuse of older adults. Several factors associated with various forms of elder abuse need to be studied further. This study has attempted to capture the prevalence, pattern and associated factors of elder abuse in urban slums., Methods: This study was a cross-sectional community-based study conducted between August 2019 to August 2020 in an urban field practice area of the All India Institute of Medical Sciences, Bhubaneswar. It covers four wards of the Bhubaneswar Municipal Corporation, served by the Urban Primary Health Centre, IRC Village, Nayapalli. A total of 360 participants aged 60 years and above were included in this study. They were interviewed using various semi-structured interview schedules. Validated study tools such as Activities of Daily Living (ADL- Barthel Index), Hindi Mental Scale Examination (HMSE), Geriatric Depression Scale (GDS), and Vulnerability to Abuse Screening Scale (VASS) were also used to assess various factors., Results: Approximately one in five (19.4%) older adults reported some form of abuse. The types of elder abuse reported were physical abuse in 12 (3.3%), verbal abuse in 25 (6.9%), emotional abuse in 40 (11.1%), and financial abuse in 15 (4.2%) older adult participants. The sons and daughters-in-law of the older adult participants were the main perpetrators of abuse reported. Depression and past history of abuse were found significantly associated with any type of abuse., Conclusions: The prevalence of elder abuse in this study was considerably high, with 70 (19.4%) out of the 360 participants reporting some form of abuse. Emotional abuse was the most reported, and physical abuse was the least reported type. The most common perpetrators were those on whom the older adults depended, like their sons and daughters-in-law., (© 2022. The Author(s).)

Mangroves play a key role in ecosystem balancing and climate change mitigation. It acts as a source and sink of methane (CH 4 ), a major greenhouse gas responsible for climate change. Energy metabolic pathways of methane production (methanogenesis) and oxidation (methanotrophy) are directly driven by sulphur (S) and nitrogen (N) metabolism and salinity in coastal wetlands. To investigate, how mangrove-degradations, affect the source-sink behaviour of CH 4 ; the pathways of CH 4 , S and N were studied through whole-genome metagenomic approach. Soil samples were collected from degraded and undisturbed mangrove systems in Sundarban, India. Structural and functional microbial diversities (KEGG pathways) of CH 4 , S and N metabolism were analysed and correlated with labile carbon pools and physico-chemical properties of soil. Overall, the acetoclastic pathway of methanogenesis was dominant. However, the relative proportion of conversion of CO 2 to CH 4 was more in degraded mangroves. Methane oxidation was higher in undisturbed mangroves and the serine pathway was dominant. After serine, the ribulose monophosphate pathway of CH 4 oxidation was dominant in degraded mangrove, while the xylulose monophosphate pathway was dominant in undisturbed site as it is more tolerant to salinity and higher pH. The assimilatory pathway (AMP) of S-metabolism was dominant in both systems. But in AMP pathway, adenosine triphosphate sulfurylase enzyme reads were higher in degraded mangrove, while NADPH-sulfite reductase abundance was higher in undisturbed mangrove due to higher salinity, and pH. In N-metabolism, the denitrification pathway was predominant in degraded sites, whereas the dissimilatory nitrate reduction pathway was dominant in undisturbed mangroves. The relative ratios of sulphur reducing bacteria (SRB): methanogens were higher in degraded mangrove; however, methanotrophs:methanogens was higher in undisturbed mangrove indicated lower source and greater sink capacity of CH 4 in the system. Microbial manipulation in mangrove-rhizosphere for regulating major energy metabolic pathways of methane could open-up a new window of climate change mitigation in coastal wetlands., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Breast and cervical cancers are the two leading causes of cancer-specific mortality and morbidity amongst Indian women. Screening methods are cost-effective. However, the uptake of screening methods in India is very low. Knowledge and attitude of healthcare professionals (HCPs) play an important role in reducing the mortality related to cancer., Materials and Methods: This study aimed to assess the knowledge and utilisation of screening methods for cervical and breast cancer and to elaborate barriers for non-utilisation amongst female HCPs, both doctors and nurses. A cross-sectional study was carried out from April to July 2017 in a tertiary healthcare hospital of eastern India amongst 200 female HCPs using a pre-designed, pre-tested, self-administered questionnaire. Data were analysed using the Statistical Package for the Social Sciences version 20.0. Statistical tests such as proportion and mean were calculated and the Chi-square test was used as a test of significance for categorical variables., Results: Clinical breast examination and mammography were practiced by only 26.5% and 7% of respondents, respectively. Only seven doctors and one nurse had ever undergone Pap smear. More than 90% of respondents knew risk factors, signs and symptoms and the availability of screening tools for the detection of cervical and breast carcinoma., Conclusions: The utilisation of breast and cervical cancer screening was unsatisfactory despite having good knowledge of the preventable cancers and screening methods amongst HCPs. There is a need for attitudinal change amongst HCPs by continuous sensitisation programmes., Competing Interests: None

Background: The provision of preconception care approaches such as maternal assessments and education on healthy lifestyle (including physical activity, nutrition, and dietary supplements such as folic acid), general and sexual health, avoidance of high-risk behavior, and immunizations has been shown to identify and reduce the risk of adverse birth outcomes through appropriate management and preventive measures., Objective: The goal of the study is to determine the effect of an integrated preconception care intervention on delivery outcomes, which is a novel challenge for lowering unfavorable birth outcomes in India's low-resource setting. The main objectives are to investigate the relationship of birth outcomes to both maternal and paternal preconception health and determine the effect of preconception care intervention on improvement of maternal nutritional status and reduction of the risk of adverse birth outcomes such as prematurity, low birth weight, and maternal and neonatal complications., Methods: A nonrandomized controlled trial design will be used for comparing 2 groups: preconception care with a standard maternal health care (MHC) program and an integrated MHC program (without preconception care). Two rural field areas of Khordha district, Odisha, will be selected for conducting the study. The study will enroll 782 married women between the ages of 18 and 35 years with their spouses, with 391 women in each group. The couples will receive preconception care based on their health circumstances, and they will be followed up at 3-month intervals before pregnancy. Following pregnancy, they will be followed up for 8 prenatal monitoring and care visits as well as 6 weeks after delivery as part of the standard MCH program. The preconception care intervention package includes couples counseling, contraceptive education and distribution, sex education, lifestyle modification, and nutritional supplementation of iron and folic acid, along with multivitamins if needed., Results: The proposal was approved by the institutional ethical committee for conducting the study in June 2020 (Ref No: T/EMF/Nursing/20/6). Participants were enrolled in phase 1 in April 2021, phase 2 of offering preconception services will begin in August 2021, and study outcomes will be measured from 2023 to 2024., Conclusions: Through preconception care and counseling, the eligible couples will recognize, embrace, and implement the actions to improve their preconception health. Finally, it is expected that maternal and paternal health will have a significant impact on enhancing maternal nutritional status and birth outcomes., Trial Registration: Clinical Trials Registry-India CTRI/2021/04/032836; http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=48239&EncHid=&userName=CTRI/2021/04/032836., International Registered Report Identifier (irrid): PRR1-10.2196/28148., (©Dharitri Swain, Jasmina Begum, Swayam Prangnan Parida. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 16.08.2021.)

Objective: To assess the correlates of sociodemographic profile with abnormal blood profile in tribal districts of Odisha., Design: This was a cross-sectional study. The abnormal blood profile cut-offs were: Random blood sugar >200 mg/dl, Triglycerides >150 mg/dl, and Cholesterol >200 mg/dl., Setting: The study was carried out in Daringbadi and Tangi (Choudwar) blocks from Kandhamal and Cuttack district, respectively, in the eastern state of Odisha in India., Participants: Data of 2,000 households selected consecutively from 30 villages was collected for persons aged more than 6 years from either block on sociodemographic aspects and food consumption by households. Anthropometric measurements were taken for persons aged 11 years and above. Approximately 10%, that is, 400 households were chosen for blood sample collection for estimation of random blood sugar (RBS) and lipid profile [Serum Triglycerides (TG) and cholesterol] in persons aged 11 years and above., Results: The blood reports revealed that out of the total samples collected, 9.2% had elevated RBS, 20.8% had elevated TG, and 8.8% had elevated cholesterol levels overall. The prevalence of elevated RBS, TG, and Cholesterol was 2.3%, 15%, and 5.3%, respectively, in Daringbadi, while in Tangi-Choudwar the elevated markers were 17%, 27.2%, and 12.8% for RBS, TG, and Cholesterol, respectively. Our study found that compared to the Daringbadi block, a significantly higher ( P < 0.05) proportion of people from the Tangi-Choudwar block suffered from hyperglycemia (OR = 0.11; 95% CI: 0.06, 0.20), hypertriglyceridemia (OR = 0.47; 95% CI: 0.34, 0.64), and hypercholesterolemia (OR = 0.38; 95% CI: 0.24, 0.59). Hence, it was observed that the population of Daringbadi was 89%, 53%, and 62% less likely to have elevated random blood sugar level, serum triglycerides, and serum cholesterol, respectively, than the population of Tangi-Choudwar block. Overall, the population of Tangi-Choudwar was found to be more predisposed to an abnormal blood profile which might be indicate a less healthy lifestyle and diet in this block as compared to Daringbadi block., Conclusions: This study found that the sociodemographic factors influencing lifestyle and diet patterns of a population have an impact on the health of a population. We found that the tribal block which was more developed and had more intake of junk food and sedentary lifestyle similar to urban areas also had a greater proportion of population with an abnormal blood profile as compared to the less-developed tribal block. Hence, health promotion for a healthy lifestyle and diet is needed as a part of national health policy to implement primordial prevention and to prevent the emergence of risk factors from an early age. The frontline health workers and family physicians can play an important role in promoting a healthy lifestyle., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Adolescence is a period that is characterized by growth and development rapidly. They have only limited knowledge regarding sexual and reproductive health (SRH). Adolescents girls are more marginalized and face many problems in society. Owing to a lack of knowledge on SRH, they succumb to various situations such as unhealthy menstrual hygiene practices, unwanted sex, teenage pregnancy, unsafe abortions, reproductive tract infections (RTIs), and sexually transmitted diseases (STDs) such as HIV/AIDS. These have adverse effects on their mental health. This article reviews the literature to explore the knowledge, attitude, practices, and life skills regarding SRH among adolescent girls. Need for the inclusion of SRH and life skill education for adolescents in schools, strengthening health care programs, and involvement of various Non-Governmental organizations (NGO for adolescent wellbeing. A Search of relevant publications between 2011 and 2020 was done through multiple electronic databases such as MEDLINE, PUBMED, and Google scholar. A manual search on world health statistics, national programs regarding SRH was done., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

The coronavirus (COVID-19) pandemic has caused the world to undergo an unprecedented change in a short period. Personal protective equipment such as the face mask or face cover has become a daily necessity. Moreover, since some states and countries have made the use of face covers or face masks compulsory, one cannot ignore or afford to have a wrong or incomplete awareness about face masks. Current information suggests that the two main routes of transmission of the COVID-19 virus are respiratory droplets and contact. This article aims to review the existing information and highlight the need for the use of face masks or face covers to combat the COVID-19 pandemic and promote and provide necessary recommendations. Many countries have implemented or recommended mask wearing in the community, but recommendation for rational use of masks is being issued, as the crisis and shortage for masks are universally existing. The use of different types of masks has been assigned according to the risk of exposure and should be therefore judiciously used. As this is a novel disease, the guidelines are changing every day and one needs to be updated with correct information so that one can protect themselves and their families from this extreme level of the crisis faced by the world now. The use of face covers or masks should not be discouraged as there has been substantial evidence that its use can help reduce the spread of infection. "Mass masking" along with hand hygiene and social distancing are the only effective recommended measures to prevent the spread of the disease., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)

Introduction : International tourism has grown tremendously in the past 2-3 decades in India resulting in exposure of travelers to varied spectrum of diseases prevalent in different parts of the world. Immunization plays a prominent role in protection of the exposed individuals. The objective of the present study was to assess the awareness and knowledge regarding yellow fever and other travel vaccinations amongst travelers of eastern India. Materials and methods : In the present cross-sectional study, participants attending Yellow Fever Vaccination Clinic at All India Institute of Medical Sciences, Bhubaneswar, during August-September 2018 were approached. Newly registered participants aged 15 y and above were interviewed consecutively till the required sample size of 300 was fulfilled. Awareness and knowledge regarding travel vaccinations and their adverse effects were assessed with pretested structured interview schedule. Bivariate and multivariate logistic regressions were done to assess the association of various factors with awareness of travel vaccinations. Results : Among the participants, most of them were males (90.7%), belonged to the age group of 15-45 y (87.3%), married (64.3%), graduates (19%), and were working (78.3%). Most of the participants were traveling to South Africa (85.4%). Only 57.3% participants were aware of any travel vaccinations. Only 37.5% participants knew that yellow fever vaccine confers lifelong immunity. On multivariate logistic regression higher education, working occupation and history of previous vaccination were significantly associated with awareness of travel vaccinations. Conclusion : Awareness regarding travel vaccinations is important to prevent fatal diseases like yellow fever. Vital information pertaining to diseases in different locations and availability of vaccines for prevention needs to be disseminated to the travelers to prevent occurrence of travel bound diseases.

Background: The study was conducted to estimate the prevalence and risk factors of obstetric fistula in the rural area of the south eastern community of India and the training of community health workers for its prevention., Methods: A population-based cross-sectional analytical study was conducted in the south eastern rural community of India. A total of 3939 women were included in the study and Probability proportional to size sampling was used in the study. Frequency distribution and logistic regression were computed to analyse the data using STATA version 11.2., Results: Out of 3939 participants interviewed, 23.7% women reported obstetric fistula symptoms whereas after clinical diagnosis and speculum examination the obstetric morbidity pattern was: Obstetric fistula 0.3%, stress urinary incontinence 20.0%, pelvic inflammatory diseases 1.2%, uterine prolapse 1.4% and urinary tract infection 3.8%. The awareness level of the rural women regarding the obstetric fistula was assessed by a structured knowledge questionnaire and found to be very poor, hence community based fistula training was implemented among community health workers as a health system based strategy for its prevention. Obstetric fistula found to be more prevalent among women of poor educational level, low socioeconomic status, less no of antenatal visits, delay in accessing the emergency obstetric care and prolonged labour (p ≤ 0.05)., Conclusion: Finding of the study indicated that the prevalence and risk of developing obstetric fistula was associated with less number of antenatal visits, prolonged labour, delay in timely intervention, delay in accessing emergency obstetric care and more number of movements from home to the delivery place. Finally, our study suggests that emphasis needs to be placed on training of community health workers to facilitate early screening for identification and referral of women with obstetric fistula.

Background: Birth preparedness and complication readiness extends the maternal and neonatal health continuum of care and thus contributes to one of the important tools for pregnant women to experience better pregnancy outcome, strengthening family and community health, creating space for other interventions. The present study aimed to evaluate community-based birth preparedness and complication readiness training on pregnancy outcome., Method: The study adopted a quasi-experimental time series only one experimental design which was conducted in rural south-eastern India for 1 year among the reproductive age group 15-49 years (≤ 24 weeks pregnancy), and cases were followed up till postnatal period. A standardized birth preparedness assessment index (BPAI) was used to assess preparedness level of respondents. Community-based continuous training (CBCT) was introduced, and its effect was measured on birth preparedness level, involvement of family and their pregnancy outcomes., Result: CBCT interventional program was effective in promoting positive behaviors on birth preparedness and complication readiness as per BPAI: 13% of women were at level 1, 15% at level 2, 19% at level 3, 49% participants were at 4th level and 5% were at 5th level which represented the best level of preparedness for their present delivery. Pregnant mothers who completed their antenatal visits and were well prepared for delivery were found to be having two times favorable pregnancy outcome than those who had not (OR 2.79)., Conclusion: BPCR intervention strategy can be utilized as a timely and effective community action plan for ensuring a favorable pregnancy outcome., Competing Interests: Conflict of interestAuthors would declare that no conflict of interest involved in this study., (© Federation of Obstetric & Gynecological Societies of India 2019.)

Introduction: Anemia is a major public health challenge in India. Despite national programmes and targeted interventions over the years, the decline has been unsatisfactory. National Iron Plus Initiative (NIPI) was launched by the Government of India with a vision to combat anemia. In this context, we discuss the programmatic facilitators and issues in the monitoring, supervision, and reporting aspects of NIPI implementation., Materials and Methods: A process documentation study was undertaken in four districts of Odisha to assess the NIPI implementation. A total of 170 interviews were conducted during March-May 2016 among officials and frontline workers through qualitative techniques such as in-depth interviews, focus group discussions, and process observation. Data analysis was thematic using NVivo software., Results: Monitoring and supervision consisted primarily of visiting field sites by supervisors and review of the progress in meetings with inadequate documentation. Lack of coordination and ownership among the various departments involved were observed as revealed in the interviews. Some of the reporting formats were outdated and missed section for IFA syrup. Focus had been on the collection of data, but its utilization for informed decision-making and policy decisions was lacking., Conclusion: Better interdepartmental coordination and ownership, streamlining the reporting system and web-based monitoring system need to be prioritized to improve the effectiveness of the programme. The three key departments involved must strengthen the evaluation process for sustained outcomes to reduce anemia burden., Competing Interests: There are no conflicts of interest.

Obstetric fistula (OF) is one of the most important consequences of a prolonged obstructed labor, a big issue for low-income countries (LICs) like India. The objective is to identify and explore the knowledge regarding OF as a public health problem in LICs from peer review literature. The PubMed, Google Scholar, and Science Direct databases were searched to identify the prevalence, risk factors, and management of OF in LICs. Quantitative evidence-based paper reviewed. Twenty-seven articles met the inclusion criteria. The 15 provided population-based OF prevalence data of OF and 12 provided risk factors and social causes of OF rates associated with the birth that caused an OF. OF has one of the big public health problems. There is a lack of scientific research on the prevalence and risk factors of OF in LICs. This review helps to eradicate or alleviate the problem of OF in LICs like India., Competing Interests: None

Objective: Cervical cancer incidence and mortality rates remain high in developing country due to low levels of awareness on preventive measures. The main study objective was to sensitize the young girls on the prevention of cervical cancer., Study Design: Quasi-experimental pretest and posttest design was used., Methods: A total of 240 young girls enrolled and 60 were selected randomly for the sensitization program. The preparedness for prevention of cervical cancer was assessed through structured preparedness criteria and perception toward vaccination was ascertained through rating scale., Results: Changes in knowledge level and intention to be vaccinated and for developing positive attitude to be screened in future were assessed using paired t -tests and found to be statistically significant. There is been an improvement in knowledge score noticed from pretest to posttest. The greatest improvements were observed in responses to questions on knowledge on symptoms (60%) and prevention (88%) that is maximum responded vaginal bleeding is the most common symptoms of cervical cancer and avoiding early sexual intercourse is the preventive measures of cancer cervix. Out of the 60 girls, 52 (86%) shown their agreement for human papillomavirus (HPV) vaccination, 35 (58.33%) took the HPV vaccine as a preventive measure., Conclusion: Study concludes that periodical sensitization through educational intervention may act as a cascade for girls and help them to be more aware about the preventive aspects of cervical cancer., Competing Interests: There are no conflicts of interest.

Background: Hematology and plasma biochemistry parameters are useful in the assessment and management of snake physiological status. Although reference ranges are readily available for many snake species, they are lacking for most venomous ophidians. We determined hematology and plasma biochemistry reference ranges for the wild-caught Indian cobra, Naja naja., Results: Blood samples, taken from the ventral tail vein, were assessed for erythrocyte count, total leukocyte count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration, considering the sex of snakes. Results revealed the erythrocyte numbers (male, 390000 ± 12503.33/mm(3) and female, 347500 ± 7505.55/mm(3)), shapes and the centrally located oval nuclei. Leukocytes were round, circular or disk-shaped, and the mean size was larger in male than female snakes. The maximum number of leukocytes was found to be 11700 ± 100/mm(3) in male and 12100 ± 200/mm(3) in female snakes, and mean values of differential leukocyte count differed statistically between male and female snakes. The total leukocyte levels were found to be higher in female snakes, but the levels of hemoglobin, hematocrit, and MCV values were higher in male snakes. However, the MCH and MCHC values remained higher in female snakes throughout the study period. Mean protein and cholesterol contents differed significantly between male (45.32 ± 1.76 and 3.76 ± 0.06 mg/mL) and female (12.47 ± 0.82 and 4.72 ± 0.2 mg/mL) snakes., Conclusions: In conclusion, monitoring snake hematological and biochemical parameters can serve as a means to evaluate the physiological and health status of N. naja populations, which may be a useful indicator of their environmental status.