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Context: Miscarriage is the most distressing complication in early pregnancy, with one in every five pregnant women ending in a miscarriage, and its causes are multifactorial. AIM: This study aimed to find the risk and protective factors of miscarriage among women aged 15–49 years in India by using the National Family Health Survey (NFHS-5) data. Methods and Material: The data were taken from NFHS-5; 53,560 women aged 15–49 years who had reported either a miscarriage (n = 5104) or livebirth (n = 48,456) during the last 12 months preceding the survey were included in the study. Statistical Analysis Used: Various sociodemographic, lifestyle, comorbid, and fertility-related factors were considered in the Poisson regression analysis, and adjusted prevalence ratios were obtained. Results: Significant sociodemographic risk factors were age less than 20 years or more than 34 years, urban residence, primary and higher education levels, wealth index middle and above, and occupation as employed. Muslim religion, Scheduled Tribe, and Other Backward Class castes were statistically significant protective factors. Obesity, severe anemia, hypertension, and thyroid disorder were the significant comorbid risk factors, whereas tobacco chewing was the only significant lifestyle risk factor. A higher number of ever-born children was the fertility-related risk factor, whereas the use of intrauterine devices was a significant protective factor for miscarriage. Conclusions: To reduce the incidence of miscarriage in developing countries like India, the respective governments and healthcare providers should develop intervention programs targeting women in well-educated and high-income families.

Aberrant alterations in any of the two dimensions of consciousness, namely awareness and arousal, can lead to the emergence of disorders of consciousness (DOC). The development of DOC may arise from more severe or targeted lesions in the brain, resulting in widespread functional abnormalities. However, when it comes to classifying patients with disorders of consciousness, particularly utilizing resting-state electroencephalogram (EEG) signals through machine learning methods, several challenges surface. The non-stationarity and intricacy of EEG data present obstacles in understanding neuronal activities and achieving precise classification. To address these challenges, this study proposes variational mode decomposition (VMD) of EEG before feature extraction along with machine learning models. By decomposing preprocessed EEG signals into specified modes using VMD, features such as sample entropy, spectral entropy, kurtosis, and skewness are extracted across these modes. The study compares the performance of the features extracted from VMD-based approach with the frequency band-based approach and also the approach with features extracted from raw-EEG. The classification process involves binary classification between unresponsive wakefulness syndrome (UWS) and the minimally conscious state (MCS), as well as multi-class classification (coma vs. UWS vs. MCS). Kruskal-Wallis test was applied to determine the statistical significance of the features and features with a significance of p < 0.05 were chosen for a second round of classification experiments. Results indicate that the VMD-based features outperform the features of other two approaches, with the ensemble bagged tree (EBT) achieving the highest accuracy of 80.5% for multi-class classification (the best in the literature) and 86.7% for binary classification. This approach underscores the potential of integrating advanced signal processing techniques and machine learning in improving the classification of patients with disorders of consciousness, thereby enhancing patient care and facilitating informed treatment decision-making.

Background: Police personnel experience the highest levels of stress due to the nature and demands of work. Though many researchers have studied these variables quantitatively, there is a lack of qualitative study, particularly in India. Methods: A qualitative study has been carried out to explore the stress and coping strategies of police personnel. This study conducted in-depth interviews with ten police personnel and three focus group discussions with 22 police personnel. Results: Thematic analysis revealed five themes: family stressor, personal stressor, work stressor, and adaptive and maladaptive coping. Inability to take leave, multi-tasking, unscheduled excessive working hours, inability to spend time with the family members, and lack of basic amenities to meet personal hygiene were significant factors for their high level of stress. Conclusion: The results reinforce the need for mitigating the impact of stress by using positive coping strategies and social support resources, which could be achieved through capacity building and mental health programs.

Background: Stroke is a leading cause of death and disability worldwide. In India, it is the fourth leading cause of death and fifth leading cause of disability, posing a major public health concern. National surveys reveal an increasing trend in stroke risk factors such as tobacco use, physical activity, alcohol use, hypertension, and dyslipidemia. However, knowledge regarding the combined effect of these risk factors and their various combinations is limited. Understanding the individual, combined, and synergistic effects of known risk factors, along with new risk factors, is essential to address gaps in stroke epidemiology. This study aims to examine the effect of various risk factors of acute stroke and their association with stroke occurrence and its outcomes (survival, disability and quality of life). Methods: This retrospective-prospective cohort will be conducted in one taluka of Kolara district and two urban wards of Bengaluru with a total population of ~400,000. All stroke-free individuals above 30 years of age ~200,000 individuals in the selected sites will be participants of stroke-free period and all first ever stroke patients in the community will be part of stroke and post-stroke period respectively. The study subjects will be recruited through a complete house-to-house survey at baseline and undergo annual follow-ups during the stroke-free period, with specific assessments at defined time points during the stroke and post-stroke period for a period of one year. Efforts are implemented to minimize loss to follow-up, including community engagement, a helpline number, and hospital-based surveillance. Discussion: This large population-based cohort study addressing stroke epidemiology in the country, is one -of-its-kind, attempting to fill certain critical gaps in the natural history, management, and outcomes of stroke in India. This research has the potential to provide important insights into the effect of novel risk factors of stroke and various combinations of risk factors of stroke. Furthermore, the development of a stroke risk predictability calculator will add value to the existing Indian National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD) and offers a model for similar countries once developed. [ABSTRACT FROM AUTHOR]

Background: Literature has emphasized the role of biopsychosocial factors in internalizing disorders; however, the role of developmental competencies of a child have not been explored much in this context. The current study aimed to understand the differences in developmental competencies, temperament, parenting practices and psychosocial adversities between children with and without internalizing disorders. Method: The sample consisted of 200 children and adolescents aged seven to 18 years, with equal number of those with and without an internalizing disorder; and one of their parents. Psychopathology, temperament, interpersonal competence, emotion regulation, executive function, self-concept, adaptive behaviour, parenting practices, life events, family environment and abnormal psychosocial situations were measured using standardized tools. Findings: Discriminant analysis revealed that temperamental domains of sociability and rhythmicity, developmental competencies of adaptive behaviour and self-concept, parenting practices involving father's involvement and overall positive parenting differentiated the clinical and control groups better. Among psychosocial adversities, family environment domains of cohesion and organization, and subjective stress from life events and abnormal psychosocial situations were the most important discriminators. Conclusion: The current study reveals that specific individual factors involving temperament and developmental competencies and environmental factors involving parenting practices and psychosocial adversities are significantly associated with internalizing disorders. This has implications for the mental health care of children and adolescents with internalizing disorders. [ABSTRACT FROM AUTHOR]

Introduction: Involuntary childlessness is a distressing condition that has considerable social implications in developing nations. Aim: The present study aims to investigate the less known sociocultural determinants of infertility stress in patients undergoing assisted conception and reproductive treatments. Methods: This cross-sectional research was conducted on 300 men and women with primary infertility. The profile of sociodemographic variables, clinical variables, and sociocultural variables was collected using a locally devised questionnaire. Infertility stress was assessed using the psychological evaluation test. Statistical Analysis: Research data were analyzed using SPSS 15. Chi-square test is used for univariate analysis. Multiple logistic regression with enter method is used to examine the association between infertility stress and sociocultural variables. Results: The findings suggest that in both men and women, low spousal support, financial constraints, and social coercion in early years of marriage predicts infertility distress. Peer-support neither predicts nor protects against distress. Discussion: Family acceptance and social security for infertility is low. Stigma, concealment, and discrimination among men are reported to be high. Distress is three times greater in women with overinvolved family members who had unrealistic expectations from treatments. Taking continuous cycles of fertility treatments seems unaffordable for most patients. Subfertile individuals were socially perceived to be deprived, blemished, incomplete, and sexually incompetent. Conclusion: Data from this investigation, provides a glimpse into sociocultural aspects of infertility. The findings may be useful for identifying targets for individual and family-focused psychological interventions for distress reduction in infertility.

Losing a much-awaited pregnancy and an unborn child, time and again is known to be a painful experience in recurrent miscarriage or pregnancy loss (RPL). Literature on psychological consequences of RPL is abundant. Nonetheless, application of psychological intervention in RPL remains to be an overlooked area. Using a repeated measures design and standardized psychological measures, this case study assessed the outcomes of mindfulness-based therapy administered with routine fertility treatment in a couple with the history of recurrent miscarriages and secondary infertility. Data analysis was done using clinically significant change and analysis of graphic trends. Psychotherapy helped the couple initiate a meaningful discourse with the stress following miscarriage, uncertainty of pregnancy, and fertility-related emotional struggles by mindfully transforming stressors into less painful experiences. Control studies on applications of such therapies are needed to provide definitive answers to “what works, for whom, when, and how,” with distressed patients experiencing RPL.

Background: Emotional response to infertility is mediated by numerous interrelated psychological variables such as personality, health perceptions, cognitive appraisals, coping, and social support. While men and women respond to infertility differently, illness cognitions are a vital component of their emotional adjustment. The aim of this study is to compare the infertile men and women undergoing fertility treatments on perceived distress, helplessness, acceptance, benefits, anxiety, and depression. Materials and Methods: Eighty-one infertile couples, undergoing intrauterine insemination participated in the study. They were assessed on the presence of infertility distress using the fertility problem inventory, for psychiatric morbidity using the Mini International Neuropsychiatric Interview, for affective disturbances using the Hamilton Anxiety and Depression scales, and for illness cognitions using the Illness Cognition Questionnaire. Statistical Analysis: Data are analyzed using SPSS version 15. The paired sample t-test is performed for assessing differences on normally distributed data. The Wilcoxon Signed-Rank test is performed for assessing differences in medians obtained on data that was skewed. Results and Discussion: Infertile women (wives) were more emotionally distressed, anxious, and depressed than men (husbands). Gender-wise differences were found for perceptions of helplessness and acceptance of infertility. Infertility was perceived to be a nonbeneficial event for both partners investigated. Conclusion: Negative cognitions and affective disturbances may contribute to higher treatment burden in couples seeking-assisted conception. The present study suggests that psychosocial intervention for couples plays a central role and should be integrated within the conventional treatments for infertility.

Background: Infant mortality rate (IMR) is globally identified by the policymakers as the marker of health of a population. Objectives: This study aimed to detect the change in hotspots of IMR in Indian states from the year 2000 to 2012, identify hotspots of IMR at district level in selected states from each of the six regions of India and determine the potential predictors of IMR after accounting for spatial autocorrelation. Methods: Ecological study design was used to analyze state and district level data on IMR of India. For the first objective, the data were obtained from Sample Registration System. For the second objective, we classified India into six regions and selected a state in each region that had the highest IMR. The district level data on IMR and potential predictors were obtained from surveys, namely, Annual Health Survey, District Level Household and Facility Survey and Census. Spatio-temporal hotspots of IMR were examined using local indicators of spatial association statistic. Spatial regression was used to identify the potential predictors of IMR after accounting for spatial autocorrelation. Results: Temporal hotspots of IMR were found in the central part of India. Spatial hotspots were identified in districts of Uttar Pradesh. A negative association of IMR existed with female literacy rate, mothers receiving antenatal checkup (%), and people living in urban areas (%). Conclusion: IMR continues to be a problem in the states that have previously shown to be poor performing. Certain districts within these states need emphasis for focused activities.

Context: Non-alcoholic fatty liver disease (NAFLD) is associated with hepatic insulin resistance (IR) and glucose intolerance. Indian data in this area are sparse, and hence, we undertook this study to find the relationship between NAFLD and diabetes. Objective: The objective of this study is to find the relationship between NAFLD and various levels of glucose intolerance and IR. Settings and Design: A cross-sectional study on 150 patients aged 18 or above and diagnosed to have NAFLD by ultrasonography from October 2013 to June 2015 who were admitted or outpatients in the Department of General Medicine, Kasturba Medical College, Manipal. Methodology: NAFLD was graded as mild, moderate or severe by a single radiologist using high-resolution B-mode ultrasonography system. Basic anthropometric, clinical examination and relevant biochemical investigations were done for all patients. Glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and post-load plasma glucose (PG) were measured in all subjects, fasting insulin levels were measured in all subjects by chemiluminescence method to determine IR and it was calculated using homeostasis model assessment model. Statistical Analysis Used: Data were analysed using SPSS software version 15 and P < 0.05 considered as statistically significant. Results: The percentage of pre-diabetes and diabetes in NAFLD patients were 52.7% and 30.7% respectively, There was a greater proportion of pre-diabetics and diabetics in the higher grades of NAFLD (P < 0.001). We observed mean FPG, PG and HbA1c levels increased as the severity of NAFLD increased in this study. The overall mean HOMA-IR score in our subjects was found to be 4.68 ± 2.81 and 76.7% of patients had IR was significantly (P < 0.001) higher in Grade 2 and Grade 3 NAFLD. Conclusions: There is a high prevalence of pre-diabetes and diabetes in patients with NAFLD, and this is associated with increasing IR in higher grades of NAFLD.

BACKGROUND: According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were “semi-structured questionnaire ” compiled by the authors, “ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines), ” and “Psychological Evaluation Test for infertility. ” STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION: The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties.

Background: Maternal morbidities are considered a leading contributor to the burden of disease among women. Especially, if postpartum morbidities are left untreated, this can cause a negative impact on the quality of life. The study was conducted to determine the proportion and types of postpartum morbidities among women visiting government health facilities in Udupi Taluk, Karnataka and to find out the association between the morbidities and various factors. Subjects and Methods: A cross-sectional study was conducted in various government hospitals in Udupi Taluk, consisted of 229 postpartum women. These subjects were selected from mothers who accompanied their children for immunization from February 2013 to July 2013 using purposive sampling technique. Multiple logistic regression analysis was used to find out the association between the morbidities and various factors using SPSS version 15. Results: Among 112 (48.9%) women who experienced postpartum morbidities, back pain (23.6%), and perineal pain (15.7%) were most commonly reported physical morbidities. Similarly, anxiety (10%) and irritability (7.9%) were the most common psychological problems. Demographic factors such as religion 2.4 (95% confidence interval [CI] 1.1, 5.4) and occupation 2.5 (95% CI 1.1, 5.9) were associated with the morbidities. Likewise, obstetric factors such as place of delivery 1.5 (95% CI 0.8, 2.9) and type of delivery 1.9 (95% CI 1.0, 3.6) were also associated with various morbidities. Conclusions: The findings showed a high proportion of postpartum morbidities being reported in our study settings. These observation priorities a need of health program for early recognition, treatment and improving awareness of postpartum morbidities among near mothers.

Background: Blood volume measurement though important in management of critically ill-patients is not routinely estimated in clinical practice owing to labour intensive, intricate and time consuming nature of existing methods. Aims: The aim was to compare blood volume estimations using trivalent chromium [51 Cr(III)] and standard Evans blue dye (EBD) method in New Zealand white rabbit models and establish correction-factor (CF). Materials and Methods: Blood volume estimation in 33 rabbits was carried out using EBD method and concentration determined using spectrophotometric assay followed by blood volume estimation using direct injection of 51Cr(III). Twenty out of 33 rabbits were used to find CF by dividing blood volume estimation using EBD with blood volume estimation using 51Cr(III). CF is validated in 13 rabbits by multiplying it with blood volume estimation values obtained using 51Cr(III). Results: The mean circulating blood volume of 33 rabbits using EBD was 142.02 ± 22.77 ml or 65.76 ± 9.31 ml/kg and using 51Cr(III) was estimated to be 195.66 ± 47.30 ml or 89.81 ± 17.88 ml/kg. The CF was found to be 0.77. The mean blood volume of 13 rabbits measured using EBD was 139.54 ± 27.19 ml or 66.33 ± 8.26 ml/kg and using 51Cr(III) with CF was 152.73 ± 46.25 ml or 71.87 ± 13.81 ml/kg (P = 0.11). Conclusions: The estimation of blood volume using 51Cr(III) was comparable to standard EBD method using CF. With further research in this direction, we envisage human blood volume estimation using 51Cr(III) to find its application in acute clinical settings.

Background: Smokeless tobacco is found to be as addictive and harmful as smoking but have not been explored into, especially among youth. Objectives: This study was conducted to find the prevalence of tobacco chewing among college students in Nepal and the factors that have influence over their use. Study design: A cross-sectional study with a self-administered questionnaire. Materials and Methods: Five colleges of different streams in Pokhara city were selected for the study. A total of 816 students participated. The study was conducted during the period of May 2006-February 2007, using a semi-structured, self-administered questionnaire. Results: Overall prevalence of ever tobacco chewing was 21.3% (males 30.2% and females 10.9%) among the youth with average age of initiation 15.7 years. Pan masala and gutka were used by 63.6% and frequency of use varied widely and only 5.7% said they were daily users. Reasons cited for chewing were most commonly ′just like it′ or ′friends chew′. Multiple logistic regression analysis showed age, ever smoking status, being ever alcoholic, and having friends or family members who chewed were significantly associated with students′ tobacco chewing. Almost one-tenth of the students believed they were addicted to chewing tobacco and 42.5% of them had tried to quit the habit. Conclusion: The study shows a high prevalence of tobacco chewing by Nepali youth. Important factors that influenced the habit were having chewer friends, their own smoking and alcohol status and having family members who chewed. It is pertinent to consider these when formulating cessation and prevention programs

The changing professional and educational needs of an individual is the major determining factor that decides the energy to be consumed and the extent of involvement required for acquiring a foreign language. As the number of employment seekers passing out every year from engineering colleges to the job market outnumbers the available jobs, the empowerment of an engineering graduate in English language has become a major sine qua non and thereby facilitates a serious discussion. Education's categorical role shift from "nurturing" to "manufacturing" resulted in a rather make-believe approach to the teaching-learning process. English is treated with much indifference and the deprivation of a value added education imparted a false impression about the whole process of learning foreign language as trivial. It also spoiled the actual reason behind the need of being educated in the skill of language. This paper demystifies the current scenario of English language learning of engineering colleges in the Indian context. A survey was conducted among the students of Engineering and Engineering graduates and gathered feedback on a few aspects which throws further insights into the reality. [ABSTRACT FROM AUTHOR]

The Hewitt-Flett multidimensional perfectionism scale (HMPS) was developed three decades ago and is one of the most extensively used measures in investigation on perfectionism. However, its factor structure remains unconfirmed. The objective of the exercise is to critically review methodological issues of the existing literature on the factor structure of the HMPS. A comprehensive literature review was carried out using Google scholar, PubMed, Psychinfo from July 1991 to May 2020using the keywords 'perfectionism', 'Hewitt-Flett', 'Factor structure', 'construct validity'. Articles were included in the systematic review if they reported factor-structure validation of HMPS, article was in full length and accessible in full length were included in this study. The systematic search yielded five articles in the final review. The review indicated methodological concerns such as inadequate samples, ignoring gender differences, choice of incorrect matrix for factor analysis (FA), inappropriate extraction and rotation method in exploratory FA (EFA), incorrect estimation method and fit statistics in confirmatory FA (CFA). This study tried to address approaches that are likely to help researchers to arrive at the hypothesized factor structure of HMPS accurately in future. [ABSTRACT FROM AUTHOR]

Background: Problematic social media use (PSMU) is a growing problem all over India and is associated with a decline in mental well-being. However, a limited number of studies demonstrate the relationship between affective states, emotional regulation, coping styles, and PSMU in India compared to problematic internet use. Methods: This study was undertaken on 392 participants aged 18 to 30 years to explore relationship between affective states, rejection sensitivity, and coping styles in those with PSMU. Bergen Social Media Addiction Scale (BSMAS), Patient health questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7) scale, Difficulties in emotion regulation scale (DERS), Rejection Sensitivity Adult Questionnaire (A-RSQ), and Brief Approach/Avoidance Coping Questionnaire (BACQ) were utilized for the online collection of study data. Results: The findings showed that 19.6% (95% CI: 15.8%, 23.9%) of participants were engaging in PSMU, and those who had moderate to severe depressive symptoms had 5 times more prevalence of PSMU than those without depression after adjusting for remaining variables (p<0.001), prevalence among participants with a substantial extent of upward comparison was 3.8 times more than the participants who were not involved in upward comparison (p=0.001), for every 5 unit increase in DERS total score, the prevalence of PSMU increases by 1.16 (95% CI of 1.1, 1.2). Pearson goodness-offit results indicate that the model fits reasonably well (276.41, P=1.000). Conclusions: Findings suggested that depression, difficulty in regulating emotions, and upward comparison were found to be significant risk factors for PSMU and these variables are to be considered for inclusion in the design of targeted prevention approaches for PSMU. [ABSTRACT FROM AUTHOR]

Background: National Family Health Survey (NFHS) reported that percentage of women who were obese at age group 15 - 49 years increased from 11% to 15% from NFHS - 2 to NFHS - 3. In rural parts, under nutrition is more predominant, but in urban areas, obesity and overweight are more than three times higher, which may be owing to less physical activity levels in urban. The prevalence of obesity is greater for urban women and it is largely preventable through changes in lifestyle. It is important to assess the individual's knowledge about the link between food, physical work, and obesity in planning any intervention strategies. So it is necessary to explore the knowledge, attitude, and practices on obesity before planning any intervention programs. Objective: To assess Knowledge, Attitude, and Practices (KAP) on obesity among obese homemakers in urban Udupi Method: A cross-sectional study was carried out among obese homemakers residing in urban Udupi. A total of 180 obese homemakers were recruited from 30 wards in urban Udupi community based on BMI criteria within the age group of 30 to 45 years. An investigator developed KAP questionnaire on obesity was administered to the participants. Results: The mean age of study population was 36.77 years. In knowledge section, 45% respondents had a low level of knowledge regarding obesity. 51.7% had a negative attitude towards obesity and 76% had a poor practice related to obesity. Conclusion: Women who are obese and homemakers by occupation residing in the urban community had a limited knowledge, negative attitude and worst in practices related to obesity. [ABSTRACT FROM AUTHOR]

In complementary DNA (cDNA) microarray experiments, the measurement of interest is signal intensity ratio of spots. Each spot have four types of pixel intensities namely red foreground, green foreground, red background and green background. The uncertainty associated with the intensity ratio of a spot depends on the correlations between intensities of these pixels. In this article, we propose a method to estimate correlations between various types of pixel intensities within a spot using a modified form of Moran's I spatial autocorrelation. We estimate these correlations for eight selected spots from image files downloaded from the Gene Expression Omnibus (GEO) database. These estimated correlations are used for finding the uncertainty associated with each of the selected eight spots using the theory of error propagation. We observed that the estimated uncertainty associated with intensity ratio of a spot is less if we consider the correlation between various pixel intensities compared to assuming zero correlation. [ABSTRACT FROM AUTHOR]

BACKGROUND: According to the existing literature on infertility, stress appears to be inevitably associated with infertility diagnosis and treatment in sub-fertile individuals. The epidemiological data on the prevalence and predictors of infertility-specific stress in cultural specific scenario are scarce. The objective of the present study was to estimate the prevalence of infertility-specific stress and identify predictors of infertility-specific stress in women diagnosed with primary infertility. MATERIALS AND METHODS: This cross-sectional study was conducted on 300 infertile married women, diagnosed with primary infertility. The tools used for the assessment were "semi-structured questionnaire" compiled by the authors, "ICD-10 Classification of Mental and Behavioral Disorders (Clinical Descriptions and Diagnostic Guidelines)," and "Psychological Evaluation Test for infertility." STATISTICAL ANALYSIS: Data were analyzed using SPSS (version 15). Chi-square test was used for univariate analysis followed by multiple logistic regressions between stress and the predictor variables. RESULTS AND DISCUSSION: The prevalence of stress among women was 80%. Univariate analysis revealed that predictors of stress were years of marital life, duration of infertility, infertility type, history of gynecological surgery, cycles of ovulation induction with timed intercourse and intra-uterine inseminations, present and past psychiatric morbidity, coping difficulties, gynecological diagnosis, and severity of premenstrual dysphoria. Multivariate analysis showed leading associations of stress with infertility type and coping difficulties. [ABSTRACT FROM AUTHOR]

Background: Geohelminth infections are a major problem of children from the developing countries. Children with these infections suffer from developmental impairments and other serious illnesses. This study aimed to measure the prevalence of geohelminth infection, infection intensity as well as the change in the intensity in children from Western Nepal over years. Methods: This 6-year hospital based prospective study at the Manipal Teaching Hospital, Pokhara included children (< 15 years) visiting the hospital from Kaski and 7 surrounding districts. Samples were also collected from children in the community from different medical camps. Three stool samples from every child were processed using direct and concentration methods. The Kato-Katz technique was used for measuring the intensity of infection. Results: The overall prevalence in hospital - attending children was 9.2% with 7.6% in preschool (0-5 y) and 11.0% in school-age (6 - 15 y) children, and in community 17.7% with 14.8% in preschool and 20.5% in school-age children. Ascaris lumbricoides, Trichuris trichiura, Ancylostoma deodenale and Strongyloides stercoralis were the common geohelminths with a gradual decrease in worm load over the years. School-age children were found to be significantly more prone to geohelminth infection as compared to preschool children, but no statistical difference was detected by gender, district as well as season. Conclusion: This heavy infection of geohelminths in children should be corrected by appropriate medication and maintaining strict personal hygiene. Health education, clean water, good sewage management and a congenial environment should be ensured to minimise infection. [ABSTRACT FROM AUTHOR]

Background: Child marriage is a breach of the basic fundamental rights of a child and is a major concern for policy makers in many countries., Objective: The present study intended to identify the direct and indirect socio-demographic factors associated with child marriage among 15-17 years old girls in India., Participants and Setting: The study used National Family Health Survey-4 data. The sample comprised of 1459 married girls and an equal number of unmarried girls aged 15-17 years at the time of the survey., Methods: Multivariable logistic regression was performed to identify the factors associated with child marriage. A hypothetical path model was constructed and tested. The path models were refitted after removing the insignificant path coefficients, and finally, the significance of direct as well as indirect effects were obtained., Results: Path analysis revealed that mother's education was the only factor that had both significant direct and indirect effects on child marriage (p < 0.001). Religion had only significant indirect effect (p = 0.047) through girls' education. Besides mother's education, the factors that showed significant direct effects on child marriage were wealth index (p = 0.012), caste (p = 0.009) and education of the girl (p = 0.009)., Conclusions: Education of both mothers and the girls, wealth index and caste had significant direct effects on child marriage whereas significant indirect effect was exerted by mothers' education and religion. Therefore, these factors should be given primary focus while formulating strategies to curb child marriage in countries like India., (Copyright © 2022. Published by Elsevier Ltd.)

In view of the alarming increase in the incidence of diabetes mellitus in Malaysia, we conducted a study to assess the awareness of complications of diabetes among the diabetics attending the peripheral clinics in Melaka. The study period was from January 2007 to December 2007. 351 patients were included in the study. 79.8% were aware of the complications of diabetes mellitus and 87.2% were aware that diabetes can affect the eyes. However, only 50% of the patients underwent an ophthalmological evaluation. Although awareness was good, the motivation to undergo the assessment was poor.