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Antimicrobial resistance (AMR) is one of the important public health problems across the world. Low-middle-income countries are facing the problem more strongly than the high-income countries. AMR is likely to increase the cost of healthcare expenditure over the years. Over the years, various factors like unprecedented use of the antimicrobials in humans, animals, and plants or vegetations and over-the-counter sell of the antibiotics without prescription along with poor sanitation have led to the development and transfer of AMR across the various animal groups. To tackle the issue of the AMR in the country, the Government of India has launched the national program for containment of AMR in 2013 with six identified domains. A containment plan is currently being executed but yet to achieve the full extent as intended. Programmatic consideration aimed to address all the components of AMR development of AMR and its transmission across all levels of health care. [ABSTRACT FROM AUTHOR]

Introduction: Acute encephalitis syndrome (AES) is one of the important causes of mortality among children in India. Active management of the cases, followed by addressing the cause of AES, is the key strategy for preventing mortality. Lack of laboratory facility and difficulty of sampling blood and cerebrospinal fluid (CSF) for assessing causes is one of the important barriers to early initiation of treatment. The main objective of the study is to validate the Scrub Typhus Encephalitis Assessment Tool (SEAT) for the management of AES. Methods: The study is a continuation of a study conducted in a tertiary care hospital in Eastern Uttar Pradesh. A machine learning (LightGBM) model was built to predict the probability of scrub typhus diagnosis among patients with acute encephalitis. Three models were built: one with sociodemographic characters, the second with Model 1 variables and blood parameters, and the third with Model 2 variables and CSF parameters. Results: The sensitivity of diagnosing the scrub typhus case was 71%, 77.5%, and 83% in Model 1, Model 2, and Model 3, respectively, and specificity was 61.5%, 75.5%, and 76.3%, respectively, in the models. In Model 1 fever duration, in Models 2 and 3, neutrophil/lymphocyte ratio was the most important predictor for differentiating the scrub and nonscrub cases. Conclusion: With the available sensitivity and specificity of the tool, the SEAT can be a valuable tool for the prediction of scrub typhus as a cause of AES cases in remote areas. [ABSTRACT FROM AUTHOR]

Background: High levels of stress among pregnant women have been reported during the coronavirus disease 2019 (COVID-19) pandemic because of various infection-related and lockdown measures. Concerns about safe delivery, breastfeeding, and child care may increase the risk of depression in vulnerable women during the perinatal period. Aim: To study the perceptions regarding child care and prevalence of perinatal depression during the COVID-19 pandemic. Materials and Methods: A cross-sectional community-based survey was conducted among 750 lactating mothers post delivery between September 2020 and February 2021 in 51 districts of Uttar Pradesh. A convenient purposive sampling technique was used. A semi-structured questionnaire was used to collect the socio-demographic details and perceptions regarding child care during the COVID-19 pandemic. Assessment of depression symptoms was performed with the help of patient health questionnaire 9 (PHQ-9). Results: A total of 440 participants were suffering from some form of depression symptoms; the majority had mild depression. Depression was found to be higher among homemakers and young mothers (age <25 years). Depression was found in more than 40% of the respondents who felt fear of COVID infection during breast feeding and hospital stay. Similarly, more than 50% of the respondents who feared unavailability of timely health services and social ignorance had depression. More than 60% of the mothers who did not have any knowledge about safe breast-feeding and child care practices had some form of depression, and the results were statistically significant. Conclusions: Perinatal depression is highly prevalent during the ongoing pandemic. Hence, regular screening, psychoeducation, awareness regarding safe breast feeding, and child care practices are recommended. [ABSTRACT FROM AUTHOR]

Context: Diabetic retinopathy (DR) is a major cause of visual disability leading to irreversible blindness. Awareness of diabetes and its ocular co-morbidities may help in preventing vision loss. Aim: To assess the awareness of diabetic retinopathy among diabetic mellitus patients visiting a hospital in North India. Setting and Design: Cross-sectional study conducted at an outpatient clinic of ophthalmology department of a hospital. Materials and Methods: An interviewer-administered, pre-tested, semi-structured questionnaire was used to evaluate the awareness of DR for the period from July 2020 to January 2021. Results: A total of 272 patients with diabetes mellitus (44.4% females and 55.5% males) were included in the study. The mean age of the study population was 53.4 ± 10 years. Of the 272 patients, 79% were aware that diabetes can affect the eyes, and 69.5% knew that DR can lead to blindness. Regarding prevention and treatment of DR, 58.1% of patients were aware that good glycemic control prevents DR and 52.6% knew that DR can be treated. Physicians were the main source of information in 47.4% of patients. The participants were not compliant with a routine retinal assessment with only 26.5% of them having previous fundus examination for DR screening. Conclusion: Most of the participants were aware of DR but there existed major deficits in the knowledge and behavior of diabetic patients toward management of DR. There is a need to create awareness about DR and emphasize the importance of retinal screening to reduce visual disability caused by diabetes. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the functionality of labour rooms by evaluating the labour room infrastructure with reference to the standard guidelines, the status of the availability of human resources, the availability of essential equipment and consumables in the labour room and by documenting the knowledge of the healthcare provider in terms of labour room practices. The study also explored the facility parameters associated with its delivery load taking the facility as a unit of analysis. Design: A cross-sectional analytical study. Setting: India has realised the importance of improving the quality of care in public health facilities, and steps are being taken to make healthcare more responsive to women's needs. With an increase in the proportion of institutional deliveries in India, the outcome of the delivery process can be improved by optimising the health facility components. Participants: The study was conducted in 52 health facilities and healthcare providers involved in the delivery process in the selected facilities. Results: The infrastructure of the facilities was found to be the best for medical college followed by district hospitals, Community Health Centres (CHCs), Primary Health Centres (PHCs) and subcentres. Similar findings were observed in terms of the availability of equipment and consumables. Lack of healthcare providers was observed as only 20% of the posts for health personnel were fulfilled in CHCs followed by PHCs, subcentres and district hospitals where 43, 50 and 79% of the available vacancies were fulfilled. The level of knowledge of healthcare providers in terms of partograph, active management of the third stage of labour and post-partum haemorrhage ranged as per their designation. The specialists were the most knowledgeable while the Auxiliary Nurse Midwife (AMNs) were the least. All the components of structural capacity, i.e. infrastructure (r2 = 0.377, P value < 0.001), equipment and consumable (r2 = 0.606, P value < 0.001) and knowledge of healthcare providers (r2 = 0.456, P value < 0.001) along with the overall facility score were positively correlated with the average delivery load of the health facility. The results from multivariate linear regression depict significant relation between the delivery load and availability of equipment and consumables (t = 4.015, P < 0.01) and with the knowledge of healthcare providers (t = 2.129, P = 0.039). Conclusions: The higher facilities were better equipped to provide delivery and newborn care. A higher delivery load was found at high-level facilities which can be attributed to better infrastructure, adequate supply of equipment and consumables and availability of trained human resources. [ABSTRACT FROM AUTHOR]

Introduction: Japanese encephalitis (JE) is a vector-borne, viral illness caused by the Japanese Encephalitis Virus. Permanent neurologic or psychiatric sequelae can occur in 30%–50% of those with encephalitis; hence, JE is a cause of major public health concern. For the ease of diagnosis and facilitation of surveillance, National Vector Borne Disease Control Programme uses the term Acute Encephalitis Syndrome (AES). In this study, an attempt has been made to ascertain the status and trends of AES and JE in Uttar Pradesh, India. Methodology: This is a record-based retrospective study. The data were obtained from the Directorate of Medical and Health Services of Uttar Pradesh and analyzed using software SPSS version 24.0. Results: In Uttar Pradesh, there were 47,509 reported cases of AES from 2005 to 2018,. With yearly fluctuations, the average Case Fatality Rate of AES was 17.49% with highest in 2005 (24.76%) and lowest in 2018 (8%). Among the patients with AES, 9.98% were found positive for JE. The most commonly affected age group is 1-5 years for both AES and JE, closely followed by the age group of 5-10 years. Peak occurrence of both AES and JE was recorded in month of September. Among the AES-affected patients 53.8% were males and 46.2% were females. Conclusion: The most commonly affected age group was 1-5 years with peak occurrence in the month of September. Though there was a downward trend in CFR, awareness activities like "Dastak" campaign and intersectoral preventive activities, needs to be strengthened. [ABSTRACT FROM AUTHOR]

Introduction: Disorders of menstruation are common problems among women. They have several psychological effects on women's health. Aim: This study aimed to estimate prevalence of menstrual disorders, usage of sanitary pads and their determinants among married women in selected villages of rural Haryana. Materials and Methods: A cross-sectional study was conducted during September 2011 in 10 villages of PHC (Primary Health Centre) Mandi, Haryana, using a systematic random sampling technique. Currently married women in the age group of 18-45 years living in study area for more than 1 year were included in the study while those who were pregnant and unable to understand questions were excluded. Informed verbal consent was obtained from all participants. results: A total of 344 women were interviewed. The mean (SD) age of participants was 28.0 (5.4) years. Majority of women were housewives (78.8%) and most had education up to middle school (22.7%). Mean (SD) age at menarche was 14.3 (1.2) years. Nearly one-tenth of women had married before 18 years of age. Prevalence of all menstrual disorders was 20.3% and most common disorder was excessive pain. About one ifth reported irregularity of menstrual cycles. Almost half were not using sanitary pads during menses. Menstrual disorders were more common among non-users of contraception (OR=1.7, p = 0.04) and housewives (OR = 2.4, p= 0.03). conclusion: Disorders of menstruation were fairly common among women surveyed. Usage of sanitary pads was quiet low. Awareness generation among women regarding menstrual problems and Behaviour Change Communication to promote usage of sanitary pads are important measures to reduce related morbidity. [ABSTRACT FROM AUTHOR]

A cross-sectional study was carried out at the Animal Bite Management (ABM) clinic in a primary health centre in the Faridabad district of Haryana. Information about socio-demographic characteristics, animal bite exposure and pre-treatment practices was obtained. Clinical examination determined the severity of the bite. All 619 patients who reported to the ABM clinic during January 2011 to December 2012 were included. Out of the total, 38% had applied chilli-oil paste, and 4% antiseptics to the wound as pre-treatment; only 30.6% had washed the wound with water. There was a direct association between traditional pre-treatment practices and delay in seeking treatment for animal bites which was statistically significant (P = 0.01). Health education of the general population with culturally appropriate Information, Education and Communication material is therefore a necessary strategy to reduce delay in seeking appropriate treatment. [ABSTRACT FROM AUTHOR]