Clinicodemographic Profile and Clinical Outcome of Children Presenting to Telemedicine Center at Institute of National Importance of India: A Prospective Observational Study.

Background: There is a global shortage of healthcare professionals, especially in developing countries, leading to disparities in access to healthcare, worsened by the pandemic. Telemedicine is emerging as a solution, with growing adoption worldwide due to advancements in technology and increased awareness. Research Problem. The establishment of telemedicine depends on resources, infrastructure, and knowledge about healthcare needs. Further studies are needed to monitor and address evolving issues in telemedicine. The Overall Purpose of the Study. Rural health disparities stem from multiple factors, like limited healthcare access, workforce shortages, lifestyle choices, and lower socioeconomic status, leading to higher mortality and chronic diseases. Addressing these challenges is vital for rural community well-being. Telemedicine centers present a promising solution, bridging gaps, and improving healthcare outcomes for underserved remote populations. Methodology. Objective: This study assessed the clinicodemographic profile and clinical outcome of children presenting to the telemedicine center at the Institute of National Importance in India. Design: Prospective observational study. Setting: A single-center tertiary care level. Participants: This study included 79 children aged up to 18 years. Major Findings and Summary of Interpretations. In our study, 79 children using telemedicine found a near-equal gender distribution. 8.9% needed emergency care, with common complaints being respiratory issues, fever, abdominal pain, and vomiting. After two weeks, 83.5% showed improvement, emphasizing telemedicine's effectiveness in pediatric care. Conclusion: Our study underscores telemedicine's positive impact on pediatric healthcare, emphasizing its potential to enhance access, outcomes, and cost-efficiency. Wider telemedicine adoption can reduce morbidity and mortality, support preventive care, and streamline posttreatment services, alleviating pressure on specialized facilities. While our focus was pediatrics, the telemedicine model is adaptable to various age groups and conditions, but it should be seen as a valuable supplement to, not a total substitute for, in-person healthcare visits.

Bidirectional and cross-lag relationship between social media use and psychological wellbeing: evidence from an Indian adolescent cohort study.

INTRODUCTION: In an online era like today, the relationship between social media and depression among adolescents and young adults is erratic and still continues to be a debatable subject. The study aims to examine the association and bi-directional relationship between social media usage and depressive symptoms among the adolescent boys and girls in India. METHODS: The study uses data from two waves of Understanding the Lives of Adolescents and Young Adults (UDAYA) project survey conducted in two Indian states of Uttar Pradesh and Bihar. Depression was measured by a Patient Health Questionnaire. Logistic regression has been used for analyzing the data comprising the same time period, whereas the bidirectional relationship between two time periods has been evaluated by Cross-Lagged Path Model. RESULT: Findings suggest that the percentage of moderate depressive symptoms increased from 1.7% to 3.0% from Wave 1 to Wave 2. Depression among adolescent girls increased slightly from wave 1 to wave 2 whereas a slight decrement was noticed in the moderate form of depressive symptom among adolescent girls using social media for the two waves. Socioeconomic factors like education, age, gender played an important role in affecting depression among adolescents in both the Wave of the survey. The path relationship reveals that social media users in Wave 1 [ß=0.22, p<0.001] were positively associated with social media users in Wave 2. Similar patterns were observed for depressive symptoms at both the waves of the survey. However, cross lagged relations between social media use and depression could not be established between the survey periods. CONCLUSION: A significant degree of association was found between social media use and depression among adolescent boys and girls in the study. The present study concludes that factors like age, gender and education showed significant relationships with social media use and depression.

Factors contributing to socio-economic inequality in utilization of caesarean section delivery among women in Indonesia: Evidence from Demographic and Health Survey.

BACKGROUND: Most of the existing literature in developing countries focused on either the rising trend of CS or its determinants. There is a paucity of population-based studies on existing socioeconomic inequalities in availing CS services by women in Indonesia. This study aimed to assess the factors associated with caesarian section (CS) delivery and explore the various factors contributing to inequalities in CS delivery rates in Indonesia. METHODS: The study utilized nationally representative cross-sectional data from the Indonesia Demographic and Health Survey (IDHS), 2017. We conducted multivariable logistic regression to find the factors associated with CS delivery. Concentration index and Wagstaff's decomposition analysis were used to examine the socioeconomic inequalities in CS delivery among women and associated factors. RESULTS: About 17% of women in Indonesia delivered babies through CS. A concentration index of 0.31 in CS delivery rate showed a higher CS delivery rate among women belonging to rich households. About 44.7% of socioeconomic status inequality in CS delivery was explained by educational status among women who went for CS delivery. Women's place of residence explained 30.1% of socioeconomic inequality, and women's age at first birth explained about 11.9% and reporting ANC visits explained 8.4% of the observed inequality. Highest socioeconomic inequality was witnessed in central Sulawesi (0.529), followed by Maluku (0.488) and West Kalimantan (0.457), whereas the lowest was recorded in Yogyakarta (0.021) followed by north Sulawesi (0.047) and east Kalimantan (0.171). Education (44.7%) followed by rural-urban place of residence (30.1%) and age of first birth (11.9%) contributed most to explain the gap in CS delivery among rich and poor women. CONCLUSION: The study highlighted the higher CS delivery rates among women from higher socioeconomic groups and thus, it is important to frame policies after identifying the population subgroups with potential underuse or overuse of CS method of delivery.

Prevalence and determinants of socioeconomic inequality in caesarean section deliveries in Bangladesh: an analysis of cross-sectional data from Bangladesh Demographic Health Survey, 2017-18.

BACKGROUND: Caesarean section deliveries, which involve incisions in the abdomen and uterus of the mother, have been a widespread event among women with obstructed labour. The current study not only estimated the socioeconomic and demographic factors of caesarean deliveries in Bangladesh but also decomposed the existing socioeconomic inequality in caesarean deliveries. DATA AND METHODS: 2017-18 Bangladesh Demographic and Health Survey (BDHS) data was used for this study. The adequate sample size for the analysis was 5,338 women aged 15-49 years who had given birth at a health facility for three years preceding the survey. Explanatory variables included women's age, women's educational level, women's working status, mass media exposure, body mass index (BMI), birth order, Ante Natal Care (ANC) visits, place of delivery, partner's education and occupation, religion, wealth index, place of residence, and divisions. Descriptive statistics along with bivariate and multivariate logistic regression analysis was performed to identify the factors associated with the outcome variable. Concentration index and concentration curve were made to measure the socioeconomic inequality in caesarean births in Bangladesh. Further, Wagstaff decomposition analysis was used to decompose the inequalities in the study. RESULTS: About one-third of the deliveries in Bangladesh were caesarean. Education of the women and the family's wealth had a positive relationship with caesarean delivery. The likelihood of caesarean delivery was 33% less among working women than those who were not working [AOR: 0.77; CI: 0.62-0.97]. Women who had mass media exposure [AOR: 1.27; CI: 0.97-1.65], overweight/obese [AOR: 1.43; CI: 1.11-1.84], first birth order, received four or more Antenatal check-ups (ANC) [AOR: 2.39; CI: 1.12-5.1], and delivered in a private health facility [AOR: 6.69; CI: 5.38-8.31] had significantly higher likelihood of caesarean delivery compared to their counterparts. About 65% of inequality was explained by place of delivery followed by wealth status of the household (about 13%). ANC visits explained about 5% of the inequality. Furthermore, the BMI status of the women had a significant contribution to caesarean births-related inequality (4%). CONCLUSION: Socioeconomic inequality prevails in the caesarean deliveries in Bangladesh. The place of delivery, household wealth status, ANC visits, body mass index, women's education and mass media have been the highest contributors to the inequality. The study, through its findings, suggests that the health authorities should intervene, formulate specialized programs and spread awareness about the ill effects of caesarean deliveries amongst the most vulnerable groups of women in Bangladesh.

A 3D-Printed Biomaterial Scaffold Reinforced with Inorganic Fillers for Bone Tissue Engineering: In Vitro Assessment and In Vivo Animal Studies.

This research aimed to substantiate the potential practicality of utilizing a matrix-like platform, a novel 3D-printed biomaterial scaffold, to enhance and guide host cells' growth for bone tissue regeneration. The 3D biomaterial scaffold was successfully printed using a 3D Bioplotter® (EnvisionTEC, GmBH) and characterized. Osteoblast-like MG63 cells were utilized to culture the novel printed scaffold over a period of 1, 3, and 7 days. Cell adhesion and surface morphology were examined using scanning electron microscopy (SEM) and optical microscopy, while cell viability was determined using MTS assay and cell proliferation was evaluated using a Leica microsystem (Leica MZ10 F). The 3D-printed biomaterial scaffold exhibited essential biomineral trace elements that are significant for biological bone (e.g., Ca-P) and were confirmed through energy-dispersive X-ray (EDX) analysis. The microscopy analyses revealed that the osteoblast-like MG63 cells were attached to the printed scaffold surface. The viability of cultured cells on the control and printed scaffold increased over time (p < 0.05); however, on respective days (1, 3, and 7 days), the viability of cultured cells between the two groups was not significantly different (p > 0.05). The protein (human BMP-7, also known as growth factor) was successfully attached to the surface of the 3D-printed biomaterial scaffold as an initiator of osteogenesis in the site of the induced bone defect. An in vivo study was conducted to substantiate if the novel printed scaffold properties were engineered adequately to mimic the bone regeneration cascade using an induced rabbit critical-sized nasal bone defect. The novel printed scaffold provided a potential pro-regenerative platform, rich in mechanical, topographical, and biological cues to guide and activate host cells toward functional regeneration. The histological studies revealed that there was progress in new bone formation, especially at week 8 of the study, in all induced bone defects. In conclusion, the protein (human BMP-7)-embedded scaffolds showed higher regenerative bone formation potential (week 8 complete) compared to the scaffolds without protein (e.g., growth factor; BMP-7) and the control (empty defect). At 8 weeks postimplantation, protein (BMP-7) significantly promoted osteogenesis as compared to other groups. The scaffold underwent gradual degradation and replacement by new bones at 8 weeks in most defects.

Inequalities and Effect of Non-Biological Factors on Perinatal Mortality in Uttar Pradesh.

Approximately 6 million neonatal deaths occur globally, with approximately 99 percent of them occurring in developing countries. This study is an attempt to examine the prevalence and influence of non-biological factors on perinatal mortality in India. National Family Health Survey (2015-2016) data and bivariate and multivariate techniques have been used to fulfill the aforesaid objectives. Findings suggest that approximately 47 perinatal deaths occurred per 1,000 pregnancies lasting seven or more months during the last five years preceding the survey in Uttar Pradesh. Parental education, wealth status, variables related to pregnancy and delivery, mother's demographic factors, mother's height, and child characteristics have shown significant impact on perinatal mortality. For a policy point of view, more emphasis is needed on quality of care of National Health Mission (NHM) strategy at times of greater risk-that is, birth and the first few days of life-which could be the way forward for reducing high perinatal deaths.

Assessment of Edaphic pollution indices and bioaccumulation of trace metals in Solanum lycopersicum, Spinacia oleracea and Triticum aestivum: an associated health risk evaluation.

The present study investigates bioaccumulation factor (Bfc), Edaphic pollution indices and associated health risk assessment of trace metals (TMs) i.e., Cu, Fe, Zn, Mn and Co in the crops, agricultural soil (AgS), and irrigation water (IgW) collected from various peri-urban area of metropolitan city of India, Lucknow. Though the level of these TMs was within the permissible limits (PL) (FAO/WHO, 2011) in AgS and IgW however it was higher than PL in tomato, spinach and wheat cultivated in the fields. The bioaccumulation factor of Cu, Fe and Mn in edible parts of tomato, spinach and wheat was 8 to 25 times higher through the AgS and 10 to 300 times higher through the IgW in the tomato, spinach and wheat samples. The enrichment factor (Efc), contamination factor (Cfc), contamination degree (Cdg) and modified contamination degree (mCdg) values of Co, Cu, Mn, Fe and Zn ranged from low to high levels of contamination, whereas the geo-accumulation index reflected low contamination in agricultural soil. on the other hand, the metal pollution load index (Mpi) was found strongly contaminated in most of the study areas. Due to the consumption of these contaminated vegetables and cereal (VCs) by human consumers, the hazard quotient (HQ), total hazard quotient (THQ) and hazard index (HI) were found to be more than the requisite value of 1, which indicates a far-long health risk in this crowded city and its surrounding regions.

Current Trends in API Co-Processing: Spherical Crystallization and Co-Precipitation Techniques.

Active Pharmaceutical Ingredients (APIs) do not always exhibit processable physical properties, which makes their processing in an industrial setup very demanding. These issues often lead to poor robustness and higher cost of the drug product. The issue can be mitigated by co-processing the APIs using suitable solvent media-based techniques to streamline pharmaceutical manufacturing operations. Some of the co-processing methods are the amalgamation of API purification and granulation steps. These techniques also exhibit adequate robustness for successful adoption by the pharmaceutical industry to manufacture high quality drug products. Spherical crystallization and co-precipitation are solvent media-based co-processing approaches that enhances the micromeritic and dissolution characteristics of problematic APIs. These methods not only improve API characteristics but also enable direct compression into tablets. These methods are economical and time-saving as they have the potential for effectively circumventing the granulation step, which can be a major source of variability in the product. This review highlights the recent advancements pertaining to these techniques to aid researchers in adopting the right co-processing method. Similarly, the possibility of scaling up the production of co-processed APIs by these techniques is discussed. The continuous manufacturability by co-processing is outlined with a short note on Process Analytical Technology (PAT) applicability in monitoring and improving the process.

Assessment of hydrologic impact on flow regime due to dam inception using IHA framework.

In the last century, thousands of dams and diversions have been built to regulate the streamflow, resulting in water impoundment in the upstream and frequent drought conditions in the downstream. It has pressured researchers to study flow regime change and its complication on the downstream biota. The present study planned to develop a framework for trend analyzing of river flow and detecting flow regime change after the inception of Isapur and Arunavati dams, situated on the upstream side of Penganga bridge. Mann-Kendall (MK) and Sen's slope estimator for trend analysis and Indicators of Hydrologic Alteration (IHA) for flow regime alteration analysis were utilized. A total 26 parameters showed negatively altered flow regime with a magnitude varying from - 5.56 to - 100%. Fourteen altered parameters were modified drastically (more than 50% decrease) with the highest modification in 30-day maximum (100%) post-single dam inception. a total of 13 parameters were negatively altered with alteration value - 9.09 to - 86.36% post-double dam inception, out of which, three parameters were severely altered, with the highest alteration in the month of June. The period (1983-1994) was more altered than 1995-2016. This shows that Isapur dam has higher impact on flow regime change than Arunavati dam. Information about alteration of hydrological parameters will be helpful to improve the water flow regulation at Isapur and Arunavati dams for restoring river ecology on the downstream side.

Linkages of Multi-Dimensional Vulnerabilities with Infant and Child Mortality Rates in India and Its Specific Regions: Are Social Determinants of Health still Relevant?

The present study investigated linkages between multiple socio-economic vulnerabilities with infant and child mortality in India and its specific regions. Data from the National Family Health Survey (2015-16) was used for calculating the key-outcome variables, namely infant mortality and child mortality. The effective sample size for the study was 259,627. Bivariate analysis and binary logistic regression analysis were employed to examine three dimensions of vulnerabilities such as education, wealth, and caste on infant and child mortality. Children born to women with multiple-vulnerabilities were more likely to die than those born to non-vulnerable women. Women who were vulnerable in all the three-dimensions were more likely to have their children die as infants than those who were not vulnerable in any dimensions (predicted probabilities; 0.054 vs 0.026). The predicted probability for child mortality was 0.063 for women who were vulnerable and 0.028 for non-vulnerable women.

Socioeconomic determinants of smokeless tobacco use among Indian women: An analysis of global adult tobacco survey-2, India.

Introduction: The predominant form of tobacco consumption among women from many Asian countries, including India, is smokeless tobacco (SLT). The present study aimed to assess the prevalence and socioeconomic determinants of SLT use among Indian women. Methodology: The study used data from the Global Adult Tobacco Survey-2, India, conducted during 2016-2017, with a sample size of 40,265 women aged 15 years and above. Chi-square test and binary logistic regression were applied with the current use of SLT as the dependent variable to find the sociodemographic factors associated with it. Results: Overall, 12.8% (95% confidence interval [CI]; 12.4-13.1) of all women and 7.4% (CI: 6.0-8.8) of pregnant women reported SLT use. Its use was higher among women >50 years (23.1%, CI: 22.2-23.8), and those from northeast India (34.9%, CI: 33.8-36.0). Adjusted odds of using SLT were higher among older women (adjusted odds ratio [AOR]: 5.8, CI: 4.5-7.3), women from rural areas (AOR: 1.5, CI: 1.4-1.7), and women belonging to scheduled tribe (AOR: 2.4, CI: 2.2-2.7) as compared to their counterparts. In addition, poor (AOR: 2.6; 95% CI, 2.4-2.8) and middle class (AOR: 1.8; 95% CI, 1.7-2.0) women were more likely to use SLT compared to their rich counterparts. The use of SLT within 30 min of waking up in the morning was seen in 57.2 percent of women users. SLT prevalence was highest among Mizo-speaking women (46.1%, CI: 42.6-49.6), followed by Manipuri (38.9%, CI: 35.5-42.2), Odiya (34.4%), and Khasi (34%, CI: 29.8-38.2). Conclusions: There is an imperative need for women-centric schemes on SLT cessation, with special attention to older women, pregnant women, from rural areas, poor households, and the north-eastern region of India.

Assessment of Acute Oral Toxicity of Thiolated Gum Ghatti in Rats.

Various drug delivery systems were developed using a modified form of gum ghatti. Modifying gum ghatti using thioglycolic acid improves its mucoadhesive property, and hence, it is a suitable approach for the fabrication and development of controlled drug delivery systems. In accordance with regulatory guidelines, namely, the Organization for Economic Co-operation and Development's (OECD) 423 guidelines, an acute oral dose toxicity study was performed to examine the toxicological effects of gum ghattiin an animal (Wistar rat) after a single oral dose administration of pure gum ghatti and thiolated gum ghatti. Orally administered pure and thiolated gum ghatti do not reveal any considerable change in the behavioral pattern, food intake, body weight, hematology, or clinical symptoms of treated animals. Furthermore, histopathological studies showed no pathological mutations in the vital organs of Wistar rats after the oral administration of single doses of both types of gumghatti (i.e., 300 mg/kg and 2000 mg/kg body weight). Whole blood clotting studies showed the low absorbance value of the modified gum (thiolated gum ghatti) in contrast to the pure gum and control, hence demonstrating its excellent clotting capability. The aforementioned toxicological study suggested that the oral administration of a single dose of pure and thiolated gum ghatti did not produce any toxicological effects in Wistar rats. Consequently, it could be a suitable and safe candidate for formulating various drug delivery systems.

Correlates of access to sanitation facilities and benefits received from the Swachh Bharat Mission in India: analysis of cross-sectional data from the 2018 National Sample Survey.

OBJECTIVE: Equitable and affordable access to improved sanitation facilities is linked to health and is among the priority areas of development programmes in a country like India. This study assesses the level of different sanitation facilities accessed by households and attempts to understand the socioeconomic characteristics of the households that received financial benefits from the Swachh Bharat Mission (Swachh Bharat Abhiyan), a Government of India flagship programme. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: The study extracted data from the 76th round (2018) of the National Sample Survey, consisting of 106 837 households in India. OUTCOME MEASURES: Sanitation services and benefits received from the Swachh Bharat Mission in the last 3 years preceding the survey were the two outcome variables of this study. Bivariate and multinomial logistic regression analysis were performed to identify factors associated with the outcome variables. RESULTS: Findings show the existence of state and regional disparities, along with rural-urban gaps, in the accessibility of sanitation facilities. Half of the households (52%, n=55 555) had access to safely managed sanitation facilities, followed by basic services (14.8%, n=15 812), limited services (11.4%, n=12 179) and unimproved services/open defecation (21.8%, n=23 290). Limited and unimproved facilities decreased significantly (p<0.001) with increase in economic status, although poor and less educated households received the maximum benefit from the Swachh Bharat Mission. CONCLUSION: The mission has been successful in increasing access overall; however, many people continue to lack access to improved sanitation and there remains a need to follow up poor and rural households to determine their usage of and the current state of their sanitation facilities.

Inequalities in overweight and obesity among reproductive age group women in India: evidence from National Family Health Survey (2015-16).

BACKGROUND: In developing nations like India, fertility and mortality have decreased, and diseases related to lifestyle have become more common. Females in India are more prone to being overweight and obese than their male counterparts, more specifically in affluent families than the poor ones. Understanding the overweight and obesity trend may help develop feasible public health interventions to reduce the burden of obesity and associated adverse health outcomes. METHODS: The study utilizes the fourth round of the National Family Health Survey (NFHS-4), 2015-16. Descriptive statistics, bivariate and multivariate analysis was used to check the significant relationship between overweight and obesity, and other background characteristics. Income-related inequality in overweight and obesity among women was quantified by the concentration index and the concentration curve. Further, Wagstaff decomposition analysis was done to decompose the concentration index, into the contributions of each factor to the income-related inequalities. RESULTS: Overweight & obesity among women had a significant positive association with their age and educational level. The odds of overweight and obesity were 57% more likely among women who ever had any caesarean births than those who did not [AOR: 1.57; CI: 1.53-1.62]. The likelihood of overweight and obesity was 4.31 times more likely among women who belonged to richest [AOR: 5.84; CI: 5.61-6.08] wealth quintile, than those who belonged to poor wealth quintile. Women who ever terminated the pregnancy had 20% higher risk of overweight and obesity than those who did not [AOR: 1.20; CI: 1.17-1.22]. The concentration of overweight and obesity among women was mostly in rich households of all the Indian states and union territories. Among the geographical regions of India, the highest inequality was witnessed in Eastern India (0.41), followed by Central India (0.36). CONCLUSION: The study results also reveal a huge proportion of women belonging to the BMI categories of non-normal, which is a concern and can increase the risks of developing non-communicable diseases. Hence, the study concludes and recommends an urgent need of interventions catering to urban women belonging to higher socio-economic status which can reduce the risks of health consequences due to overweight and obesity. Development nutrition-specific as well as sensitive interventions can be done for mobilization of local resources that addresses the multiple issues under which a woman is overweight or obese.

Comprehensive technological assessment for different treatment methods of leather tannery wastewater.

The leather-making process necessitates large amounts of water and consequently generates tons of liquid waste as leather tannery wastewater (TWW) is disposed of directly in the open environment. Open disposal of untreated TWW into the natural environment causes an accumulation of various polluting compounds, including heavy metals, dyes, suspended solids inorganic matter, biocides, oils, tannins, and other toxic chemicals. It thus poses potential hazards to the environment and human health. This study primarily focuses on providing in-depth insight into the characteristics, treatment strategies, and regulatory frameworks for managing TWW in leather processing industries. Different technologies of conventional physico-chemical (equalization, coagulation, and adsorption), advanced approaches (Fenton oxidation, ozonation, cavitation), thermo-catalytic and biological treatments available to treat TWW, and their integrative approaches were also highlighted. This review also sheds light on the most frequently applied technologies to reduce contaminant load from TWW though there are several limitations associated with it such as being ineffective for large quantities of TWW, waste generation during treatment, and high operational and maintenance (O&M) costs. It is concluded that the sustainable alternatives applied in the current TWW technologies can minimize O&M costs and recirculate the treated water in the environment. The exhaustive observations and recommendations presented in this article are helpful in the industry to manage TWW and recirculate the water in a sustainable manner.

An overview on microalgal-bacterial granular consortia for resource recovery and wastewater treatment.

Excessive generation of wastewater is a matter of concern around the globe. Wastewater treatment utilizing a microalgae-mediated process is considered an eco-friendly and sustainable method of wastewater treatment. However, low biomass productivity, costly harvesting process, and energy extensive cultivation process are the major bottleneck. The use of the microalgal-bacteria granular consortia (MBGC) process is economic and requires less energy. For efficient utilization of MBGC, knowledge of its structure, composition and interaction are important. Various microscopic, molecular and metabolomics techniques play a significant role in understating consortia structure and interaction between partners. Microalgal-bacteria granular consortia structure is affected by various cultivation parameters like pH, temperature, light intensity, salinity, and the presence of other pollutants in wastewater. In this article, a critical evaluation of recent literature was carried out to develop an understanding related to interaction behavior that can help to engineer consortia having efficient nutrient removal capacity with reduced energy consumption.

Comprehensive health risk assessment of microbial indoor air quality in microenvironments.

The higher airborne microbial concentration in indoor areas might be responsible for the adverse indoor air quality, which relates well with poor respiratory and general health effects in the form of Sick building syndromes. The current study aimed to isolate and characterize the seasonal (winter and spring) levels of culturable bio-aerosols from indoor air, implicating human health by using an epidemiological health survey. Microorganisms were identified by standard macro and microbiological methods, followed by biochemical testing and molecular techniques. Sampling results revealed the bacterial and fungal aerosol concentrations ranging between (300-3650 CFU/m3) and (300-4150 CFU/m3) respectively, in different microenvironments during the winter season (December-February). However, in spring (March-May), bacterial and fungal aerosol concentrations were monitored, ranging between (450-5150 CFU/m3) and (350-5070 CFU/m3) respectively. Interestingly, Aspergillus and Cladosporium were the majorly recorded fungi whereas, Staphylococcus, Streptobacillus, and Micrococcus found predominant bacterial genera among all the sites. Taken together, the elevated levels of bioaerosols are the foremost risk factor that can lead to various respiratory and general health issues in additional analysis, the questionnaire survey indicated the headache (28%) and allergy (20%) were significant indoor health concerns. This type of approach will serve as a foundation for assisting residents in taking preventative measures to avoid exposure to dangerous bioaerosols.

Severe contamination of carcinogenic heavy metals and metalloid in agroecosystems and their associated health risk assessment.

The contamination of toxic heavy metals (i.e., Cd, Cr, Pb, and Ni) and metalloid (i.e., As) (TMMs) is considered as a major cause of increasing incidences of human and livestock cancers, gastrointestinal disorders and neurological problems. The levels of these TMMS in soil, irrigation water, and plants like Salanum lycopersicum (tomato), Spinacia oleracea (Spinach), and Triticum aestivum (Wheat) samples were detected which were collected from various localities across 100 km around the city of Lucknow, India. This study reported that the concentration of TMMs was within the range of maximum allowable concentration (MAC) (FAO/WHO, 2011) in most of the agricultural soil, whereas, it was higher in irrigation water. The TMMs levels in the edible parts of vegetables and cereal were in the range 1.91-53.94 µg/g, 5.06-40.49 µg/g, 4.08-2312-29 µg/g, 0.43-51.48 µg/g, and 0.01-1.65 µg/g, respectively which was significantly higher than the MAC. The BAF of Cd and Ni was very high in the edible parts of the vegetables and cereal samples indicating an entry of TMMs in food chain through the metal-contaminated irrigation water, even if TMMs are low in the field soil. The contamination coefficient (Cfi) and Ecological risk factors (Efi) of the TMMs were detected in the range of low risk in all agricultural soil. The Ecological risk index (ERI) of TMMs was at moderate risk, indicating a mild impact of the metal toxicity in the agro-ecosystems but the high risk on the consumers. The daily intake (DI) of TMMs through vegetables and cereal was below the maximum allowable daily intake (MTDI) but the carcinogenic risk factor (CRs) potential of Cr, Cd, Ni, and As was observed significantly higher for these vegetables and cereal, which indicated a complex scenario of a far-future carcinogenic health hazard on consumers in densely populated city of Lucknow, India and its surrounding regions.

Spatial inequalities in skilled birth attendance in India: a spatial-regional model approach.

BACKGROUND: Despite a significant increase in the skilled birth assisted (SBA) deliveries in India, there are huge gaps in availing maternity care services across social gradients - particularly across states and regions. Therefore, this study applies the spatial-regression model to examine the spatial distribution of SBA across districts of India. Furthermore, the study tries to understand the spatially associated population characteristics that influence the low coverage of SBA across districts of India and its regions. METHODS: The study used national representative cross-sectional survey data obtained from the fourth round of National Family Health Survey, conducted in 2015-16. The effective sample size was 259,469 for the analysis. Moran's I statistics and bivariate Local Indicator for Spatial Association maps were used to understand spatial dependence and clustering of deliveries conducted by SBA coverage in districts of India. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of deliveries conducted by SBA. RESULTS: Moran's I value for SBA among women was 0.54, which represents a high spatial auto-correlation of deliveries conducted by SBA over 640 districts of India. There were 145 hotspots for deliveries conducted by SBA among women in India, which includes almost the entire southern part of India. The spatial error model revealed that with a 10% increase in exposure to mass media in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Interestingly, also with the 10% increase in the four or more antenatal care (ANC) in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Again, if there was a 10% increase of women with first birth order in a particular district, then the deliveries conducted by SBA significantly increased by 6.1%. If the district experienced an increase of 10% household as female-headed, then the deliveries conducted by SBA significantly increased by 1.4%. CONCLUSION: The present study highlights the important role of ANC visits, mass media exposure, education, female household headship that augment the use of an SBA for delivery. Attention should be given in promoting regular ANC visits and strengthening women's education.

Socioeconomic inequalities in non- coverage of full vaccination among children in Bangladesh: a comparative study of Demographic and Health Surveys, 2007 and 2017-18.

BACKGROUND: Vaccination is considered as a powerful and cost-effective weapon against many communicable diseases. An increase in full vaccination among the most vulnerable populations in Bangladesh was observed in the last decade. This study aimed to capture the socioeconomic inequalities in non-coverage of full vaccination among children aged 12-23 months using the nationally representative data from the Bangladesh Demographic and Health Surveys (BDHS). METHODS: Data for this study have been drawn from the 2007 and 2017-18 BDHS, which covered 10,996 and 20,127 ever-married women aged 15-49 years in 2007 and 2017-18, respectively. Binary logistic regression analysis was performed to find the factors associated with children who did not receive full vaccination. Further, the concentration index was used to observe the socioeconomic inequality for the outcome variable. RESULTS: The proportion of children who did not get fully vaccinated decreased by more than 6 points (18.2 percent to 11.8 percent) between the years 2007 and 2017-18. In 2017-18, the odds of children who were not fully vaccinated were 58 percent and 53 percent less among mothers who had primary education in 2007 [adjusted odds ratio (AOR): 0.42; confidence interval (CI): 0.24-0.73] and 2017-18 [AOR: 0.47; CI: 0.23-0.94] respectively, compared to mothers with no education. The inequality for children who were not fully vaccinated had declined between two survey periods [concentration index (CCI) value of - 0.13 in 2007 and -0.08 in 2017-18]. The concentration of inequality in children with higher parity who did not receive full vaccination had increased from 5 percent in 2007 to 16.9 percent in 2017-18. There was a drastic increase in the socioeconomic inequality contributed by place of delivery from 2.9 percent (2007) to 60.5 percent (2017-18) among children who did not receive full vaccination. CONCLUSIONS: The present study provide eminent evidence that non-coverage of full vaccination is more prevalent among children from poor households in Bangladesh, which is mainly associated with factors like mother's education, father's education and working status and household wealth index across the two rounds. These factors suggest multifaceted pro-poor interventions that will protect them from hardship and reduce their socioeconomic inequalities in coverage of full vaccination.