Indian Journal of Community Health

Personal Life of Medical Journal Editor: Artificial Intelligence as almost First Author may come to Rescue

Deepak Gupta — Fri, 31 Mar 2023 00:00:00 +0000

Utopic or dystopic future is on the horizon unless it is already here. Maybe it is utopic for medical journal editors if artificial intelligence (AI) is writing medical research papers submitted to medical journals because in due course of time, AI may evolve to become AI editors and AI peers relieving humans from burning the midnight oil to run medical journals as medical journal editors while seeking human peers for review of submitted articles before editing and publishing as many peer-reviewed articles as humanely and appropriately possible.

Is there any Window of Opportunity to Tackle Geriatric Malnutrition?

Ruchita Ramesh Khandre — Fri, 31 Mar 2023 00:00:00 +0000

India has seen an increase in its greying population in recent years. The elderly population has a lot to contribute to society, but various problems like malnutrition can hinder their activities. India has been taking various nutritional interventions but has mainly focused on women and children, while the elderly have been neglected. Even after taking nutritional programmes to national platforms, the sustainability question hovers in the policy makers’ minds. Advanced and novel steps should be taken to ensure the long-term viability of existing programs, which can serve as the foundation for new interventions for the new group. Public health should participate in the new schemes that are currently in place to achieve the other SDGs (Sustainable Development Goals), as the SDG 2030 agenda brings different opportunities to act against malnutrition.

Conceptual understanding of Sustainable Health and Linking Nutrition to Sustainable Development Goals

Khushboo Juneja, Ratnesh Sinha — Fri, 31 Mar 2023 00:00:00 +0000

Nutrition is a development indicator. It indicates advancement in health, education, employment, women’s empowerment, poverty, inequality reduction, and it can help in building peaceful, secure, and stable societies.” It is one of the important components which is directly or indirectly related to Sustainable Development Goals (SDGs). Multiple factors such as education, economic status, occupation, water, sanitation, hygiene, etc are interlinked with nutrition. In this article, we have emphasized the relationship of various SDGs with nutrition. Global and multi-sectorial involvement is required in the battle with malnutrition. Adequately nourished people are more productive and active. By breaking the cycles of hunger and malnutrition, we can create a path for achieving SDGs.

Intra-natal Care Practices in Rural Areas of Gaya District, Bihar

Suman, Ghanashyam Sethy, Chandramani Singh, Bhavan Jain, Ajeet Singh Bhadoria — Fri, 31 Mar 2023 00:00:00 +0000

Context: Antenatal care (ANC) effectively reduces infant and maternal mortality rates mainly by promoting institutional deliveries. In view of this, the Government of India introduced Janani Suraksha Yojna (JSY) in 2005 and Janani Shishu Suraksha Karyakram (JSSK) in 2011.

Aims: To estimate the proportion of home and institutional deliveries in the district, assess the impact of JSK and JSSY on institutional deliveries, and identify the different intranatal care providers.

Settings and Design: This cross-sectional study was conducted in the Gaya district, Bihar. A total of 657 females of the reproductive age group (15-49 years) were included in the study.

Methods and Material: Predesigned, pre-tested & semi-structured questionnaire was used to collect information on place of delivery, type of delivery, knowledge regarding JSY and JSSK schemes and source of information Statistical analysis used: Data was entered into excel sheets and analyzed using SPSS version 23 utilizing appropriate statistical methods.

Results: Out of 519 deliveries, 63% were institutional and 37% were home deliveries. About 91 and 11.4% of respondents were aware of JSY and JSSK schemes. There was a significant association between those who opted for institutional delivery and awareness regarding JSY and JSSK services.

Conclusion: Despite awareness and running of various government programs, the percentage of institutional deliveries is still less. An increase in institutional deliveries at primary care level through JSY and JSSK will not only decrease the Out of Pocket expenditure of the population but also help build faith in the government health facilities.

Influenza outbreak in India: A course ahead

Vartika Saxena, Ashutosh Mishra — Fri, 31 Mar 2023 00:00:00 +0000

“Influenza” is commonly known as “flu” caused by a single-stranded RNA virus. There are four types of Influenza viruses A, B, C and D, of which type A and B are mainly known to cause respiratory tract infection in humans, especially during the winter and post-monsoon season. It is transmitted rapidly through infectious droplets in crowded places, including schools and hospitals.[1] The incubation period of influenza ranges from1 to 4 days with its period of communicability ranges from one day before the onset of symptoms to 7 days after the symptoms begin.[2] It has already caused multiple pandemics in the past, with a recent one in year 2009 was caused by the Influenza subtype A H1N1 variant (pdm09). Millions of deaths have occurred during these pandemics. The vulnerable population like under-five children, elderly people (? 65years of age), pregnant women, and people with comorbidity like diabetes, chronic kidney disease, chronic obstructive pulmonary disease, chronic heart disease, chronic liver disease and immunocompromised conditions (i.e., HIV/ AIDS, malignancy, individuals on chemotherapy or steroid) are at higher risk of developing severe illness due to infection by Influenza viruses.

Challenges of Second-hand Smoke: Are We Asking the Right Questions?

Fri, 31 Mar 2023 00:00:00 +0000

Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions.

A Narrative Review on Priorities of Mental Health Issues among Transgenders: “So Near, Yet so Far”

Sai Chandan Das, Deep Shikha, Sudip Bhattacharya, Richa Sinha — Fri, 31 Mar 2023 00:00:00 +0000

In recent years there is a rapid rise in coming out of sexual and gender minority adults to their family members and society. Unfortunately, studies on unmet health needs of transgenders with a special focus to mental health is under-researched in India. The current paper aimed to explore about the mental health of transgenders and a literature search was done using PubMed, Google Scholar, and Scopus databases for the following medical subject headings (MeSH) key terms “transgender”, “mental Health”, “social stigma”, “LGBT”, “gender dysphoria”, “genderqueer”, “intersex”, “MSM”, “hijra”, “gay”, “lesbian”, “bisexual”, and “homosexual”. Transgender individuals were found to show high rates of mental health concerns. The most common mental health problems that we have shown in this review article are depression, obsessive-compulsive disorders, generalized anxiety disorders, suicidal attempts and bipolar disorders. Transgender people are at more risk for mental health problems than their heterogenous counterparts. The intervention program to eliminate or reduce these problems needs to be planned carefully, considering all the determinants.

Upsurge in Firearm related Deaths among Children and Adolescents in the United States: An Alarming Trend

MD. Abu Bashar, Nishat Ahmed Sheikh — Fri, 31 Mar 2023 00:00:00 +0000

Firearm-related violence is a leading cause of death, disproportionately affecting adolescents and young adults across the world, especially in the Americas. It is one of the most common forms of suicide and homicide across the globe. Recent data from the Centers for Disease Control and Prevention (CDC) shows an alarming increase in firearm-related mortality among children and Adolescents which is a cause of concern and requires strict gun licensing regulation in countries like the U.S.

A Study of Clinico-social Profile of Animal Bite Patients Attending the Antirabies Clinic of BRD Medical College, Gorakhpur

Fri, 31 Mar 2023 00:00:00 +0000

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.

Prevalence of Anemia among Adolescent Girls in Rural Area of a District of Maharashtra

Abhilasha Nair, Mohan K Doibale — Fri, 31 Mar 2023 00:00:00 +0000

Introduction: Nutritional anemia is one of India’s major public health problems. Adolescence is a vulnerable period in the human life cycle for the development of nutritional anemia. Anemia in adolescent girls contributes to maternal and foetal mortality and morbidity in future.

Aim and Objectives: To estimate the prevalence of anemia among adolescent girls and to study the sociodemographic factors associated with anemia.

Method: It was a community based cross sectional study in 10 villages of a district. 420 adolescent girls were interviewed using a predesigned, pretested questionnaire, and their anemic status was assessed by hemoglobin estimation. Results were analyzed by using percentage, proportion and Chi-square test, with the help of Microsoft Excel 2007 and SPSS version 20.0 statistical software.

Result: Mean age of the study sample was 14.01 ± 2.57 years. The majority (64.8%) of the girls were Hindu by religion and belonged to a nuclear family (53.6%). 45.2 % were educated up to high school level. Most of the girls belonged to socioeconomic class IV (46.0%). The prevalence of anemia in this study was found to be 65.7%. The prevalence of mild and moderate anemia among study participants was 32.6 and 29.8%, respectively. A statistically significant association was found between the prevalence of anemia with age group, educational status of both father and mother, and status of attainment of menarche (p<0.05).

Conclusion and Recommendation: The prevalence of anemia among adolescent girls was very high; therefore, attempts must be made to sensitize adolescents and their parents through health and nutrition education, information, education, and communication (IEC), and appropriate behavioral change communication (BCC) activities.

Prevalence of Smartphone Addiction and its Relation with Depression among School-going Adolescents

Fri, 31 Mar 2023 00:00:00 +0000

Background: Smartphone addiction among adolescents is an increasingly recognized problem worldwide. It affects the

psychological well-being of an individual.

Aim and objective: The current study aimed to assess smartphone addiction’s prevalence and its relation to depression among adolescents.

Methods: This cross-sectional study was conducted among 400 school-going adolescents. Smartphone Addiction Scale - Short version (SAS-SV) and Patient Health Questionnaire (PHQ-9) were used to assess the prevalence of smartphone addiction and depression. Data were analyzed using Epi info software for windows (CDC, Atlanta). Statistical significance was set at p < 0.05. Results: The mean age of study participants was 14.4 years (SD=1.5 years). The prevalence of smartphone addiction was 23%, while depression was present among 45% of the study participants. Comparatively higher duration of smartphone use was significantly associated with smartphone addiction. Depression was significantly higher among smartphone addicts (77.2%) as compared to their counterparts (35.4%).

Conclusion and Recommendation: The smartphone usage of adolescents, if not monitored, could lead to its addiction and thus increase the risk of depression among them. To prevent smartphone addiction, limiting children’s screen time is recommended. In this regard, parents can play a pivotal role by becoming responsible digital role models for their children.

Perspectives of Teachers at Medical Colleges Across India regarding the Competency based Medical Education Curriculum – A Qualitative, Manual, Theoretical Thematic Content Analysis

Fri, 31 Mar 2023 00:00:00 +0000

Background: Competency-based medical education (CBME) curriculum has been implemented in India since 2019 with a goal to create an “Indian Medical Graduate” (IMG) possessing requisite knowledge, skills, attitudes, values, and responsiveness. Objectives: To explore teachers’ perceptions across India at medical colleges on the newly implemented competency-based medical education curriculum.

Methods: This was a qualitative cross?sectional study conducted among teachers working at medical colleges across India, between February and April 2022 (n = 192). The data collection was done using Google forms online survey platform on teachers’ perception regarding CBME, its specific components, and perceived bottlenecks. We analyzed this qualitative data using manual, theoretical thematic content analysis following the steps endorsed in Braun and Clarke’s six-phase framework.

Results: The majority of the teachers (64.1%) have positively responded to the CBME curriculum’s implementation. However, it came with a caution that the curriculum should continuously evolve and adapt to regional demands. The foundation course, early clinical exposure, and the family adoption program were the specific components of CBME curriculum over which the teachers raised concerns. The need for additional teachers in each department (department-specific teacher or faculty per hundred students ratio to be worked out) and the need for enabling faculty preparedness through adequate training was highlighted. Concerns were also raised regarding implementing CBME with teachers without a medical background (especially in preclinical departments). Conclusion: It is the need of the hour for the curriculum to incorporate a systematic feedback mechanism built into the system, though which such critical appraisals can be meaning collated and acted upon, to ultimately evolve, thereby creating an “Indian Medical Graduate” for the needs of todays’ society.

Knowledge, Attitude and Practices Regarding Electronic Waste (e-waste) Management Among Users of Electronic Equipments Living in Lucknow City

Fri, 31 Mar 2023 00:00:00 +0000

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.

Association of Dietary and Physical Activity Patterns and Hypertension in Western Rajasthan, 2022

Fri, 31 Mar 2023 00:00:00 +0000

Introduction: Hypertension (HTN) is a modifiable risk factor for coronary artery disease, heart failure, cerebrovascular disease and chronic renal failure. HTN affects about 1 billion people globally; by 2025, up to 1.58 billion adults worldwide are likely to suffer from complications of HTN. This study was done to know the diet and physical activity patterns and HTN among the population of three districts of Western Rajasthan.

Objectives: To study the dietary and physical activity patterns among the population of Western Rajasthan. and to compare key findings among three districts Pali, Jodhpur and Barmer so that lifestyle changes can be recommended.

Methods: A case-control study was done among attendees of NCD clinics of tertiary-level centers in Pali, Barmer and Jodhpur. Hospital Controls were matched to age (± 5 years) and gender Considering the prevalence of HTN to be 20%*, the proportion of exposure in the general population as 0.2, odds ratio to be 2.2, power =80%, alpha=5% sample size is estimated to be 102 cases & 102 controls (from each district).

Results: Overall being married (OR= 3.3), having diabetes Cardiac disease (OR= 2.6), excessive salt consumption (OR= 2.7), moderate physical exercise less than 30 minutes (OR=1.9), using oil other than vegetable oil(OR=1.8) , Age >?60 years (OR =1.4) were the key risk factors. It was found that high BMI (BMI>27), consumption of non-vegetable oils (12.7%) was highest in Jodhpur, lack of moderate exercise for at least 30 minutes (81%), lack of sports activity (92%) was highest in Pali, least number of days/week of fruits and vegetables consumption (~1.64 days) was seen in Barmer.

Conclusions: Change in quantity of salt consumption and incorporation of moderate physical exercise for >30 minutes was most followed in control of HTN among the attendees of NCD Clinics from the multiple advise given.

Behavioral Risk Factors of HBV Infection and its Association with HBs Ag Positivity among Residents of Kaza Sub- division of District Lahaul & Spiti in Himachal Pradesh

Fri, 31 Mar 2023 00:00:00 +0000

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 pre-tested interview plan. A blood sample of 5ml 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.

An Exploratory Study on Quality of Life among Road Traffic Accident Victims in India

Lalithambigai Chellamuthu, Devi Kittu, Yogesh Bahurupi, Kavita Vasudevan — Fri, 31 Mar 2023 00:00:00 +0000

Background: Road traffic accidents are India’s sixth leading cause of mortality, with a substantial share of physical, psychosocial and economic losses in the productive age group.

Objectives: To explore the victims’ and stakeholders’ perceptions on quality of life among road traffic accident victims in India.

Methods: A qualitative study incorporating in-depth interviews among road traffic accident victims and key informant interviews among stakeholders was conducted from June to August 2019 (3 months) in Puducherry. Participants were selected using purposive sampling. Data was collected till the point of saturation with a semi-structured interview guide through six in-depth interviews among accident victims and six key informant interviews among stakeholders. Content analysis of the data was performed, and a conceptual framework was developed. Written informed consent from each participant was sought. Ethical clearance was obtained from the Institute Ethics Committee.

Results: Four themes were identified: reasons for road traffic accidents, problems faced by the victims, problems faced by the caretaker or family member, and preventive measures for road traffic injuries.

Conclusion: Physical, psychological, and financial problems were encountered by the victims, caretakers, and family members after a major road traffic accident. Accident victims felt that support from family members was indispensable in returning to normal life.

A Study on Internet and Gaming Addiction, Hikikomori Trait and Insomnia Status among Medical Undergraduates at one of Cities of Western India

Sahil R Solanki, Rujul Pankajbhai Shukla, Viral R Dave, Vasu G Rathod — Fri, 31 Mar 2023 00:00:00 +0000

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.

Prevalence, Socio-cultural Restrictions and Determinants of School Absenteeism during Menstruation among Adolescent School Girls in Bangalore

Fri, 31 Mar 2023 00:00:00 +0000

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: 1. To determine the prevalence of school absenteeism among adolescent school girls during menstruation. 2. To assess the restrictions which are imposed on adolescent school girls during menstruation. 3. 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.

Determination of Gender using Discriminant Analysis of Hand Dimensions among Adult Participants

Syed Azizur Rahman, Kamlesh Kumar Shukla, Pankaj Kumar Mishra, Ranjana Singh — Fri, 31 Mar 2023 00:00:00 +0000

Background: The estimation of gender using hand dimensions is a crucial role in forensic investigation and legal sciences.

Objectives: In this study, the mean score of hand measurements have been derived and linear discriminant analysis has been applied to predict gender from hand dimensions. An Independent t-test has been employed to know discrimination between male and female. The accuracy of gender estimation has been derived and checked by ROC curve.

Material and Methods: A sample of 150 participants has been collected for the completion of this study, where 78 males and 72 females were found aged between 18 and 24 years. The breadths and lengths of left and right hands of the participants have been measured.

Results: Respondents’ mean score of length and breadth of left hand were found 17.69 ± 1.30 and 7.56 ± 1.17, respectively. It was found to be significantly different in the respondents’ mean scores of males and females.

Conclusions: The hand dimensions of males were higher than females. The prediction of a number of females and males were 76 and 74, respectively, and its accuracy was observed 0.87. This research can be applied for larger sample and would be helpful in predicting gender discrimination among adults through hand dimensions.

Incidence and Determinants of Low birth weight babies at rural tertiary care hospital in central Uttar Pradesh

Fri, 31 Mar 2023 00:00:00 +0000

Background: An infant’s birth weight is a reliable index of intrauterine growth and a sensitive predictor of newborn chances of survival, growth and long-term physical and psychosocial development. Low birth weight has been defined as birth weight <2.5 kg regardless of gestational age. The incidence of low birth weight (LBW) in India varies between 25–30% and of which 60–65% are because of intrauterine growth retardation.

Aim & Objective: To determine the incidence and various determinants of low birth weight among babies delivered at rural tertiary care hospitals in central Uttar Pradesh.

Methods and Material: The study was conducted at UPUMS, Saifai, Etawah, among pregnant women who delivered babies from 1st January 2018 to 31st December 2018. Details regarding age of the mother, gravida, parity, gestation period, presence of complications, the procedure for delivery and birth weight of the newborn were recorded and analyzed using SPSS software (version 23)

Results: A total of 7615 deliveries were conducted (53.2% were males, 46.8% were females). The mean birth weight of babies was 2.65 Kg with S.D ± 0.52. Preterm babies were 32% while 67% were term babies and 23% of babies were low birth weight. There was a statistically significant association between birth weight of babies and factors like age of mother, parity of mother, gestation period, and presence of complications during the antenatal period.

Conclusions: Prompt identification of high-risk factors, prevention of premature delivery, increasing the use of health services during pregnancy and management of the risk factors would reduce the incidence of low birth weight.

Acceptance of COVID-19 Vaccination Among Health Care Workers in India

Fri, 31 Mar 2023 00:00:00 +0000

Background: The coronavirus disease 2019 has been spread almost all over the world in the last two years, including in India. Vaccines are a critical tool in the battle against COVID-19, and India has flagged the largest vaccination drive on 16 January 2021. Although public acceptance was varying, which can lead to non-acceptance.

Aim & Objective: To estimate an acceptance of the COVID-19 vaccine and its associated factors.

Settings and Design: An analytical cross-sectional study among health care workers in India

Methods & Material: It was conducted using a validated, self-administrated online survey questionnaire, and data were analyzed using SPSS 23 version. The outcome variable was healthcare workers’ acceptance of a COVID-19 vaccine.

Results: A total of 450 HCWs participated, including 205(45.6%) women and 245(54.4%) men. A total of 270 (60%) subjects will accept vaccines, while 33.3% were unwilling to accept and wait for vaccines. Male gender (OR=3.14), being married and experienced (OR=11.49), vaccine effectiveness (OR=6.4), vaccine safety (OR=3.4), and past history (OR=2.28) were significantly associated. On applying logistic regression for associated factors, gender (B= -1.145, S.E.= 0.200, Wald 32.748), being married (B= -1.482, S.E.= 0.216, Wald 46.937), for experienced (B= -0.865, S.E.= 0.200, effectiveness (B= -1.856, S.E.= 0.245, Wald 57.431), Safety (B= -1.224, S.E.= 0.202, Wald 36.633) and past history (B= -0.357, S.E.= 0.248, Wald 2.071) found significant. Recommendation: Proper information is crucial and healthcare workers’ attitudes about vaccines are an important factor for acceptance and recommendation of the vaccine to the public for population-wide coverage.

Repercussions of COVID-19 Pandemic on prenatal and antenatal care in Bahadarbad block of Dist Haridwar Uttarakhand, India

Rajeev Bijalwan, Ruchira Nautiyal, Nikku Yadav — Fri, 31 Mar 2023 00:00:00 +0000

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 (Uttarakhand). 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.

Antibody Response to SARS-COV-2 Vaccination in Healthcare Workers of Uttarakhand: A Prospective Follow-up Study

Fri, 31 Mar 2023 00:00:00 +0000

Background: Countries around the world are now racing to vaccinate people against SARS-CoV-2, the virus that causes COVID-19. The Government of India also rolled out its vaccination drive from 16th January ‘2021.

Aims: To estimate the antibody response of the COVID-19 vaccine in the form of SARS-COV-2 IgG antibodies in vaccinated healthcare workers.

Methods: Prospective follow-up was study conducted on healthcare workers (HCWs) of a Medical college in Dehradun, Uttarakhand. Healthcare workers who have been vaccinated for COVID-19 were tested for SARS-CoV-2-IgG antibodies at regular intervals i.e at 4 weeks after the 1st dose and then again at 4 weeks after the 2nd dose. The third sample was taken 6 months after the 2nd dose.

Results: A total of 302 HCWs were enrolled in the study who gave their samples for IgG antibody estimation after the Covishield vaccine. After 4 weeks of completion of both doses, 96% HCWs formed SARS-COV-2 IgG antibodies, whereas 4% didn’t. Then after 6 months of follow-up, 14% HCWs have become negative for antibodies and better immunity is seen in people who also got infected with COVID-19 during this time.

Conclusion: This study concludes that the immunity gained after vaccination is waning off in around 6 months and there is a need for a booster dose, especially for people at high risk. The infection control practices still play a crucial role in the prevention of this deadly disease.

Healthcare Seeking Behaviour of Hospitalised COVID-19 Patients During Second Wave in Tertiary Care Hospital of Northern India

Fri, 31 Mar 2023 00:00:00 +0000

Background: The Coronavirus Disease (COVID-19) pandemic continues its deadly reign all over the world. Devising effective strategies for detecting and controlling the infection has become ever more critical. Effective prevention and control of the pandemic is entirely dependent on human behavior in terms of practicing preventive and curative measures. During the second wave of COVID-19, people’s perceptions of preventive and curative measures changed.

Objective: To study healthcare-seeking behavior of hospitalized COVID-19 patients.

Methods: Hospitalized patients due to COVID-19 in the month of March, April and May of 2021 were included in the study. Their attendants/close relatives were contacted telephonically to know about the admitted patients’ healthcare-seeking behavior. Verbal consent was taken from attendants before the commencement of the interview, followed by informing them about the purpose of the interview.

Results: Amongst the subjects, there were more males than females (67.5 vs 32.4%), age ranged between 18 to 88 with a mean value of 56.61 ± 14.7 years. Self-medication was significantly associated with study subjects’ mortality (p=0.03). Conclusion: Elderly people were having higher mortality rate than their younger counterparts. People were hesitant to visit primary care physicians after having symptoms of COVID-19.

Vulnerability to Mental Health Problems in Indian Population during Lockdown amidst COVID-19 Pandemic: An Alarm not to Snooze

Fri, 31 Mar 2023 00:00:00 +0000

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 18-45 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.

Missed and Lost to Follow-up Cases in HIV Positive Patients and the Impact of Lockdown During COVID-19 Pandemic on Adherence to Anti-retroviral Therapy at ART Center, Jhansi, Uttar Pradesh

Sudha Sharma, Rambabu Singh, Anil Kumar Malhotra — Fri, 31 Mar 2023 00:00:00 +0000

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.