Burden of alcohol use and inclusion of alcohol use disorder medications in the essential medicine lists across 132 countries: An observational study.

Harmful use of alcohol effects the health of the population. The treatment coverage of alcohol use disorders (AUD) varies among countries. The study aimed to determine the inclusion of AUD medicines in various national Essential Medicine Lists (EMLs) and its association with alcohol consumption. It was a secondary data analysis of alcohol consumptions and AUD related medicines in EML. Data were extracted from the WHO Global Essential Medicines database and the WHO Global Status Report on Alcohol and Health 2018. Data were extracted for 194 countries. Only 132 of 194 countries (68.0%) had EML, and among the 132 countries only 27.3% had included AUD medicines in their EML. Only 36 countries had included any of the AUD medicines in their EML. Disulfiram was included by 23 countries, while Acamprosate and Naltrexone was included by only four and 19 countries, respectively. Among the countries, 36.1% were from upper-middle income countries and 16.65 from low-income countries. The inclusion of AUD medicines in national EML was neither associated with alcohol consumption parameters nor the alcohol consumption related policy parameters. Considering the high prevalence of AUD and its complications, there is an urgent need to focus on including AUD medicines in national EML for making AUD treatment available and accessible across the world.

Effectiveness of Entrustable Professional Activity-Based Clinical Psychiatry Training for Indian Medical Interns: A Preliminary Study.

ObjectiveEntrustable Professional Activities (EPA) are discretely measurable specific professional tasks that integrate multiple competencies to define and provide varying levels of faculty support per trainee needs. Methods: We developed an EPA-based psychiatry curriculum for medical interns. Fifty-four interns completed the OSCE stations, Multiple Choice Questions, and Attitude questionnaires to assess EPAs, knowledge and attitudes towards the relevance and utility of clinical psychiatry in general practice. Results: Two weeks of EPA-based psychiatry training resulted in improvement in median scores on attitude questions (p < 0.05), clinical skills measured using EPA levels. Conclusions: EPA-based curriculum can improve clinical skills, knowledge, and attitudes towards clinical psychiatry in interns.

A study on knowledge, attitude, and practice about eye donation among medical students and healthcare professionals at a tertiary hospital in Eastern India.

Purpose: To assess and analyze the rate of knowledge, attitude, and practice patterns about eye donation among medical and healthcare professionals in a tertiary care hospital in eastern India. Methods: This was a cross-sectional, descriptive study conducted on medical students, resident doctors, and nursing and paramedical staff at a tertiary institute in the year 2020. A pretested, structured questionnaire consisting of 28 questions in the three subsections based on knowledge and awareness, attitudes and beliefs, and practice patterns mainly willingness to donate eyes by pledging, was noted. All the responses were individually scored, and the total scores were calculated. Univariate analysis was done to find out the factors that had a positive or negative influence on the knowledge and willingness about eye donation. Results: Around 270 participants responded to this survey. The majority of the respondents (206, 76.3%) were below 30 years and 64.4% were males. Awareness about eye donation was 95.6% but a willingness to pledge was observed in 51.5% of participants. The total practice score was lower among nonmedicos compared with medicos (3.33 ± 1.22 vs 3.74 ± 0.64), (P < 0.001). On univariate analysis, the Crude Odds Ratio with a 95% confidence interval was 25.787 (5.18-128.33) in the occupational category (P < 0.001). Conclusion: The study reported an adequate knowledge level among doctors and healthcare workers. The practice pattern among the nursing staff and paramedical workers needs to be improved as they can play a pivotal role in strengthening the hospital corneal retrieval program. They can also be the key messengers during public awareness campaigns for eye donations in our country.

Health system factors related to COVID-19 mortality in Eastern India: Hospital-based cross-sectional study.

Introduction: Mortality from coronavirus disease 2019 (COVID-19) pandemic has left footprints across all ages and socio-economic strata. The deaths because of COVID-19 are usually multi-factorial. The study aimed to assess the health system factors related to COVID-19-related deaths. Materials and Methods: A hospital-based retrospective study was conducted at a tertiary care hospital of eastern India. A total of 272 COVID-19 deaths that occurred between April and November 2020 were investigated. Data were extracted from Medical Record Department, and telephonic interviews were conducted to assess the different delays related to death. Data were analysed using Statistical Package for Social Sciences. Travel time, travel distance, delay in testing, and delay in receiving quality care were presented as median with inter-quartile range. Results: Complete information could be collected from 243 COVID deaths of the 272 deaths (89.3%). The duration of hospital stay was 1-7 days for 42% of the deceased. The median travel time was 120 min, and the median distance travelled was 60 km. The median time to receive first attention of health care workers was 10 minutes. There was hardly any delay in reporting of test results, whereas the median time from symptoms to test and the median time from symptoms to admission were 4 days each. Conclusion: Health system factors related to death of COVID-19 need to be addressed to avoid the avoidable deaths during the pandemic situation. The resilience of the health system can be helpful in reducing death toll in a low-resource country like India.

The top 100 cited articles in menstrual health among adolescent girls: a citation analysis.

BACKGROUND: Menstrual health is an important public health concern where it is still considered a taboo, and adolescent girls often lack knowledge about menstrual health, face limited access to sanitation facilities, and struggle with the affordability of sanitary materials. Every year numerous articles are published; however, only a few of them would be influential in the evolution of a particular field. The number of citations received by an article serves as a quality factor for the impact of the article in a particular field. Citation analysis analyses the relationship between citations received by articles. From the literature search, no citation analysis was conducted on menstrual health. Hence the objective of the study was to identify the articles which received hundred or more citations and also to identify the leading countries, journals, study designs, and departments conducting research on menstrual health. METHODS: Citation analysis was done with search terms pertaining to adolescent and menstrual health using Google Scholar as a database in Publish or Perish software. The articles retrieved were exported to Microsoft Excel. Articles that received a hundred or more citations were screened for the type of article, department, and country where the study was conducted. A descriptive analysis of the hundred or more cited articles was done in Microsoft Excel. RESULTS: A total of 982 articles pertaining to menstrual health among adolescent girls were retrieved. There were hundred articles with hundred and more citations pertaining to the menstrual health of adolescent girls. Cross-sectional study design, Obstetrics and Gynaecology department, India and USA countries, and PLOS ONE journal had the most citations in research on menstrual health among adolescent girls. The top ten articles were on menorrhagia, menstrual hygiene practices, Water, Sanitation and hygiene (WASH), stigma on menstruation, and education on menstrual health. CONCLUSION: The hundred cited articles on menstrual health among adolescent girls were mainly from high-income countries and were of more observational in nature than interventional. Thus, highlighting the need to strengthen experimental studies on the menstrual health of adolescent girls in Lower-middle-income countries.

Menstrual health is an important public health entity where menstrual health management remains poor among adolescent girls in lower-middle-income countries. From the literature, it has been observed that there is a lack of research pertaining to menstrual health. Research-related performances are evaluated through various objective measures; one of them is the number of citations received by the articles, which implicates the impact of the article in a particular field. Hence the objective of our study was to enlist the articles pertaining to menstrual health on adolescent health, which received hundred and more citations. The most common study design, department, country, and journal were determined from articles that received hundred and more citations. The study results showed that the Cross-sectional study design, Obstetrics and Gynaecology department, India and USA countries, and PLOS ONE journal conducted research with the highest number of articles having hundred and more citations. The top ten articles included research pertaining to domains such as menorrhagia, menstrual hygiene practices, Water, Sanitation, and hygiene (WASH), stigma on menstrual health, and education on menstrual health, which are imperative with respect to adolescent girls' menstrual health. From the current citation analysis, it is evident that there is a need for strengthening research on menstrual health, which will generate evidence-based interventions and help policymakers implement necessary policies for adolescent health.

Effectiveness of school-based sexual and reproductive health education among adolescent girls in Urban areas of Odisha, India: a cluster randomized trial.

BACKGROUND: Various studies revealed that adolescent girls have limited knowledge pertaining to sexual and reproductive health (SRH). The current study assessed the effectiveness of SRH education among adolescent girls in urban areas of Odisha, India. METHODS: The study design was a cluster randomized trial, where the clusters composed of eight Odia (regional language) medium government girls' high schools in Bhubaneswar, the capital city of the state of Odisha, India. For the selection of study participants, adolescent girls who were studying in the ninth and tenth standards were recruited from each school. Eight schools were randomized through restrictive randomization at a 1:1 ratio, with four schools each in the intervention and control arm. Baseline and end-line assessments were done using a pre-tested, semi-structured questionnaire. Following baseline assessment, an intervention was given with the help of handbooks developed by the study authors to the schools in the intervention arm. Outcomes included change in knowledge, attitude and practices pertaining to SRH. RESULTS: In our study at baseline, there were a total of 790 students, where 469 (59.4%) students were in the intervention arm, and 321 (40.6%) students were in the control arm. At baseline, only 282 (60.1%) in the intervention arm and 171 (53.3%) in the control arm were aware that physical bodily changes due to puberty were normal. After the intervention, there was a statistically significant increase in knowledge in intervention group 367 (94.8%) (p-value < 0.001). Most students used sanitary pads as absorbent, 97.2% in the intervention group and 98.4% in the control group. However, after the intervention, the use of other absorbents reduced to zero in the intervention group with a statistically significant difference (p < 0.05). The number of students having awareness on different methods of contraception increased from 51 (10.9%) to 337 (87.1%) in the intervention arm (p < 0.001), and of those having awareness on STIs/RTIs increased from 177 (38.2%) to 371 (96.1%) in the intervention group (p < 0.001). CONCLUSION: From our study, there is a significant proportional change in knowledge, attitude, and practices pertaining to SRH. Our study recommends policymakers and program managers for the implementation of comprehensive SRH in the regular school curriculum. Trial registration CTRI/2021/01/030490, registered on January 15, 2021. Prospectively registered at https://ctri.nic.in/Clinicaltrials/login.php.

Adolescent girls lack adequate knowledge pertaining to sexual and reproductive health, for which they face various issues such as teenage pregnancy, unsafe abortions and sexually transmitted infections. Hence the authors conducted this study to assess the effectiveness of school-based sexual and reproductive health education among adolescent girls in Odisha state of India in terms of improving knowledge, attitude and practices pertaining to reproductive health. A total of eight vernacular (Odia language) medium schools were selected for the conduct of the study, and the schools were randomly assigned where four schools received SRH education, and the other four received no intervention. A baseline assessment pertaining to SRH was done among adolescent girls studying in ninth and tenth classes of all eight schools, and then education was given to the four schools in the intervention arm. Students were educated on topics such as puberty, menstrual health, pregnancy, contraception and STIs/RTIs with the help of handbooks prepared by the authors. After 3 months of providing education, an endline assessment was done for the adolescent girls in all eight schools. There was an increase in knowledge, attitude and practices pertaining to SRH among the students who received education when compared to those who didn't. Hence our study recommends policymakers and program managers include SRH education in the regular school curriculum.

Correlation of bone mineral density using the dual energy x-ray absorptiometry and the magnetic resonance imaging of the lumbar spine in Indian patients.

Background: Dual-energy x-ray absorptiometry (DEXA) scan is extensively used to diagnose osteoporosis. But surprisingly, osteoporosis remains an underdiagnosed condition with many fragility fracture patients who have failed to undergo DEXA or received concomitant treatment for osteoporosis. Magnetic resonance imaging (MRI) of the lumbar spine is a routine radiological investigation bring done for low back pain. MRI can detect changes in the bone marrow signal intensity on the standard T1-weighted images. This correlation can be explored to measure osteoporosis in elderly and post-menopausal patients. The present study aims to find any correlation of bone mineral density using the DEXA and MRI of the lumbar spine in Indian patients. Methods: Five regions of interest (ROI) of size 130-180 mm2 were placed in the vertebral body in the mid-sagittal section and parasagittal sections on either side (four in L1-L4 and one outside body) of elderly patients who underwent MRI for back pain. They also underwent a DEXA scan for osteoporosis. Signal to Noise Ratio (SNR) was calculated by dividing the mean signal intensity obtained for each vertebra by the standard deviation of the noise. Similarly, SNR was measured for 24 controls. An MRI-based "M score" was calculated by getting the difference in SNR patients to SNR controls and then dividing it by the control's standard deviation (SD). Correlation between the T score on DEXA and M scores on MRI was found out. Results: With the M score greater than or equal to 2.82, the sensitivity was 87.5%, and the specificity was 76.5%. M scores negatively correlated with the T score. With the increase in the T score, the M score decreased. The Spearman correlation coefficient for the spine T score was -0.651, with a p-value of <0.001, and the hip T score was -0.428, with a p-value of 0.013. Conclusion: Our study indicates that MRI investigations are helpful in Osteoporosis assessments. Even though MRI may not replace DEXA, it can give insight into elderly patients who get an MRI routinely for back pain. It may also have a prognostic value.

Assessment of Health Status of Newborns Discharged From Sick Newborn Care Units of the Five Cyclone Fani Affected Districts of Odisha, India.

OBJECTIVE: This study was undertaken to assess the health status of newborns discharged from Sick Newborn Care Units (SNCU) of the Cyclone Fani affected districts of Odisha, which is amongst the highest neonatal mortality rate states in the country. METHODS: Cyclone Fani hit the coast of Odisha on May 3, 2019. This cross-sectional study was conducted in 5 districts and targeted the babies discharged from SNCU's from January to May 2019. A telephonic interview of the caregivers was conducted to assess the health status of the newborns. Data was collected in a web-based portal and analyzed by statistical package for social sciences SPSS (IBM Corp., Armonk, New York, USA). RESULTS: We inquired about 1840 babies during the study period but only 875 babies could be followed up, with the highest proportion of the babies from the most affected district. Out of 875 babies, 111 (12.7%) had 1 or more illnesses during follow up. Distance from the health facility and time constraints were the major reasons for not seeking health care. Of the babies, 35.7% were reported as being underweight. Poor breastfeeding (14.1%) and kangaroo mother care (31.7%) practices were reported. Only 32% of the babies were completely immunized. CONCLUSION: The health status of the babies discharged from the SNCUs was found to be poor. Newborn care can be strengthened by improving home-based and facility-based newborn care.

Perception of undergraduate medical students toward stressors and de-stressors during COVID-19 pandemic: Online cross-sectional survey from a medical institute in Eastern India.

Introduction: COVID-19 has affected the quality of life of all age groups. Medical education during the pandemic shifted to online mode due to lockdown restrictions. The stress felt by medical students during the pandemic has been studied less. The current study aimed to assessed the stressors and de-stressors for undergraduate medical students during the COVID-19 pandemic. Materials and methods: A cross-sectional online survey was conducted for the undergraduate medical students of a tertiary care institute of eastern India. A total of 307 medical students were included in the study by convenient and snowball sampling. A self-designed semi-structural questionnaire was created as a Google form and circulated among the students between September and October 2020. A combination of purposive and snowball sampling was adopted. Responses regarding stressors and de-stressors were recorded on a Likert scale. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. Categorical variables were presented as percentages and descriptive statistics were performed. Results: A total of 307 students responded and 64.5% of them were men and 35.5% were women. 47.6% of the students experienced stress due to changes brought about by COVID-19. Risk of parents getting infection (63.2%), fear of not easily returning home (53.1%), lack of clinical exposure (52.7%), and financial impact (47.9%) were the major stressors perceived by the students. Connecting with family and friends through social media (47.5%), gaming (45.0%), online streaming platform (51.2%), spending time with family members (54.4%) were the coping strategies adopted by these students. Conclusion: Higher level of psychological stress perceived by the undergraduate students needs psychological intervention. Academic revamp and adaptation of coping strategies are required for the medical under-graduates.

Effect of treatment interruptions and outcomes in cancer patients undergoing radiotherapy during the first wave of COVID-19 pandemic in a tertiary care institute.

INTRODUCTION: COVID-19 patients with cancer had poorer outcomes due to immunosuppression during cancer care, poor general condition, and other comorbidities. The study was conducted to present the real-world analysis of the effect of treatment interruptions on the outcomes of patients treated with radiation therapy during the first wave of the COVID-19 pandemic in a tertiary care institute in India. MATERIALS AND METHODS: The study is a retrospective observational cohort study on cancer patients undergoing radiation therapy from March 2020 to January 2021. The study's primary outcome was to analyze the effect of treatment interruptions on the outcomes of patients treated with radiation therapy during the first wave of COVID-19 pandemic. RESULTS: Between March 2020 to January 2021, 218 eligible patients undergoing radiation therapy were found for the study. Among the 218 patients, 25 patients (11.47%) were found positive for COVID-19, while 193 patients (88.53%) were negative for COVID-19. Among COVID-19-positive patients, ten patients had < 3 weeks of treatment interruption, while 15 patients had > 3 weeks of treatment interruptions. After recovering from COVID-19, treatment was resumed and completed for 15 (60.00%) of the COVID-19-positive patients. In comparison, 13 patients (52.00%) were lost to follow-up. Three of the COVID-19-positive patients died. The disease was clinically controlled in 12 (48.00%) of the COVID-19-positive patients, and the patients reported locoregional disease progression in 10 (40.00%). Among the 193 COVID-19-negative patients, 32 patients (16.58%) had treatment interruption. Twelve patients (37.50%) had treatment interruptions for less than 1 week. There was a significant difference in the delay of radiation treatment delivery by 2 weeks (11 fractions) in COVID-19-positive patients compared to only two fractions delay in COVID-19-negative patients. CONCLUSION: COVID-19 impacted the treatment outcomes in both COVID-19-positive and COVID-19-negative cohorts of patients. There was a longer duration of treatment interruptions in the COVID-19-positive patients, leading to fewer patients completing the radiation treatment and thereby increased locoregional disease progression. There was a significant difference in the delay in treatment between the two groups.

Effectiveness of COVID-19 vaccine (Covaxin) against breakthrough SARS-CoV-2 infection in India.

India approved COVID-19 vaccine called Covaxin, developed by the Indian Council of Medical Research and Bharat Biotech Ltd. The primary objective of the study was to estimate the effectiveness of Covaxin in preventing breakthrough SARS-CoV-2 infection in healthcare workers (HCWs). A test-negative matched case-control study was conducted among HCWs of tertiary care hospital in Eastern India. Any HCW who tested positive for COVID-19 using RT-PCR during April and May 2021 was taken as the case. The HCWs who tested negative for COVID-19 by RT-PCR were considered as controls after matching with the date of testing and profession of the cases. Vaccination data were collected from the institution's vaccine database and recall. In case of discrepancy, it was confirmed from the CoWIN portal (cowin.gov.in). The sample size was 670 participants (335 pairs). Conditional logistic regression models were used to calculate the adjusted odds ratio for breakthrough SARS-CoV-2 infection. Vaccine effectiveness was calculated using the following formula: VE = (1-aOR) × 100%. Sensitivity analysis was done for effectiveness of Covaxin, excluding Covishield vaccination. The mean age of participants was 29.1 years (SD = 7.1), and the majority were males (55.2%). Among the study participants, 60% were completely vaccinated, 18.51% were partially vaccinated, and 21.49% were unvaccinated. After adjusting for age, gender, type of household and past history of COVID-19 disease in conditional logistic models, the vaccine effectiveness was 22% (aOR 0.78, 95% CI: 0.52-1.17; p = .233). Sensitivity analysis with Covaxin showed an effectiveness of 29% (aOR 0.71, 95% CI: 0.47-1.08; p = .114) for preventing breakthrough SARS-CoV-2 infection.

Adverse events following immunization of COVID-19 (Covaxin) vaccine at a tertiary care center of India.

The study aimed to assess the adverse events following COVID-19 vaccine (Covaxin) immunization at a tertiary care institution and also assess the predictors of the adverse events following immunization (AEFI). The prospective observational study was conducted in a tertiary care institute among the Covaxin beneficiaries between June 28 and September 6, 2021. A total of 1826 participants were assessed for any local or systemic adverse events after seven days of vaccination. A telephonic interview was conducted, and the beneficiaries were assessed according to the adverse event grading. A total of 1826 participants were assessed for AEFI, and 544 (29.8%) reported at least one of the AEFI. No severe adverse events were reported, and about 1.6% had moderate AEFI. Pain at the injection site (14.6%), fever (9.7%), and myalgia (5.9%) were the common adverse events reported by the participants. AEFI incidence was higher in the first dose (38.1%) when compared to the second dose (26.4%), and this finding was significant with a p < 0.001. The major factors associated with AEFI were female sex, history of an allergic reaction, presence of comorbidities, acute infection in the past 3 months, and intake of chronic medications. Precaution needs to be taken while vaccinating individuals having allergies, comorbidities, acute infection in the last 3 months, and individuals on chronic medication.

Knowledge and attitude towards, and the utilisation of cervical and breast cancer screening services by female healthcare professionals at a tertiary care hospital of Eastern India: A cross-sectional study.

BACKGROUND: Breast and cervical cancers are the two leading causes of cancer-specific mortality and morbidity amongst Indian women. Screening methods are cost-effective. However, the uptake of screening methods in India is very low. Knowledge and attitude of healthcare professionals (HCPs) play an important role in reducing the mortality related to cancer. MATERIALS AND METHODS: This study aimed to assess the knowledge and utilisation of screening methods for cervical and breast cancer and to elaborate barriers for non-utilisation amongst female HCPs, both doctors and nurses. A cross-sectional study was carried out from April to July 2017 in a tertiary healthcare hospital of eastern India amongst 200 female HCPs using a pre-designed, pre-tested, self-administered questionnaire. Data were analysed using the Statistical Package for the Social Sciences version 20.0. Statistical tests such as proportion and mean were calculated and the Chi-square test was used as a test of significance for categorical variables. RESULTS: Clinical breast examination and mammography were practiced by only 26.5% and 7% of respondents, respectively. Only seven doctors and one nurse had ever undergone Pap smear. More than 90% of respondents knew risk factors, signs and symptoms and the availability of screening tools for the detection of cervical and breast carcinoma. CONCLUSIONS: The utilisation of breast and cervical cancer screening was unsatisfactory despite having good knowledge of the preventable cancers and screening methods amongst HCPs. There is a need for attitudinal change amongst HCPs by continuous sensitisation programmes.

Experience from a COVID-19 screening centre of a tertiary care institution: A retrospective hospital-based study.

BACKGROUND: The COVID-19 pandemic continues to be a significant public health concern across the whole world, including India. In the absence of any specific treatment or vaccine against COVID-19, the role of efficient testing and reporting has been uncontested so far as the number of cases is rising daily. In order to strengthen the screening activities and to prevent nosocomial infection, facility-based screening centres have been designed and operated at various levels of healthcare, including tertiary care institutions. METHODS: The present study has been planned with an objective to understand the patient profile and evaluate the functioning of COVID-19 screening OPD (CS-OPD) at a tertiary care hospital. In this hospital-based retrospective study, data from individuals visiting the COVID-19 screening OPD during the period from 17th March 2020 to 31st July 2020 were collected. We documented and analysed relevant demographic, epidemiological and clinical characteristics of the patients. RESULTS: A total of 10,735 patients visited the COVID-19 screening OPD during the defined study period of which 3652 individuals were tested. The majority of the patients, i.e., 65.67% (7050) were male and in the 15-59 years age group (84.68%). The most common symptoms among patients visiting CS-OPD was cough (9.86%). Of the total, 17.17% (1843) of patients reported to the CS-OPD with a contact history of COVID-19-positive patient. On the other hand, 13.49% (1448) of patients were with either domestic or international travel history. The overall testing rate and positivity rate for CS-OPD during this period were found to be 34.02% and 7.94%, respectively. CONCLUSION: The clinical, demographic and epidemiological characteristics of patients visiting CS-OPD varied across the study period depending upon the containment and testing strategy. The CS-OPD played a crucial role in preventing nosocomial infection and maintaining non-COVID care at the tertiary care hospital.

Hospital-Based Contact Tracing of Patients With COVID-19 and Health Care Workers During the COVID-19 Pandemic in Eastern India: Cross-sectional Study.

BACKGROUND: The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation. OBJECTIVE: This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases. METHODS: This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts. RESULTS: During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non-COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003). CONCLUSIONS: Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19-related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings.

Fear and anxiety among COVID-19 Screening Clinic Beneficiaries of a tertiary care hospital of Eastern India.

India is one among the most affected countries in the COVID-19 pandemic. The increasing number of cases in India and the fear of COVID-19 infection is causing fear and anxiety. Fear and anxiety related to COVID-19 the community dwellers are less studied. This study was conducted to assess the fear and anxiety related to COVID-19 among the people seeking COVID-19 screening test. The cross-sectional study was conducted on a sample of 398 participants aged 18 years and above who attended the screening clinic of a tertiary care hospital of eastern India. Participants were assessed using Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 scale which are validated screening scales. Result showed that 20.4 % of the participants were having anxiety due to COVID-19. The mean fear score was 17.87 ± 4.48. Females, Middle aged, housewives, less educated, symptomatic, co-morbid and people under institutional quarantine were having more fear. People with COVID-19 related anxiety faced more fear. These findings suggest the need for screening anxiety in COVID-19 screening clinics. People with high levels of COVID related anxiety and fear are at risk for developing psychiatric disorders hence need targeted approach to address their mental health.

The Pattern of Morbidity and Use of Social Security Schemes among the Steel Plant Workers in an Industrial District of Odisha.

BACKGROUND: An occupational hazard is a growing concern for developing countries. The study aims to assess the pattern and the factors associated with morbidity of the steel plant workers and the usage of social security schemes among them. MATERIALS AND METHODS: The cross-sectional study was conducted in two steel plants of the Angul district of central Odisha from May to August 2019. The steel plant workers were assessed for occupational hazard using a structured questionnaire and a physical examination was conducted. Chi-square test and binary logistic regression were used to find out the association. RESULTS: Dust was the most common exposure followed by noise and heat. Myopia (26.7%), generalized weakness (19.0%), hearing impairment (19.0%), respiratory illness (15.9%), hypertension (11.0%), myalgia (10.2%), and peripheral neuropathy (9.1%) were the common morbidities among the steel plant workers. Exposure to dust, noise, vibration, chemicals, and year of exposure is the common determinants of morbidities. Only 63.5% of the study participants availed of different social-security schemes. CONCLUSIONS: Pre-placement examination, regular medical check-ups, and the use of proper safety measures during work can reduce the chance of morbidities. Authorities need to sensitize the workers to safety equipment and hazard-prone conditions and also regarding social-security schemes.

Cancer awareness and attitude towards cancer screening in India: A narrative review.

Cancer awareness is the key to early detection and better health-seeking behaviour. Cancer is quite common in both developing as well as developed countries, but awareness is yet poor among the general population. Poor awareness may lead to poor uptake of screening modalities and delay in diagnosis. One factor that has been consistently shown to be associated with late diagnosis and treatment is a delay in seeking help for cancer-like symptoms. This paper reviews the literature on cancer awareness among the general population and attitude towards screening modalities. The poor awareness level among the Indian population shows the need for health education and sensitisation regarding cancer and its different aspects. This will be helpful in the successful implementation of health programmes related to cancer.

Mis-infodemic: The Achilles' heel in combating the COVID-19 pandemic in an Indian perspective.

In this ongoing SARS-CoV2 Corona virus pandemic, we are witnessing an uninhibited spread of mis-information on various social media platforms. This spread of mis-information or "mis-infodemic" is playing a negative role in our fight against the virus with far reaching consequences. International organizations like the WHO and other governmental organizations have geared up to the occasion to limit the spread of these and bring clarity in this context. In this time of crisis, risk communication is vital in the communication between organizations/government and the people. But apart from the organizations, the onus is on the people and media to realise the importance and verify the authenticity of information being circulated. It is imperative that information, being a double edged sword, is handled with caution and effective communication strategies are devised for the dissemination of accurate and scientific health related information. Social media can be used in a constructive way in mitigating the effects of this pandemic for the betterment of the society.