Prevalence and Determinants of Avian Allergic Manifestation in a Selected Rural Population in Mysuru: A Cross-Sectional Survey.

Background: Avian diseases should be known to people who raise birds as pets or for commercial purposes. Exposure to high levels of airborne dust and endotoxins is known to cause allergies. This study, therefore, intends to assess avian allergy and its associated factors among poultry workers and bird fanciers in urban Mysuru. Methods: A cross-sectional study was done over three months among 60 poultry workers and 60 bird fanciers in a selected rural population of the Mysuru district. The participants were selected by simple random sampling method and their data were obtained by interview method using a pre-tested semi-structured questionnaire. Chi-square test/Fisher's exact test was used to check the associations between the demographic variables' avian allergy. Results: The survey revealed that 31.67% of poultry workers and 53.33% of bird fanciers had symptoms. The majority of the study participants were illiterate and were not using personal protective equipment (PPE) regularly. The results showed a significant association between education (P = 0.013) and the use of PPE (P = 0.020) with avian allergy. Observing the health hazards, 42.10% had respiratory problems, 42.10% had skin problems, and 26.31% had eye problems. Further, a significant association was also found between education and knowledge about diseases (P = 0.001). Conclusion: The avian allergy among the bird fanciers was higher when compared to poultry workers. It is necessary to organize routine counseling, awareness, and training programs about diseases and prevention strategies related to their work and living environments and keep them updated.

Hand Hygiene Auditing: Is It a Roadway to Improve Adherence to Hand Hygiene Among Hospital Personnel?

Background Over the years, there has been an increase in hospital-acquired infections (HAIs) among patients in India. One of the main reasons is a lack of compliance with infection control guidelines, such as hand hygiene. So the present study was conducted to determine the compliance of hand hygiene among healthcare workers in a private tertiary care teaching hospital in South India. Materials and methods The prospective observational study was carried out between April 2017 and March 2020. Nineteen areas were directly observed for hand hygiene (HH) compliance. At each location, HH audit was conducted for one hour per day for five days per month. HH complete adherence rate (HHCAR) and HH partial adherence rate (HHPAR) were analyzed. Results Nine hundred and twenty observation periods were completed during the entire study period. Overall, hand hygiene complete adherence rate was 29.9% (11,981/39,998); partial adherence rate was 45.3% (18,131/39,998) and the non-adherence rate was 24.7% (9886/39,998). A better adherence rate was seen among nurses (44.7%), followed by other staff (33.7%) and doctors (33.04%). Moment-specific adherence rates show almost equal adherence rates of 50.7%, 50.75%, and 50.1%, respectively, for moments 2, 3, and 4, and comparatively low for moments 1 and 5 (48.4% and 47.6%, respectively). Conclusion Despite adequate hand hygiene facilities, compliance remains low. Hand hygiene is a bundle care approach that needs to consider factors including healthcare staff, clinical, institutional, environmental, and behavioral changes. Multimodal interventions and multidisciplinary commitment are mandatory for sustained compliance.

Covid-19 vaccination coverage and break through infections in urban slums of Bengaluru, India: A cross sectional study.

BackgroundThe ongoing pandemic of Corona virus disease 2019(covid-19) is caused by severe acute respiratory syndrome Corona virus 2(SAR-COV-2). The world health organization declared it as public health emergency of international concern on January 2020, and later declared as pandemic on 11 March 2020.One of the high-risk groups for COVID-19 disease are people residing in urban overcrowded slums and as most of the population is migrant, they are less aware of the pandemic and have less access to health care facilities. Vaccinating these high-risk groups can decrease disease burden and control the ongoing pandemic. Objectives1] To estimate COVID 19 vaccination coverage 2] To assess the factors responsible for COVID - 19 vaccination coverage and vaccine hesitancy 3] To study AEFI pattern following COVID-19 vaccination 4] To determine the prevalence of breakthrough infections after COVID - 19 Vaccination in urban slums of Bengaluru, India. MethodologyA community based cross sectional study was conducted in Urban slums belonging to Urban Health and Training Centre, Department of community medicine, Akash Institute of Medical Sciences and Research Centre, Bengaluru Rural District, Karnataka, India. After obtaining Institutional ethical clearance and informed consent from study participants, data was collected from 1638 participants, fulfilling inclusion criteria using a predesigned, pretested, structured questionnaire. Data was entered in Microsoft excel and analyzed using SPSS version 24. Chi square test and Fischers exact test was applied and p <0.05 considered as statistically significant. ResultsIn the present study, 35.5% (583 out of 1638) of the study participants had taken COVID Vaccine, of which 533 (91.42%) were partially vaccinated and remaining 50 (8.5%) were fully Vaccinated. Majority i.e., 98.45% have taken vaccine at Govt health centers. 63.65% vaccinated with Covishield reported adverse events, whereas 18.6% vaccinated with Covaxin reported adverse events. Adverse events were more likely to be reported by women (74.7%) compared to men (58.6%), this observation was consistent across all age groups. Vaccination coverage was high among 18 - 45 years age group (37.75%), males (64.86%), Christians (47.05%) followed by Hindus (43.56%), graduates (95.67%), clerical and skilled workers (70.75%), Upper middle socioeconomic class (72.41%). This difference was statistically significant. Our study reported Break through infections in 7 out of total 583 vaccinated with a prevalence of 1.2%. The break through infections was very high among partially vaccinated (85.71%) as compared to fully vaccinated individuals (14.28%). This was observed among those vaccinated with Covaxin only. ConclusionThe COVID vaccine coverage was low in urban slums. The prevalence of Break through infections in our study was higher as compared to available data/reports in the country. Break through infections was very high among partially vaccinated as compared to fully vaccinated individuals. This study on break through infections on COVID vaccination is first study in South India on general population. The most important factor for vaccine hesitancy is the occurrence of mild or serious adverse effects following immunization, and this may be the biggest challenge in the global response against the pandemic.

An android smartphone-based randomized intervention improves the quality of life in patients with type 2 diabetes in Mysore, Karnataka, India.

BACKGROUND AND AIMS: Associated with severe complications and morbidity, Diabetes Mellitus is a significant public health burden. The need for regular monitoring and adherence to treatment and lifestyle changes have a high impact on the quality of life of the patients. This study attempts to assess the effect of smartphone-based lifestyle modification intervention in the quality of life of patients with type 2 Diabetes through a randomized filed trial. METHODS: A randomized field trial was performed among the patients attending the outpatient department of a tertiary care hospital in Mysuru city. A mobile application named DIAGURU, mainly focusing on the lifestyle modification and medication management was used for a period of 6 months from April 2019 to September 2019 by 150 patients in the intervention group while another 150 participants served as controls. The quality of life was assessed using the WHO QOL BREF questionnaire at the beginning of the study and after six months. RESULTS: The change in the quality of life in a positive direction was significantly higher in the intervention group compared to the non-intervention group after six months. The differences in the change in scores of quality of life of participants recruited in intervention and non-intervention groups were statistically significant in all the four domains after the intervention with a p value < 0.001. CONCLUSION: The evidence generated in this study suggest that such technological approaches can be used as a public health measure to improve the quality of life of patients with type 2 Diabetes Mellitus.

Treatment of dentinal hypersensitivity using propolis varnish: A scanning electron microscope study.

BACKGROUND: Dentin hypersensitivity (DH) affects all age groups in a population and is perceived as pain to any stimuli. From time immemorial, researchers have sought herbal or natural solutions to treat hypersensitivity. Propolis is one such natural, nontoxic resinous substance produced by honey bees, which is useful in various applications in dentistry and effective in treating dentinal hypersensitivity. AIM: The aim of this in vitro study is to assess the effect of propolis varnish on occlusion of dentinal tubules thus aiding in the treatment of dentinal hypersensitivity. The objective is to evaluate the effectiveness of the proposed treatment using scanning electron microscope (SEM) imaging. MATERIALS AND METHODS: Twenty naturally extracted teeth were collected and stored until in vitro assessment. Discs obtained from each tooth were divided into two groups of 20 each - I (test) and II (control), with each tooth acting as its own control. Propolis varnish was applied only to the acid-etched surface of the exposed dentin of discs in the test group, whereas all the discs were subjected to SEM imaging. RESULTS: Statistical analysis showed a significant reduction in open tubules (P < 0.001) from 160 ± 6.97 before treatment to 61.20 ± 9.10 after propolis varnish application in the test group. CONCLUSION: This study showed the promise of propolis varnish as a natural treatment modality for DH.

Transition of Children with Perinatally Acquired HIV-Infection into Adulthood: Social Outcome and Quality of Life.

OBJECTIVES: In India, access to free anti-retroviral therapy has improved the survival of perinatally human immunodeficiency virus (HIV) infected children resulting in the transition of many such children to adulthood. This study aims to understand the social-outcomes and quality of life (QOL) among these adults. METHODS: This cross-sectional study was conducted in two tertiary HIV care centers in south India. Perinatally HIV-infected adults aged >18 y were enrolled after obtaining consent. Data were collected by questionnaire based interviews for social outcomes and WHO Quality of Life-BREF (WHOQOL-BREF) for QOL. The social-outcome indicators monitored pertained to family support, educational qualification and occupational, economic, and marital status. RESULTS: The mean age of 107 participants was 18·9 ± 1·1y. The school drop-out rate was 58%. Sixty-two percent were double orphans. Forty-three-percent of the participants were employed with mean per-capita monthly income of Rs.4105 ± 2979 ($65·2 ± 47·3). Fourteen-percent of the participants were married, or in a relationship, and a majority of them, 93%, were females. For QOL, the mean raw score was highest for social relationship (15·79). Relative to studying subjects, a higher proportion of school dropouts scored poorly in social relationship (42% vs.14·8%; Chi-square = 5·28; p = 0·02) and environmental QOL (46% vs.19·6%;Chi-square = 8·09; p = 0·004). The proportion of subjects with a poor physical health QOL was higher among those with a per-capita monthly income above the national average than those with below the national average (69% vs.33·3%; Chi-square = 5·27; p = 0·02). CONCLUSIONS: Though clinico-immunological disease was stable in these perinatally HIV-infected young adults, their social-outcomes pertaining to education, occupation, income, and family support were poor. Factors like education, parental care, and income of the subjects were associated with poor QOL.

Inhibitory activity of bio-active compounds isolated from Anadara granosa in shrimp health management.

The crude extract isolated from the visceral mass of Anadara granosa, an intertidal bivalve mollusc was tested for inhibitory activity against pathogenic bacteria of the shrimp and fish viz. Vibrio harveyi and Staphylococcus aureus respectively by agar well diffusion and contact bioautography methods. Maximum inhibitory activity was shown against V. harveyi by methanol and chloroform (9:1) extract. Twelve fractions (1-12) could be separated from the crude extract through column chromatography. Five out of twelve fractions (7, 8, 9, 10, and 11) showed antibacterial activity and they were further run on column chromatography for purity. The fraction no. 9 showed highest antibacterial activity among the five and was subjected to NMR for the proton, C13 and H1-H1 correlation, IR and mass spectral analysis for structural elucidation. Structure of the compound isolated from fraction no: 9 was determined as 1-(((2Z, 4Z)-dodeca-2,4-dienoyl)oxy)-3-hydroxypropan-2-yl tetradecanoate.

Parental concerns on disclosure of HIV status to children living with HIV: children's perspective.

Disclosure is an important component of comprehensive management of children living with HIV infection (CLHIV). Many parental concerns are barriers for disclosure in children and only few studies addresses children's perspective on these concerns. Our study aims to understand children's perspective on parental concerns for disclosure and assess the knowledge of HIV. A questionnaire-based cross-sectional study involving CLHIV between 10 and 18 years attending HIV clinic in southern India, was conducted. Data were collected by directly interviewing only the children after obtaining consent from parents/caregivers. Initial open-ended questions were asked to assess the disclosure status and only fully disclosed children were included. Out of 362 enrolled eligible children, the prevalence of full and partial disclosure was 36.7% and 24%, respectively. The mean age of disclosure was 10.4 years (SD ± 2.6) and non-parental family members in an informal setting were the most common source of disclosure (38.3%). Forty-six percentages of parents were unaware of their child's disclosure status. Only 2% had disclosed their status to others who were not part of their care. Among disclosed children, 33.8% became upset or sad upon knowing their status, 12% faced discrimination and 41.4% had complete knowledge about their illness. Though the prevalence of disclosure among CLHIV was high, a majority of them had incomplete knowledge about HIV infection. The parental concerns as reported in literature like the child is too young to disclose, concerns about coping, fear of stigma and discrimination and child disclosing to others were not expressed by children.

Predictors of Mortality and Mortality Rate in a Cohort of Children Living with HIV from India.

OBJECTIVES: To study the predictors of mortality and mortality rate in a clinical cohort of Children Living with Human Immunodeficiency Virus infection (CLHIV) from India. METHODS: This retrospective cohort analysis of CLHIV aged between 2 mo and 18 y registered during January 2004 through December 2014 at Pediatric Centre of Excellence (PCOE), Indira Gandhi Institute of Child Health (IGICH), was conducted using standard data collection sheet. Demographic and clinical characteristics of all eligible children were analyzed. The primary outcome measured was mortality. The authors also analyzed the cause of death and baseline parameters associated with death to study the predictors of mortality. RESULTS: Out of 1289 CLHIV registered in the PCOE during the study period, 834 (64.7 %) CLHIV, with or without antiretroviral therapy (ART) care, were included. The total time contributed by the study participants was 2872.8 child-years. The mortality rate in these children was 4.9/100 child-years. A significantly higher mortality rate of 28.2 % was found in children < 5 y, 38.6 % in children with advanced WHO clinical staging, 35.2 % among severely immunosuppressed children and 22.3 % in severely malnourished children. Tuberculosis accounted for 28 % of deaths. Univariate Cox regression analysis showed treatment status, age <5 y, baseline WHO clinical stage 3 and 4, severe immune suppression and severe malnutrition were strongly associated with mortality. CONCLUSIONS: The mortality rate in the index study cohort was 4.9/100 child-years and tuberculosis was the major cause of death. Younger age, baseline advanced clinical and immunological staging were predictors of mortality. Even though mortality was significantly higher in Pre-ART children, treatment status was not found to be an independent predictor of mortality.

The feasibility of using mobile phone technology for sexual behaviour research in a population vulnerable to HIV: a prospective survey with female sex workers in South India.

Sexual behaviour studies are often challenged by sampling, participation and measurement biases, and may be unacceptable to participants. We invited 293 randomly selected female sex workers (FSWs) in Bangalore, India, to participate in a telephone survey, with condom breakage as the main outcome. Free cell phones were supplied and trained interviewers telephoned FSWs daily to ask about all sex acts the previous day. Later, we undertook focus groups to discuss the methodology with the participants. We evaluated technical and operational feasibility; data reliability and measurement error; emotional and fatigue effects; interviewer bias; survey reactivity effects; and user acceptability. Response rates were high, with 84% of invited participants complying fully with the protocol. The study ran smoothly, with little evidence of biases. The methodology was highly acceptable; the respondents enjoyed using a new telephone and being interviewed at times convenient to them. Other reasons for the success of the method were that the study was sanctioned and supported by the sex worker collective, and the interviewers were well trained and developed a strong rapport with the participants. The success of this methodology, and the wealth of data produced, indicates that it can be an important tool for conducting sexual behaviour research in low literacy, high sex volume populations.