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.

Managing acute acromioclavicular joint dislocation during COVID 19 pandemic by minimally invasive technique with suture anchor and miniplate: A pilot study.

Background: Acromioclavicular (AC) joint dislocation is common in sportsmen and physically active population. Its management depends upon the grade of injury and functional demands of the patient. A variety of surgical procedures have been described with different limitations and advantages. The present study has assessed the clinical and radiological outcome of acute AC joint dislocation managed with a 3.5 mm Titanium suture anchor and 2 mm miniplate construct which requires lesser dissection, surgical time and thus contact with the patient as mandated by COVID-19 pandemic. Methods: We enrolled 10 patients of Rockwood type-III, IV and V acute AC joint injury (<3 weeks old) reporting at this hospital from Feb 2020 to May 2021. All were tested for COVID-19 using reverse transcriptase polymer chain reaction test (RTPCR) and managed by closed/open reduction and fixation with a 3.5 mm Titanium Suture Anchor and a 2 mm Titanium miniplate construct. Follow-up was done at 3, 6 and 9 month post-operatively. Results: The average age of patients was 31 yrs. RTPCR test for COVID-19 was negative in all patients. Median surgical time was 25 min (Interquartile Range[IQR] = 16-34 min) and median follow-up duration was 36 weeks (IQR = 33-39 weeks). Median visual analogue scale score and IQR at pre-operative, 3 month, 6 month and 9 month follow-up was 7(IQR = 6-8), 3.5(IQR = 2.5-4.5), 2(IQR = 0) and 1(IQR = 0), respectively. Median constant score at pre-operative, 3 month, 6 month and 9 month follow-up were 34(IQR = 25-43), 65.5(IQR = 60.5-70.5), 82.5(IQR = 77.5-87.5) and 88(IQR = 81-95). There was significant improvement in clinical status (non parametric-Friedman test p < 0.001). Radiographs showed no loss of reduction, fracture or implant failure till last follow-up. Conclusions: Minimally invasive technique with a 3.5 mm Ti-suture anchor and 2 mm plate is an easy, fast and reliable construct for the management of acute AC dislocation in physically active population.

Association of CD 34 positive cell dose with engraftment kinetics in autologous peripheral blood stem cell transplant patients of multiple myeloma.

Background: Treatment with high-dose chemotherapy and stem cell transplantation has prolonged survival in patients of multiple myeloma (MM). A dose-response relationship between number of CD34+ cells infused and leukocyte and platelet recovery, exists. Patients receiving dose of <2.0 × 106 CD34+ cells/kg have delayed engraftment. The level of optimal cutoff for accelerated engraftment is yet to be validated. Hence, this study was undertaken to study the association of CD 34+ cell dose with engraftment kinetics in patients of MM who underwent autolgous peripheral blood stem cell transplant (PBSCT). Methods: We retrospectively analyzed 19 patients of MM who underwent PBSCT at our center between December 2016 to December 2018. Complete blood counts were carried out daily after transplantation to record neutrophil and platelet engraftment. Results: Based on the CD34+ cell dose given : <5 × 106/kg (category 1), 5-10 × 106/kg (category 2), >5 × 106/kg (category 3), the mean (SD) neutrophil engraftment time was 11.3 (0.5) days, 10.6 (0.9) days, and 10.2 (1.3) days respectively. Platelet engraftment time was 12.4 (2.60) days, 10.6 (1.14) days, and 11.2 (1.64) days for category 1, 2, and 3 patients, respectively. Correlation co-efficient between CD 34+cell dose and days for neutrophil and platelet engraftment was found to be -0.24 and -0.20, respectively. Time for neutrophil engraftment was found to be significantly associated with CD34+ cell dose category. Conclusion: CD 34+ cell dose appears as the strongest predictor of leukocyte and platelet engraftment. CD 34+ cell dose of >5.0 × 106 cells/kg leads to an accelerated neutrophil and platelet engraftment in patients of MM.

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.

Determinants of consistently high HIV prevalence in Indian Districts: A multi-level analysis.

INTRODUCTION: Factors associated with persistently high Human Immunodeficiency Virus (HIV) prevalence levels in several districts of India are not well understood. This study was undertaken to determine the association of socio-demographic characteristics, economic factors, awareness about HIV and Sexually Transmitted Infections (STIs), and condom use with consistently high HIV prevalence in the Indian districts and to ascertain whether these associations differed across various regions of India. METHODS: This study was carried out including all 640 districts of India. Secondary analysis of data obtained from the Census of India-2011, HIV Sentinel Surveillance in India and District Level Household Survey-III was done. Population profile, socio-economic characteristics, levels of HIV/STI/condom awareness and condom use, were compared between the districts with and without consistently high HIV prevalence. Due to the presence of collinearity among predictor variables, we used principal component analysis and the principal component scores were included as covariates for further analysis. Considering the districts at level 1 and the regions at level 2, multi-level analysis was done by generalised linear mixed models. Variance partition coefficient and median odds ratio were also calculated. RESULTS: Sixty-three districts with consistently high HIV prevalence were found clustered in the South and the North-east regions of India. Population size, density and urbanisation were found to be positively associated with consistently high HIV prevalence in these districts. Higher levels of literacy, better socio-economic status, higher proportion of population in reproductive age group and late marriages were positively associated with consistently high HIV prevalence in all regions of India except in the Southern region. Higher levels of knowledge about the role of condoms in HIV prevention and condom use were associated with low HIV prevalence at the district level. CONCLUSIONS: Considerable heterogeneity among factors associated with consistently high HIV prevalence at the district level in different regions of India necessitates special region-specific strategies for HIV control. Increasing awareness about HIV alone is not sufficient for controlling the HIV epidemic and there is a need to raise knowledge levels about preventive measures against HIV and promote the use of condoms amongst population.