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Abstract Eisenia fetida, commonly known as the red earthworm, holds significant ethnozoological importance due to its traditional use in various cultures as a medicinal agent. This study aims to explore the potential anticancer effects of Eisenia fetida paste (EFP) and evaluate its therapeutic efficacy in mice with ascites Dalton's lymphoma (DL). The EFP extract demonstrated a significant antitumour effect, possibly by initiating programmed cell death and mitochondrial changes in the tumour cells. The viability of tumour cells exhibited a reduction over time due to EFP treatment. Comparative analysis with the reference drug cisplatin revealed that EFP exhibited fewer or no adverse effects on mutagenicity, hepatotoxicity, and nephrotoxicity in tumour-bearing hosts. EFP treatment was found to show progressive increase in the quantity of apoptotic DL cells over time suggesting a time-dependent impact on the induction of apoptosis in the treated groups. These results imply that EFP might serve as a safer substitute for cancer treatment and hold promise for developing new and improved therapeutic strategies against cancer. The main implication of the study is that EFP might serve as a safer substitute for cancer treatment. It suggests a promising avenue for developing new and improved therapeutic strategies against cancer, with the potential to enhance treatment outcomes while minimising adverse effects. Graphical abstract

Patient-generated health data are a promising arena that can create a revolutionary change in the field of healthcare. Although a lot has been done globally to incorporate the information and data directly from the patient for their benefit, patient-generated health data (PGHD) remains a nascent area for the stakeholders including the clients themselves as well as the healthcare professionals and the system itself. This narrative review aims to familiarise the readers with the concept of PGHD, the strategies utilised by key organisations across the globe and to make them cognizant of the challenges and potential hurdles in the implementation and amalgamation of PGHD into the healthcare system. With the advancement in information technologies, artificial intelligence and remarkably evolving software, it has become easy to access health-related data such as heart rate, blood pressure, pulse oximetry and even electrocardiograms at the comfort of our homes with the touch of a button. The easy availability and affordability of smartphones for most of the population have led to the blooming of the wearable device industry, and there is a surge of primary health-related data overflowing around us everywhere. Proper utilisation of this deluge of data in the form of PGHD can reduce the healthcare cost and burden of care, especially in developing countries by improving the patient–provider interactions and bridging the existing information gaps. PGHD plays a significant role in health promotion also by supporting self-management activities such as healthy eating and exercise. In this modern era of precision health with comprehensive veracity, it becomes essential that researchers and healthcare professionals should lead from the front in the amalgamation of PGHD into healthcare.

Background: India's flagship program on adolescent health – Rashtriya Kishor Swasthya Karyakram (RKSK) emphasises the importance of strengthening Adolescent Friendly Health Clinics (AFHCs) under its facility-based approach for improving the health of adolescents. AFHCs are intended to provide targeted intervention in six domains – nutrition, injuries & violence (including gender-based violence), mental health, sexual & reproductive health, substance abuse and noncommunicable diseases. Objective: The current study was conducted to assess the determinants of awareness and utilisation of AFHC services in districts with RKSK services in Madhya Pradesh. Subjects: In total, 1605 adolescents (both males and females) within the age group of 10–19 years were included in the study. Methods: Multistage stratified random sampling was employed to enrol participants from three districts of Madhya Pradesh, where AFHC services have been launched. Results: The mean age of the participants was 15.07 ± 2.32 years. Only 153 (9.5%) adolescents were aware of AFHC services. On multivariate logistic regression, awareness of AFHC was seen to be associated with being aware of RKSK, being a part of the peer educator-led peer group, having had adolescent health days organised in the village and belonging from one of the financially better off districts. Utilisation rate of AFHC services was lower still – at 2.74%. Conclusion: Both awareness and utilisation of AFHC services remain very low among adolescents. There is a pressing need to focus on awareness generation campaigns – via mass media, but more importantly, through community health workers and peer educators – in order to sensitise target beneficiaries about the available services.

Purpose: Cisplatin is a cancer chemotherapeutic drug that has been extensively used in the treatment of a variety of cancers. However, the full usage of cisplatin is limited due to its treatment associated development of multiple side effects in the host. In the present study, the modulatory effect of rutin, a type of flavonoid, on the cisplatin mediated antitumor activity and allied genotoxicity in ascites Dalton’s lymphoma (DL)-bearing mice were investigated. Methods: The antitumor activity was determined by calculating the percent increase in the life span of mice, cell viability and scanning electron microscopy (SEM) of DL cells. Further, the modulatory effect of rutin on the cisplatin-induced genotoxic effects in the same DL-bearing mice was assessed by the analysis of micronuclei, chromosomal aberration and sperm abnormality. Results: The combination treatment of mice with rutin and cisplatin showed a considerable increase in the life span of the DL-bearing mice depicting better antitumor efficacy. SEM of these DL cells showed severe membrane deformities in DL cells such as fusion of cell membrane, membrane blebbing, cell shrinkage, membrane folding and loss in microvilli from the tumor cell surface which may lead to cell death. Cisplatin alone treatment caused an increase in the frequency of chromosomal aberrations, micronuclei and sperms abnormality. However, the combination treatment of DL-bearing mice with rutin and cisplatin comparatively reduced these genotoxic effects. Conclusion: The overall findings suggest that rutin enhances the cisplatin-mediated antitumor activity and cytotoxicity against DL cells and at the same time diminishes the genotoxic effects induced by cisplatin in the DL-bearing mice.

BackgroundCOVID-19 vaccination of the healthcare workers (HCWs) is a key priority in the fight against the SARS-CoV-2 pandemic. India launched its COVID-19 vaccination program in January 2021. We aimed to understand the trends in willingness to receive COVID-19 vaccines and its associated factors among HCWs in India.MethodsUsing a repeated cross-sectional survey design, we collected information from HCWs in three critical time points: before (n = 937, October 2020), during (n = 1346, January 2021); and after (n = 812, May 2021) the introduction of COVID-19 vaccines in India. The third survey coincided with the peak of the second wave of COVID-19 pandemic in India.FindingsOf the study participants, 43.7, 60.2, and 73.2% were willing to receive COVID-19 vaccines during the first, second and third rounds of surveys, respectively. In multivariable logistic regression analysis, participants who trusted the health care system were more likely to report willingness to receive a COVID-19 vaccine; medical trust emerged as a significant factor in all the three rounds of surveys (First survey—aOR: 2.24, 95% CI: 1.67–2.99; Second survey—aOR: 3.38, 95% CI: 2.64-4.33; Third survey—aOR: 2.54, 95% CI: 1.65–3.91). Having confidence in domestic vaccines (Second survey—aOR: 2.21, 95% CI: 1.61–3.02; Third survey—aOR: 2.05, 95% CI: 1.24–3.37); and high perceived risk of contracting COVID-19 (Second survey—aOR: 1.48, 95% CI: 1.13–1.93; Third survey—aOR: 2.02, 95% CI: 1.31–3.13) were found to be associated with willingness to receive vaccines. Among socio-demographic characteristics, being married (aOR: 1.71, 95% CI: 1.08–2.71) and having high socio-economic status (aOR: 3.01, 95% CI: 1.65–5.51) emerged as significant factors associated with willingness to receive COVID-19 vaccines in the third round of the surveys.InterpretationWillingness to receive COVID-19 vaccine increased with time, as the severity of the pandemic increased. To increase COVID-19 acceptance and coverage among HCWs, it is important to instill confidence in domestic vaccines and assist in accurate assessment of risk toward contracting COVID-19 infection.

Background: Vaccine hesitancy is of considerable concern as it threatens the great potential of a vaccine against COVID-19. This study aims to determine factors associated with community health workers’ willingness to participate in clinical trials of COVID-19 vaccine, and their vaccination intention, in India. Methods: A cross-sectional study was conducted among 377 community health workers using self-administered anonymous questionnaire during the lockdown periods in India. Participant's socio-demographics, willingness-to-participate in COVID-19 vaccine trials, intention to accept COVID-19 vaccine were recorded in a Likert scale. Data were analysed descriptively, and a multivariate logistic regression model was used to investigate factors associated with willingness to participate and accept the vaccine. Results: Among 377 CHWs, 70 (19%) intended to participate in COVID-19 vaccine trial, 151 (40%) responded positively regarding their intention to get vaccinated. Those with knowledge on development of COVID-19 vaccine [aOR 3.05 (95% CI: 1.18–7.88), p = 0.021], and men [aOR 3.69 (95% CI: 1.51–8.97), p = 0.004] were more willing to participate in clinical-trial, while an undergraduate degree, and trust in domestic vaccines were identified as deterrents for the same. Perceiving COVID-19 as risk [aOR 2.31 (95% CI: 1.24–4.31), p = 0.009], and male gender [aOR 2.39 (95% CI: 1.17–4.88), p = 0.017] were factors associated with intention to get vaccinated. Respondents who had knowledge about COVID-19 virus were less likely to uptake the hypothetical vaccine [aOR 0.32 (95% CI: 0.12–0.88), p = 0.027]. Conclusions: Increasing knowledge regarding COVID-19 is not enough to improve vaccine acceptance rates. Targeted interventions addressing socio-demographic determinants related to COVID-19 vaccination should help improve acceptance.

BackgroundResponding to the fast transmission rates and increasing fatality rates, countries across the world expedited the development and deployment of the vaccine for coronavirus disease 2019 (COVID-19). Evaluation of individuals' willingness to pay (WTP) would provide pertinent information regarding future demand and financing preferences, which shall help to devise the effective payment strategy for COVID-19 vaccination.MethodsA nationwide, cross-sectional, and self-administered online survey using a structured questionnaire was conducted to identify the sociodemographic determinants of willingness and extent to pay for COVID-19 vaccine in India. A non-probability convenience sampling followed by snowball sampling was employed to recruit participants (n = 3,341). The likelihood of sociodemographic determinants to predict willingness and extent to pay was modeled using the multivariate binary logistic regression analysis.ResultsOut of 3,341 participants, 68% (n = 2,271) were willingness to pay for COVID-19 vaccine. Results showed significantly higher odds for willingness to pay among participants who were single [adjusted odds ratio (aOR) = 1.394, p < 0.01] and having a family size of 4 members (aOR = 1.346, p < 0.01). The adjusted odds ratio sizably increased from 1.396 for participants whose monthly income was between INR 10,000 and 20,000/month to 2.240 for participants whose monthly income was above INR 50,000/month. Further, out of 2,271 of those participants who were willingness to pay for COVID-19 vaccine, majority (n = 1,246, 54.9%) of participants were willingness to pay below 50% of COVID-19 vaccine cost. This study found that those who are single (aOR = 0.688, p < 0.01), having an income between INR 20,000 and 50,000/month (aOR = 0.686, p < 0.05), and those who belonged to socially disadvantaged category (aOR = 0.450, p < 0.01) were estimated to have significantly lower odds of willingness to pay more than 50% of COVID-19 vaccine cost.ConclusionThis study observed that majority of those participants who willingness to pay for COVID-19 vaccine were willingness to pay only up to 50% of COVID-19 vaccine and income was observed as a precursor predictor of the willingness and extent to pay for COVID-19 vaccine. The understanding on the willingness and extent to pay for COVID-19 vaccine and its sociodemographic determinants will be helpful for making the strategic decisions related to the financing of COVID vaccine in India.

Background: Anemia and poor menstrual hygiene practices have a considerable impact on all aspects of an adolescent girl's life. There is a dire need for evidence on the burden and its association to provide actionable preventive measures. Objective: The objective of this study is to explore the magnitude and association between poor Menstrual Hygiene Management (MHM) practices and anemia. Materials and Methods: A cross-sectional study conducted among 393 adolescent girls of the urban slum of Bhopal (June 2017–July 2018). Hemoglobin (Hb) was determined by a portable Hb meter (HemoCue). Logistic regression analysis was done to find out if there is any association between poor MHM practices and anemia. Results: The present study found the prevalence of anemia as 38.7% among which 65.1%, 31.5%, and 3.2% were suffering from mild, moderate, and severe forms of anemia, respectively, and 87.3% were practicing poor MHM. Logistic regression found that the MHM, bleeding during menstruation, religion, educational status, and nutritional status of adolescents were significant factors associated with anemia. Conclusion: The study concluded that there is a significant association between poor MHM and anemia. Concerted convergent actions focusing on the provision of awareness regarding MHM and sanitary facilities to maintain proper menstrual hygiene are needed to reduce the burden of anemia.

Introduction: The Coronavirus disease 2019 (COVID-19) pandemic created havoc within a few weeks of its outbreak affecting over 100 countries. The rapid increase in the established cases urged for the prevention and control of COVID-19 belligerently on both national and worldwide fronts to prevent the healthcare systems from collapsing. For the sake of successfully preventing and restricting a fatal pandemic outbreak such as COVID-19, it requires the apex health institutions to have a uniform, urgent, flexible and effective policy response framework ensuring strict adherence too. In this regard, the Apex Institutes of National Importance in India (INIs) have released a series of documents on COVID-19 prevention and management. Methods: Documents regarding COVID-19 preparedness and management were retrieved from the official websites of the INIs in India. The general population and healthcare workers' guidelines, standard operating procedures (SOPs) on COVID-19 prevention and management, action and response plans were included in the study. The full text of each document was analysed in detail and themes and subthemes were derived through content analysis. Results: A total of 68 documents was included in the study. Five major themes and 12 subthemes were formulated after content analysis. A major similarity was found across all INIs on screening and testing and infection prevention control measures. The INIs formulated guidelines adhering to the World Health Organization, Indian Council of Medical Research and Ministry of Health and Family Welfare Recommendations. Conclusion: Common measures like quarantine, social distancing, travel bans and mass gathering restrictions were adopted to prevent the spread of COVID-19 during the initial period. The INIs have developed policies and standard operating protocols on COVID-19 management based on the Government of India guidelines. Better understanding of these guidelines will help in effective implementation of the nationwide pandemic management.

BackgroundDespite the success of adult vaccination against COVID-19, providing vaccines to children remains a challenge for policymakers globally. As parents are primary decision-makers for their children, we aimed to assess parents' perceptions and intentions regarding COVID-19 vaccination in India.MethodsA cross-sectional web-based study was designed, parents or caregivers (N = 770) were recruited through snowball sampling using Google form. Cross-tabulation was performed by parents' intention to vaccinate their children against COVID-19 virus with sociodemographic characteristics and their risk perception toward COVID-19, trust in the healthcare system, and their history of vaccine hesitancy behavior. Multivariable logistic regression analysis was performed to compute the predictors of child vaccination intention among Indian parents.ResultsSeven hundred and seventy parents across the country have completed the survey. Of the 770 participants, 258 (33.5%) have shown intent to vaccinate their children. The stated likelihood of child vaccination was greater among parents who had a bachelor's degree or higher education (aOR: 1.98, 95% CI: 1.15–3.51); as well as among parents who intended to vaccinate themselves (aOR: 2.35, 95% CI: 1.30–4.67). Parental concerns centered around vaccine safety and side effects.ConclusionIndian parents reported high knowledge of the COVID-19 virus and were aware of the development of a vaccine. However, about one-third of parents intended to vaccinate their children, and about half of them were not sure whether to vaccinate their children or not against the COVID-19 virus. The study highlighted the need for health promotion strategies that promote vaccine uptake among parents.

Background: In a country with a high demand for contraception such as India, one of the most common methods is surgical sterilization, which is delivered by two approaches namely the camp approach and the fixed day static approach. The quality of services for sterilization in India for both the approaches has remained questionable. Objectives: This paper seeks to determine the quality of sterilization services at fixed day static centers of Madhya Pradesh. Methods: It was a descriptive observational study done between September 2017-December 2017 in 10 districts of Madhya Pradesh. One District Hospital and 2 Community Health Centers were randomly chosen from each district. The study was carried out using a prestructured, pretested, and prevalidated tool which used the Ona Platform. Results: Two of the facilities conducted more than 30 operations on the day of the visit. In only 18.3% of the cases was the patient informed about all contraception options. The duration between the start of surgery and the signing of consent was less than 2 h in 42% of the patients. The surgical protocol for proper surgical wear was not followed in most cases. Conclusion: The quality of care of sterilization services was found to be substandard in the fixed day static centers. The guidelines for the sterilization services were not being followed, and follow up of the patients was also neglected. Better training of the staff with strict and timely supervision is required for the better quality provision at the fixed day static centers.

Background: Betulinic acid, a naturally occurring pentacyclic triterpenoid is found in a variety of plants. A range of biological properties including anticancer activity has been reported for betulinic acid. Changes in glutathione and some glutathione-related enzymes and mitochondrial membrane potential have not been explored relating to the anticancer activity of betulinic acid against murine ascites Dalton's lymphoma.The present study was undertaken to examine betulinic acid-mediated changes in glutathione and mitochondrial membrane potential in murine malignant ascites Dalton's lymphoma cells to identify their involvement as the possible mechanism in its anticancer activity. Method: : The anticancer efficacy of betulinic acid was explored as a percentage increase in the life span (ILS) of the tumor-bearing mice. Betulinic acid-mediated changes in glutathione level, glutathione-related enzymes, succinate dehydrogenase activity, and mitochondrial membrane potential were determined in Dalton's lymphoma cells using well-established methods. In silico molecular docking study was done to know the binding affinity of betulinic acid with selected glutathione related enzymes and succinate dehydrogenase. Results: : Betulinic acid significantly increased the life span of ascites Dalton's lymphoma-bearing hosts, thus exhibiting anticancer potential. The treatment caused a decrease in glutathione and glutathione-related enzymatic activities in DL cells. In silico molecular docking analysis revealed that betulinic acid illustrates good binding affinity with glutathione-related enzymes indicating its inhibitory potentials. Further, a decrease in mitochondrial membrane potential and succinate dehydrogenase activity was also noted after treatment. Conclusions: : Betulinic acid-mediated decrease in glutathione in DL cells may hamper cellular antioxidant defense potential, which could play an important causative role in exerting its anticancer activity. Further, a concurrent decrease in mitochondrial membrane potential and succinate dehydrogenase activity is also important in its anticancer activity.

Background: Students act as messengers in delivering effective messages for better uptake of health-promoting behavior. Understanding their knowledge about coronavirus disease 2019 (COVID-19), intentions to use the COVID-19 vaccine, and its associated factors will help develop promising strategies in vaccine promotion concerning the current COVID-19 pandemic.Methods: A cross-sectional online survey was carried out among students in the healthcare and non-healthcare sectors to assess their intentions to get vaccinated against the COVID-19. A non-probability snowball sampling technique was used to recruit study participants (N = 655) through social media platforms and emails. Study participants were recruited across the country, including six major geographical regions (Eastern, Western, Northern, Southern, North-east, and Central) in India between November 2020 and January 2021 before the introduction of the COVID-19 vaccine. Descriptive statistics were used to present the sociodemographic, and vaccine-related behaviors of the study participants. Key determinants that likely predict vaccine acceptance among students were modeled using logistic regression analysis. For each analysis, p < 0.05 was considered significant.Results: A total of 655 students were recruited, 323 from healthcare and 332 from non-healthcare sectors, to assess their intentions to receive the COVID-19 vaccine. Of the 655 students, 63.8% expressed intentions to receive the COVID-19 vaccine. The acceptance was higher among non-healthcare students (54.07 vs. 45.93%). At the time of the study, 27.8% of the students indicated that they had been exposed to a confirmed COVID-19 patient. A vast majority (93.4%) of the students knew about the COVID-19 virus, and most (89.3%) of them were aware of the development of a COVID-19 vaccine. The history of vaccine hesitancy was found to be low (17.1%). Only one-third (33.4%) of the students showed concern about contracting COVID-19. Trust in the healthcare system [adjusted odds ratio (aOR): 4.13; (95% CI: 2.83–6.04), p < 0.00] and trust in domestic vaccines [aOR: 1.46; (95% CI: 1.02–2.08), p < 0.05] emerged as the significant predictors of student's intention to get vaccinated. Higher acceptance for vaccine was observed among students in the non-healthcare [aOR: 1.982; 95% CI: 1.334–2.946, p < 0.00].Conclusion: This study shows that the Indian college students had relatively high levels of positive intentions to receive COVID-19 vaccines, although about one-third were not sure or unwilling to receive the vaccine, highlighting possible vaccine hesitancy. Informational campaigns and other strategies to address vaccine hesitancy are needed to promote uptake of COVID-19 vaccines.

Weaver ants are known for their unique nest-building skills using leaves and larval-silk as a binding agent. The weaver ants, Oecophylla smaragdina are present in large numbers in the Ri-Bhoi district, Meghalaya. Ri-Bhoi district is a hot and humid place with 22 -30°C. This is the first study from this region to examine the nesting behavior along with the population of these ants from here. It was noted that they build nests in different types of trees but it is more abundant in needlewood trees (Schima wallichi) locally known as ‘diengngan.’ From the central trunk of the S. wallichi tree, the nearest distance of the nest is about 0.7 m and the farthest up to 3.4 m. The nests of O. smaragdina are somewhat round-oval and use leaves of different sizes ranging from 8-32 cm2. The nests are made at a height ranging from 4-25 m and their average nest size is about 9,483 cm3. They utilize about twenty leaves with a specific number of chambers to keep their broods, the queen, and food. The number of worker ants, pupae, and larvae are variable in different nests because of nest size, location/height of the nests, and the trees. When the nest population increases, they locate a new spot and build a satellite nest where they get the right amount of sunlight and shelter from predators and adverse environmental factors. These weaver ants are also used as medicine, food and fish bait by the indigenous people in Meghalaya.

Context: India has the second-largest population in the world with a significant growth rate that adversely affects the quality of life (QoL). Sterilisation is one of the main methods of female contraception in the country. Meeting the sterilisation services' numerical demand and quality requirements have remained a challenge. Aims: This study was done to assess the infrastructural component of the sterilisation services provided by the static centres. Settings and Design: This was a descriptive cross-sectional facility-based study conducted from September to December 2017. It involved 30 facilities (10 district hospitals and 20 community health centres [CHCs]) from 10 divisions of the state of Madhya Pradesh. Methods and Materials: The data were collected using a pre-tested and pre-structured questionnaire, which was uploaded on the Ona platform. Statistical Analysis Used: Data analysis was performed using SPSS version 21. Results: Only 11 of the 30 facilities had proper waiting areas for the patients. Approximately, only 63% of the facilities had proper toilets, 50% had display of the contraceptives, and 43% had a complaint/suggestion box. In terms of the availability of equipment, only 43% of the facilities had a table with the Trendelenburg facility. Conclusions: The main limitations in the infrastructure of the facilities were general cleanliness; availability of proper waiting and post-operative areas; and the lack of equipment, record keeping, and supervision. To accomplish the provision of quality sterilisation services, policy-makers and programme managers need to pay attention to and address these limitations.

INTRODUCTION: Targeting the huge burden of adolescent anemia, the Weekly Iron and Folic acid Supplementation (WIFS) was launched by the Government of India. Few studies have been done to assess the effective functioning of the program since its inception. The present study was done to assess the knowledge WIFS among adolescents of Madhya Pradesh and the associated factors. MATERIALS AND METHODS: A cross-sectional study was done in a total of six districts (3 districts where the national adolescent program was implemented and 3 districts where it was not) of Madhya Pradesh. Multistage stratified random sampling technique was used for the enrollment of 3213 adolescent boys and girls, and a prestructured and validated tool was used to collect paperless data. Ethical approval and consent from the participants were obtained. Statistical analysis was performed using SPSS v21. RESULTS: It was observed that the knowledge of WIFS was more among adolescent girls (29.3%) as compared to adolescent boys (14.1%). More of the adolescent girls received Iron and folic acid tablets as compared to adolescent boys (60.8% girls vs. 24.1% boys). Mostly, the adolescents got Iron tablets from school followed by Anganwadi and PHC/CHC. Girls, rural location, literacy, below poverty line status, knowledge of anemia, adolescents who got iron and albendazole tablets, and adequate consumption of iron tablets (>4) were associated with higher knowledge of WIFS. CONCLUSION: The knowledge of WIFS was found to be less in adolescent boys. There is a hint of the fact that effective execution of the program among its beneficiaries leads to an automatic increased knowledge of the program, at least among the beneficiaries. Thus, an indirect but significant indirect finding is that the nationwide WIFS program needs to be put to greater focus among the adolescent boys, apart from its major focus on the female gender among most age groups.

The National Health Mission tracks the proportion of women delivered by skilled birth attendants (SBAs). We assessed SBAs competence in Madhya Pradesh, India, using structured evaluation tools. It is a cross-sectional study conducted from 2014 to 2015. We evaluated 335 trained SBAs using multistage stratified random sampling. Of total, 335 skilled births attendant selected 41.8% were auxiliary nurse midwife, 47.8% were staff nurse, and 10.4% were lady health visitors. Grouping all provider and knowledge test versions, SBAs were correct on 75.4% of the questions. By topic, results ranged from 77.9% correct for the management of normal pregnancy and childbirth to 70.2% correct for intranatal care. The skill evaluation score was 88.1% of infection prevention practices to 74.3% for postnatal care. The present study found significant variations in knowledge and skill competency scores of the SBAs. There is a critical need to improve the training quality of skill birth attendants.

Abstract Background India has an immense faunal, floral, as well as cultural diversity with many ethnic communities who are primarily dependent on the traditional medicinal system for their primary health care. Documentation and evaluation of this indigenous remedial knowledge may be helpful to establish new drugs for human health. The present study is intended to look into different zootherapeutic medicinal uses in the traditional health care system among the native inhabitants adjacent to the Gibbon Wildlife Sanctuary, Assam, India. Methods Field survey was carried out from March 2015 to August 2015 by personal interviews through semi-structured questionnaires. In some cases where participants were uncomfortable with the questionnaires, informal interviews and open group discussions were conducted with a total of 62 indigenous respondents (43 male and 19 female) who provided the information regarding various medicinal uses of animals and their products (local name of animal, mode of preparation, application etc). Results The study recorded a total of 44 different species, 44 genera and 36 families of animals which are used for the treatment of 40 different ailments. Insects occupied the highest uses (30.9%), followed by mammals (23.8%), fishes (16.7%), reptiles (11.9%), amphibians (7.1%), annelids (4.8%) and gastropods (4.8%). Further, some zootherapeutic animals i.e. cockroach (Periplaneta americana), praying mantis (Mantis religiosa) and earthworms (Metaphire houletti, Pheretima posthum) are used for the treatment of asthma, otorrhoea and cancer respectively. Conclusion The findings suggest that the traditional zootherapeutic remedial measures followed by the native people adjacent to Gibbon Wildlife Sanctuary plays an important role in their primary health care. The documentation of this indigenous knowledge on animal based medicines should be very helpful in the formulation of strategies for sustainable management and conservation of bio-resources as well as providing potential for the novel drugs discovery.

This exploratory paper is written in the context of establishment of Community and Family Medicine Departments in new six AIIMS. Through the review of published literature, key papers, guidelines, web2.0 interface and inductive reasoning, this article attempts to explain the forces behind the restructuring and possible implications. Further considering changeover as a welcome sign; a seven P competency model is proposed by authors, which may facilitate the disciples' journey for searching the purpose of discipline

Cisplatin is one of the well-established anticancer drugs being used against a wide spectrum of cancers. However, full therapeutic efficacy of the drug is limited due to development of various toxicities in the host. This study examines the comparative therapeutic effectiveness and toxicities of cisplatin alone and in combination of dietary ascorbic acid (AA) in ascites Dalton's lymphoma-bearing mice. The findings show that the combination treatment of mice with ascorbic acid plus cisplatin has much better therapeutic efficacy against murine ascites Dalton's lymphoma (DL) in comparison to cisplatin alone and this may involve a decrease in reduced glutathione (GSH), catalase activity and increased lipid peroxidation (LPO) in Dalton's lymphoma tumor cells. At the same time, combination treatment indicates a protective role of ascorbic acid against cisplatin-induced tissue toxicities (side effects) in the hosts. Cisplatin-induced histopathological changes in liver, kidney and testes were decreased after combination treatment. The analysis of renal function test (RFT), liver function test (LFT) and sperm abnormalities also suggest an improvement in these parameters after combination treatment. Therefore, it may be concluded that the increased GSH level, catalase activity and decreased LPO in the tissues, i.e., liver, kidney and testes after combination treatment may be involved in its protective ability against cisplatin-induced tissue toxicities in the host.

Background: In India, only one woman is diagnosed with tuberculosis (TB) for every 2.4 men. Previous studies have indicated gender disparities in care-seeking behavior and TB diagnosis; however, little is known about the specific barriers women face. Objectives: This study aimed to characterize socio-cultural and knowledge-based barriers that affected TB diagnosis for women in Bhopal, India. Materials and Methods: In-depth interviews were conducted with 13 affected women and 6 health-care workers. The Bhopal Diagnostic Microscopy Laboratory Register (n = 121) and the Bhopal district report (n = 261) were examined for diagnostic and care-seeking trends. Results: Women, especially younger women, faced socio-cultural barriers and stigma, causing many to hide their symptoms. Older women had little awareness about TB. Women often sought treatment from private practitioners, resulting in delayed diagnosis. Conclusions: Understanding these diagnostic and help-seeking behaviors barriers for women is critical for development of a gender-sensitive TB control program.

Introduction: Anaemia continues to be a major hurdle to achieve optimum health in Indian population context. Although government continues to promote Iron Folic Acid (IFA) supplementation as one of the key strategies to combat with burden of anaemia, the expected level of IFA consumption and subsequent anaemia reduction could not be achieved. This study tries to investigate those influences, concerns, experiences and behaviour from an end user perspective through a qualitative methodology which may affect the IFA consumption ambidirectionally. Aim: To explore and understand the several aspects related with anaemia and IFA supplementation with special emphasis to reveal the contributory factors behind low level of IFA consumption at consumer end. Materials and Methods: A community based qualitative study was conducted in clusters identified through multileveled stratification from a state of central India. A conceptual construct was made in priory for this study. As the research question was related with policy, this study adapted a framework technique for making interview topic guides. Two consumers and two non consumers from each identified cluster were interviewed in depth. The data obtained through 160 in depth interviews (from 80 consumers and 80 non consumers) was utilized for thematic framework, linkage association and to typify the phenomenon. Results: Ignorance, difficult intake, meaninglessness, misconceptions and discontentment with the system were the major dimensions (sub themes) associated with discontinuation. All these sub themes were further converged into major theme of informational discontinuity. Investigators further typified the users/non users into persistent user, potential defaulters, impending defaulters and absolute non users. Conclusion: Informational gap seems to be the fundamental factor behind sub optimum IFA consumption. On a policy perspective, all the attempts should be done to instigate arise felt need’ among target groups for IFA consumption.

Background: Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community-based surveys, facility-based data provide a good alternative. The aim of this study was to describe the morbidity profile of patients attending the Centre for Urban Health All India Institute of Medical Sciences (AIIMS) Bhopal (CUHA). Methodology: A record-based descriptive study was carried out in the CUHA Bhopal, Madhya Pradesh, Central India. Information on age, gender, residence, new case, and principal diagnosis were extracted from the outpatient registers for the period between January 2014 and December 2014. Only newly registered patients for the study year (2014) were included. Descriptive analysis was done. Results: A total of 6685 new episodes of illnesses were treated. Adults (>15 years) constituted about 85.0%. Overall, the respiratory disorders were the most common (27.2%) followed by the digestive disorders (10.9%), circulatory disorders (9.9%), musculoskeletal disorders (8.8%), and infectious and parasitic disorders (7.4%). Conclusion: This study gives a brief description of the morbidity profile of patients attending a primary health care center over a period of 1 year. This knowledge would help in planning health services to meet the patients’ needs and help in training health staff.

Purpose: Cisplatin is a cancer chemotherapeutic drug that has been extensively used in the treatment of a variety of cancers. However, the full usage of cisplatin is limited due to its treatment associated development of multiple side effects in the host. In the present study, the modulatory effect of rutin, a type of flavonoid, on the cisplatin mediated antitumor activity and allied genotoxicity in ascites Dalton's lymphoma (DL)-bearing mice were investigated. Methods: The antitumor activity was determined by calculating the percent increase in the life span of mice, cell viability and scanning electron microscopy (SEM) of DL cells. Further, the modulatory effect of rutin on the cisplatin-induced genotoxic effects in the same DL-bearing mice was assessed by the analysis of micronuclei, chromosomal aberration and sperm abnormality. Results: The combination treatment of mice with rutin and cisplatin showed a considerable increase in the life span of the DL-bearing mice depicting better antitumor efficacy. SEM of these DL cells showed severe membrane deformities in DL cells such as fusion of cell membrane, membrane blebbing, cell shrinkage, membrane folding and loss in microvilli from the tumor cell surface which may lead to cell death. Cisplatin alone treatment caused an increase in the frequency of chromosomal aberrations, micronuclei and sperms abnormality. However, the combination treatment of DL-bearing mice with rutin and cisplatin comparatively reduced these genotoxic effects. Conclusion: The overall findings suggest that rutin enhances the cisplatin-mediated antitumor activity and cytotoxicity against DL cells and at the same time diminishes the genotoxic effects induced by cisplatin in the DL-bearing mice. [ABSTRACT FROM AUTHOR]