National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis.

BACKGROUND: Gestational diabetes mellitus (GDM) is frequently misdiagnosed during pregnancy. There is an abundance of evidence, but little is known regarding the regional prevalence estimates of GDM in India. This systematic review and meta-analysis aims to provide valuable insights into the national and regional prevalence of GDM among pregnant women in India. METHODS: We conducted an initial article search on PubMed, Scopus, Google Scholar, and ShodhGanga searches to identify quantitative research papers (database inception till 15th June,2022). This review included prevalence studies that estimated the occurrence of GDM across different states in India. RESULTS: Two independent reviewers completed the screening of 2393 articles, resulting in the identification of 110 articles that met the inclusion criteria, which collectively provided 117 prevalence estimates. Using a pooled estimate calculation (with an Inverse square heterogeneity model), the pooled prevalence of GDM in pregnant women was estimated to be 13%, with a 95% confidence interval (CI) ranging from 9 to 16%.. In India, Diabetes in Pregnancy Study of India (DIPSI) was the most common diagnostic criteria used, followed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) and World Health Organization (WHO) 1999. It was observed that the rural population has slightly less prevalence of GDM at 10.0% [6.0-13.0%, I2=96%] when compared to the urban population where the prevalence of GDM was 12.0% [9.0-16.0%, I2 = 99%]. CONCLUSIONS: This review emphasizes the lack of consensus in screening and diagnosing gestational diabetes mellitus (GDM), leading to varied prevalence rates across Indian states. It thoroughly examines the controversies regarding GDM screening by analyzing population characteristics, geographic variations, diagnostic criteria agreement, screening timing, fasting vs. non-fasting approaches, cost-effectiveness, and feasibility, offering valuable recommendations for policy makers. By fostering the implementation of state-wise screening programs, it can contribute to improving maternal and neonatal outcomes and promoting healthier pregnancies across the country.

Prevalence of Internet Addiction and Impact of Internet Socialization on Professional, Academic, Social Lives and Sleep Pattern Among Students and Professionals from Various Fields Across India.

Background: Internet addiction was found to be associated with a variety of psychosocial problems, including academic failure, low self-esteem, poor diet, mental disorders like depression and anxiety, sleep deprivation, and social withdrawal. Objective: To determine the prevalence and risk factors of internet addiction and evaluate the impact of internet socialization on professional, academic, social lives and sleep pattern among students and professionals from various fields across India. Methodology: This cross-sectional, descriptive study was conducted from January 2022 to July 2023 among 772 participants who were aged ≥18 years. The study tool consisted of a questionnaire with four parts comprising questions related to demographic characteristics, pattern of use and impact of internet over academic, professional, social life, sleep pattern, and Kimberley Young's Internet Addiction Test (IAT) questionnaire. Results: The prevalence of Internet addiction was 53.6% among the participants. Participants aged above 30 years demonstrated a decreased risk of internet addiction compared to those aged below 30 years (AOR = 0.35). Participants who reported becoming restless without internet access (AOR = 4.88) and going to bed late because of the use of internet or social media (AOR = 3.01) had a significantly higher risk of internet addiction. Conclusion: Internet addiction is very common among professionals, and students and there is a high risk of internet addiction in persons who get restless when they cannot log in, spend too much time online, stay up late using the internet, and share personal information soon after meeting others on social media sites.

Exploring internet addiction and its associated factors among college students in Western Rajasthan, India: A mixed-methods study.

Background: With near universal use of internet by college students, there is propensity for internet addiction (IA) among them. This study aimed to estimate the prevalence and predict the factors for internet addiction among college students in Jodhpur, Rajasthan, India, and qualitatively explore the factors associated with internet addiction. Materials and Methods: Explanatory sequential (QUAN-QUAL) mixed-methods design was used. A cross-sectional questionnaire-based survey was conducted among three streams of undergraduate colleges (health, engineering, and others). Survey instruments included Young's internet addiction test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety, and Stress Scale-21 (DASS-21) Items. Focus group discussions (FGDs) and in-depth interviews (IDIs) among the students with mild-to-moderate levels of addiction were conducted to understand the reasons for excessive internet use. Results: The prevalence of internet addiction (IA) among the college students was 51% and the rates for mild, moderate, and severe addiction were 31.8%, 18.5%, and 0.7%, respectively. Predictors of IA were male gender, age in years, age of first internet use in years, urban origin, accessing internet at college, mobile internet use, using internet to make online friendship, sleep disturbance, depression, anxiety, and stress. Qualitative study identified five major themes related to situations initiating internet use for nonacademic purpose, content of internet use, triggers for internet overuse/addiction (IA), perceived impact of IA, and measures to overcome IA. Conclusions: Internet addiction was found to be highly prevalent in college students across various streams. Qualitative results provide deeper insights into IA among college students. It is imperative to screen for IA among the students and devise suitable preventive interventions, which can be easily implemented at community level.

Application of Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) as Metabolic Syndrome prediction tools.

BACKGROUND: Indian Diabetic Risk Score (IDRS) and Community Based Assessment Checklist (CBAC) are easy, inexpensive, and non-invasive tools that can be used to screen people for Metabolic Syndrome (Met S). The study aimed to explore the prediction abilities of IDRS and CBAC tools for Met S. METHODS: All the people of age ≥30 years attending the selected rural health centers were screened for Met S. We used the International Diabetes Federation (IDF) criteria to diagnose the Met S. ROC curves were plotted by taking Met S as dependent variables, and IDRS and CBAC scores as independent/prediction variables. Sensitivity (SN), specificity (SP), Positive and Negative Predictive Value (PPV and NPV), Likelihood Ratio for positive and negative tests (LR+ and LR-), Accuracy, and Youden's index were calculated for different IDRS and CBAC scores cut-offs. Data were analyzed using SPSS v.23 and MedCalc v.20.111. RESULTS: A total of 942 participants underwent the screening process. Out of them, 59 (6.4%, 95% CI: 4.90-8.12) were found to have Met S. Area Under the Curve (AUC) for IDRS in predicting Met S was 0.73 (95%CI: 0.67-0.79), with 76.3% (64.0%-85.3%) sensitivity and 54.6% (51.2%-57.8%) specificity at the cut-off of ≥60. For the CBAC score, AUC was 0.73 (95%CI: 0.66-0.79), with 84.7% (73.5%-91.7%) sensitivity and 48.8% (45.5%-52.1%) specificity at the cut-off of ≥4 (Youden's Index, 2.1). The AUCs of both parameters (IDRS and CBAC scores) were statistically significant. There was no significant difference (p = 0.833) in the AUCs of IDRS and CBAC [Difference between AUC = 0.00571]. CONCLUSION: The current study provides scientific evidence that both IDRS and CBAC have almost 73% prediction ability for Met S. Though CBAC holds relatively greater sensitivity (84.7%) than IDRS (76.3%), the difference in prediction abilities is not statistically significant. The prediction abilities of IDRS and CBAC found in this study are inadequate to qualify as Met S screening tools.

Prevalence of Depression Among Undergraduate Medical Students in India: A Systemic Review and Meta-Analysis.

BACKGROUND: Systematic reviews have proved that there is a high rate of depression among medical students when compared with their age-matched peers. Very few studies have evaluated the pooled prevalence of depression among medical students in India. OBJECTIVES: To determine the pooled prevalence of depression among medical students in India. MATERIALS AND METHODS: This review was done by searching databases like PubMed, Google Scholar, and Scopus for available original articles published between 2019 and 2022 on depression among Indian medical (MBBS) undergraduate students using PRISMA guidelines. RESULTS: A total of 19 original research articles were included in this review, involving students at different medical colleges from various regions of India. The pooled prevalence of depression among 5944 medical students was 50.0% (95% CI: (31%-70%)) based on the random effect model. This meta-analysis also found that the pooled prevalence of depression among females (pooled prevalence: 38.0%, 95% CI: 20.0 to 58.0) was slightly higher than among males (pooled prevalence: 34.0%, 95% CI: 15.0 to 55.0). CONCLUSION:  The high prevalence of depression among medical students demands regular screening for depression along with counselling services. It shows that there is a need to raise awareness among students and other stakeholders, such as parents and medical educators, concerning symptoms and signs of depression among medical students.

Psychological impact of Covid-19 pandemic among the Healthcare workers in a North-Eastern state of India.

Background: Previous studies done during SARS 2003 outbreak and early reports related to COVID-19 show that healthcare workers experience considerable anxiety, stress and fear. Although similar studies were done in other parts of India, there is dearth of data on this topic in the Northeastern region. Aim: This study aimed to assess the mental health status of Healthcare Workers during Covid-19 pandemic in the region. Methods: The study was conducted among the doctors and nurses of a Northeastern state of India through an online survey. PHQ-9, GAD-7 and ISI scales were used to assess depression, anxiety and insomnia among the participants. Results: The prevalence of depression, anxiety and insomnia among the HCWs was 74.5%, 42% and 32%, respectively. Moderate to Severe form of depression, anxiety and insomnia was experienced by 15.5%, 20.5% and 8.5%, respectively. Females and those who directly cared for Covid-19 patients were more prone to suffer from depression. Participants who reported having previous history of any psychological problems reported eight-fold, seven-fold and three-fold increased odds of developing depression, anxiety and insomnia, respectively, during the pandemic. Conclusions: A large proportion of HCWs reported symptoms of depression, anxiety and insomnia among the healthcare workers. Protecting the mental health of these health workers is paramount to ensure psychological wellbeing, which in turn will ensure a healthy and robust workforce. Relevance for Patients: Improves the productivity of Healthcare workers in terms of Patient care and Management.

An evidence-based review of neuronal cholesterol role in dementia and statins as a pharmacotherapy in reducing risk of dementia.

INTRODUCTION: Dementia is a progressive neurodegenerative disorder impairing memory and cognition. Alzheimer's Disease, followed by vascular dementia - the most typical form. Risk factors for vascular dementia include diabetes, cardiovascular disease, hyperlipidemia. Lipids' levels are significantly associated with vascular changes in the brain. AREAS COVERED: The present article reviews the cholesterol metabolism in the brain, which includes: the synthesis, transport, storage, and elimination process. Additionally, it reviews the role of cholesterol in the pathogenesis of dementia and statin as a therapeutic intervention in dementia. In addition to the above, it further reviews evidence in support of as well as against statin therapy in dementia, recent updates of statin pharmacology, and demerits of use of statin pharmacotherapy. EXPERT OPINION: Amyloid-ß peptides and intraneuronal neurofibrillary tangles are markers of Alzheimer's disease. Evidence shows cholesterol modulates the functioning of enzymes associated with Amyloid-ß peptide processing and synthesis. Lowering cholesterol using statin may help prevent or delay the progression of dementia. This paper reviews the role of statin in dementia and recommends extensive future studies, including genetic research, to obtain a precise medication approach for patients with dementia.

Prevalence of Diabetes and Its Relationship With Body Mass Index Among Elderly People in a Rural Area of Northeastern State of India.

Background Diabetes and its complications are a major public health concern in elderly populations. However, there is little population-based data on diabetes and its risk factors among the elderly population living in rural areas of India. The objective of this population-based study was to assess the prevalence of diabetes in the elderly population and its relationship with body mass index (BMI). Methodology A population-based, cross-sectional study was conducted among elderly individuals (≥60 years) during the period 2013-2016 in rural areas of Dibrugarh district of Assam. Multi-stage sampling design was adopted to select the study participants. Data on socio-demographic profile and diagnosis/treatment history of diabetes were collected using pre-designed and pre-tested questionnaire. Fasting blood sugar was tested. Weight and height were measured to calculate BMI. Multivariate logistic regression analysis was performed to assess the relationship between diabetes and BMI. Results Data were collected from 430 (male: 210, female: 220) individuals. The overall prevalence of diabetes was 7.9% (male: 7.1%, female: 8.6%). Higher level of education was associated with increased prevalence of diabetes. Prevalence of diabetes increased as the BMI of participants increased. Prevalence of diabetes among obese individuals (BMI ≥25 kg/m2) was 30.4% compared to only 5% among normal weight individuals. Obesity was associated with eight-fold higher risk of diabetes compared with the individuals of normal weight in multivariate analysis. Conclusions The study reveals nearly 8% population-based prevalence of diabetes in rural elderly people in the study district. Our study provides epidemiological evidence that obesity is a major driver of diabetes among rural elderly people.

Knowledge and practice of hand hygiene among undergraduate students and junior doctors in the Regional Institute of Medical Sciences, Imphal.

CONTEXT: Maintenance of proper hand hygiene among treating doctors and nurses is one of the most important measures to curb health-care-associated infections. Hand hygiene can prevent the spread of germs including those that are resistant to antibiotics and are becoming difficult, if not impossible, to treat. There are few published articles on similar topic in different settings in India but not in Manipur. Keeping this in mind, the study was conducted. AIMS: To assess the knowledge and practice of hand hygiene among undergraduate students and junior doctors in rims, imphal and its association with the selected variables of interest. SETTINGS AND DESIGN: Regional Institute of Medical Sciences (RIMS). METHODS AND MATERIAL: A cross-sectional study was done on 924 participants by using a self-administered questionnaire. The data was analyzed using the software SPSS 21 version. RESULTS: Of the participants, 49.1% had poor knowledge about hand hygiene; 14.3% had average knowledge, and 36.6% had good knowledge. Knowledge was significantly associated with the frequency of washing hands after patient contact or any laboratory procedure or after the removal of hand gloves (P < 0.001) and the frequency of following the six steps of hand washing (P = 0.001). CONCLUSIONS: Nearly half (49.1%) of the participants had poor knowledge about hand hygiene; more than one-tenth (14.3%) had average knowledge, and more than one-third (36.6%) had good knowledge.