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Yujeong Kim,1 Eunhee Nam1,2 1College of Nursing, Research Institute of Nursing Innovation, Kyungpook National University, Daegu, Republic of Korea; 2Health Insurance Review and Assessment Service, Wonju, South KoreaCorrespondence: Eunhee Nam, Health Insurance Review and Assessment Service, Review and Assessment Research Department, 60, Hyeoksin-ro, Wonju-si, Gangwon State, Republic of Korea, 26465, Tel +082-33-739-0941, Fax +082-33-811-7433, Email dmsgml7278@naver.comPurpose: This study aimed to examine the level of patient measures of safety and identify the influencing factors of patient measures of safety among Korean.Methods: This study was a cross-sectional study. From February 7 to February 12, 2024, data were collected through a structured on-line questionnaire consisting of items about general characteristics, patient safety knowledge, nurse–patient interaction, experience of patient participation, willingness to participate in patient safety, and patient measures of safety involving 330 adults. Since there were no incomplete responses, data from all 330 participants were included in the final analysis. The collected data were analyzed using descriptive statistics, t-test, chi-square test, analysis of variance, post-hoc test, correlational analysis, and regression analysis.Results: Patient measures of safety showed significant positive correlations with patients’ safety knowledge, nurse–patient interaction, patient experience in participating in safety activities, and patients’ willingness to participate in safety activities. The employment status, nurse–patient interaction, patient experience in safety activities, and willingness to participate in safety activities were identified as significant factors affecting patient measures of safety.Conclusion: Enhancing nurse–patient interaction—a crucial determinant of patient safety measures—would require implementing effective communication programs. Additionally, it is significant to facilitate patient expression of safety concerns and establish a patient-centered safety monitoring and feedback system. This would actively promote patient participation in safety activities.Keywords: patient safety, nurse-patient relations, patient participation, patient reported outcome measures

Tiantian Jia,1 Yunxia Lan,2 Jing Pang,2 Mengdan Ma,1 Zhe Ding,3 Yongting Wang,1 Enshe Jiang4 1Cardiac Surgery Intensive Care Unit, The Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, 450008, People’s Republic of China; 2Department of Nursing, The Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, 450008, People’s Republic of China; 3Department of Rehabilitation, The Affiliated Chest Hospital of Zhengzhou University, Zhengzhou, 450008, People’s Republic of China; 4Institute of Nursing and Health, Henan University, Kaifeng, 475004, People’s Republic of ChinaCorrespondence: Enshe Jiang, Institute of Nursing and Health, Henan University, No. 1 Jinming Road, Kaifeng, Henan, 475004, People’s Republic of China, Email esjiang@gmail.com Yongting Wang, Cardiac Surgery Intensive Care Unit, the Affiliated Chest Hospital of Zhengzhou University, No. 1 Weiwu Road, Zhengzhou, Henan, 450008, People’s Republic of China, Email 2313992171@qq.comPurpose: To construct a training course program for ICU nurses to care for oral mucosal membrane pressure injury (MMPI) and evaluate its implementation effects based on the ADDIE model.Patients and Methods: A research team was established to construct the training course program in January 2024. According to the ADDIE model, a training course was designed and developed after the literature research and Delphi expert inquiry. The training course program was implemented in 138 ICU nurses from a tertiary A hospital in China from April to May 2024. The ICU nurses’ knowledge, attitude, and practice in preventing medical device-related pressure injury in critically ill patients and the incidence of oral MMPI were compared before and after the training program.Results: A particular training course program for the ICU nurses to care for oral MMPI was constructed in this study. It contained three aspects of particular training subjects (professional knowledge, practical skills and professional literacy) and included 16 specific training courses. One hundred and thirty-eight ICU nurses received the training course program in the hospital. The total score of MMPI knowledge-attitude-practice of the ICU nurses was (167.73± 8.13) after the training, which was significantly improved compared with the score before the training (145.81± 13.57) (t = 16.283, P< 0.001). The incidence of oral MMPI after the training (5.94%) was significantly lower than that before training (22.93) (x2=12.034, P< 0.001).Conclusion: The training course program for ICU nurses to care for oral MMPI based on the ADDIE module can effectively improve ICU nurses’ comprehensive ability to prevent oral MMPI and reduce the incidence of oral MMPI. It can be applied in clinical nursing education and practice.Keywords: ADDIE model, ICU nurses, mucosal membrane pressure injury, training course

Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend on who will use the new technology.Objective The objective of the study was to investigate differences between users and non-users of telemedicine integrated into traditional office-based primary health care.Methods Quantitative registry-based population study in two regions in the southeast part of Sweden (n = 73,486), comparing users with non-users of telemedicine across the variables sex, age, socioeconomic status (SES), morbidity and health care seeking behaviour (HSB). Two study periods of six months were used (September 2019–February 2020 for Region Östergötland, and September 2021–February 2022 for Region Kalmar County) to collect user data. A reference period of 36 months (September 2016–August 2019) was used, to collect data on HSB.Results Users were more often women under the age of 60 and had higher morbidity (measured as resource utilisation) than non-users (p

Peng Sun,1 Guanting Li,2 Yunhe Zhu1 1Department of Nuclear Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China; 2Research School of Physics, The Australian National University, Canberra, ACT, AustraliaCorrespondence: Yunhe Zhu, Email zjkc139@163.comObjective: To analyze and investigate the causes of radiation protection safety risks in nuclear medicine diagnosis and treatment, formulate radiation protection safety management countermeasures, and evaluate their effectiveness.Methods: In October 2020, the Department of Nuclear Medicine at our hospital established a radiation protection safety management team, utilizing association rules to investigate and analyze the causes of radiation protection safety risks. A Wuli-Shili-Renli (WSR) system management approach was implemented, addressing physical (Wuli), procedural (Shili), and human factors (Renli) to improve technical safeguards, optimize processes, and enhance personnel awareness. A total of 1200 patients receiving diagnosis and treatment were divided into two groups. The control group (600 cases) used standard inspection-based radiation protection, while the observation group (600 cases) adopted WSR system management in addition to standard measures. Radiation protection risk control effectiveness and safety control capability scores were compared between the two groups.Results: The proportions of excessive diagnostic doses and additional radiation harm in the observation group were both lower than those in the control group (P < 0.05); the proportions of risk sources, including building environment, protective measures, dose monitoring, safety awareness, and waste disposal, in the observation group were all lower than those in the control group (P < 0.05). The observation group’s scores in radiation protection theory, practical risk management skills, and radiation protection safety literacy, as well as the total score, were higher than those of the control group (P < 0.05).Conclusion: The WSR system management approach effectively reduces radiation protection safety risks, improves the diagnostic and therapeutic environment, minimizes radiation exposure to patients and staff, and enhances safety risk management levels in nuclear medicine departments.Keywords: nuclear medicine, radiation protection, radiation safety, risk management, safety management, association rule learning, Wuli-Shili-Renli framework

Yun Zhou,1,&ast; Zheyun Xu,2,&ast; Zhifen Zhang,3 Jun Su4,5 1Outpatient Department, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, 310008, People’s Republic of China; 2The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People’s Republic of China; 3Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, 310008, People’s Republic of China; 4School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China; 5Intensive Care Medicine Department, Hangzhou Women`s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, 310008, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jun Su, Email junjunsu@163.comBackground: We investigated the key factors that influence the awareness, health beliefs, and self-efficacy of osteoporosis among the staff of an obstetrics and gynecology hospital to identify the key target population for carrying out education and promotion in medical institutions, hoping to improve women’s awareness and prevention and treatment consciousness of osteoporosis from the source.Methods: A cross-sectional study was conducted from October 15 to October 24 in 2023, and 200 staff members were randomly sampled from an obstetrics and gynecology hospital in Hangzhou city for a questionnaire survey. We used a quantile regression model to analyze the key factors influencing the scores of each item.Results: The study results showed that undergraduate degree or above, working as a doctor, work experience of < 5 years or 10– 20 years and high professional technical title are related to a higher level of osteoporosis knowledge. Male gender was associated with higher exercise efficacy and calcium barriers scores. Older age and long years of working experience were associated with higher susceptibility score. Lower education level was associated with higher calcium barriers score. Doctor occupation was associated with lower seriousness score, higher exercise benefits score, higher calcium benefits scores and higher health motivation score. Professional and technical title was also related to exercise and calcium benefits score.Conclusion: When carrying out education and promotion work on osteoporosis prevention and treatment targeting the group of healthcare workers, different content and emphases should be considered, and different groups should be selected for more targeted publicity and popularization.Keywords: obstetrics and gynecology hospital, osteoporosis, awareness, health belief, self-efficacy

Background: Abortions in India are increasing despite the laws to legalize them. Many abortions are conducted through unsafe practices and are underreported. To determine the prevalence of abortions in women of a reproductive age group in a rural area of Delhi and to determine associated factors. Methodology: A cross-sectional study was conducted among married women in the reproductive age group residing in Barwala village, Delhi/NCR. An interview schedule was used to interview 315 women, and information was obtained for socio-demography, use of contraceptives, medical history, and history of abortions. Chi-square and Fisher’s exact test were used for analyzing the association of abortions with other variables. Results: Of all 315 women, 47% had a history of one or more abortions. Of all pregnancies (n = 953), 25.6% ended in abortions (n = 244). Of the total number of abortions reported, 60.7% (n = 148) were induced, while 39.3% (n = 96) were spontaneous. Of induced abortions, only 35% were safe, while 65% were unsafe abortions. Age of mother, age at marriage, history of contraception use, and gender of first child were significantly associated with abortions. However, no significant association was found with socio-economic status, education, and occupation of women and their spouses. Only 1.3% women knew that abortions are legal in India. Conclusion: A high proportion of women are going for induced abortions, of which a greater proportion is that of unsafe abortions. There is also lack of knowledge about the legalisation of abortions in India.

The postpartum period is characterized by physiological changes, and maintaining core and pelvic floor muscle strength is crucial for overall health. Flexibar (FB) training, involving oscillating vibrations, shows promise for postpartum muscle strengthening. This study aimed to assess the effectiveness of FB training in restoring muscle strength in postpartum women. Eighteen postpartum women, who had given birth within 2 months to 1.5 years prior, participated in a two week FB training program consisting of four sessions per week. Core muscle strength was evaluated using manual muscle testing for trunk flexion, and pelvic floor muscle strength was assessed using the two finger test. Descriptive statistics analysed demographic data and pre/post treatment measurements. Statistical analysis included the Wilcoxon test and non parametric inter quartile range test. The results showed improvements in core and pelvic floor muscle strength after the 2 week FB training program. Participants demonstrated increased muscle strength, as indicated by positive ranks and significant mean rank differences in both manual muscle testing (P < 0.001) and the two finger test (P < 0.001). This study provides statistical evidence supporting the effectiveness of FB training in restoring core and pelvic floor muscle strength in postpartum women. The dynamic movements and proprioceptive feedback of FB exercises contribute to improved muscle coordination and whole body integration. Further research with larger samples and longer follow up periods is needed to determine optimal training protocols and explore the potential benefits of FB training. These findings enhance our understanding of effective interventions for postpartum muscle strengthening and provide a foundation for future investigations.

Background: East Nusa Tenggara is a province in the east of Indonesia with a relatively high stunting proportion than other provinces. This situation is exacerbated by the poverty that characterizes the people of this region. The study analyzes children’s characteristics related to stunting among children under 2 years in East Nusa Tenggara, Indonesia. Methods: The cross-sectional study examined 3,134 children under 2 years. Besides nutritional status (stature), the study analyzed five children’s characteristics as exposure variables (birth weight, birth length, early initiation of breastfeeding, gender, and age) and six control variables (residence, maternal age, marital, maternal education, employment, wealth). We employed a binary logistic regression test in the last step. Results: Low-birth-weight children are 1.970 times more likely than normal children to experience stunting [95% confidence interval (CI) 1.905–2.037]. Children with short birth lengths are 1.373 times more likely than those with standard measurements to be stunted (95% CI 1.331–1.417). On the other hand, children without early initiation of breastfeeding are 1.034 times more likely than those with early initiation of breastfeeding (95% CI 1.013–1.057). Meanwhile, a boy is 1.426 times more likely to be stunted than a girl to experience stunting (95% CI 1.397–1.456). Moreover, based on children’s age, 12–23 are 3.435 times more likely than those ≤12 to be stunted (95% CI 3.360–2.513). Conclusion: The study concluded that five children’s characteristics were related to the stunting incidence in East Nusa Tenggara, Indonesia: birth weight, birth length, early breastfeeding initiation, gender, and age.

Background: Pregnant women and neonates are often considered as being a vulnerable group during the coronavirus disease 2019 (COVID-19) pandemic. Several studies have compared the impact of COVID-19 on pregnant and nonpregnant women. This study aimed to examine the reasons for severe acute maternal morbidity (SAMM) and “near-miss cases” and their effects on perinatal outcomes before and during the COVID-19 pandemic. Materials and Methods: All women admitted to our facility with pregnancy-related complications for birth or in the puerperium who required critical care unit (CCU) or high dependency unit (HDU) admission were included in the study. A modified version of the World Health Organization (WHO)’s Maternal Near-Miss Screening Tool was used to identify maternal near-miss cases and other obstetric emergencies requiring CCU admission. Results: The incidence of “near-miss” obstetric emergencies was -30.7 per 1000 live births. Over the 3 years of data obtained, 152 near-miss cases were found. Thirty-five cases were seen in the pre-COVID-19 period, whereas 117 near-miss cases were noted during the COVID-19 pandemic. The most common cause of near-miss cases in both groups was severe preeclampsia (65.8%). The rate of ICU admissions was 80.3% (94/117) during COVID-19, while only three cases required ICU before the COVID-19 pandemic. There were a total of 11 maternal deaths, and all were reported during the COVID-19 pandemic. Conclusion: There was a significant increase in ICU admission rates and “near-miss” obstetric emergencies during the COVID-19 pandemic. The COVID-19 infection indirectly led to higher maternal morbidity secondary to lockdown effects on antenatal care and delayed referrals. This study will contribute to the existing literature on the impact of the COVID-19 pandemic on maternal and child health. The results will help inform policy decisions and guide the development of interventions to improve the quality of care for pregnant women during the pandemic.

Background: Sensitization plays a pivotal role in raising awareness about critical youth issues and encouraging them to access support services, contributing to the success of programs like Yuva Spandana, a youth-centric mental health promotion initiative in Karnataka, India. For youth to access support within YSKs, the quality and effectiveness of sensitization programs (SPs) are crucial. A standard quality assessment through indicators for SPs is required to provide recommendations for improvement. To enlist quality indicators and assess the quality of SP conducted under Yuva Spandana (YS) program across Karnataka. Material and Methods: We performed secondary data analysis (utilizing data available within the computerized management information system over 5 years; 2017-2022) and direct/in-person observation of SPs (by the researcher and the core team of YS between June and July 2022 using a specifically developed checklist). Quality indicators were developed using a process of consensus building. Each attribute within the checklist was scored, and a composite mean score and mean percentage scores for quality were calculated. Results: Overall, 33257 SP reports and 31 in-person SPs were assessed. A total of 36 quality indicators (10 quality indicators based on SP reports and 26 based on in-person observation) were developed. The average quality score of report-based SPs was 10.93 (±2.59; range 1-20) and in-person assessment was 63.06 (±6.61; range 50-73). Conclusion: The study emphasizes the importance of addressing all youth issues, including sensitive topics like gender, sex, and sexuality, to ensure a holistic approach to youth mental health. Challenges faced during program execution and the distribution of Information, Education, and Communication (IEC) materials also contribute to program quality. This research offers valuable insights for improving the conduct of SPs, enhancing youth access to services, and guiding future community-based health promotion initiatives.

The objective of this systematic review and meta-analysis is to assess the efficacy and safety of Ivermectin compared to placebo or standard of care for the treatment and prevention of COVID-19 disease. Literature search was carried out in PubMed, Scopus, and google scholar. Clinical trial registries (clinical trail.gov) and preprint servers (Medrxiv) were also searched for registered and preprint data respectively. Mortality, Clinical recovery, Clinical worsening, duration of hospital stay, and adverse events were considered as primary outcomes while viral clearance is considered as a secondary outcome. Revised Cochrane risk of bias assessment tool was used to assess the risk of bias. Random effect meta-analysis was carried out for all the outcomes. GRADE was used to rate the certainty of evidence. A total of 19 RCTs with 1111 patients were included in the analysis. Ivermectin use did was not associated with a reduction in the incidence of mortality, duration of hospitalization, clinical worsening, and incidence of adverse events nor it was associated with an increase in clinical improvement compared to either placebo or standard of care. Ivermectin also did not show any reduction in viral clearance compared to both placebo or standard of care and this was associated with substantial inconsistency. The overall certainty of the evidence was very low to low. Based on the very low to low certainty of the evidence, we consider Ivermectin ineffective in the management of COVID-19 disease, both as treatment and prophylaxis.

Background: Respectful maternity care (RMC) is increasingly being accepted as an essential element for health systems. Every childbearing woman has a right to get dignified and respectful healthcare. Initial research has highlighted that disrespect and abuse are widespread, however, there is a paucity of quantitative evidence. Materials and Methods: In this community-based cross-sectional study, among 485 participants, conducted in 28 villages of Northern India, we ascertained the experience of RMC during childbirth by using the person-centered maternity care (PCMC) scale. Results: The majority (88.7%) of women experienced RMC. The domain with the lowest score was communication and autonomy (62.9%), followed by supportive care (76.1%). Self-introduction by health providers, the position of choice during delivery, relief from pain, and availability of preferred companions during delivery were the deficient areas. Women who gave birth in private health facilities were more likely to receive RMC than those who gave birth in government facilities, while those belonging to marginalized social groups had lesser odds of receiving RMC as compared to other women. Conclusion: Communication skills should be promoted to maternity care providers. Self-introduction by healthcare providers and choice of position during delivery are the deficient areas, which should be focused upon.

Background: Nutrition is an indispensable part of human life. Vitamin A deficiency(VAD) is the most important cause of preventable blindness in young children. It has long been a nutritional problem of public health significance in India and continues to be so. It is estimated that 50,000 preschool children become blind every year owing to VAD, and many of them will eventually die because of increased susceptibility to infections. To estimate the prevalence of clinical forms of vitamin A deficiency among the preschool children aged 1 to 5 years in the community and to determine the risk factors associated with vitamin A deficiency among the children aged 1-5 years. Material and Methods: This community based cross-sectional study was conducted among the pre-school children of RHTC area of a medical college between March 2019 to June 2019, IEC 24/2019. The data obtained was entered in MS-EXCEL 2010 and statistical software Epi info version 7. Results: The prevalence of vitamin A deficiency in our study was found to be 5.59%. On bi-variate analysis, the prevalence of vitamin A deficiency was more among the children belonging to class 4 and class 5 BG Prasad scale and was significant (p

Background: Supportive supervision of the Community health workers (CHWs) is critical for their efficient functioning in various health programmes. CHWs in India are supervised by facilitators known as ASHA Sahyogini. Our study aimed to investigate the linkage between the knowledge and skills of CHW facilitators and their CHWs. To understand the problems encountered by the CHW facilitators while assisting their CHWs. Also, to determine the perceptions of CHWs on the nature of supportive supervision of their facilitators. Materials and Methods: A mixed-method explanatory study using purposive sampling was conducted in a rural block of Madhya Pradesh (Central India). The CHWs were categorized into relatively high performing (RHP) and relatively low performing (RLP) groups based on their performance-based incentives received during (2017-2018). The quantitative component comprised of self-administered questionnaire and skill assessment while the qualitative component comprised of three focused group discussions with RHP, RLP CHWs and their facilitators. Results: The mean (SD) supportive supervision score given by CHW facilitators were found to be significantly associated with CHW’s performance. Problems faced by CHW facilitators while assisting their CHWs resulted from inadequate education of CHWs, insufficient incentives, transport problems and repetitive surveys. While some CHWs perceived to have received good assistance from their facilitators, there were a few who were not dependent on their facilitators and executed duties by themselves. Conclusion: CHW’s performance cannot be ascribed completely to the CHW facilitator’s performance. The challenges perceived by CHW facilitators were unmodifiable and required them to strongly motivate and support their CHWs to improve their functionality.

Background: One of the biggest problems faced by the homosexual population is the high prevalence of sexually transmitted diseases including human immunodeficiency virus which can be attributed to inconsistent and incorrect use of condom. Condom usage among homosexuals is affected by many factors which may have a positive or negative impact on it. This study aimed to find out the different sociodemographic determinants that were associated with consistent and correct condom use among homosexual males aged 18–24 years. Materials and Methods: This descriptive cross-sectional study was conducted among 240 homosexual (including bisexual) males aged 18–24 years living in the Metropolitan city for minimum 1-year duration at the outreach sites of an NGO. Data pertaining to sociodemographic variables and consistent and correct condom use were obtained and analyzed in SPSS using the Chi-square test to find out the association between condom use and sociodemographic profile. Results: Only 43.3% of participants were using condoms consistently and correctly. Consistent and correct use of condom was observed among participants who were younger (p =

Cervical cancer is a largely preventable disease that claimed the lives of more than 300 000 women in 2018. Hesitation to adopt cervical cancer screening strategies motivated us to find out the knowledge gaps and attitudes of the educated section toward these practices. An in-depth knowledge of this aspect will help us comprehend the barriers that are deterring women from accepting these practices. A cross-sectional survey was conducted from November 1, 2021, to November 30, 2021, to assess the public knowledge, attitudes, and practices regarding cervical cancer. The self-designed online questionnaire was shared on social media such as Telegram, WhatsApp, LinkedIn, and Facebook. Girls and women aged 15 years and more studying in educational institutions or those who have completed their graduation were asked to fill out the questionnaire if willing to do so anonymously. 824 respondents filled out the online survey. 75% of the respondents had good knowledge about pap smear and HPV vaccination. Only 80 respondents (9.7%) were vaccinated against HPV. 255 (30.9%) had been screened with a pap smear at least once in their lifetime. Screening with pap smear was never performed in 412 subjects, which constituted 50% of the respondents. A poor knowledge about the eligibility of pap smear and the availability of HPV as a screening modality may have contributed to a poor conversion to the regular practice of screening modalities. Awareness drives need to focus on these issues.

There is growing evidence from developed countries that type 2 diabetes stigma has been prevalent. However, whether or not type 2 diabetes has a social stigma in India has not been explored. Against this background, a study was attempted to clarify type-2 diabetes-related stigma among general community members. A cross-sectional community-based survey using a locally adapted Explanatory Module Interview Catalog was conducted among 100 randomly selected general community members who did not have diabetes from slum pockets of Pune city. The stigma index was computed based on the responses of stigma indicators and the internal consistency assessed. In addition, based on the mean prominence values, socio-cultural group characteristics were analyzed across stigma indicators. Further, multivariate logistic regression assessed the relationship between socio-demographic characteristics as predictors and stigma indicators as outcome variables. General community members reported widespread awareness regarding type-2 diabetes. More than half of the respondents perceived that diabetes would be a fatal disease without any outside treatment. The resultant stigma index was 7.22 (Cronbach’s alpha = 0.75). The milder stigma for type-2 diabetes was revealed through the preference to hide, problems in arranging marriages, difficulties in ongoing marriages, and discrimination instances at the workplace. Adjusted logistic regression (AOR) across stigma indicators showed a tendency to hide diabetes across marital status (AOR = 8.39) and difficulty forming marriage alliances across religions (AOR = 3.10). Documented socio-cultural features of stigma should be considered priorities for action to mitigate its negative influence on the physical health and emotional well-being of persons who have diabetes.

The 2030 Sustainable Development Goal (SDG) envisions eliminating preventable newborn deaths and reducing neonatal mortality to 12 per 1000 live births. There is a paucity of data on outborn newborns. By doing this study, areas for further reductions in neonatal mortality rate (NMR) can be identified and interventions can target these areas for reduction of NMR. The objectives of this study were to determine the causes of admission of outborn newborns, identify the timing and causes of mortality, distinguish between possibly preventable or probably unpreventable deaths, and identify areas for further reductions in NMR. A cross-sectional, retrospective, and descriptive study was conducted on outborn newborns at a Special Newborn Care Unit (SNCU) of a medical college hospital in eastern India from January 1, 2021 to December 31, 2021. Admission and mortality data were collected after ethics committee approval and analyzed. Sick outborn newborns admitted to the SNCU were 1671. Deaths occurred in 281. Males were 62.28%. The highest number of deaths occurred in birth weight ≤999 g, (91.84%), gestational age

Background: Stroke is a major public health and clinical challenge that results in significant mortality and disability. Stroke survivors require care and support, particularly during the crucial 3 months post-stroke when 95% of functional neurological recovery occurs. To estimate case-fatality and extent of disability, assess perceived needs, barriers, and unmet needs for care, and ascertain pathways to care post-discharge (at 3 months) among first-ever stroke patients attending a tertiary care neuro-specialty center in India. Material and Methods: A cross-sectional descriptive study was conducted among patients receiving care within [NIMHANS]. Patients with confirmed computed tomography (CT) scans experiencing their first-ever stroke between September 1 and October 31, 2022, were contacted between November 1, 2022, and March 31, 2023. A pre-tested semi-structured questionnaire was used to collect information. Descriptive statistics were performed using STATA version 16. Results: Stroke fatality among study subjects was 13.8%. Almost half (49.09%) had some form of disability, with 40% having moderate to severe disability. The majority perceived the need for follow-up visits (87%) and compliance with stroke medication (84%). Distance and transportation (60%) were cited as the main barriers to care. After discharge, the majority preferred healthcare facilities close to their homes (60%). Conclusions: This study emphasizes the need for stroke survivors to have follow-up and compliance with medication, along with various unmet needs such as de-addiction services, vocational training, and emotional support. A network-based multi-disciplinary approach, along with a comprehensive hub and spoke model of stroke management services, could help address these challenges and improve patient outcomes.

Background: India contributes to the maximum of the world’s health burdens attributable to tobacco use. Exposure to secondhand smoke (SHS) is also associated with adverse health effects, causing 1.2 million deaths worldwide each year. In Delhi, 28.0% had SHS exposure at public places. About one-fifth experienced exposure to SHS at workplace. This study aimed to determine the prevalence of SHS exposure among adults in an urbanized village in Delhi. Materials and Method: It was a community-based cross-sectional house-to-house survey conducted between January 2020 and June 2021 in Aliganj, an urbanized village in Delhi. A total of 490 residents ≥15 years were included using simple random sampling. The interview was conducted by the primary author using the Global Adult Tobacco Survey (GATS). Each subject enrolled in the study was explicitly informed of the purpose of the study by the investigator and provided written informed consent before enrolment. Data were checked for errors, entered in Microsoft Excel, and analyzed in Statistical Package for the Social Sciences (SPSS). Results: Of the 490 participants, 14.7% were exposed to SHS in their house and 16.1% were exposed to SHS outside the house in the last 1 month. The majority (85.3%) believed secondhand smoking is harmful, 6.5% disagreed, and the rest were unaware. Conclusion: Though most participants knew that exposure to SHS can cause serious illness, further awareness sessions need to be conducted to improve knowledge and understanding and reduce exposure to secondhand tobacco smoke in homes. Strict adherence to no-smoking policies should be implemented as per law to reduce exposure to SHS in public areas.

Background: Measles continues to pose a significant health threat to children in India, contributing significantly to the global burden of measles-related fatalities. Moreover, a considerable number of children did not even receive their first dose of the measles vaccine, and those who did generally did not receive it at the recommended age. Additionally, there is limited information available in India about age-appropriate measles immunization coverage. Hence, a modest attempt was made to evaluate the extent of timeliness of measles immunization and identify factors associated with the administration of the same among children aged 12 to 23 months in India. Materials and Methods: Data from the most recent National Family Health Survey (NFHS 5, 2019–2021) were used in the present study. The sample comprised 48,928 children aged 12 to 23 months. Cox Proportional Hazard regression analysis was used to determine the significant influencing factors on age-appropriate measles immunization in India. Results: Despite fairly up-to-date measles immunization coverage in India, more than 55% of immunized children received their immunization after the recommended age. Significant percentages of untimely immunization were observed for a substantial number of States and Union Territories across India. From the regression analysis, maternal age and education, religious affiliation, access to media, and healthcare-seeking behaviors such as institutional delivery and utilization of antenatal checkup were identified as the prominent factors related to age-appropriate immunization in India. Conclusion: Untimely immunization is a crucial issue in India. Addressing the timeliness of measles immunization requires a comprehensive strategy that includes healthcare delivery, family planning, immunization perception, and general education. Efforts should be prioritized to improve awareness and accessibility for ensuring timely immunization, thereby safeguarding the health of children across India.

Severe Acute Malnutrition (SAM) is multifactorial including poor maternal health, sociodemographic factors, and poor quality of diet of both the mother and child. Present study was carried out to determine sociodemographic factors and antenatal service utilization for SAM occurrence. This hospital-based case-control study was carried out from April 2021 to April 2022. Cases (77) and controls (77) were matched for age and sex with 1:1 ratio. Cases were selected from Nutritional Rehabilitation Centre and controls from an immunization clinic using WHO’s Multicentric Growth Reference Study Criteria 2006. Mothers of study participants were interviewed by using semistructured questionnaires. The weight and height of study participants were measured. The odds of children having SAM increased significantly with illiterate parents, working mothers, and labor work of fathers. The absence of toilet facility at home and poor hygienic practices of mothers were significant risk factors. Mother’s

Finding missing tuberculosis (TB) cases from the “under-reached” population of urban slums and connecting them with TB services is a priority and ongoing challenge for India. It requires the effective engagement of community health workers including urban Accredited Social Health Activists (U-ASHAs). The study aimed to understand the current engagement of U-ASHAs in TB care and their commensurate preparedness in terms of TB knowledge and training. An exploratory study was conducted in Mumbai and Pune cities of Maharashtra during 2022–23. The study used a mixed-methods approach, including a semi-structured survey of U-ASHAs (n = 222) and in-depth interviews with relevant stakeholders (n = 33). The statistical analysis used was descriptive statistics using MS Excel. The average age and work experience of U-ASHAs were 35.4 (21–50) years and 2.7 (0.5–6) years, respectively. They considered maternal child health services as their main portfolio and TB as an ancillary program. They were mainly involved in a biannual active case finding (ACF) and were recently envisioned as TB treatment supporters with poor clarity about other roles in TB care. Just half-day training for TB as part of 8-day general induction training, brief updates before ACFs, and the absence of an on-the-job supervisory structure resulted in TB knowledge gaps particularly for the latest diagnostic tests, adverse drug reactions, government schemes for TB patients, and contact tracing. Conclusions: Intermittent TB activities coupled with insufficient training impede U-ASHAs’ functionality in TB care. Clarity of TB-related roles, integration of TB activities in daily tasks, comprehensive training, and on-the-job supervisory structures have merit in strengthening U-ASHAs’ engagement in urban TB care.

Lymphatic filariasis is one of the neglected tropical diseases still present in many areas. A community-based cross-sectional study was conducted during 2019–2020 in the Gourbazar gram panchayat area of Paschim Burdwan District, West Bengal, to find out the prevalence of lymphatic filariasis based on morbidity and its distribution in terms of selected sociodemographic variables and to assess the healthcare-seeking practices of the affected people. The entire area was covered by the National Center for Vector Borne Diseases Control flashcards. Data was analyzed by SPSS software (version 20.0). Overall, the prevalence of LF was found to be 0.97%. About 49.6% of filariasis patients were male. Among the males, the majority suffered from hydrocele, followed by lymphoedema of the legs. Overall, about 2/3rd of the patients (66.1%) consulted with doctors regarding their health problems. Overall, 90.8% consulted from the private healthcare sector and the majority relied on traditional healers. It is now essential to line list the cases and to provide appropriate management from the designated service area so as to promote health and well-being.

Background: Physical activity (PA) offers innumerable benefits and is a promising intervention against common mental disorders, such as depression and anxiety. We examined the association between PA and depression or anxiety in adults. Materials and Methods: A study was conducted between March 2021 and August 2022 using a cross-sectional study design. We recruited 334 participants >40 years of age from the noncommunicable disease (NCD) screening clinic of a tertiary care institute in North India. Health-enhancing PA (HEPA) was estimated using the International Physical Activity Questionnaire (IPAQ), while depression and anxiety were screened using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder scales. Bivariate and univariate analyses were performed using Statistical Package for the Social Sciences (SPSS) version 21 to depict our results. Results: Engagement in HEPA was 23.4%. The HEPA depicted significant socioeconomic disparities. The mean total cholesterol and triglyceride levels were considerably higher in the HEPA active group, despite having lower GAD-7 and PHQ-9 scale scores. The prevalence of depressive and anxiety symptoms was 59.0% and 13.4%. PA depicted better odds against depression but not against anxiety symptoms. Conclusions: Low HEPA engagement in adults is a matter of concern, and it is high time we look beyond NCDs toward the risk factors. It is essential to incorporate PA counseling universally and not be restricted to a particular clinical department to realize its full potential in restraining the growing NCD burden.

Background: Stroke is a fatal disease with huge burden worldwide. Nonetheless, it is preventable, provided risk factors are controlled. Modifiable risk factors are associated with 90% of attributable risk for stroke. The growing burden of stroke indicates that the current stroke prevention strategies are either not used properly or insufficiently effective. The study aimed to assess the prevalence of risk factors of stroke and to assess the impact of a VAK (visual-auditory-kinesthetic) model-based educational program on knowledge of stroke among security guards. Materials and Methods: The data were collected in two phases. In the first phase, prevalence of risk factors of stroke among security guards was assessed. In the second phase, the security guards who were found to have high risk of stroke were given the educational package employing the VAK model. The educational package included researcher-developed videos on risk factors and management of stroke, a poster on Act FAST, and a card game on symptoms of stroke. Paired t-test was used to compare the means of knowledge score before and after intervention. Result: The security guards had risk factors for stroke including hypertension (12.7%), smoking (59%), and obesity (29.4%). The security guards showed improvement in knowledge score regarding stroke from a mean score of 9.2 ± 1.9 to a mean score of 16.3 ± 1.2 (P < 0.001) after the educational intervention. Conclusion: Hypertension, smoking, and obesity were the most common risk factors of stroke among security guards. The VAK model-based educational package was effective in improving knowledge of security guards regarding signs, symptoms, risk factors, and action to be taken on any sign of stroke.

Background: Amid the global concern over alcohol consumption’s ramifications for public health, the escalating prevalence of alcohol misuse among young individuals, especially students, is alarming. This study examines the prevalence of alcohol use disorder (AUD) among medical students, exploring its link to depression, anxiety, and socioeconomic factors. Material and Methods: We conducted this cross-sectional study at a medical college in New Delhi in the month of June, 2023. We determined a sample size of 425 using prevalence estimates for AUD, a 4% margin of error, and a 15% nonresponse rate. We selected participants using simple random sampling from the MBBS enrollment list and provided them with self-administered questionnaires. We utilized validated screening tools, including PHQ-9, GAD-7, AUDIT-C, and CAGE, to assess depression, anxiety, and AUD. Statistical analysis was performed using STATA 18. AUD prevalence was presented with 95% confidence intervals. Associations between AUD and variables were examined using Chi-square tests. Significant variables (P < 0.2) in univariate analysis were considered in multivariate logistic regression (P < 0.05). Results: In our study, 413 students participated. The prevalence of AUD was 13.6%, depression was 31.5%, and anxiety was 24.2%. Univariate and multivariate logistic regression revealed significant associations between AUD and factors such as gender, current living space, tobacco use, and anxiety. Conclusion: The current study highlights worrisome levels of AUD, depression, and anxiety among medical students in New Delhi. Our research also reveals connections between AUD and factors like gender, living situation, tobacco use, and anxiety.

Background: Reproductive Tract Infections (RTIs)/Sexually Transmitted Infections (STIs) are the main cause of maternal mortality and morbidity in India. The prevalence of the symptoms of RTIs was found to be very high in community-based studies. However only a few studies have explored the factors associated with it. This study aims to determine the socio-personal factors associated with the prevalence of symptoms of RTIs among sexually active married women in Ernakulam district of Kerala. Material and Methods: The study adopted a cross-sectional approach and was conducted among 640 married women in the reproductive age group. Results: The prevalence of the symptoms of RTIs was found to be 56.9% and about 60.16% of them had experienced multiple symptoms. Multivariate analysis showed that those women living in the urban areas (OR: 0.49, 95% CI: 0.334, 0.719), having no previous history of obstetric/gynecological risk factors (OR: 1.89, 95% CI: 1.119, 3.19) and using both clothes and sanitary pads interchangeably during menstruation (OR: 0.46, 95% CI: 0.282, 0.734) were found to be at less risk of contracting RTIs. Conclusion: The use of sanitary pads along with cloth pads can be enhanced rather than only using reusable cloths during menstruation. Also, efforts to improve the reproductive health of the women and reduce the obstetric/gynaecological risk factors should be devised to curtail the peak of RTIs.

Background: Coronavirus disease 2019 (COVID-19) pandemic has caused a significant disruption of all healthcare services. Tuberculosis (TB) services were also affected by the COVID-19 pandemic policies. Therefore, this study was planned to observe whether TB services and treatment outcome were affected in pre-COVID, COVID, and post-COVID eras among TB patients. Materials and Methods: Secondary data analysis was carried out from the data obtained from District Tuberculosis Centre. Comparison of TB care data includes notification, diagnosis, treatment services, and outcome for the pre-COVID, COVID, and post-COVID periods. Results: TB notifications and diagnostic services were significantly hampered during the COVID-19 period as compared to pre-COVID and post-COVID periods (P < 0.05). However, in those diagnosed with TB, treatment was initiated timely and regular follow-up was done by health care workers to ensure treatment adherence, and hence, more cure rate was reported in the study. High mortality during COVID-19 period was found. Conclusion: TB care was significantly restrained during COVID-19 pandemic, and further reclamation of services occurred during the declining phase of COVID-19.

Background: Self-efficacy is the ability by which a person confronts problems in day-to-day life with goal- centered attitude. The clinician plays a vital role in promoting self-care though a series of social, cultural and economic factors also contribute positively towards it. This study was conducted to assess the self-care practices among diabetic individuals aged 30 years and above and to understand its enablers and barriers. Materials and Methods: Explanatory mixed method study was conducted from August 2018 to October2020. Quantitative assessment was done wherein a questionnaire was administered to 297 study participants enrolled by simple random sampling followed by in-depth interviews by purposive sampling as qualitative component. Multivariate logistic regression analysis was used to study the relationship of independent variables with various domains of self- care practice. P value

Background: Globalization and urbanization have increased international and internal migration. However, migrants are still not absorbed into the local communities and remain vulnerable groups. Hence, the present study aimed to determine the quality of life (QoL) and healthcare-seeking behavior (HCSB) of internal migrant laborers in Coimbatore, Tamil Nadu. Methodology: An analytical cross-sectional study was conducted in the year 2023 among 321 migrant laborers residing for a minimum duration of 6 months in Coimbatore. A pre-tested questionnaire was used to collect data on socio-demography, QoL (using the WHO BREF scale), HCSB, and healthcare expenses. Ethical clearance was obtained from the institutional ethical committee. Informed written consent was obtained from the participants. Data were analyzed using SPSS version 27. Mann–Whitney U test and Kruskal–Wallis test were used to compare QoL across socio-demographics and HCSB. Results: The overall QoL score was 61, and those in social and environmental domains were also above 60. The QoL was higher in the environmental and social domains than in the physical and psychological domains. Females, married people, those currently living with their family, those working in the organized sector, and those in higher socio-economic status had better QoL than their counterparts. Per capita income had a positive correlation with physical, psychological, and environmental aspects of life. About 68% of those who used private sector healthcare services had catastrophic health expenditures (CHEs). Conclusion: The overall QoL among migrant laborers was moderate. Migrants preferring formal healthcare enjoyed better QoL. Major CHE was for delivery, and hence, the barriers to accessing free government services are to be explored.

Antimicrobial resistance [AMR] is a global problem that affects multiple domains including healthcare, agriculture, aquaculture, and many more. Every year, 700,000 people die from it. AMR is predicted to claim 10 million lives by 2050 if immediate action is not taken. Thus, to halt the spread of AMR it is important to understand what contributes to its emergence and transmission across borders and domains. The burden is disproportionately higher in Low middle income countries (LMICs) due to multiple factors such as environmental, social, healthcare, and cultural barriers. This review paper describes the comprehensive analysis of the past, present, and future trends in AMR, focusing on the complex interconnectedness of the factors contributing to this issue. Historical trends reveal antibiotic discoveries, resistance periods, resistance genes, and multidrug-resistant pathogens, providing insights into crisis evolution and the emergence of multidrug-resistant pathogens. The present trends reflect the current state of AMR in India and emphasize the negative consequences of AMR for clinical medicine and healthcare systems. It identifies the factors driving the global pandemic surge and examines current global and country-level policies and actions to mitigate its impact. The future trends anticipate the trajectories of AMR and discuss innovative approaches to combat resistance, including the exploration of alternative therapies and the implementation of stewardship programs. Thus, by synthesizing existing knowledge and identifying emerging gaps, this review paper presents a holistic perspective on the evolution of AMR.

Background: Postpartum depression (PPD) is a nonpsychotic mental health condition associated with child birth. It poses a major global public health challenge as it remains unrecognized most of the time and impairs both the immediate and long-term health of both the mother and child. The study was conducted to estimate the prevalence and associated risk factors for PPD. Materials and Methods: A cross-sectional study was conducted among 450 women who delivered babies within the past 1–12 months and attending a tertiary care hospital during April to November 2021. Systemic random sampling was used to obtain the desired sample size. Basic sociodemographic variables (age, duration of postpartum period, residence, religion, education, occupation, birth spacing, complication during pregnancy, desired gender of child, birth weight of baby) related to pregnancy were collected. The Edinburgh Postnatal Depression Scale was used to estimate the prevalence of PPD. Results: The prevalence of PPD in the study was 14.2%. The mean ± standard deviation age of women was 27.1 ± 4.7 years. Sociodemographic factors such as maternal age, low level of education, and family type and obstetric factors such as age at first pregnancy, parity, and history of abortion were significantly associated with PPD (P < 0.05). Conclusion: Risk factors related to sociodemographic and obstetric history were found to be significantly associated with PPD. To prevent major depression in postpartum, early detection and timely referral are needed.

Background: Recurring advances in the field of mechanical plaque control (MPC) devices have shown promise in improving the oral hygiene status of the community. However, little is known about the association between the knowledge of healthcare professionals regarding these advances, the manufacturers in understanding the demand of the community, and the community’s willingness to switch to these “smarter” advances in MPC. This article puts forth a novel classification system of smart MPC to bridge this research gap. Materials and Methods: After a Delphi consensus and a sample pretesting, a customized questionnaire survey based on the knowledge, attitude, and practice model was filled by 618 participants. The participants were divided into two groups: Group I from the healthcare profession (n = 236) and Group II from other professions (n = 382). A Chi-square test was used to determine the significant variables. These variables went through K-means and cluster silhouette scoring for cluster analysis. A correlation coefficient using regression line was used to analyze the relation between related variables. Results: The Chi-square test revealed nine components with statistically significant associations (P < 0.05). K-means clustering of the nine parameters revealed six clusters (silhouette score >0.5) that guided in drawing a classification of smart MPC. Conclusion: This study reveals the dearth of knowledge among the participants regarding advanced MPC and their negligence in following basic oral hygiene routines. The classification system derived through cluster analysis provides a basis for understanding the upgraded modes of MPC.

Background: A high proportion of sexual minorities like Hijras/Eunuch engage in sex work and thus become a high-risk population for HIV and sexually transmitted infections (STIs). Hence, we conducted a study with objective to assess prevalence of high-risk behavior among self-identified Hijras/Eunuch and associated factors. Material and Methods: A cross-sectional study was conducted in a field practice area of Tertiary Care Hospital from December 2019 to December 2020. All participants in the age group of 18 to 45 years were interviewed. Univariate and bivariate analysis was done to determine the correlates. Results: Out of 163, 85% of participants were involved in high-risk sexual behavior and 46.63% did only sex work, 51.5% of participants had comprehensive knowledge about HIV/STI. On applying logistic regression, the factors associated with high-risk sexual behavior include 18–24 years of age group, history of addiction, practicing paid sex, using psychotropic substances, comprehensive knowledge regarding HIV/STI, and comprehensive exposure to preventive measures. Conclusion: Our study findings suggest the urgent need for appropriate preventive measures to understand and address sexual health and risk behavior vulnerabilities faced by Hijras to make significant progress against the HIV epidemic in the country.

Background: Engaging patients in healthcare for diagnosis and treatment through active case-finding, which is initiated by healthcare providers, involves methodically searching for tuberculosis in individuals who may not seek medical attention otherwise. Active case finding provides a promising opportunity to identify additional undetected cases of tuberculosis within the community. The current study aimed at evaluating household contact tracing of Tuberculosis among the household contacts of pulmonary TB cases who were recently diagnosed, as well as to identify risk factors in both household contacts and index cases that contribute to the transmission of TB within households. Materials and Method: This cross-sectional study, which was conducted within the community, focused on the household contacts of recently diagnosed patients of Pulmonary Tuberculosis (TB) who were confirmed through microbiological testing. These patients were registered at Tuberculosis Units (TUs) of JNMC and Jawan of Aligarh district, West U.P. The investigator conducted visits to each household and met with both the index case and their corresponding household contacts to establish rapport and gather necessary information. Results: Within this investigation, a total of 103 individuals who tested positive for sputum smear were identified as index cases, alongside 405 household contacts of these index cases. The predominant symptom observed in household contacts who tested positive during the screening process was a cough, with fever following closely behind. Among the 405 household contacts examined, 54 individuals (13.3%) exhibited symptoms associated with Tuberculosis. Further investigation revealed that 11 of these individuals (20.37%) tested positive for tuberculosis. The total prevalence of tuberculosis cases among household contacts was determined to be 2.72%. Conclusion: The present research affirms that conducting contact screening for households of active TB cases is a comparatively feasible and beneficial strategy that could result in prompt diagnosis and initiation of treatment for active TB, thereby diminishing the severity of the disease and lowering the rate of transmission. Also, it can help to improve TB-related health effects, social and economic implications, and treatment outcomes in the index cases.

The known risk factors for cardiovascular diseases (CVDs) are diabetes, obesity, unhealthy diet, lack of exercise, smoking, and excessive use of alcohol. The 10-year cardiovascular risk factor prevalence of hypertension, obesity, and diabetes mellitus is 55.8%, 14.4%, and 9.8%, respectively. Besides these known risk factors, other potential but less searched risk factors also need to be explored for better prevention of CVDs. To evaluate the association between Udavarta (STC), changes in lead III of ECG, and heart disease score to demonstrate the earliest pathological changes in the heart. A cross-sectional observational study using a survey method to collect data from November 11, 2021 to January 5, 2022. The Udavarta symptom score (USS) is associated with ECG changes in lead III (P > 0.0098). The USS shows an association with the Hrudroga (heart disease) symptom score: relative risk 1.83 (95% CI: 1.20–3.1), odds ratio 5.65 (95% CI: 1.06–30), and P > 0.0385. Udavarta (slow transit constipation) shows a strong association with heart disease symptom score and lead III ECG changes, and clinically is an equally contributing risk factor for the development of CVDs compared to the other risk factors. This study reports that the minimum duration of constipation for starting the development of heart diseases assessed by ECG is 3 months, and the maximum duration is 25 years. This study emphasizes that slow transit constipation is a risk factor for developing heart disease. Clinical research in this direction is warranted.

Background: There was always a need for some innovative assessment method like an objective structured practical examination (OSPE) which is objective, reliable, and valid over conventional practical examinations (CPEs), which lack objectivity and reliability and carries risk of teachers’ bias as learning is assessment-driven. The aim of this study was to find out the effectiveness of OSPE over CPE among seventh-semester medical students and to assess the objectivity of structured questions among different OSPE stations. Materials and Methods: A total of 207 students appeared in the seventh-semester examination in community medicine, and they were divided into three groups depending on their total marks. Each student had to face both OSPE stations and conventional viva voce tables and their scores were recorded. A paired T-test was done to assess differences in mean marks between OSPE and CPE. A one-way analysis of variance (ANOVA) was done to compare the OSPE station-wise mean among different series of examinations. Results: The high-scorer students secured significantly higher mean marks of 30.30 ± 3.94 in OSPE than in CPE (26.93 ± 3.85). The mean marks obtained by high-scorer students showed no significant difference except in one station. Among the low-scorer group, statistically significant differences in mean marks were found among various stations. Conclusions: OSPE is an effective tool of assessment than CPE. Still, meticulous care is to be taken in designing respective OSPEs, and proper training of assessors is also needed, to avoid biases.

Ayushman Bharat scheme is a National Health Protection Scheme introduced on September 23, 2018 by the government of India. The study was done to estimate the awareness and utilization of the Ayushman Bharat scheme in the urban and rural beneficiaries of Gautam Buddha Nagar. A comparative cross sectional study was conducted in the field practice areas of the Department of Community Medicine, Gautam Buddha Nagar, Uttar Pradesh among 224 households. Simple random sampling was done, and data was collected using a semi-structured questionnaire. Our study found that around 8.9% and 18.8% of beneficiaries in urban and rural areas, respectively were aware of the benefits of the scheme. The study also reported that only 8% of beneficiaries in urban areas have utilized the benefits of the scheme while 15.2% of beneficiaries in rural areas have utilized the benefits in rural area. Creating good awareness campaigns, special drives, and working toward quality assurance in both the public and private sectors will help beneficiaries get the best out of this dynamic healthcare scheme.

Background: When the coronavirus vaccine was launched, many Hindi language videos on YouTube were uploaded and audiences were accessing these videos in good numbers. However, the scientific evaluation of these videos was never done. There is a need to understand the accuracy, validity, and quality of these videos so that they can further be utilized for other health awareness purposes. The study objective was to evaluate the validity, quality, and accuracy of the Hindi videos that were viewed the most on YouTube. Material and Methods: Two search terms, “COVID-19 Vaccine–Hindi” and “Corona vaccine Hindi,” were used, and the most viewed 50 videos were selected. All the videos were manually coded and statistically evaluated. Two public health researchers evaluated all the videos blinded to each other using the DISCERN, GQS, and JAMA scales. The correlation score was calculated to know the agreement between them. Scores of professionals and news-based organizations were also compared. Results: Out of all 50 videos, professionals uploaded 48% of videos, and news-based organizations uploaded 46% of videos. The DISCERN median was found to be 9.00 (5–10), the JAMA median score was 6.00 (3–8), and the DISCERN score was 40.50 (16–49). DISCERN, JAMA, and GQS scores were also calculated separately for both observers, and no statistically significant difference was found. Between both the observer’s agreement was found with statistical significance. Conclusion: YouTube was found to be an excellent source of information on the coronavirus vaccine in the Hindi language. Almost all 50 videos had wide viewership, so health professionals and news media organizations cannot ignore this popular platform to improve the health awareness of citizens in a developing country like India.

Background: Non-communicable diseases (NCDs) have a considerable impact on an individual’s social life. Life-long medication, fear of death, dietary restrictions, hospital admissions, dependency on caregivers, and strained interpersonal relationships play a role. The available questionnaires measure only individual aspects of social impact. The aim of the study was to develop and validate a comprehensive questionnaire to assess the social impact of NCDs. Material and Methods: A cross-sectional study was conducted among patients and caregivers seeking care at a tertiary care hospital for diabetes, hypertension, chronic obstructive pulmonary disease (COPD), stroke, coronary artery disease (CAD), and cancer. Thirty patients each with the above diseases were administered Cousineau Self-Perceived Burden Scale to assess perceived burden among patients, Caregiver Burden Scale to assess caregiver burden, EuroQol-5D-3L to assess the quality of life, and face validated questions of sociodemographic details, cost of healthcare, and stress due to disease. Rasch analysis was performed to identify items that lie within the traditional bounds of mean-square item fit. The Delphi method with 10 subject experts was used to identify the questions that would be included in the final tool. Results: The data consists of 150 observations, with 77 categorical questions subdivided into various domains. From this, a total of 30 questions were extracted by Rasch analysis. The new questionnaire had good internal consistency (Cronbach’s alpha: 0.969, 95% confidence interval: 0.96–0.98). The questionnaire was finalized after reaching a consensus among subject experts. Conclusion: The social impact questionnaire developed consisted of 30 questions, has good internal consistency, and can be used to measure the social impact of NCDs.

Background: The first mass vaccination program for COVID-19 in India started on January 16, 2021. Initially, Covaxin and Covishield were used. Later, the Government of India has approved the usage of Corbevax, a Hyderabad-based biological E SARS-CoV-2 (COVID-19) vaccine among 12- to 14-year age group from March 16, 2022. Corbevax vaccination was started in our hospital setting on March 19, 2022, for 12- to 14-year age group. Monitoring safety of any vaccine is of importance in a real-world setting. Limited study has been performed till date on side effects of Corbevax vaccine. Therefore, this study has been planned to assess the side effects after Corbevax vaccination among 12- to 14-year age group in a tertiary care hospital setting in Meerut district. To assess the side effects after Corbevax vaccination among 12- to 14-year age group in a tertiary care hospital setting in Meerut district. Tertiary care hospital setting and cross-sectional study design. Methods and Material: A cross-sectional study was conducted among 270 study participants. Sample size was calculated assuming 50% prevalence of side effects after vaccination. Study subjects were selected by using simple random sampling among the beneficiaries of a tertiary care center. Data were collected using a pretested semistructured questionnaire. Proportions, Chi-square test. Results: Of all the participants, 41.48% had developed side-effects with pain at site of injection being the most commonly reported symptom (64.29%), and about half among those affected had resolved spontaneously. Conclusions: The vaccine causes only mild symptoms and is safe for use in children.

Background: Urinary tract infection (UTI) is the most common bacterial infection occurring in pregnant women with untreated, recurrent, and inadequately treated bacteriuria accentuating the risk of multiple adverse fetal and maternal health outcomes. The study objective was to determine the proportion of UTIs and their predictors along with antibiotic resistance patterns of causative organisms in pregnant women. Materials and Methods: This cross-sectional study was conducted among 348 pregnant women in an urban resettlement and slum colony. Urine samples were examined through semi-quantitative culture on plated Mac Conkey and blood agar. Antibiotic susceptibility testing was done on Muller Hinton agar using the modified Stokes’ disc diffusion method. Results: At least one symptom related to UTI was reported by 35.7% (95% CI: 30.7-41.1) of the participants. The proportion of pregnant women detected having UTI on urine culture was 7.4% (n = 24, 95% CI: 5.1-10.8) with 13 (54.2%) asymptomatic and 11 (45.8%) symptomatic cases. Overcrowding was a significant predictor of UTI. The most common organisms detected were Escherichia coli (n = 12), Klebsiella pneumoniae (n = 7), Staphylococcus aureus (n = 3), and Acinetobacter species (n = 2). Conclusions: The use of individual toilets and active screening for UTI through culture and sensitivity testing in pregnant women should be promoted in low-resource settings irrespective of symptoms. The initiation of presumptive antibiotic therapy for UTI cases in pregnant women should be restricted to painful micturition due to high false positivity of other symptoms with Nitrofurantoin being a likely preferred drug for empirical administration due to its low resistance pattern among isolated organisms.

Background and aims Alcohol use disorder (AUD) and hazardous alcohol use are common but underdiagnosed in primary health care (PHC). This study aimed to explore general practitioners’ (GPs’) experiences and perceptions of using B-Phosphatidylethanol (PEth), a specific quantitative biomarker for alcohol use, in their clinical work with patient consultations and treatment follow-up in Swedish PHC.Design, participants, and setting Individual interviews were conducted with GPs and resident GPs (n 20) in Swedish PHC and analysed using qualitative content analysis.Findings The overarching theme PEth testing in primary health care—a game changer and a challenge illustrated that PEth testing has improved the prerequisites for the GP-patient interaction while making it more complex. Four categories underpinned this theme: Comprehending the context, describing the challenges in the GP-patient interaction when hazardous alcohol use or AUD was suspected; Getting the pieces in place, illustrating the struggle of integrating PEth testing into clinical practice and how it diminished the role of alcohol history taking; The challenges and facilitators of the conversation, comprising both the difficulties in informing about PEth testing and the positive impact on the interaction, and Considerations based on the PEth test results, emphasising the consequences of elevated PEth test results and their influence on physicians’ motivation to using PEth.Conclusions PEth is an important tool in the identification of hazardous alcohol use. Emerging ethical dilemmas regarding patient information on PEth testing and management of medical and medico-legal obligations when test results indicate high alcohol use need to be addressed in future guidelines for clinical management of PEth.

Background In addition to peripheral neuropathy of various kinds, diabetes can also cause central neuropathy, which among other things can manifest itself as premature cognitive dysfunction, often linked to vascular dysfunction. Although the link between diabetes and cognitive dysfunction was discovered more than 100 years ago and has important clinical implications, this diabetes complication remains relatively unknown. Recent years have seen research that has clarified cerebral insulin resistance and defective insulin signaling as examples of pathogenic factors behind this cognitive impairment in diabetes.Method We provide a narrative review of select and contemporary publications with relevance for the interface between diabetes/prediabetes and cognitive function.Results Recently published studies show that physical activity can reverse insulin resistance in the brain as well as cognitive impairment and pathological appetite regulation. Pharmacological interventions with, for example, nasal insulin, GLP-1 receptor agonists, SGLT-2 inhibitors, or PPAR-γ agonists have also shown promising results.Conclusion Optimization of lifestyle factors (e.g. physical activity), as well as several pharmaceutical agents already in clinical use against diabetes, have shown promising results in improving cognitive function in diabetic patients. An important task for primary health care, where most patients with type 2 diabetes are diagnosed, treated, and followed, is to increase awareness and early detection of cognitive dysfunction in these patients for optimizing risk factor control.

Jenny Skumsnes Moe,1,2 Jørgen G Bramness,1– 4 Ingeborg Bolstad,1,5 Jørg Gustav Mørland,3,6 Philip Gorwood,7,8 Nicolas Ramoz7,8 1Research Center for Substance Use Disorders and Mental Illness, Innlandet Hospital Trust, Brumunddal, Norway; 2Institute for Clinical Medicine, The Arctic University of Norway, Tromsø, Norway; 3Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway; 4Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway; 5Department of Health and Social Science, Inland Norway University of Applied Sciences, Elverum, Norway; 6Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 7Université Paris Cité, Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Team Vulnerability of Psychiatric and Addictive Disorders, Paris, France; 8GHU PARIS Psychiatrie & Neurosciences, Hôpital Sainte-Anne, CMME, Paris, FranceCorrespondence: Jenny Skumsnes Moe, Research Center for Substance Use Disorders and Mental Illness, Innlandet Hospital Trust, P.O. Box 104, Brumunddal, 2381, Norway, Email jenny.s.moe@uit.noPurpose: Alcohol use is a leading risk factor for preventable death, injury, and disease globally. Low sensitivity to the effects of alcohol is influenced by genes and predicts risk for harmful alcohol use and alcohol use disorder (AUD). Alcohol induces effects partly by modulation of gamma-aminobutyric acid receptors type A (GABAARs). This study investigates the relationship between genetic variation in GABAAR subunit genes and individual alcohol sensitivity among French university students.Patients and Methods: The study involved 1,409 French university students (34.5% women; mean age 20.3 years). Alcohol sensitivity was measured by the Self-Rating of the Effects of Alcohol Scale (SRE). SRE-scores from initial drinking, regular drinking, and heavy drinking were investigated for correlations with alcohol consumption and for associations with single nucleotide polymorphisms (SNPs) in GABAAR subunit genes (GABRA2, GABRG2, GABRA6).Results: We replicated correlations between low alcohol sensitivity and high alcohol consumption. We further found an association between the minor allele in rs211014 (GABRG2) and higher SRE-scores, linked to dizziness and motor incoordination. Genetic variation in GABRG2 has previously been associated with processes involving motor coordination (alcohol withdrawal, febrile- and epileptic seizures).Conclusion: The results from our study suggest that genetic variation in GABRG2 may influence alcohol sensitivity, which could inform strategies for assessing risk for harmful alcohol use and AUD.Keywords: alcohol use, GABRG2, self-rating of the effects of alcohol, genetic, AUD, AUDIT

Reinhard Strametz,1,&ast; Hannah Roesner,1,2,&ast; Thomas Neusius,1,&ast; Isabell Wiesenhuetter,1 Stefan Bushuven,3,4 José Joaquín Mira,2,5 Dominik Hinzmann,6 Susanne Heininger7 1Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain UAS, Wiesbaden, Germany; 2Miguel Hernández University of Elche, Elche, Spain; 3Training Center for Emergency Medicine (NOTIS e.V), Engen, 78234, Germany; 4Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, 79106, Germany; 5Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Alicante, Spain; 6Department Clinical Medicine, Department of Anesthesiology and Intensive Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany; 7Faculty for Applied Healthcare Sciences, Deggendorf Institute of Technology, Deggendorf, Germany&ast;These authors contributed equally to this workCorrespondence: Reinhard Strametz, Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain UAS, Bleichstr. 3, Wiesbaden, 65183, Germany, Email reinhard.strametz@hs-rm.dePurpose: The objective of this study is to evaluate whether the nationwide establishment and institutionalization of a peer-support program, is economically justified given the potential positive effects on the Second Victim Phenomenon (SVP) among healthcare professionals in Germany.Methods: A comprehensive methodological approach was employed, using data from the SeViD studies to assess the prevalence and duration of SVP among physicians and nurses in Germany. Economic impact assessments were conducted to estimate the potential cost savings associated with implementing a peer-support program.Results: The economic analysis reveals significant annual costs associated with SVP-induced absenteeism: approximately 1.56 billion euros for physicians and 1.87 billion euros for nurses. Implementing comprehensive peer-support programs could reduce these costs to approximately 0.85 billion (physicians) and 1.02 billion euros (nurses), respectively, demonstrating substantial potential economic benefits.Conclusion: Investing in a structured peer-support program could yield annual savings exceeding 1.55 billion euros while enhancing workforce resilience and improving patient care. This underscores the economic rationale for scaling up peer support initiatives in healthcare settings.Keywords: peer support program, economic impact, second victim phenomenon, healthcare professionals

Richard Paul Green,1 Kenneth Blum,2– 5 Kai Uwe Lewandrowski,5,6 Mark S Gold,7 Alexander PL Lewandrowski,8 Panayotis K Thanos,2,9 Catherine A Dennen,10 David Baron,3,11 Igor Elman,2,12 Alireza Sharafshah,13 Edward J Modestino,14 Rajendra D Badgaiyan15 1Precision Translational Medicine, LLC, San Antonio, Tx, USA; 2Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel; 3Center for Sports, Exercise, Global Mental Health, Western University Health Sciences, Pomona, CA, USA; 4Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; 5Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA; 6Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá, DC, Colombia; 7Department of Psychiatry, Washington University, School of Medicine, St. Louis, Missouri, USA; 8Department of Biological Sciences, Dornsife College of Letters, Arts & Sciences, University of Southern California, Los Angeles, CA, USA; 9Behavioral Neuropharmacology and Neuroimaging Laboratory, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA; 10Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA, USA; 11Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA; 12Department of Psychiatry, Harvard University School of Medicine, Cambridge, MA, USA; 13Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; 14Brain & Behavior Laboratory, Department of Psychology, Curry College, Milton, Massachusetts, USA; 15Department of Psychiatry, Texas Tech University Health Sciences, School of Medicine, Midland, TX, USACorrespondence: Rajendra D Badgaiyan; Kenneth Blum, Email badgaiyan@gmail.com; drd2gene@gmail.com

Yibala Ibor oboma,1,2 God’sman C Eberechukwu1,3 1Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Health Sciences, Niger Delta University Wilberforce Island Bayelsa State, Amassoma, Nigeria; 2Department of Medical Laboratory Science, School of Allied Health Sciences, Kampala International University, Ishaka Municipal, Uganda; 3Department of Histopathology and Cytopathology, Faculty of Medical Laboratory Science, Federal University, Otuoke, Bayelsa State, NigeriaCorrespondence: Yibala Ibor oboma, Department of Medical Laboratory Science, School of Allied Health Sciences, Kampala International University, Western Campus, Bushenyi District, Ishaka Municipal, Uganda, Tel +256740059020, Email yibaaoboma@kiu.ac.ugBackground: Datura metel is reported to induce hallucinations and mental disorders.Objective: This study investigates the neurotoxic effects of Datura metel stramonium hydroethanolic root extract on the hippocampus and cerebral cortex of adult rats using biochemical, histological and immunohistochemical techniques.Methodology: Twenty five adult rats were assigned to 5 groups (n = 5 each). Group A - negative control, group B (lead positive control). Groups C, D, and E exposed to 150 mg/kg, 300 mg/kg and 600 mg/kg body weight of extracts for 14 days once daily, respectively. Histology, biochemistry and immunohistochemical techniques were used to study cell injury in the brain tissue.Results: Biochemical alterations were observed in superoxide dismutase (SOD), Malondialdehyde (MDA), Glutathionine S-transferase (GST) and Catalase among the experimental groups. Catalase was statistically significant at P< 0.05. Histology reveals neurons damage, depletion and vacuolation. NFP and NSE were over expressed in the experimental groups.Discussion: Oral administration of Datura metel root extracts at high concentration alters the antioxidant enzymes activity and body weight. Extracts cause cortex and hippocampus neurotoxicity through heightened oxidative stress.Conclusion: Datura metel root extract is a neurotoxic agent and causes depopulation of hippocampus and cerebral cortex neurons. The use of this plant should be highly regulated to reduce neuropathies associated with consumption.Keywords: Datura metel, oxidative stress, neuronal damage

Aim To investigate the association between Systematic Coronary Risk Evaluation 2 (SCORE2) and subclinical damage in two vascular beds: atherosclerosis in the coronary arteries and aortic arterial stiffness, in a large population-based cohort without cardiovascular disease or diabetes.Methods Design: A cross-sectional study based on Swedish CArdio Pulmonary bioImaging Study (SCAPIS) data. Study population: A population-based cohort of 3087 participants aged 50–64.Outcome Pulse Wave Velocity (PWV) was measured, and aortic arterial stiffness was defined as PWV≥ 10 m/s. Coronary artery calcium score (CACS) was determined by coronary computed tomography and clinically significant coronary calcification was defined as CACS > 100.Results The prevalence of arterial stiffness was 6.6% in the low-moderate SCORE2 risk group, 31.0% in the high-risk group, and 53.3% in the very high-risk group. The prevalence of coronary calcification was 4.5%, 18.5% 23.0%, respectively. There was a modest overlap between arterial stiffness and coronary calcification in all SCORE2 risk groups. When comparing the high SCORE2 risk group with the low-moderate risk group, the Odds ratio (OR) was 6.4, 95% confidence interval (CI 5.1–8.0) for arterial stiffness and 4.8 (CI 3.7–6.3) for coronary calcification. When comparing the very high SCORE2 risk group to the low-moderate group, the OR was 16.2 (CI 11.3–23.1) for arterial stiffness and 6.4 (CI 4.2–9.7) for coronary calcification.Conclusion Our study shows that high cardiovascular risk according to SCORE2 is associated with increased arterial stiffness and significant coronary calcification in a population without prevalent cardiovascular disease or diabetes. This knowledge can be useful in primary care, where SCORE2 is frequently used as a risk prediction tool. The modest overlap between arterial stiffness and coronary calcification suggests that CACS and PWV describe different types of vascular damage.