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Background: Attitudes and impressions toward the tobacco industry and tobacco products among the general public are important determinants for curbing the menace of the tobacco epidemic. Accordingly, this study aimed to assess the knowledge and perceptions about the tobacco industry and tobacco products and analyze attitudes towards social denormalization (SD) of tobacco use and tobacco industry denormalization (TID) among the rural population of Bihar, India. Methods: This community-based cross-sectional survey was conducted on 421 adults aged 18 to 65 years who were selected using multistage systematic random sampling in a rural area of Bihar State in India from January to March 2022. Results were presented as proportions and the factors associated with support for TID and SD were identified using the chi-square test and binary logistic regression. Findings: Out of 421 participants, 342 (81.2%) did not consider smokeless tobacco to be very dangerous. Nearly half (192, 45.6%) of the individuals believed that tobacco companies never tell the truth about the ill effects of tobacco use on health. Maximum, 345 (89.5%) also believed that the tobacco industry is responsible for adverse health effects of tobacco use and that the government should sue them. The prevalence of favorable attitudes toward TID and SD was found to be 55.1% [95% CI: 50.3% - 59.8%] and 38.2% [95% CI: 33.7% - 42.9%], respectively. Conclusion: One out of every two and one out of every three individuals showed favorable attitudes toward TID and SD, respectively. There is a need to inform and educate the public on the ill effects of tobacco and the deceptive strategies used by the tobacco industry to help them choose health over tobacco.
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BACKGROUND: The Life-Space Assessment (LSA) is an instrument that measures mobility in older adults as they reach different areas, defined as life-spaces extending from home to beyond towns or regions. The purpose of the study was to develop the Hindi version of the LSA (LSA- H) and to investigate the validity and reliability of the Hindi version as well as its cultural adaptation. METHODS: A cross-sectional study of two hundred forty-five older adults participated in the study from four different study practice areas. Following forward backwards translation, the LSA-H was developed, and the scores were correlated with those of the Activities-Specific Balance Confidence Scale Hindi (ABC- H), the Physical Health Subscale of the WHO-BREF Questionnaire and the Geriatric Depression Scale: Short Form Hindi (GDS-SFH) to test the criterion and concurrent validity. RESULTS: The mean score and standard deviation of the LSA-H questionnaire were 56.53 ± 35.99, those of the Physical Health Subscale of the WHO-BREF instrument were 18.54 ± 7.87, those of the GDS-SFH questionnaire were 6.95 ± 4.21 and those of the ABC- H questionnaire were 54.40 ± 28.96. The Pearson correlation coefficient (r) between the LSA-H score and ABC-H score was 0.707 (p value < 0.0001), that between the LSA-H score and the Physical Health Subscale of the WHO-BREF was 0.766 (p value < 0.0001), and that between the LSA-H score and GDS-SFG score was - 0.674 (p value < 0.0001). CONCLUSION: This study demonstrated that the Hindi version of the LSA is a valid and reliable instrument for assessing living space among older adults in the Hindi language in an Indian population. Furthermore, the LSA-H was significantly correlated with other health assessment tools in terms of functional mobility, general health status and mental well-being.
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Geriatric Assessment , Independent Living , Humans , Cross-Sectional Studies , Aged , Male , Female , Geriatric Assessment/methods , India , Aged, 80 and over , Activities of Daily Living/psychology , Surveys and Questionnaires/standards , Reproducibility of Results , Middle AgedABSTRACT
Introduction The emergence of coronavirus disease 2019 (COVID-19) posed significant challenges to global health, leading to the declaration of a pandemic by the World Health Organization. Vaccination efforts have effectively reduced severe outcomes and mortality, but breakthrough infections and new variants are of concern. In response, annual booster doses of COVID-19 vaccines are being considered to maintain immunity. Healthcare professionals, as frontline workers, play a pivotal role in vaccination campaigns. This study explores their attitudes toward and willingness to accept annual COVID-19 booster doses in India. Methods A pan-India cross-sectional survey was conducted among healthcare professionals, including faculty, resident doctors, interns, and nursing staff, across Indian medical and nursing colleges. Convenience sampling was used to collect responses via an online questionnaire. The questionnaire assessed demographics, vaccine status, attitudes toward COVID-19 vaccination, and willingness to accept annual booster doses. Multivariate analysis was performed to identify predictors of booster dose acceptance. Results A total of 535 participants responded from 28 states and 8 union territories of India. Most were 34.2 years (± 11.1 SD), and 372 (69.5%) had taken Covishield (Serum Institute of India, Pune, India) as their primary vaccine. While 525 (98.1%) had taken the first dose and 518 (96.8%) of them had taken the second dose, only 333 (62.2%) had received a booster. Around 318 (60%) of healthcare professionals were willing to accept an annual booster dose. The mean attitude score toward annual booster doses was 75.4 (range: 28-111). Healthcare professionals' trust in government recommendations and medical experts significantly influenced their willingness to accept annual booster doses. Conclusion This study provides insights into the attitudes of healthcare professionals in India toward annual COVID-19 booster doses. At the same time, a significant proportion showed a willingness to accept boosters.
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Objetivo Evaluar mediante linfogammagrafía in vivo y con detección SPECT/TC los patrones de drenaje linfático de los tumores del seno paranasal (SPN). Confirmar o rebatir la creencia de que el ganglio linfático retrofaríngeo (GLRF) se erige en el ganglio de drenaje índice para dichos tumores. Métodos Estudio de cohorte prospectivo realizado en pacientes con tumores del SPN no tratados previamente y sin evidencia clínico-radiológica de metástasis a nivel ganglionar. La linfogammagrafía se realizó mediante la inyección peritumoral de sulfuro coloidal marcado con [99m]TcO4 y asistida por endoscopia nasal. Las inyecciones se clasificaron como anteriores o posteriores en función de una línea vertical que pasaba por el orificio del seno maxilar. Resultados Se incluyeron 17 pacientes. La linfogammagrafía identificó satisfactoriamente 17 ganglios centinelas en 15 pacientes, y no pudo evidenciarlo (fracaso de la linfogammagrafía) en 2 pacientes. Se observó que los lugares predominantes de drenaje del ganglio centinela fueron el GLRF (n=8; 47%) y el nivel I (n=7; 42%). Se identificó drenaje ocasional en el ganglio periparotídeo (n=1) y en el nivel II (n=1). Se observó drenaje linfático contralateral en 2 pacientes (en el nivel I y GLRF, respectivamente). Las inyecciones anteriores drenaron predominantemente hacia el nivel I (6/8) y a GLRF (2/8), mientras que las inyecciones posteriores drenaron predominantemente a GLRF (6/7). El riesgo relativo de que el GLRF fuera identificado como ganglio centinela fue significativamente mayor en las inyecciones administradas posteriormente respecto a las administradas anteriormente (RR: 3,43; IC 95%: 1,0-11,8; p=0,05). Conclusión El GLRF es considerado un ganglio de drenaje frecuente asociado a los tumores del seno nasal, y merece su atención rutinaria en todos los casos de tumor del seno nasal (AU)
Objective To evaluate by in vivo lymphoscintigraphy and SPECT-CT imaging, the lymphatic drainage patterns of para-nasal sinus (PNS) tumours. To confirm or refute the belief of the retropharyngeal lymph node (RPLN) being the significant draining lymph node for such tumours. Methods Prospective cohort study conducted on previously untreated PNS tumours with no clinico-radiological evidence of lymph node metastasis. Lymphoscintigraphy undertaken by nasal endoscopic assisted peritumoral injection of 99mTc sulphur colloid. Injections were classified as anterior or posterior as per a vertical line along the maxillary sinus ostium. Results Seventeen patients were included. Lymphoscintigraphy successfully identified 17 sentinel nodes in 15 patients and was unsuccessful (lymphoscintigraphy failure) in 2 patients. Predominant sites of sentinel lymphatic drainage were noted to be the RPLN (n=8; 47%) and level I (n=7; 42%). Occasional drainage was identified at the peri-parotid node (n=1) and at level II (n=1). Contralateral drainage was noted in 2 patients (level I-1 and RPLN-1). Anterior injections drained predominantly to level I (6/8) and RPLN (2/8), while posterior injections drained predominantly to the RPLN (6/7). The relative risk of RPLN being identified as the sentinel node was significantly higher for posteriorly placed injections than for anteriorly placed injections (RR: 3.43; 95% CI: 1.0-11.8; P=.05). Conclusion The RPLN is noted as a frequent draining node for sino-nasal tumours and merits routine attention in all sino-nasal tumours. The radio-colloid SPECT-CT technique described here offers an excellent in vivo technique to further explore and validate the lymphatic drainage pathways of these tumours (AU)
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Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Lymphoscintigraphy/methods , Nose Neoplasms/diagnostic imaging , Sentinel Lymph Node/diagnostic imaging , Neoplasm Staging , Prospective Studies , Cohort StudiesABSTRACT
OBJECTIVES: To assess the blood lead level (BLL) of school children in 10 cities of India. METHODS: This multi-centric cross-sectional study enrolled participants from randomly selected schools. Data on demographic details, socioeconomic status (SES) and anthropometric indicators was collected. Samples were collected for assessment of lead level in blood. Inductively coupled plasma-optical emission spectrometry technique was used to assess BLL. RESULTS: From April 2019 through February 2020, 2247 participants were recruited from sixty schools (62.6% government schools) with equal gender distribution. The overall median (interquartile range) BLL was 8.8 (4.8, 16.4) µg/dl. The highest median (interquartile range) BLL was in Manipal 30.6 (23.0, 46.7) and lowest in Dibrugarh 4.8 (3.2, 7.0). Overall, 82.5% of participants had BLL above ≤4 µg/dl. Significant negative correlation was observed between BLL and SES (correlation= -0.24, p <0.001), anthropometric indicators (correlation= -0.11, p <0.001), hemoglobin level (correlation= -0.045, p = 0.03) and multivariate regression model showed association with gender, SES and anthropometric indicators. CONCLUSIONS: BLL are elevated in urban school going children and there is intercity variation. Hence, urgent focus is needed to reduce exposure to lead in India.
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BACKGROUND: Happiness is a state of mental well-being and influences the learning and performance of an individual. Medical education due to its academic culture and longer course duration affects the performance and happiness of the students. So, this study was done to assess the level of happiness and the factors associated with it among medical students in Bihar. MATERIALS AND METHODS: A cross-sectional online survey was conducted among 321 medical students of all academic years from various medical colleges in Bihar. This study used a self-administered study tool using the online Google Form platform for data collection and assessed the level of happiness using Oxford Happiness Questionnaire. A multivariable binary logistic regression analysis was done to find out the predictors of happiness. RESULTS: A total of 34.6% (95% CI: 29.5-39.9%) medical students were happy. Male (38.2%) students were found to be happier than female (29.2%) students. Age, place of stay, physical activity, meditation and yoga, frequent socialization, absence of psychiatric illness, and stressful situation in the family were the independent predictors of happiness. Around 42.4% of students had another career option, and 32.1% had a second thought about a career due to the COVID-19 pandemic. The presence of any psychiatric illness had a significant effect on the happiness level of the students. CONCLUSION: Only one in three medical students is happy. Promotion of physical activity, meditation and yoga, and socialization will improve the happiness and thereby learning among medical students.
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BACKGROUND: Excess use of the internet and gadgets for learning, gaming, and socialization has resulted in addictive behavior and nomophobia, especially among college-going students. Thus, this study was designed to find out the proportion and predictors of internet addiction and nomophobia among medical undergraduates. MATERIALS AND METHODS: This cross-sectional study conducted on 367 medical undergraduates of a teaching hospital was carried out using a standard tool: the Internet Addiction Test Short Form for screening internet addiction and the Nomophobia Questionnaire for nomophobia. Results were tabulated and multivariable binomial logistic regression analysis was performed to find out the predictors of internet addiction and nomophobia. RESULTS: A total of 116 (31.6%, 95% CI: 27%-36.5%) students were addicted to the internet and 247 (67.3%, 95% CI: 62.3%-71.9%) were screened to have moderate-to-severe nomophobia. The age of the student (adjusted odds ratio (AOR): 0.83 [0.69-0.99]), male gender (AOR: 2.24 [1.33-3.79]), screen time (AOR: 1.24 [1.14-1.34]), checking the phone first in the morning (AOR: 1.98 [1.107-3.54]), non-leisure time usage of phone (AOR: 2.07 [1.25-3.4]), and altered reading habit (AOR: 2.51 [1.26-5.01]) were independent predictors of internet addiction. Increased screen time (AOR: 1.103 [1.016-1.23]), checking the phone first in the morning after waking up (AOR: 1.68 [1.05-2.81]), altered academic performance (AOR: 1.99 [1.079-3.68]), and presence of internet addiction (AOR: 8.17 [3.56-18.76]) were independent predictors of moderate-to-severe nomophobia among medical students. CONCLUSION: One and two out of every three medical students were found to have internet addiction and moderate-to-severe nomophobia, respectively. Increased screen time, altered academic performance, and the presence of internet addiction were independent predictors of moderate-to-severe nomophobia.
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Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6-16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50â 2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93â 4 % (246â 5 ± 149â 4 mg), iron 86â 5 % (7â 6 ± 3â 0 mg), zinc 84â 0 % (3â 9 ± 2â 4 mg), selenium 30â 2 % (11â 3 ± 9â 7 mcg), folate 73â 8 % (93â 6 ± 55â 4 mcg), vitamin B12 94â 4 % (0â 2 ± 0â 4 mcg), vitamin A 96â 0 % (101â 7 ± 94â 1 mcg), and vitamin D 100â 0 % (0â 4 ± 0â 6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1â 37 (95 % CI 1â 07-1â 76)], zinc [AOR = 5â 14 (95 % CI 2â 24-11â 78)], selenium [AOR = 3â 63 (95 % CI 2â 70-4â 89)], folate [AOR = 1â 59 (95 % CI 1â 25-2â 03)], and vitamin B12 [AOR = 1â 62 (95 %CI 1â 07-2â 45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.
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Anemia, Iron-Deficiency , Selenium , Female , Adolescent , Humans , Child , Male , Cross-Sectional Studies , Calcium , Anemia, Iron-Deficiency/epidemiology , Vitamins , Folic Acid , Micronutrients , Vitamin B 12 , Vitamin D , Zinc , Eating , IronABSTRACT
INTRODUCTION: Women presenting for mammography occasionally have pacemakers or other cardiac-implantable electronic devices (CIEDs) in situ. This research investigates Australian radiographers' awareness of CIEDs in the diagnostic and screening settings. METHODS: A survey of radiographers with mammography experience in Australia was conducted using SurveyMonkey™. Respondents were asked if they could confidently identify images of devices and whether they had imaged them mammographically. A Chi-squared test of independence was used to compare the association between demographics and CIED awareness. A value of p < 0.05 was deemed statistically significant. RESULTS: There were 220 valid responses. All CIED types had been imaged. Most respondents had imaged a pacemaker (94.5%) and implantable cardioverter-defibrillator (ICD) (85.6%), compared to the three different implantable loop recorders (ILRs) (ILR-1: 63.4%; ILR-2: 14.1%; and IRL-3: 26.9% and the emerging subcutaneous ICDs (S-ICDs) (11.9%). Most respondents felt confident identifying the pacemaker (95%) and the ICD (86.1%). Only 19.4% of respondents could confidently identify the emerging S-ICD. CONCLUSION: A lack of awareness of new and emerging devices may impact approaches to imaging and present significant risk to patients. The lack of studies comprehensively describing devices and their mammographic appearance to support radiographers' knowledge and awareness highlights an urgent need to progress research in this area. IMPLICATIONS FOR PRACTICE: As a part of continuing professional development, radiographers performing mammography must ensure they remain up to date with current and emerging technology, including CIEDs. This study has identified a lack of awareness of the different types of CIEDs currently being implanted and imaged, which may translate to unsafe imaging practices. There is an urgent need for further education to bridge this knowledge gap and ensure the safety of practice in imaging women with CIEDs. FOOTLINE: Mammography: CIED Imaging.
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Defibrillators, Implantable , Pacemaker, Artificial , Humans , Female , Australia , Heart , MammographyABSTRACT
Introduction: Exposure to secondhand smoke (SHS) is an established causal risk factor for cardiovascular disease (CVD) and chronic lung disease. Numerous studies have evaluated the role of tobacco in COVID-19 infection, severity, and mortality but missed the opportunity to assess the role of SHS. Therefore, this study was conducted to determine whether SHS is an independent risk factor for COVID-19 infection, severity, mortality, and other co-morbidities. Methodology: Multicentric case-control study was conducted across six states in India. Severe COVID-19 patients were chosen as our study cases, and mild and moderate COVID-19 as control were evaluated for exposure to SHS. The sample size was calculated using Epi-info version 7. A neighborhood-matching technique was utilized to address ecological variability and enhance comparability between cases and controls, considering age and sex as additional matching criteria. The binary logistic regression model was used to measure the association, and the results were presented using an adjusted odds ratio. The data were analyzed using SPSS version 24 (SPSS Inc., Chicago, IL, USA). Results: A total of 672 cases of severe COVID-19 and 681 controls of mild and moderate COVID-19 were recruited in this study. The adjusted odds ratio (AOR) for SHS exposure at home was 3.03 (CI 95%: 2.29-4.02) compared to mild/moderate COVID-19, while SHS exposure at the workplace had odds of 2.19 (CI 95%: 1.43-3.35). Other factors significantly related to the severity of COVID-19 were a history of COVID-19 vaccination before illness, body mass index (BMI), and attached kitchen at home. Discussion: The results of this study suggest that cumulative exposure to secondhand cigarette smoke is an independent risk factor for severe COVID-19 illness. More studies with the use of biomarkers and quantification of SHS exposure in the future are needed.
Subject(s)
COVID-19 , Tobacco Smoke Pollution , Humans , COVID-19/epidemiology , COVID-19 Vaccines , Case-Control Studies , Tobacco Smoke Pollution/adverse effects , Body Mass IndexABSTRACT
OBJECTIVE: To evaluate by in- vivo lymphoscintigraphy and SPECT-CT imaging, the lymphatic drainage patterns of para-nasal sinus(PNS) tumors. To confirm or refute the belief of the retropharyngeal lymph node (RPLN) being the significant draining lymph node for such tumors. METHODS: Prospective cohort study conducted on previously untreated PNS tumors with no clinico-radiological evidence of lymph node metastasis. Lymphoscintigraphy undertaken by nasal endoscopic assisted peritumoral injection of 99mTc Sulfur colloid. Injections were classified as anterior or posterior as per a vertical line along the maxillary sinus ostium. RESULTS: 17 patients were included. Lymphoscintigraphy successfully identified 17 sentinel nodes in 15 patients and was unsuccessful (lymphoscintigraphy failure) in 2 patients. Predominant sites of sentinel lymphatic drainage were noted to be the RPLN (nâ¯=â¯8; 47%), and Level I (nâ¯=â¯7; 42%). Occasional drainage was identified at the peri-parotid node(nâ¯=â¯1) and at Level II (nâ¯=â¯1). Contralateral drainage was noted in 2 patients (level I-1 and RPLN-1). Anterior injections drained predominantly to Level I (6/8) and RPLN (2/8), while posterior injections drained predominantly to the RPLN ( 6/7). The relative risk of RPLN being identified as the sentinel node was significantly higher for posteriorly placed injections than for anteriorly placed injections (RR- 3.43; 95% CI-1.0-11.8, pâ¯=â¯0.05). CONCLUSION: The RPLN is noted as a frequent draining node for sino-nasal tumours and merits routine attention in all sino-nasal tumors. The radio-colloid SPECT-CT technique described here offers an excellent in-vivo technique to further explore and validate the lymphatic drainage pathways of these tumours.
Subject(s)
Lymphoscintigraphy , Sentinel Lymph Node Biopsy , Humans , Lymphoscintigraphy/methods , Sentinel Lymph Node Biopsy/methods , Prospective Studies , Radiopharmaceuticals , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymphatic Metastasis/diagnostic imaging , ColloidsABSTRACT
INTRODUCTION: Academic integrity among radiographers and nuclear medicine technologists/scientists in both higher education and scientific writing has been challenged by advances in artificial intelligence (AI). The recent release of ChatGPT, a chatbot powered by GPT-3.5 capable of producing accurate and human-like responses to questions in real-time, has redefined the boundaries of academic and scientific writing. These boundaries require objective evaluation. METHOD: ChatGPT was tested against six subjects across the first three years of the medical radiation science undergraduate course for both exams (n = 6) and written assignment tasks (n = 3). ChatGPT submissions were marked against standardised rubrics and results compared to student cohorts. Submissions were also evaluated by Turnitin for similarity and AI scores. RESULTS: ChatGPT powered by GPT-3.5 performed below the average student performance in all written tasks with an increasing disparity as subjects advanced. ChatGPT performed better than the average student in foundation or general subject examinations where shallow responses meet learning outcomes. For discipline specific subjects, ChatGPT lacked the depth, breadth, and currency of insight to provide pass level answers. CONCLUSION: ChatGPT simultaneously poses a risk to academic integrity in writing and assessment while affording a tool for enhanced learning environments. These risks and benefits are likely to be restricted to learning outcomes of lower taxonomies. Both risks and benefits are likely to be constrained by higher order taxonomies. IMPLICATIONS FOR PRACTICE: ChatGPT powered by GPT3.5 has limited capacity to support student cheating, introduces errors and fabricated information, and is readily identified by software as AI generated. Lack of depth of insight and appropriateness for professional communication also limits capacity as a learning enhancement tool.
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Artificial Intelligence , Diagnostic Imaging , Humans , Radiography , Learning , SoftwareABSTRACT
Background: Community-based screening is one of the key preventive strategies to tackle the ever-rising burden of non-communicable diseases (NCDs) under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Objective: The current study was aimed to build capacity among frontline health workers (FHWs) in screening for cardiovascular diseases (CVDs) under NPCDCS in the selected districts of Bihar state. Methodology: This was an implementation study with follow-up components, conducted among 75 FHWs [14 auxiliary nurse midwives (ANMs) and 61 accredited social health activists (ASHAs)] from 15 primary healthcare facilities across four districts of Bihar state from October 2019 to September 2021. The selected FHWs were initially trained on NPCDCS for a day, including pre- and post-training knowledge assessment. Then, supportive supervision (SS) visits using a predesigned questionnaire were done. Results: The pre- and post-training mean knowledge scores of the FHWs were 12.9 and 22.1, respectively, with an overall effect size of 2.5. During SS visits, only 20.0% of the visited primary healthcare facilities had all the required logistics to conduct weekly NCD screening clinics for CVDs. Considering different measurements and operative skill proficiencies of FHWs, waist circumference skills (41.7% for ANMs and 50.8% for ASHAs), followed by blood pressure (BP) (41.7%) and random blood sugar (RBS) measurement (25.0%), were found to be the most deficient skills (among ANMs). Moreover, the quality of initial and follow-up home visits was found to be satisfactory for only 54.1% of the ASHAs. The reported barriers of NCD screening were reported to be non-cooperation, unawareness among community dwellers, lack of knowledge and skill of FHWs, logistic constraints and delayed honorarium credit. Conclusion: One-day training on NCDs for FHWs was quite effective. However, for translating all the desired skills for CVD screening into action, periodic training needs assessment, and SS of FHWs might be fruitful.
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BACKGROUND: Micronutrient deficiency (MD) is associated with deficits in cognitive functioning of children. However, no comprehensive multicentric study has been conducted in India to explore the role of multiple MD in cognition of children and adolescents. The present study aimed to explore association of MD with level of general intelligence and specific cognitive functions, in urban school-going children and adolescents across ten cities of India. METHOD: Cross-sectional multicentric study, enrolled participants aged 6-16 years. Blood samples were collected for biochemical analysis of calcium, iron, zinc, selenium, folate, vitamin A, D and B12. Colored Progressive Matrices / Standard Progressive Matrices (CPM/SPM), Coding, Digit Span and Arithmetic tests were used for the assessment of cognitive functions of participants. Height and weight measures were collected along with socio-economic status. RESULTS: From April-2019 to February-2020, 2428 participants were recruited from 60 schools. No MD was found in 7.0% (134/1918), any one MD in 23.8% (457/1918) and ≥ 2 MD in 69.2% (1327/1918) participants. In presence of ≥ 2 MD, adjusted odds ratio (OR) for borderline or dull normal in CPM/SPM was 1.63, (95% CI: 1.05-2.52), coding was 1.66 (95% CI: 1.02-2.71), digit span was 1.55 (95% CI: 1.06-2.25) and arithmetic was 1.72 (95% CI: 1.17-2.53), controlling for gender, socioeconomic status and anthropometric indicators. CONCLUSION: Since ≥ 2 MD were found in more than 2/3rd of participants and was associated with impairment in cognitive function, attempts must be made to ameliorate them on priority in school going children in India. TRIAL REGISTRATION NUMBER: CTRI/2019/02/017783.
Subject(s)
Cognition , Micronutrients , Humans , Child , Adolescent , Cross-Sectional Studies , Folic Acid , Schools , India/epidemiology , Nutritional StatusABSTRACT
The COVID-19 has been declared a pandemic by the World Health Organization. Along with impairing the respiratory system, it also affects the gastrointestinal system. By reviewing experiments on the wastewater analysis for the detection of coronavirus, this study explores the fate, persistence, and various remediation strategies for the virus removal from the wastewater. The results indicated that the virus can be detected in the wastewater samples, feces, and sewage, even before the onset of symptoms. Coronavirus can be a potential panzootic disease, as several mammalian species get infected by the deadly virus. The disinfection strategies used earlier for the treatment of wastewater are not sufficient for the removal of viruses from the wastewater. Therefore, concerted efforts should be made to understand their fate, sources, and occurrence in the environmental matrices. To prevent the spread of the panzootic disease, revised guidelines should be issued for the remediation of the virus. Recent viral remediation methods such as membrane bioreactors and advanced oxidation methods can be used. Therefore, the present review puts a light on the current knowledge on the occurrence of coronaviruses in wastewater, the possible sources, fate, and removal strategies.
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Introduction: Remdesivir is currently approved for treating hospitalised patients with COVID-19. However, it is a priority to monitor its safety and effectiveness in various clinical settings. This study was undertaken to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19. Materials and Methods: A hospital-based prospective longitudinal study was conducted over two months comprising event monitoring of COVID-19 patients administered remdesivir as per standard guidelines. The demographic details, risk factors and all baseline parameters were collected. The patients were followed up for the appearance of any adverse drug reactions (ADRs) after the start of remdesivir therapy from Day 1 to discharge or death every day. Repeat Lab tests were done on days 2, 4, 6 and 10 days to assess the impact of remdesivir on inflammatory and prognostic markers of COVID-19 over time. Significant predictors of survival in the cohort were also assessed. Results: A total of 60 COVID-19 patients were administered remdesivir. The mean age of the patients was 59.2 (+13.7) years. There was a significant improvement in the serum creatinine (decreased from 0.9 to 0.7 mg/dL), lymphocyte count {decreased from 9.2 to 7.3 (109 cells/L)} and serum sodium (increased from 134.6 to 137.4) of the patients over six days after the administration of remdesivir. The significant survival predictors were multiple organ failure (P 0.046) and WBC count on Day 10 (P 0.001). Conclusion: Remdesivir administration improved the prognostic biomarker profile in COVID-19 patients.
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Flowering exhibits a significant relationship with environmental stimuli and changes. Effect of photoperiodism and vernalization have been well studied in flowering phenology; however, the effect of soil temperature on flowering is less explored which is one of the major factors of vegetation growth in alpine ecosystem. This study thus focuses on the effects of soil and air temperature on flowering response of Rhododendron arboreum Sm., a Himalayan tree species, which is also an indicator of spring initiation in high altitude regions. To monitor the flowering pattern, we employed automated phenocam, which was set up at 3356 masl in Tungnath (Indian Alpine region of Uttarakhand) for time-lapse photography of timberline ecotone. Soil and air temperature were recorded continuously at the timberline ecotone. Three years (2017 to 2020) of datasets were used for the present study. The phenocam observations displayed an interesting event in the year 2019-2020 with complete absence of flowering in R. arboreum population at Tungnath timberline ecotone. From the soil temperature data, an increase in winter (Dec-Jan, during which floral buds form) soil temperature, by > 1 °C, and no accumulation of freezing degree-days were found for the year 2019-2020. Air temperature however did not display any relationship with the failure of flowering, ruling out aerial chilling or frost injury of floral buds. From the results, a possible relationship between soil temperature and flowering can be suggested pointing towards necessary root apex vernalization stimulus in shallow rooted Rhododendrons. However, the dependency of flowering in Rhododendrons on winter soil temperature further requires continuous monitoring and more observations to make concrete inferences.
Subject(s)
Rhododendron , Climate Change , Ecosystem , Environmental Monitoring , Rhododendron/physiology , Seasons , Soil , TemperatureABSTRACT
BACKGROUND: In the ongoing COVID-19 pandemic, an increased incidence of ROCM was noted in India among those infected with COVID. We determined risk factors for rhino-orbito-cerebral mucormycosis (ROCM) post Coronavirus disease 2019 (COVID-19) among those never and ever hospitalized for COVID-19 separately through a multicentric, hospital-based, unmatched case-control study across India. METHODS: We defined cases and controls as those with and without post-COVID ROCM, respectively. We compared their socio-demographics, co-morbidities, steroid use, glycaemic status, and practices. We calculated crude and adjusted odds ratio (AOR) with 95% confidence intervals (CI) through logistic regression. The covariates with a p-value for crude OR of less than 0·20 were considered for the regression model. RESULTS: Among hospitalised, we recruited 267 cases and 256 controls and 116 cases and 231 controls among never hospitalised. Risk factors (AOR; 95% CI) for post-COVID ROCM among the hospitalised were age 45-59 years (2·1; 1·4 to 3·1), having diabetes mellitus (4·9; 3·4 to 7·1), elevated plasma glucose (6·4; 2·4 to 17·2), steroid use (3·2; 2 to 5·2) and frequent nasal washing (4·8; 1·4 to 17). Among those never hospitalised, age ≥ 60 years (6·6; 3·3 to 13·3), having diabetes mellitus (6·7; 3·8 to 11·6), elevated plasma glucose (13·7; 2·2 to 84), steroid use (9·8; 5·8 to 16·6), and cloth facemask use (2·6; 1·5 to 4·5) were associated with increased risk of post-COVID ROCM. CONCLUSIONS: Hyperglycemia, irrespective of having diabetes mellitus and steroid use, was associated with an increased risk of ROCM independent of COVID-19 hospitalisation. Rational steroid usage and glucose monitoring may reduce the risk of post-COVID.
Subject(s)
COVID-19 , Diabetes Mellitus , Hyperglycemia , Mucormycosis , Orbital Diseases , Antifungal Agents/therapeutic use , Blood Glucose , Blood Glucose Self-Monitoring , COVID-19/epidemiology , Case-Control Studies , Diabetes Mellitus/drug therapy , Diabetes Mellitus/epidemiology , Hospitalization , Humans , Hyperglycemia/complications , Hyperglycemia/drug therapy , Hyperglycemia/epidemiology , India/epidemiology , Middle Aged , Mucormycosis/drug therapy , Mucormycosis/epidemiology , Orbital Diseases/drug therapy , PandemicsABSTRACT
OBJECTIVES: Primary objective was to study the clinicodemographic profile of hospitalised COVID-19 patients at a tertiary-care centre in India. Secondary objective was to identify predictors of poor outcome. SETTING: Single centre tertiary-care level. DESIGN: Retrospective cohort study. PARTICIPANTS: Consecutively hospitalised adults patients with COVID-19. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome variable was in-hospital mortality. Covariables were known comorbidities, clinical features, vital signs at the time of admission and on days 3-5 of admission, and initial laboratory investigations. RESULTS: Intergroup differences were tested using χ2 or Fischer's exact tests, Student's t-test or Mann-Whitney U test. Predictors of mortality were evaluated using multivariate logistic regression model. Out of 4102 SARS-CoV-2 positive patients admitted during 1-year period, 3268 (79.66%) survived to discharge and 834 (20.33%) died in the hospital. Mortality rates increased with age. Death was more common among males (OR 1.51, 95% CI 1.25 to 1.81). Out of 261 cases analysed in detail, 55.1% were in mild, 32.5% in moderate and 12.2% in severe triage category. Most common clinical presentations in the subgroup were fever (73.2%), cough/coryza (65.5%) and breathlessness (54%). Hypertension (45.2%), diabetes mellitus (41.8%) and chronic kidney disease (CKD; 6.1%) were common comorbidities. Disease severity on admission (adjusted OR 12.53, 95% CI 4.92 to 31.91, p<0.01), coagulation defect (33.21, 3.85-302.1, p<0.01), CKD (5.67, 1.08-29.64, p=0.04), high urea (11.05, 3.9-31.02, p<0.01), high prothrombin time (3.91, 1.59-9.65, p<0.01) and elevated ferritin (1.02, 1.00-1.03, p=0.02) were associated with poor outcome on multivariate regression. A strong predictor of mortality was disease progression on days 3-5 of admission (adjusted OR 13.66 95% CI 3.47 to 53.68). CONCLUSION: COVID-19 related mortality in hospitalised adult patients at our center was similar to the developed countries. Progression in disease severity on days 3-5 of admission or days 6-13 of illness onset acts as 'turning point' for timely referral or treatment intensification for optimum use of resources.