Do children separated from fathers have higher anxiety levels? A comparative analysis.

Background: There is limited literature from India on effect of fathers' deployment on the mental health of children. This cross-sectional analytical study investigates the difference in anxiety levels of children whose fathers are deployed in a field location and compares it with children currently located with their fathers. Method: Data were collected in an army school from 200 children aged 10-17 years with fathers deployed in field locations (n = 99) and fathers currently residing with the children (n = 105) via interviewer administered and self-completed Screen for Child Anxiety-Related Disorders (SCARED) questionnaire. Results: Anxiety scores were on an average, minimally raised above the cut-off level for children who had fathers deployed. In addition, panic disorder scores were also above the cut-off levels for these children. While scores were normal in all other domain, they were higher than that for children residing with their fathers, although the difference was not significant. Girls with fathers deployed had scores higher than cut-off scores for domains such as panic, separation anxiety and school avoidance, while boys had scores higher than cut-off scores only for panic disorders. However, the girls had significantly higher scores than boys in all domains. Girls in both groups (with and without father deployed) had higher scores than cut-off scores for panic disorders. Conclusion: Anxiety levels in children were not found to be unduly affected by the deployment of fathers. But girls were found to have clinically relevant panic disorder, school avoidance and separation anxiety scores as compared with boys in the similar situation of parental separation.

Novel pyriproxyfen based treatment for Aedes breeding control through a long-lasting formulation: Laboratory and field trials in Western Maharashtra, India.

BACKGROUND & OBJECTIVES: There is a need to evaluate novel techniques for dengue control in India. Several formulations of pyriproxyfen have been assessed for efficacy and duration of action. Pyriproxyfen is also used as a microencapsulated ready-to-use formulation against the Aedes vector. We evaluated a novel pyriproxyfen-based microencapsulated formulation. This slow-release, ready-to-use aqueous spray is a larvicidal formulation, and we assessed its efficacy and residual action through laboratory and semi-field trials against Aedes immature stages. METHODS: The study was carried out as per the guidelines for laboratory and field/small-scale field testing of mosquito larvicides by the World Health Organization. The evaluation was conducted in laboratory and semi-field conditions from August to December 2018. We tested the novel formulation on three materials (plastic, ceramic, and enamel) in the laboratory for its action as an antilarval. Four containers of each kind were sprayed with the formulation and kept as replicates. Four controls were used in the laboratory trials - 120 larvae (third instar) were introduced in the replicates and the controls each. Readings were taken daily till complete adult emergence or larval and pupal mortality. In the semi-field trials, we applied this formulation to the inside of desert coolers and observed larvicidal and pupicidal activity over five months. Data is presented in numbers and percentages, along with mean and standard deviation. Adult emergence and Emergence Inhibition was calculated. RESULTS: There was 100% adult emergence inhibition amongst the exposed larvae in the treated containers in the laboratory trials. In the untreated controls, adult emergence ranged from 80-95% in all types of containers. In the semifield trials, Inhibition Emergence was 100% in the treated desert coolers during the five months of the study period. INTERPRETATION & CONCLUSION: This advancement in insecticide formulation technology promises to make dengue control more effective and efficient.

Liver function tests in COVID 19: A retrospective record-based study from a tertiary care centre in urban Maharashtra, India.

Background: COVID-19 is a multi system disorder and causes various abnormalities in liver function tests. The aim of this study was to estimate the prevalence of abnormal liver function tests in patients of COVID-19 and to describe the association of liver function tests with clinical features and disease severity in these patients. Methods: We retrospectively evaluated and analyzed the liver function tests of all real-time polymerase chain reaction (RT-PCR) positive COVID-19 patients admitted to a tertiary care hospital in Western Maharashtra. The Institutional Ethics Committee of our hospital approved the study. Results: Of the 533 patients included in our study, 50% had abnormal albumin levels while 40.1%, 43.5%, 9.3%, and 6.3% patients had deranged alanine transaminase (ALT) aspartate transaminase (AST), total protein and bilirubin levels, respectively. Hepatocellular injury was observed in 21 (3.9%) patients, and cholestatic liver injury was observed in seven (1.3%) patients. Abnormal liver function test (LFT) was significantly associated with disease severity but not with mortality. Conclusion: Abnormal LFT in patients of COVID-19 is associated with severe disease but not mortality. Liver injury is common in patients of COVID-19.

Implantable loop recorder in unexplained palpitations or syncope: A randomised study among young patients with structurally normal heart.

Background: The utility of an implantable loop recorder (ILR) in the evaluation of unexplained syncope or palpitations in young patients in the absence of structural heart disease or ventricular dysfunction is limited. To compare the diagnostic yield of ILR with conventional extended Holter evaluation in the detection of arrhythmias among young patients with a structurally normal heart presenting with unexplained palpitations or syncope. Methods: Open-label randomised control trial was conducted in a tertiary cardiac care centre among young patients with recurrent unexplained palpitations (≥3 episodes/year) or syncope (≥2 episodes) with normal electrocardiogram and echocardiography, after excluding non-cardiac causes. Patients were block randomised to either ILR implantation or conventional extended Holter monitoring. Results: Fourteen patients in the ILR group and 16 patients in the conventional group completed the study. The mean age of the patients was 31.9 ± 5.5 and 31.2 ± 5.4 years. Males constituted 78.5% and 75% in the two groups, respectively. Diagnosis was established in 10 (71.5%) patients in the ILR group as compared to only 3 (18.7%) in the conventional group (p = 0.01), with an RR of 0.26 (95% CI 0.089-0.76, p = 0.01). The arrhythmias diagnosed with ILR were narrow complex tachycardia (30%), atrial fibrillation (20%), VPCs (20%), severe bradycardia with asystole due to sinus arrest (10%), VPCs with bigeminy (10%), and ventricular tachycardia (10%). Conclusion: In young patients with unexplained syncope or palpitations, ILR has a higher diagnostic yield in the accurate detection of arrhythmia compared with conventional Holter strategy, resulting in better management.

Vaccine effectiveness to protect against moderate or severe disease in COVID cases: A prospective cohort study.

Background: This study was carried out to evaluate the effectiveness of partial and full vaccination with ChAdOx1 nCoV-19 (COVISHIELD) to prevent the development of moderate or severe illness among COVID-positive cases. Methods: This prospective cohort study was conducted among Armed Forces personnel deployed in Northern India who were found COVID positive during the study period between January and June 2021. Information about the vaccination status, age and comorbidities was collected at the time of diagnosis. Classification of COVID cases as moderate or severe was performed as per criteria given by the Government of India. Individuals were considered partially vaccinated three weeks after one dose and fully vaccinated two weeks after the second dose. Risk ratio and vaccine effectiveness (VE) to prevent moderate or severe disease among COVID cases were calculated. Results: A total of 2005 COVID-19 patients were included in our study. Partial vaccination and full vaccination with ChAdOx1 nCoV-19 offered 13% (95% credible interval (CI): -56.8%, 52.8%) and 66.6% (95% CI: 34.9%, 84.6%) protection against progression to moderate/severe illness among COVID-positive individuals. The risk of moderate-severe disease among COVID-positive cases occurring 4-11 weeks after the first dose was also lesser among those who had taken the second dose of vaccine than individuals who have been vaccinated with only one dose. Conclusion: Interval between the first and second doses of ChAdOx1 nCoV-19 vaccine should be reduced to 4-6 weeks, as partial vaccination offers lower protection against the development of moderate-severe illness after COVID infection.

Prevalence and determinants of emotional violence faced by married women in Delhi, India: A cross-sectional study.

Context: Emotional violence is the lesser recognized form of intimate partner violence (IPV) but causes long-lasting harm to a woman's mental and physical wellbeing. Aims: To estimate the prevalence and describe the determinants of emotional violence faced by women residing in a metropolitan city of India. Settings and Design: This cross-sectional study was conducted among 'presently married' women living in an urban residential area of Delhi. Methods and Material: We used the NFHS-3 questionnaire and criteria to record the study participants' responses regarding their experience of 'emotional violence'. Women saying yes to emotional violence further quantified the frequency of each type of abuse into 'often' or 'sometimes' in the past 12 months. Informed consent was obtained from all participants, and the Institutional Ethics Committee approved the study. Statistical Analysis Used: Logistic regression analysis was used to determine emotional violence with various socio-demographic factors and other forms of IPV. Results: A total of 99 (19.8%) women had 'ever' faced psychological abuse by their husbands. 15.2% of women were humiliated by husbands, and 11.6% of women were insulted and made to feel bad about themselves. Women whose husbands consume alcohol (OR = 1.74 (1.07-2.84), exhibit controlling behaviour, (OR = 2.79 (1.74-4.46) exhibit physical (OR = 10.83 (6.4-18.32) or sexual (OR = 5.53 (3-10.2) violence were at significantly higher risk of facing psychological abuse within their marriages. Conclusions: Physical violence and controlling were found to be significantly associated with the experience of emotional violence after adjusting for all other variables. Primary care physicians should be sensitized to this critical health issue.

Controlling Behavior and Intimate Partner Violence: A Cross-Sectional Study in an Urban Area of Delhi, India.

Intimate partner violence (IPV) is a widespread issue faced by women across the world. While prevalence and epidemiology of IPV has been studied extensively, its association with controlling behavior has been largely ignored. We carried out this study to assess the prevalence of IPV against married women and its association with sociodemographic factors, justification of violence, and controlling behavior by their spouses in Delhi, India. Five hundred women residing in an urban residential area of Delhi, India, responded to a validated questionnaire asking about IPV and controlling behaviors by their husbands. In our study, 30.6% of women had "ever" experienced IPV, and 43.2% women stated that they had experienced controlling behavior by their husbands. Alcohol consumption by the husband, women's justification of their partner's violence, and controlling behavior by the husbands were significantly associated with the experience of IPV among study participants. Women with a lower education status, not financially employed, those who justified violence or faced any form of violence in their marital life were at higher risk of experiencing controlling behavior from their spouses.

Anxiety level among government employees admitted to dedicated COVID-19 hospital.

INTRODUCTION: Patients of COVID-19 patients while in a hospital may have stigma, fear, and guilt among them. However, the data on anxiety among the admitted COVID-19 patients are lacking in India and elsewhere. Hence, the study was conducted among the admitted patient of COVID-19 to describe their anxiety status. METHODS: The study was conducted as a cross-sectional study in a designated COVID-19 hospital in Delhi. The data were collected from October 22, 2020, to November 21, 2020. All patients who were admitted to the hospital for more than 72 h were eligible for participation. The data collection was done using a questionnaire. The questionnaire consists of two parts. One part was sociodemographic variables, and the other part was the Anxiety Scale. The anxiety score was collected on the Zung Self-Rating Anxiety Scale. RESULTS: A total of 132 eligible patients were admitted during the period. The questionnaire was answered by 122 (92.4%) patients. All patients were male. The patients' mean age was 33.5 years (standard deviation = 8.9 years), with a range of 21 years-65 years. The mean score of the Zung Self-Rating Scale was 29.5 (7.2), with an interquartile range of 24-33. There were only five patients (4.4%; 95% confidence interval: 1.3%-9.3%) whose scores were 45 or more, indicating mild-to-moderate anxiety. There was no statistically significant association between any sociodemographic variable and Anxiety Rating Scale. CONCLUSION: The anxiety level in the specialized population was low due to social security. The level of anxiety among health-care workers may be further explored.