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Background: Cardiovascular disease (CVD) is the leading cause of death in India, surpassing all infectious causes. Early awareness of CVD and its risk factors and adoption of heart healthy lifestyle practices are crucial to reducing the impact of CVD in the community. Objective: To assess schoolteachers’ awareness of CVD and to compare the calculated ten-year risk of heart attack, stroke, and death by the Atherosclerotic Cardiovascular Disease (ASCVD) model to the observed event rates. Methods: We surveyed 4,150 schoolteachers out of 5,321 (78% response rate) from 400 schools in Calcutta during 2019 using a questionnaire assessing their awareness of CVD in five domains: prevalence, spectrum of CVD, its nature, risk factors, and benefits of a heart healthy lifestyle. The study population was stratified by risk tertile of their 10-year calculated ASCVD score. Results: Awareness about cardiovascular health among schoolteachers (male 41%, mean age 44 years) was low: 33 (mean score out of maximum 100), varying in different domains as shown below. Although most (86%) were at mild risk for CVD with ASCVD scores below five, nine percent had moderate risk, and five percent had high risk of CVD. There was no significant association between their risk score and their awareness of CVD health (correlation coefficient r = - 0.022, 95% confidence interval - 0.052, 0.009). Conclusions: Cardiovascular health awareness among schoolteachers in Calcutta is suboptimal, many of whom are at risk for CVD. Awareness of the disease, detection of risk factors at an early stage, and adoption of a healthy lifestyle may help reduce CVD in this community.

Objectives We examined the level of awareness about Rheumatic Heart Disease (RHD) among school-aged children in a rural district of India and evaluated the effects of a questionnaire-based survey in improving the level of awareness. Methods The study involved 8,646 students aged 10–16 years from 20 schools in West Midnapore, India which was conducted in August 2017. We examined changes in the level of awareness of RHD using a 29-point scoring system in seven domains. The baseline questionnaire survey assessed students’ knowledge and was followed by a multimedia presentation about RHD and a post-intervention survey using the same questionnaire. The questionnaire included 9 questions on different aspects of RHD including prevalence, nature of disease, symptoms, determinants, treatment options, impact of the disease and diagnosis. Results The mean age of the study population was 13 years and 46% were boys. At baseline, the mean level of knowledge about RHD was 42% (12.2 out of 29 points). After the school-based presentation, the score improved to a mean of 55% (15.9 points on the 29-point scale), a 31% relative improvement. Improvement in students' knowledge was noted across all seven domains, individually and combined (p Conclusions Awareness among children in rural India about RHD is modest. A school-based intervention could help in improving awareness about this chronic condition and may promote secondary prophylaxis to reduce the morbidity and mortality from RHD.

Objectives: To report changes in adult hospital admission rates for acute ENT infections following the introduction of Covid-19-related physical interventions such as hand washing, use of face mask and social distancing of 2-metres in the United Kingdom. Design: Retrospective cohort study comparing a one-year period after the introduction of Covid-related physical interventions (2020-21) with a one-year period before this (2019-20). Settings: 3 UK secondary care ENT departments Participants: Adult patients admitted with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess. Main outcome measures: Number of adult hospital admissions Results: In total there were significantly fewer admissions for ENT infections (n=1073, 57.56%, p

Despite the growing momentum behind a movement to augment adoption of continuous glucose monitoring (CGM) in clinical practice and investigation, to the best of our knowledge, there are no published data on the historical and recent use of CGM in clinical trials of pharmacologic agents used in the treatment of diabetes. We analyzed 2,032 clinical trials of 40 diabetes therapies currently on the market with a study start date between 1 January 2000 and 31 December 2019. According to ClinicalTrials.gov listings, 119 (5.9%) of these trials used CGM. CGM usage in clinical trials has increased over time, rising from

Background: India is going through a major economic and epidemiological transition. With the adoption of a Western lifestyle, atherosclerotic cardiovascular disease (CVD) has emerged as the leading cause of death. India is currently the second most populous country with a population of 1.3 billion and two-thirds of this population are less than 35 years of age. As a result, India is facing major challenges in dealing with CVD. Purpose: This study was conducted to assess the level of health awareness of CVD in school-aged children (10 to 16 years) and to evaluate the effect of a brief educational intervention in enhancing the level of awareness with a goal of developing a school-based health education program. Methods: A school-based survey was conducted in Calcutta, India in August, 2018. This involved a pre-evaluation of CVD health awareness, a short presentation on CVD, and a post-evaluation of CVD health awareness. Results: The survey involved 2,564 students from 18 schools (11 girls’, 5 boys’, 2 coeducation). The mean age of participating students was 14.6 years, 72% were girls, 55% of the students were in the 9th grade, 38% were from 10 th grade, and the rest were from a combination of 8 th ,11 th, and 12 th grades. After assessing students’ awareness in six domains with 20 multiple-choice questions, the mean pre-test score was 46.5 (SD ± 13.3) with a maximum score of 100, and the mean post-test score was 53.6 (SD ± 20.6) ( p < 0.001). Conclusions: Awareness of CVD and its risk factors was inadequate among school-aged children in Calcutta. A school-based educational program may promote awareness of CVD and adoption of healthy lifestyle practices. The results of this study may help formulate a nationwide school health program to ameliorate the morbidity and mortality of CVD in India where it has emerged as a modern epidemic.

Background: Rheumatic heart disease (RHD) is prevalent in low income countries, with a regional prevalence in South Asia of 2.2 per 1,000 children aged 10-16 years. Awareness among school children is very important for seeking effective secondary prophylaxis. We studied the current level of awareness in school-aged children and evaluated the effect of a 7-item questionnaire-based survey in improving awareness of RHD. The study was conducted in a rural district of India in August, 2017. The objectives were to assess the level of awareness of RHD and to evaluate the effect of a questionnaire-based survey in improving awareness. Methods: The study involved 8,646 students in the age group 10-16 years from 20 schools in Midnapore, India. We carried out a pre-test questionnaire survey, a multimedia presentation on RHD, and a post-test survey that assessed students’ knowledge and awareness of its incidence and prevalence, symptoms and signs, morbidity and mortality, ways to prevent and/or reduce the disease burden, and when to seek medical attention. The data were analyzed to evaluate improvement in the level of awareness by this intervention using a 29-point scoring system in 7 domains. Regression analysis was performed to identify the factors that may enhance awareness. Results: Awareness among the school children (mean age 13, 45% boys) was modest. There was a significant improvement in their knowledge after the intervention with the survey questionnaire and the presentation by the study team (Table). Regression analysis showed female sex and higher grade in school were major determinants for improvement of the knowledge level by this intervention (p < 0.05 without any significant interaction noted between sex and grades in school). Conclusions: Current awareness among children about RHD is modest. A school-based intervention by administration of a survey questionnaire and presentation can help in improving the awareness about RHD and hopefully promote secondary prophylaxis to reduce the morbidity and mortality from the disease.