Prevalence of normal weight obesity and its cardiometabolic implications among government doctors in Gujarat, India: a cross-sectional study.

BACKGROUND: Obesity is rising globally. Normal weight obesity (NWO) and normal weight central obesity (NWCO) despite normal BMI pose added metabolic risks. Limited data on these phenotypes among Indian doctors merits investigation. The present study aimed to assess the prevalence of overall obesity, NWO, NWCO, and their associations with cardiometabolic risks among doctors in Gujarat, India. METHODS: It's a Cross-sectional study among 490 doctors aged 20-60 years at a tertiary hospital. Anthropometry, blood pressure, fasting glucose, and lipids were assessed. NWO was defined as a BMI of 18.5-24.9 kg/m2 with a high body fat percentage. NWCO as normal BMI and increased waist circumference. Body composition was assessed using an Omron body composition analyzer. RESULTS: The prevalence of overall obesity was 101 (20%), NWO 239 (48.7%), and NWCO 210 (42.8%). Mean BMI, blood pressure, glucose, and LDL increased from normal weight to NWO/NWCO groups (p < 0.05). NWO and NWCO had significantly higher odds of hypertension, dyslipidemia, and high fasting blood sugar compared to non-obese after adjusting for confounders. CONCLUSION: The high burden of overall obesity, NWO, and NWCO among doctors highlights the need for lifestyle interventions to mitigate long-term cardiometabolic disease risk.

Multimorbidity, health Literacy, and quality of life among older adults in an urban slum in India: a community-based cross-sectional study.

BACKGROUND: India is experiencing a rising burden of chronic disease multimorbidity due to an aging population and epidemiological transition. Older adults residing in urban slums are especially vulnerable due to challenges in managing multimorbidity amid deprived living conditions. This study aimed to assess the prevalence of multimorbidity, associated health literacy, and quality of life impact in this population. METHODS: A community-based cross-sectional study was conducted among 800 adults aged ≥ 65 years in an urban slum in Gujarat, India. Data on sociodemographics, physical and mental health conditions, health literacy (HLS-SF-47), quality of life (Short Form-12 scale), and social determinants of health were collected. Multimorbidity is ≥ 2 physical or mental health conditions in one person. RESULTS: The prevalence of multimorbidity was 62.5% (500/800). Multimorbidity was significantly associated with lower physical component summary (PCS) and mental component summary (MCS) scores on the SF-12 (p < 0.001). After adjusting for sociodemographic variables, the odds ratio of 0.81 indicates that for every 1 unit increase in the health literacy score, the odds of having multimorbidity decrease by 19%. Older age within the older adult cohort (per year increase) was associated with greater odds of multimorbidity (AOR 1.05, 95% CI 1.02-1.09). Physical inactivity (AOR 1.68, 95% CI 1.027-2.77) and lack of social support (AOR 1.57, 95% CI 1.01-2.45) also increased the likelihood of multimorbidity. CONCLUSION: There is a substantial burden of multimorbidity among urban slum dwellers aged ≥ 65 years in India, strongly linked to modifiable risk factors like poor health literacy and social determinants of health. Targeted interventions are essential to alleviate this disproportionate burden among urban slum older adults.

Prevalence and predictors of loneliness and its association with health-seeking behaviors among the elderly population, Gujarat, A community-based cross-sectional study.

Objectives: To determine the prevalence and predictors of loneliness and its associations with health behaviors among elderly adults in Gujarat, India. Methodology: This community-based cross-sectional study included 250 participants aged ≥60 years. Loneliness was measured using the UCLA Loneliness Scale. Associations with socio-demographic, health, and social factors were explored through regression models. Health behaviors were compared between lonely and non-lonely groups. Results: The prevalence of moderate and severe loneliness was 24% (n = 60) and 16% (n = 40), respectively. 40% (n = 100) were found to be lonely. Widowhood (55/125, OR 3.67), living alone (75/125, OR 1.85), social isolation (90/125, OR 2.38), recent bereavement (68/125, OR 1.69), depression (85/125, OR 6.52), and disability (70/125, OR 6.35) were significant predictors of loneliness (P < 0.05). Lonely elders had poorer diet, exercise, sleep, increased smoking, screen time, reduced medical checkups, and social engagements versus non-lonely peers (P < 0.05). Conclusion: Loneliness was highly prevalent among 40% of elderly Indians and strongly linked to adverse health behaviors. Interventions promoting social connectedness, counseling, and peer support are recommended.

Exploring the association between depression and diabetes among type 1 and type 2 diabetic mellitus patients: A cross-sectional study in Gujarat, India.

Background: Depression and anxiety are common among patients with diabetes mellitus and it affects the control of diabetes negatively. Depression is the third leading reason for the most disability-adjusted life years. Once depression coexists with diabetes mellitus, it is related to major health consequences and ends up in poor health outcomes. Aim: The study aimed to estimate the prevalence of depression in diabetes mellitus people and to find an association of depressive symptoms with sociodemographic and clinical predictors among patients with diabetes mellitus attending follow-ups at the general public hospital, in western Gujarat. Materials and Methods: It is an institutional-based cross-sectional study conducted among people living with diabetes mellitus at Tertiary Hospitals, Urban Health Training Center, and Rural Health Training Center. The study period was from January 2023 to May 2023. Data were collected using a structured questionnaire. Depression was assessed by the Patient Health Questionnaire 9. The collected data were cleaned, edited, entered into MS Excel (2006), and analyzed using SPSS software (version 26). A P value of <0.05 was considered statistically significant. Results: A total of 380 study participants were included in this study. Among 380 participants, 282 (74%) were having depressive symptoms. Of 282, 61 (21.6%) have mild depressive symptoms, 106 (37.5%) have moderate symptoms, 111 (39%) have moderately severe symptoms, and four (1.4%) have severe symptoms. Of 380 participants, 221 (58%) have clinical depression (moderate, moderately severe, and severe symptoms). Variables significantly associated with depression were marital status, number of family members, socio-economic status, type of diabetes mellitus, treatment given, presence of comorbidities, and duration of diabetes more than 5 years. Conclusion: The present study has shown a considerably higher amount of depression in diabetic participants. So, healthcare professionals should consider screening for depression using the Patient Health Questionnaire 9 or other validated tools in all diabetic patients, especially in those who are at a higher risk.

Assessment of Knowledge, Attitudes, and Practices Regarding Menstrual Hygiene Management Among Adolescent Schoolgirls (10-19 Years) in the Saurashtra Region, Gujarat.

Background Menstrual health management proves pivotal for the adoption of hygienic practices and the embracement of womanhood from the onset of menarche. Menstrual hygiene is pivotal yet under-addressed among adolescent girls in India. This study aimed to assess the knowledge, attitudes, and practices regarding menstrual hygiene and influencing factors. Methodology A cross-sectional study was conducted among 361 adolescent schoolgirls aged 10-19 years in the Saurashtra region of Gujarat using a pretested questionnaire. Multistage sampling was used. In the first stage, six schools (three rural and three urban) were selected through random sampling. In the second stage, all adolescent girls aged 10-19 years in the selected schools who had attained menarche were invited to participate. Those who provided written assent were included in the study. The data were analyzed with descriptive statistics and logistic regression. A p-value <0.05 was considered significant. Results Knowledge about menstruation was evenly distributed as good (47.65%) and poor (52.35%). Most relied on mothers for information and considered menstruation a normal phenomenon. Attitudes reflected complex cultural perceptions. The use of sanitary pads was high (96.12%), although 39.89% used reused absorbents. Multivariate analysis revealed age 16-19 years (adjusted odds ratio (AOR) = 2.08, 95% confidence interval (CI) = 1.14-3.81), higher parental education, pit latrine usage (AOR = 6.7, 95% CI = 2.97-15.15), and knowledge about menstruation (AOR = 8.21, 95% CI = 4.56-14.78) as positive predictors of good menstrual practices. Conclusions Despite the widespread use of sanitary pads, the persisting knowledge gap and sociocultural influences lead to unhygienic practices. Improving awareness and attitudes through educational interventions among adolescent girls and mothers, in particular, addressing cultural taboos through the engagement of all stakeholders, and improving sanitation infrastructure in schools are imperative.

A Preliminary Study on the Functional Benefits of Computerized Working Memory Training in Children With Pediatric Bipolar Disorder and Attention Deficit Hyperactivity Disorder.

Twenty-nine pediatric patients (age range, 10-16 years) with working memory (WM) deficits, including children with pediatric bipolar disorder (PBD) with and without attention-deficit hyperactivity disorder (ADHD) comorbidity and children with ADHD, underwent a Cogmed WM training program. For both patient groups, WM performance on Cogmed tasks and on the Digit Span test improved significantly after training. Moreover, the PBD group improved on Trails Making Test A and on the Inhibition Scale, the Behavior Regulation Index, and the Global Executive Composite of the Behavioral Rating Inventory of Executive Function. The ADHD group improved significantly on the Trails Making Test B, the Spatial Span Test, and the Reading Fluency Test of the Woodcock-Johnson III, as well as on depressive symptoms. The present findings suggest that working memory training is beneficial not only in youths with ADHD but also in youths with PBD. They also show evidence of near and far transfer of WM improvement in these patients, although in different ways for the two patient groups. Future studies examining the mechanisms of cognitive remediation in pediatric patients will aid in creating tailored illness-specific cognitive interventions.

Improving human papilloma virus vaccination rates throughout military treatment facilities.

OBJECTIVES: The four objectives of this study were to (1) educate military healthcare providers on HPV disease and vaccine, (2) assess short term recall of information presented at educational sessions, (3) assess provider comfort level with the vaccine, and (4) assess improvement in HPV vaccination rates. METHODS: Standardized interactive educational sessions were conducted at military primary care clinics with pre- and post-educational quizzes administered before and immediately following the sessions. Provider attitudes were assessed using Likert scale questionnaires. Vaccination rates in children and young adolescents ages 11-18 at one of the participating regions that had a champion and started a Quality Improvement (QI) project were assessed at baseline, at 3-months and at 6-months post sessions. RESULTS: 200 providers were reached at 48 primary care clinics during May 2014 through October 2015 with 200 quizzes and Likert scale questionnaires returned. There was increase in knowledge following the educational sessions as revealed in the pre- and post- test scores [t(57) = -5.04, p < 0.001]. There was a significant overall increase in comfort in answering patients' and parents' questions about HPV vaccine [p = 0.003]. There was a significant increase in the number of vaccines given at all the clinics 3-months after the educational sessions at the region who had a champion dedicated to monitoring vaccine rates and ensuring implementation efforts [p = 0.01] and started a QI project. This increase was not sustained at 6-months [p = 0.324]. CONCLUSIONS: Improvement in provider short term knowledge recall and comfort level in answering parents' questions was seen. We found that educational sessions can improve HPV vaccination rates in military clinics that have a vaccine champion for up to 3-months. Further research into the effects of having clinic vaccine champions is critical.

Differences in Real World Executive Function between Children with Pediatric Bipolar Disorder and Children with ADHD.

BACKGROUND: Recent research evidence suggests that executive function (EF) is impaired in both pediatric bipolar disorder (PBD) and attention deficit-hyperactivity disorder (ADHD), although the underlying cognitive mechanisms are still unclear. In this study we examined EF, including cognitive and emotional control, in three pediatric groups with overlapping symptoms. METHODS: Sixteen children and adolescents with PBD, 17 children and adolescents with ADHD, Type Combined, and 13 children and adolescents with PBD and comorbid ADHD (PBD+ADHD) (mean age=12.70, SD=2.21) were assessed using the Behavioral Rating Inventory of Executive Function - Parental Report (BRIEF-PR), clinical scales and neuropsychological tests of attention, working memory and executive function. RESULTS: All groups showed impairment on the Trails A and B tests. However, there were no significant group differences. On the BRIEF-PR while all three groups were impaired in General Executive Functioning and Metacognition only the two PBD groups revealed more extensive EF dysfunction, in both cognitive and emotional control domains, relative to the ADHD group. Conversely, the ADHD group exhibited selective deficits in cognitive domains such as working memory, planning/organization, monitoring, and metacognition. The two PBD groups showed greater impairment than the ADHD group in the domains of Inhibition, Shifting, Monitoring and Emotional Control. Furthermore, results from regression analyses suggest cognitive predictors of EF impairment in ADHD and mood predictors for inhibition in PBD. CONCLUSIONS: The current results contribute new knowledge on domain-specific similarities and differences in executive dysfunction between PBD, ADHD, and the comorbid phenotype, which may inform the diagnostic process and cognitive intervention.

CONTEXTE: Des données probantes issues de recherches récentes suggèrent que la fonction exécutive (FE) est déficiente dans le trouble bipolaire pédiatrique (TBP) et dans le trouble de déficit de l'attention avec hyperactivité (TDAH), bien que les mécanismes cognitifs sous-jacents ne soient pas encore bien définis. Dans cette étude, nous avons examiné la FE, y compris le contrôle cognitif et émotionnel, dans trois groupes pédiatriques présentant des symptômes se chevauchant. MÉTHODES: Seize enfants et adolescents souffrant de TBP, 17 enfants et adolescents souffrant de TDAH, de type combiné, et 13 enfants et adolescents souffrant de TBP et de TDAH comorbide (TBP+TDAH) (âge moyen = 12,70, ET = 2,21) ont été évalués à l'aide de l'Inventaire de comportements reliés aux fonctions exécutives -- rapport des parents (BRIEF-PR), d'échelles cliniques et de tests neuropsychologiques de l'attention, de la mémoire de travail et de la fonction exécutive. RÉSULTATS: Tous les groupes ont indiqué une déficience aux Trail making tests A et B. Toutefois, il n'y avait pas de différences significatives entre les groupes. Dans le BRIEF-PR, même si les trois groupes étaient déficients dans le fonctionnement exécutif général et la métacognition, seulement les deux groupes de TBP révélaient une dysfonction importante de la FE, dans les deux domaines de contrôle cognitif et émotionnel, relativement au groupe de TDAH. À l'inverse, le groupe de TDAH a révélé des déficits sélectifs dans les domaines cognitifs comme la mémoire de travail, la planification/organisation, la surveillance et la métacognition. Les deux groupes de TBP ont montré une plus grande déficience que le groupe de TDAH dans les domaines de l'inhibition, la flexibilité, la surveillance et le contrôle émotionnel. En outre, les résultats des analyses de régression suggèrent des prédicteurs cognitifs de la déficience de la FE dans le TDAH et des prédicteurs de l'humeur pour l'inhibition dans le TBP. CONCLUSIONS: Les présents résultats contribuent aux nouvelles connaissances sur les similitudes et les différences propres aux domaines en matière de dysfonction exécutive entre le TBP, le TDAH et le phénotype comorbide, ce qui peut éclairer le processus diagnostique et l'intervention cognitive.

Genome subtraction for novel target definition in Salmonella typhi.

Large genomic sequencing projects of pathogens as well as human genome leads to immense genomic and proteomic data which would be very beneficial for the novel target identification in pathogens. Subtractive genomic approach is one of the most useful strategies helpful in identification of potential targets. The approach works by subtracting the genes or proteins homologous to both host and the pathogen and identify those set of gene or proteins which are essential for the pathogen and are exclusively present in the pathogen. Subtractive genomic approach is employed to identify novel target in salmonella typhi. The pathogen has 4718 proteins out of which 300 are found to be essential (" indispensable to support cellular life") in the pathogen with no human homolog. Metabolic pathway analyses of these 300 essential proteins revealed that 149 proteins are exclusively involved in several metabolic pathway of S. typhi. 8 metabolic pathways are found to be present exclusively in the pathogen comprising of 27 enzymes unique to the pathogen. Thus, these 27 proteins may serve as prospective drug targets. Sub-cellular localization prediction of the 300 essential proteins was done which reveals that 11 proteins lie on the outer membrane of the pathogen which could be probable vaccine candidates.