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Cervical cancer ranks as the second most common cancer in women in India, primarily caused by persistent infection with the human papillomavirus (HPV). Given its long latent period, secondary prevention through screening and early detection is essential. However, fear and stigma associated with cancers and the costs involved in disease management are the prominent barriers to its uptake. HPV vaccination is one of the vital components of the World Health Organization's (WHO) Global Strategy to speed up the elimination of cervical cancer as a public health problem. In India, four prophylactic HPV vaccines are currently available. These vaccines are non-infective and highly immunogenic, safe, and effective when administered before HPV exposure. According to WHO recommendations, the primary target group for HPV vaccination consists of girls between the ages of 9 and 14 years. Further, studies have confirmed that both single-dose and two-dose schedules of the HPV vaccine offer comparable efficacy and protection. HPV vaccines are administered intramuscularly in the deltoid region, with 0.5 ml as the standard dose. These vaccines may cause local reactions, as well as mild systemic reactions, such as headache and myalgia, but they are transient. Implementing catch-up vaccination for adolescent girls aged between 9 and 14 years at the time of HPV vaccine introduction would be a cost-effective and sustainable strategy. This would serve as a crucial component of public health efforts to manage HPV infections and eliminate cervical cancer in India. [ABSTRACT FROM AUTHOR]

Typhoid is a major public health concern in India, particularly among those dwelling in urban slums with poor sanitation. The disease caused by Salmonella enterica serovar Typhi spread majorly through contaminated food and water. The economic burden of the disease is catastrophic and affects both families and the government making a strong case for including typhoid vaccines in the national immunization schedule. The World Health Organization has prequalified several vaccines and has recommended their use in endemic areas. While there is robust evidence for vaccination of children from India and other LMICs, the case for adult vaccination remains less clear. The Indian Association of Preventive and Social Medicine acknowledges the necessity to adopt a widespread typhoid immunization program, along with other preventive strategies, especially in the vulnerable pockets. IAPSM recommends focusing on newer-generation Typhoid Conjugate Vaccines (TCVs), which provide long-lasting and superior immunological benefits, and are effective across all ages including adults. IAPSM suggests routine use of Typbar-TCV™ for adults up to 45 years old in India. The organization also highlights the necessity for post-marketing surveillance of these vaccines, to monitor the long-term safety and effectiveness of various vaccines in different communities. IAPSM encourages members to take front-line efforts in their community health service areas, and finally appeals for the development of vaccines to cover a more extensive range of Salmonella infections so that control over typhoid can be strengthened. [ABSTRACT FROM AUTHOR]

Pneumococcal infection among adults is associated with invasive disease and poor outcomes. Pneumococcal vaccine (PCV) introduction has significantly reduced disease burden, invasive disease and reduced the rates of antimicrobial resistance. Of the various vaccines licensed, PCV 13 and PPSV 23 are available for use in India. Pneumococcal vaccination is suggested for people aged 19–64 years with immunosuppression, chronic cardiac, lung and hepatic disease, impaired splenic function, uncontrolled diabetes mellitus, current smokers, and those abusing alcohol. It is recommended that people >65 years of age are vaccinated with PPSV23. The suggested regimen is to administer PCV13 followed by PPSV23 after one year. The vaccines have minimal side effects and tolerated well. Data on vaccine effectiveness from Indian studies is limited. Hence, documenting population demographics with surveillance on serotype specific pneumococcal disease burden in adults is needed. Following this, studies on safety, immunogenicity, and cost-effectiveness of the available vaccines need to be designed and implemented. It is suggested that in the initial phase, PCV needs to be made available for high-risk population followed by vaccination roll-out for adult population of India. [ABSTRACT FROM AUTHOR]

Influenza causes significant morbidity, hospitalizations, and mortality due to lower respiratory tract infections in India. This paper reviews the current evidence regarding influenza epidemiology, the need for vaccination, immunogenicity, and efficacy of available vaccines and provides recommendations for influenza vaccination for adults by the Indian Association of Preventive and Social Medicine (IAPSM). The risk group among adults includes people with chronic disease, the elderly, immunocompromised individuals, pregnant women, travelers, and healthcare workers. Influenza activity is affected by seasons, humidity, and latitude, leading to variability in influenza peaks in different regions of India. The most effective preventive intervention against influenza is vaccination. Current influenza vaccines have good safety profiles, vaccine efficacy, and acceptable cost-effectiveness. As the virus mutates, the vaccine composition should follow WHO recommendations for the current influenza season. Introducing readily available, conventional, and less expensive trivalent influenza vaccines under the national program can achieve maximum impact on the adult population and potentially prevent future outbreaks and pandemics. IAPSM recommends considering routine use of IIV for all individuals above 60 years, adults with comorbidities, and pregnant women in India. The program managers should consider the pattern of influenza seasonality in a particular region. Influenza surveillance conducted through a structured network of laboratories in India has the potential to provide information about circulating strains, morbidity, and mortality. IAPSM emphasizes conducting community-based studies regarding influenza's burden, vaccine efficacy, timing of vaccination, and cost-effectiveness among Indian adults to generate evidence. [ABSTRACT FROM AUTHOR]

Objective: The Global Adult Tobacco Survey conducted in India has divulged that 28.6% of the populace aged 15 years and above partakes in tobacco consumption in various modalities. Despite the availability of numerous studies on the correlation between smoking and hypertension, the nexus between tobacco smoking and hypertension remains enigmatic. Smoking has predominantly been linked to blood pressure, with scant investigations exploring the plausible association that may subsist between smoking and pulse pressure. Methodology: This study is based on secondary data analysis from the fifth National Family Health Survey (NFHS-5). 17 Field Agencies gathered information from 636,699 households, 724,115 women, and 101,839 men. The data related to only men was included and analysed in this present study. Results: Male participants had a mean age of 32.2+1.2 years, an average waist circumference of 80.4+12.2 cm, and mean systolic and diastolic blood pressure of 123.4+13.8 mmHg and 80.5+10.2 mmHg. Daily smokers had a slightly higher likelihood of hypertension compared to non-smokers (OR = 1.2, p <0.001). Male quitters had significantly lower odds of hypertension (OR = 0.9, p <0.001). Quitters had reduced odds of narrow pulse pressure but increased odds of wide pulse pressure (OR = 0.81 and 1.14, respectively). Conclusion: The study found that regular smoking was associated with hypertension, while factors such as age, obesity, urban dwelling, wealth, and tribal residence were linked to increased blood pressure. Male quitters had a lower likelihood of hypertension, and middle-aged men and those with central obesity showed distinct associations with deranged pulse pressure. [ABSTRACT FROM AUTHOR]

Background: Health professionals despite having a fair knowledge of staying fit and healthy lose their productive hours and lives to lifestyle diseases. An early identification of Metabolic Syndrome (MetS) and understanding of its lifestyle correlates can play a pivotal role in its prevention. Aim and Objectives: The objective of this study was to estimate the prevalence and associated lifestyle-related risk factors of MetS in medical students. Material and Methods: The study was an institution-based, cross-sectional, and non-interventional study. A total of 300 MBBS students of all three professional years constituted the study population. Sociodemographic variables and lifestyle-related risk factors were recorded, followed by anthropometric assessment, blood pressure measurement, and required laboratory investigations. International Diabetes Federation (IDF) criteria were used for MetS. Results: The prevalence of MetS in the current study was found to be 9.0%. Lower level of HDL-C emerged to be the most common parameter (57.37%) followed by abdominal obesity (25.6%) and raised triglycerides (18%). MetS increased as one progressed through the various academic years of medical training. Prevalence of MetS among male students (12.4%) was significantly higher than their female counterparts (4.1%). Frequency of eating > 7 times/week of fast food/ junk food [OR 1.75 (1.196- 1.306)], habit of watching screen while eating food [OR 1.78 (0.872-0.892)], >3 drinks (30 ml alcohol per drink) per month [OR 1.73 (1.068-1.170)] were found to be significant risk factors. Conclusion: Considering the high prevalence of MetS among medical students and its association with various lifestyle risk factors, it is imperative that health education, screening, early detection, lifestyle interventions and framing of new health policies are given careful consideration to manage the rising trend of MetS among them. [ABSTRACT FROM AUTHOR]

Byline: Savita. Chahal, Nikhil. Govil, Anuradha. Nadda, Amandeep. Kaloti, Nishu. Gupta Background: Poor adherence to antiepileptic drugs is one of the most important causes of treatment failure in persons with [...]

Background: Despite having one of the world's largest medical education consortium, India lacks a comprehensive and nationally representative data on suicide deaths among medical students and physicians unlike the one found in most of the developed nations of the world. Aim: We aimed to explore the different characteristics of suicide deaths among medical students, residents and physicians in India over a decade (2010–2019). Methods: Content analysis of all suicide death reports among medical students, residents and physicians available from online news portals and other publicly available sites was done. Search was done retrospectively using pertinent search words individually or in combination with language restricted to Hindi and English and timed from January 2010 to December 2019. Reports on completed suicide by allopathic medical students, residents and physicians from India were included. Socio-demographic and suicidological variables were analysed using R software. Results: A total of 358 suicide deaths among medical students (125), residents (105) and physicians (128) were reported between 2010 and 2019. Around 7 out of 10 suicides happened before the age of 30 and had mean age 29.9 (±12.2) years. Female residents and physicians were younger than their male counterparts at the time of suicide. Overall maximum suicide deaths were concentrated in South India except the state of Kerala. The specialty of anesthesiology (22.4%) followed by obstetrics-gynaecology (16.0%) had the highest suicide deaths. Violent suicide methods were more commonly used by all, with hanging being the most common mean of suicide. Academic stress among medical students (45.2%) and residents (23.1%), and marital discord among physicians (26.7%) were the most noticeable reasons for suicide. Mental health problems were the next most common reason in medical students (24%) and physicians (20%) while harassment (20.5%) was in residents. Twenty six percent had exhibited suicide warning signs and only 13% had ever sought psychiatric help before ending their lives. A total of nine reports of suicide pact were found with the average deaths per pact being 2.4 and predominantly driven by financial reasons. Conclusion: Academic stress among medical students and residents, and marital discord in physicians emerged as the key reasons for suicide. However, this preventable domain should be further explored through focused research. This is the first of its kind study from India which attempted to explore this vital yet neglected public health issue using the most feasible and practical method of online news content-based analysis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children. MATERIALS AND METHODS: Children with a body mass index (BMI) of >27 kg/m2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5–18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors. RESULTS: A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11–1.01]) and waist circumference (1.089 [1.19–0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24–1.01]) was found to be significantly associated with NAFLD. CONCLUSION: There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD. [ABSTRACT FROM AUTHOR]

Background: Inadequate sleep quality is a crucial problem in today's hectic lifestyle. Sleep is known to facilitate cognitive skills, aid memory, and is important for physical, emotional and intellectual health. Objectives: To determine the sleep quality of the medical undergraduate students and to explore differences in various phases of medical curriculum. Material and Methods: Sleep quality was assessed in 400 medical students in various phases of the medical course using the Pittsburgh Sleep Quality Index (PSQI). Chi square test was used for comparisons of the all seven components of PSQI and sleep quality for different study year, whereas ANOVA was used for comparison of the components and global score. Results: Of the total, 25.3% of the participants classified their sleep quality as either very or fairly bad, and 31.1% reported taking more than 30 min to fall asleep. The average hours slept per night was 7.1 ± 1.21. Of the total, 8.4% of the participants reported using sleep medication at least once a week. Subjective sleep quality and sleep duration were found to be significantly different among the four groups. Conclusion: Poor subjective sleep quality was high for students in all class years of the undergraduate medical course. The comparison across the various phases of the course showed that first years reported worse sleep quality than did those in other class years. [ABSTRACT FROM AUTHOR]

Background: Research across the globe highlights rights violations and abuses experienced by women and seldom are channeled toward any atrocities being experienced by men. Objectives: To find the prevalence, characteristics, and sociodemographic correlates of gender-based violence against men. Materials and Methods: It was a community-based, cross-sectional study using multistage random sampling in which a total of 1000 married men in the age group of 21-49 years were interviewed using modified conflict tactics scale. Results: In the present study, 52.4% of men experienced gender-based violence. Out of 1000, males 51.5% experienced violence at the hands of their wives/intimate partner at least once in their lifetime and 10.5% in the last 12 months. The most common spousal violence was emotional (51.6%) followed by physical violence (6%). Only in one-tenth cases, physical assaults were severe. In almost half of the cases, husband initiated physical and emotional violence. Gender symmetry does not exist in India for physical violence. Less family income, education up to middle class, nuclear family setup, and perpetrator under the influence of alcohol were identified as risk factors. Earning spouse with education up to graduation is the risk factor for bidirectional physical violence. Conclusion: Besides women, men are also the victims of gender-based violence. This demands the future investigation and necessary intervention on gender-based violence against men in India. [ABSTRACT FROM AUTHOR]

Background: Prevention of intimate partner violence is an important public health goal owing to its negative psychological and physical health consequence., Objectives: Estimate the prevalence of reciprocate and nonreciprocate violence, severity of injuries, and related risk factors., Materials and Methods: The present study was a community-based cross-sectional study using multistage random sampling in which a total of 880 currently married women in the age group 15-49 years were interviewed using modified conflict tactics scale. Logistic regression was used to identify factors associated with both the types of domestic violence., Results: Total prevalence for spousal violence was 33.2% (283), out of which 14.84% (42) were reciprocally violent. Alcoholic husband [Adjusted Odds Ratio (AOR): 3.262, P = 0.001], late year of marriage (>2 years) [AOR: 0.359, P = 0.001], low education of the participants [AOR: 1.443, P = 0.033], and low socioeconomic class [AOR: 0.562, P = 0.004] are the risk factors for nonreciprocate domestic violence. Alcoholic husband [AOR: 4.372, P = 0.001] and nuclear family [AOR: 3.115, P = 0.001] were found as significant risk factors for reciprocate domestic violence. Women indulging in reciprocate violence were associated with more severe injuries than nonreciprocate violence., Conclusion: This study depicts that every third female has experienced spousal violence and also highlights the existence of reciprocate violence in India. Alcoholism, low education of husbands, and living in nuclear family are the important determinants for reciprocate violence. Also, reciprocate violence is associated with severe injuries., Competing Interests: There are no conflicts of interest.