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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. [ABSTRACT FROM AUTHOR]

Background: COVID-19 vaccines have been rolled out recently in several parts of the world. Although the protective efficacy is frequently discussed, little is known about the factors associated with COVID-19 vaccine adverse effects. The study was conducted with the aim to evaluate the occurrence of adverse events following immunization (AEFI) with two doses of covishield and covaxin and to assess factors associated with these adverse effects. Methods: A longitudinal study was conducted for a period of three months in the adults above 18 years of age attending rural health training center (RHTC) either to receive their first or second dose of covishield or covaxin. After vaccination, the participants were observed at the health facility for 30 min for any AEFI and also followed up telephonically on seventh day from vaccination. Data was collected on predesigned and pretested questionnaire and appropriate statistical tests were applied. Results: Out of 532 participants, 250 (47%) came for their first dose while 282 (53%) came for second dose. In both the groups maximum participation was seen by males and those belonging to age group 18–30 years. Majority of the participants reported local tenderness (39.3%) after first dose of covaxin and fever (30.5%) after first dose of covishield. Mainly significant association was observed after vaccination in participants with comorbidities. Conclusion: The short-term adverse events with both the vaccines were observed, but these were mild and short lived. In this context, our study becomes more relevant in disseminating short-term safety data post vaccination. This will help individuals in their decision to accept vaccination. [ABSTRACT FROM AUTHOR]

Introduction: The practice of infant and young child feeding (IYCF) is critical for a child’s growth and development throughout the first two years of life. Poor feeding habits in early childhood contribute to malnutrition and child mortality in India. Aim and Objective: To assess the IYCF practices in children under the age of 2 years. Material and Methods: In rural Uttarakhand, India, a cross-sectional study was undertaken from March 2021 to May 2021. A probability proportional to size (PPS) method was used to select 400 children under the age of 2 years. The World Health Organization IYCF questionnaire, was used to collect house to house data. An appropriate statistical test was used for analysing the data. Results: According to the findings, 47.5 percent of babies under the age of six months were nursed within the first hour of delivery. About 73.9 percent of babies were exclusively breastfed. Approximately 22 percent infants were given pre-lacteal feeds and 20 percent were bottle fed. In addition to breast milk, half of babies aged 6 to 8 months had solid, semi-solid, or soft meals, however minimum acceptable diet was provided to only 33.5 percent children. Odds of male child who were bottle fed in the age group of 6–23 months were 2.02 times higher to that of female child. Also the odds of male child in the age group of 6–8 months to be introduced with solids, semi-solid, or soft food were 4.91 times higher to that of female child. Similarly, odds of male child received minimum dietary diversity (2.35), minimum meal frequency (1.82), and minimum acceptable diet (2.35) in the age group of 6-23 months were found to be higher to that of female child in the similar age group. Total of six mothers reported coronavirus disease (COVID) positive status and only two of them breastfed their babies using COVID appropriate behavior. Conclusion: Exclusive breastfeeding (EBF) has been practiced in more than two-thirds of children, but early breastfeeding is practised in less than half of children. Only one third children of more than six months of age are getting minimum acceptable diet. [ABSTRACT FROM AUTHOR]

Background: National Health Mission intended to achieve decentralization and community participation through creating and supporting Village Health Sanitation and Nutrition Committees (VHSNCs). The services offered through VHSNC include maternal and child health, family planning, sanitation, communicable diseases and health promotion, and nutrition. The study was carried out to assess awareness on the implementation of the functioning of VHSNC implementation among village-level functionaries in the Dehradun district. Methods: A community-based cross-sectional study was conducted in the Doiwala and Raipur blocks of Dehradun district from June 2019 to July 2019. Members of VHSNC with at least 3 months of membership were included in the study. A pretested semi-structured questionnaire was used to collect sociodemographic variables and questions about their awareness and responsibilities in implementing VHSNC. Data were collected by personal interviews using Epi-Collect and analyzed by SPSS 23. Result: Out of 69 members, 64 (92.4%) had formal education until high school. Only around 50% of members knew about the essential documents related to the VHSNC. Sixty-five members (98.48%) believed that the committee had the primary role in health-related services in the village, 54 (81.82%) members also marked providing safe drinking water as a function, 48 (72.73%) were in favor of access to clean public toilet and sanitation facilities while some others added role in Public Distribution System. Conclusion: Around half of the members were partially or completely aware of the functioning of VHSNCs. Providing them with further awareness is required. [ABSTRACT FROM AUTHOR]

The outbreak of coronavirus disease (COVID-19) has triggered changes and reforms in the health sector in India. As the pandemic points to a gap in the industry, it has led to the creation of new opportunities to solve problems. To help the country repair the damage caused by the virus pandemic, the Government of India announced that in the health budget 2021, promotion of health and well-being will be one of the six pillars. Investment in health infrastructure in the 2021 budget has increased significantly to welcome the much-needed increase in budget allocations of Rs. 2.3 lakh crore. Three areas will also be strengthened, including preventive health care and therapeutic health care. Special emphasis is placed on prevention, treatment, and health care. To promote primary health care, the country will establish 17,000 rural and 11,000 urban health care centers. Provision of affordable quality medical insurance will be provided by the government. The integrated and collaborative model of the public and private sectors in the provision of health services has led to a rapid expansion of work. This is an attempt to demonstrate the planned reforms in the health budget, especially during the COVID-19 pandemic. The budget of 2022-23 is about to be announced soon. It is to be seen how the financial allocation for the health sector impacts the health of the Indian people. [ABSTRACT FROM AUTHOR]

Background: Catheter ablation is an effective treatment for ventricular arrhythmia (VA) in ischemic cardiomyopathy (ICM). However, results in non‐ICM (NICM) patients are not satisfactory, and studies comparing differences between NICM and ICM are limited. We conducted a meta‐analysis of procedural characteristics and long‐term outcomes of catheter ablation for VA, comparing results between ICM and NICM. Methods: Studies in the PubMed, EMBASE, and Cochrane databases were systematically reviewed. Four studies reporting comparison of catheter ablation of VA between ICM and NICM were examined. The Newcastle‐Ottawa Scale was used to appraise study quality. A random‐effects model with inverse variance method was used for comparisons. Results: Epicardial approach was significantly more undertaken for the NICM group than in the ICM group (odds ratio [OR]: 0.13; 95% confidence interval [CI]: 0.09‐0.18; P <.00001). Mean ablation time (P =.54), fluoroscopy time (P =.55), and procedural time (P =.18) did not differ significantly between the ICM and NICM groups. Procedural failure rates (OR: 0.46; 95% CI: 0.24‐0.89; P =.02) and VA recurrence rates (risk ratio [RR]: 0.68; 95% CI: 0.46‐1.01; P =.06) were significantly higher in the NICM group than in the ICM group. However, all‐cause mortality (RR: 1.37; 95% CI: 0.75‐2.49; P =.31) did not differ significantly between groups. Conclusions: Procedural failure and VA recurrence rates were significantly higher in the NICM group, despite significantly more frequent epicardial access. These highlight the limitations of catheter ablation for VA in NICM, given our current knowledge. [ABSTRACT FROM AUTHOR]

Background: In India, the active case-finding (ACF) strategy began in 2017 under the Revised National Tuberculosis Control Programme to find its missing tuberculosis (TB) cases. Few studies have been conducted in India to assess the treatment outcome of TB patients detected by ACF. Aim: The aim of this study was to assess the treatment outcomes of patients detected through ACF campaigns during the year 2018 in Haridwar district, Uttarakhand. Study Design: This was a cross-sectional study which used the existing data and records. Materials and Methods: The ACF campaign records of 2018 were extracted from six TB units of Haridwar district. Details of sociodemographic, clinical profile, and treatment outcome of 100 diagnosed patients were obtained and analyzed. Results: Out of the total 100 TB patients detected, the site of disease was pulmonary in 98% of patients. Almost all (92%) the patients were diagnosed microbiologically and treatment was initiated by 78% of the patients. The proportion of successful treatment outcome was found in 64% of the patients. The median time interval from diagnosis to treatment was found to be 2 days. Conclusion: In spite of these efforts of ACF, a high proportion of initial loss to follow-up (22%) and unsuccessful treatment outcome (18%) among ACF patients is a major concern. Findings of ACF campaign pose a concern for active follow-up after diagnosis and close monitoring during treatment. [ABSTRACT FROM AUTHOR]

Context: Nutrition is one of the most important factors that affect a child's health. It plays a vital role in the prevention and control of disease morbidity and mortality. It is a major public health problem in a developing country like India. Aims: To assess undernutrition in under-five children and various sociodemographic factors affecting it. Settings and Design: A community-based cross-sectional study was conducted among under-five children of rural and urban Rishikesh. A total sample size of 400 under-five children was taken. Multistage sampling was done to select the areas and systematic random sampling was done for selection of households. Subject and Methods: A predesigned, pretested, and semistructured questionnaire was used to collect information on the sociodemographic characteristics and status of undernutrition in study participants. Statistical Analysis Used: Data was entered into excel sheets and analyzed using SPSS version 23 utilizing appropriate statistical methods. Results: The prevalence of underweight was 37.3%, stunting 43.3% and wasting 24.5%. Underweight (40.5% v/s 35.0%), stunting (46.5% v/s 40.0%), and wasting (27.0% v/s 22.0%) was more prevalent in urban areas as compared to rural areas. Sociodemographic factors such as religion, caste, parental education, father's occupation, and family size emerged as significant predictors of under nutrition. Conclusion: Undernutrition in under-five children was quite high. Since childhood malnutrition is multifactorial, there is no single cause big enough to blame but a multifaceted approach is required to combat malnutrition. [ABSTRACT FROM AUTHOR]

Background:India is in a state of epidemiological, economic, demographic and nutrition transition. And all these transitions are leading to non communicable diseases. Hypertension is a major public health problem and important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications.Objectives: To find out the prevalence of hypertension and its associated risk factors among people living in study area.Methodology: It is a community based cross sectional study conducted among people living in Barrage colony of Rishikesh, Uttarakhand. House to house survey was conducted for 3 months from December 2018 to February 2019 in all the four blocks (A,B,C,D) of Barrage colony, Rishikesh, Uttarakhand, to make a sample size of 955. Both male and female age of 15 years and above was included in the study.Results:The prevalence of hypertension among study participants was 10.4%. Prevalence of hypertension was found more in male subjects (12.6%) as compared to females subjects (6.9%).The risk factors found to be significantly associated with HTN in this study were increasing age, male gender, central obesity (high WHR), diabetes, smoking, alcohol, sedentary lifestyle and excess salt intake.Conclusion: There is significant burden of hypertension in Barrage colony, Rishikesh. Strong public health measures need to be seriously implemented to combat hypertension and its consequences. [ABSTRACT FROM AUTHOR]

Context: Population of elderly in India is growing day by day. Elderly population of India is 8.6% and in Uttarakhand it is 8.9%. Health needs of geriatric people differs from others. This study was an attempt to study the morbidity profile of geriatric people that may serve as a baseline data and also help in planning the health services. Aims: To study Morbidity profile of geriatric population in Uttarakhand. Settings and Design: Acommunity-based cross-sectional study was conducted among geriatric people in rural and urban areas of Uttarakhand. Study participants aged 60 years and above were included in the study and a sample size of 400 was calculated. Methods and Materials: Predesigned, pretested and semistructured questionnaire was used to collect information on sociodemographic characteristics and morbidity status of study participants. Statistical Analysis Used: Data was entered into excel sheets and analyzed using SPSS version 23 utilizing appropriate statistical methods. Results: Among 400 elderly people most common organ system affected was musculoskeletal (77.20%). Other commonly affected health systems were psychological (75.90%), digestive (73.60%), eye (56.67%), endocrine (35.90%), cardiovascular (33.08%), general and unspecified health problems (32.05%), ear (24.62%) and respiratory system (19.74%). Very few elderlies had neurological (6.67%) and urological (1.28%) problems. Conclusions: As shown in the present study very high percentage of morbidities were found in the study population. As a result, there is a need to further strengthen existing geriatric health care services at primary, secondary and tertiary level. [ABSTRACT FROM AUTHOR]

Context: Anaemia is defined as a decreased concentration of blood haemoglobin. It is one of the most common nutritional deficiency diseases observed globally affecting both developing and developed countries. Aims: To find out the prevalence of anaemia among the beneficiaries of Anaemia Mukt Bharat and its association with age and gender. Settings and Design: A cross-sectional study was conducted in Uttarakhand by AIIMS Rishikesh in a month-long campaign including 5,776 beneficiaries. Camps were organized at the hospital campus, schools, district hospitals, Community Health Centre (CHC), Primary Health Centre (PHC), subcentres (SC), Anganwadi Centres (AWCs), slum areas, adolescent health day celebration sites and Village Health and Nutrition Day (VHND) sites. Methods and Material: Data on age and gender along with haemoglobin level using HemoCue Haemoglobinometer was collected. Statistical Analysis Used: These data were entered into Microsoft Excel and analysed to calculate the prevalence of anaemia and its association with age and gender using Epi Info software version 7. Pearson's Chi-square test was applied. P value < 0.05 was considered as significant. Results: Out of 5,776 participants 53.2% were anaemic. Females (54.6%) were more anaemic than males (45.1%). 33.5% of pregnant females were found to be anaemic. Conclusions: Prevalence of anaemia was very high among the study participants. It shows that anaemia is a major public health problem so efforts should be taken to reduce the prevalence of anaemia and promote the health of an individual, community as well as the country. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is a chronic, debilitating non communicable diseases (NCDs) which has emerged as a leading global health problem. Aim & Objective: To find out the prevalence of known cases of diabetes mellitus and associated risk factors in the study area. Material & Methods: Community-based cross-sectional study was conducted among people living in Barrage colony of Rishikesh, Uttarakhand for a period of 3 months from December 2018 to February 2019. House to house survey was done in all the four blocks (A, B, C, D) of Barrage colony. Total of 815 study participants (both male and female) ≥ 20 years of age were surveyed. Data collected was entered into Microsoft Excel and analyzed using epi info software version 7. Results: The prevalence of DM was found to be high i.e 5.6% among the study participants. Prevalence was significantly more among females as compared to males and significantly increased by aging in both genders. Conclusions: It seems that the prevalence of diabetes is increasing in our region as well as our country and the world. To control DM public health education regarding consumption of balanced diet, increasing physical activity and leading a stress-free life is needed. [ABSTRACT FROM AUTHOR]

Background: Adolescent obesity is becoming a major public health problem in urban areas of India and its prevalence is increasing in all socioeconomic groups irrespective of religion, region and caste. Aims & Objectives : To find out prevalence of overweight & obesity among adolescents and to study its association with sociodemographic factors. Material & Methods : This cross-sectional study was carried out in the area covered by Urban Health and Training Centre of Lala Lajpat Rai Memorial Medical College, Meerut. Sample size was estimated by keeping the prevalence as 10% with 95% confidence interval and relative precision of 20%. A total of 872 adolescents were selected randomly using proportional allocation method. Results : The prevalence of overweight was found to be 17.4% and obesity 6.9%. The prevalence was significantly higher among females and in those belonging to nuclear families as well as higher socioeconomic status. Conclusion : The prevalence of overweight and obesity is quite high in the urban area and there is a need to develop an effective programme for the prevention of obesity in these areas. [ABSTRACT FROM AUTHOR]

Aim: To analyze the role of tamponade in vitrectomy for proliferative diabetic retinopathy with vitreous hemorrhage.Methods: A retrospective chart analysis of patients who underwent vitrectomy for proliferative diabetic retinopathy (PDR) between 2006 and 2013, with a minimum follow-up of six months, was done. The data collected included age, gender, control of diabetes, pre- and postoperative best-corrected visual acuity (BCVA), retinal detachment, type of tamponade, and recurrence of vitreous hemorrhage (VH). Statistical analysis was done using SPSS software version 2.0 and p values <0.05 were taken as significant.Results: A total of 73 eyes of 73 patients were included. The patients were analyzed in four groups: Group 1: no tamponade; Group 2: air; Group 3: gas; Group 4: silicone oil (SO). Eighteen (24.7%), 18 (24.7%), 15 (20.5%), and 22 (30.1%) patients were in the four groups, respectively. The mean preoperative BCVA in logMAR was 1.61, 1.84, 2.25, and 2.03 and the mean change in BCVAs at six months was -0.98, -0.94, -0.97, and -0.19 in four groups, respectively. Recurrent vitreous hemorrhage was noted in 11.1%, 11.1%, 6.7%, and 9.5% of patients of four groups; it was not statistically significant. The retina remained attached in 100%, 100%, 93%, and 90% of patients in the four groups, respectively, at six months.Conclusion: The use of an intraocular tamponade in eyes with vitreous hemorrhage due to PDR was not found to be superior to no tamponade in reducing recurrent vitreous hemorrhage. Therefore, the use of a tamponade in eyes without retinal break is not beneficial. [ABSTRACT FROM AUTHOR]