Prevalence and Predictors of Domestic Violence in India: Complex Sample Analysis of a Nationally Representative Study Conducted Between 2019 and 2021.

BACKGROUND:  Violence against women has been one of the dreaded social evils that humanity is facing. There have been concerted efforts to eliminate this evil, and sustainable development goals goal 5.2.1 gave it a timeline. The current study was carried out to estimate the burden of domestic violence (DV) against women and to investigate the sociodemographic correlates of DV victims in India. METHODS:  Data were drawn from the fifth National Family Health Survey round. According to Demographic Health Survey guidelines, DV is measured using a 13-item questionnaire in the women's survey. Complex sample analysis was done using a primary sampling unit, sample weight, and stratification variables to estimate the weighted prevalence. Chi-square and multivariate logistic regression determine the unadjusted and adjusted odds ratio. The analysis is carried out using SPSS version 26 (IBM Corp., Armonk, NY). RESULTS:  The weighted prevalence of DV against women in India in 2019-2021 was 31.2%. Approximately 28.5%, 13.1%, and 5.7% of women reported experiences of physical, emotional, and sexual violence, respectively. Karnataka was the worst affected state, with 47.3% of women facing DV. Individual factors like education and occupation, household factors like husband's education, occupation, drinking habit, wealth index, and community-level factors like caste, religion, and place of residence were significant predictors of DV. Lower levels of education and lower socioeconomic status were essential predictors of DV. CONCLUSION:  The importance of education for both females and males has repeatedly been directly associated with DV, but the interventions have failed to improve the situation and warrant a new strategy. Awareness about the legal consequences of DV in lower socioeconomic classes also has the potential to cut down the numbers. Further research into the causality can improve the planning for better intervention modalities.

Long-Lasting Insecticidal Net Coverage and Utilization in Burla Town of Sambalpur District: A Cross-Sectional Study.

Background Vector-borne diseases continue to significantly contribute to mortality and morbidity, especially in developing nations. Vector management is a key pillar in combating these diseases, and long-lasting insecticidal nets (LLINs) are cost-effective tools. The Government of India, under the National Vector Borne Disease Control Programme (NVBDCP), has distributed LLINs for free to increase coverage and utilization. This study aims to estimate the coverage and utilization of LLINs in Burla town. Method This cross-sectional study was conducted from October to December 2022 in Burla town of Sambalpur in Odisha, India. The estimated sample size was 510 households, assuming 50% coverage. Multi-stage cluster sampling was adopted to select the Anganwadi centers and households. A pretested questionnaire was utilized for data collection by trained personnel through Epicollect5 (Centre for Genomic Pathogen Surveillance, Oxford, UK). Logistic regression was used to identify predictors for LLIN usage. Results The survey covered 516 households with 2,541 individuals and 1,165 nets. Household-level coverage was 94.2%, and regular utilization was 45.74%. Skin reactions (35.7%) were the most common reason for non-usage, followed by low mosquito density (12%). Logistic regression showed that the number of rooms (adjusted odds ratio (AOR) = 0.663, p = 0.012), number of bed nets (AOR = 2.757, p < 0.001), knowledge of malaria (AOR = 2.92, p = 0.04), adopting other measures for mosquito control (AOR = 0.295, p < 0.001), and washing the net (AOR = 1.92, p = 0.028) significantly predicted sleeping under mosquito net. Conclusion Our study has depicted high coverage of LLINs in Burla town, but utilization needs further improvement. Counseling regarding proper use can decrease the skin reactions responsible for non-usage. Regular health education programs are required to emphasize the benefits of LLIN use, along with regular monitoring and supervision.

Immunogenicity of ChAdOx1 (Covishield) Booster Dose in Healthcare Providers: A Pre-Post Study.

Background Worldwide, healthcare workers who face a higher risk of contracting coronavirus disease 2019 (COVID-19) were among the first to receive COVID-19 vaccinations. Following the initial two vaccine doses, health experts recommended a third booster shot to enhance protection against the severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) virus. However, limited information about how this booster dose affects antibody levels is available. This study assesses the immune response triggered by the ChAdOx1 (Covishield) booster dose. Methods We conducted a before and after study among 132 healthcare providers at a tertiary care hospital in India who had already received their initial COVID-19 vaccine doses and agreed to participate. A booster shot was administered nine months following their second vaccine dose per the prevalent norms. We collected blood samples to measure immunoglobulin-G (IgG) levels against the spike protein's receptor-binding domain of the SARS-CoV-2 virus. These blood samples were taken both when they received the booster shot and one month after the booster. We determined IgG levels using a chemiluminescence microparticle immunoassay. Result Among the participants, approximately 54% were females. Regarding occupation, about 36% were doctors, 30% were students, 20% were nursing officers, and the remaining 14% held grade-4 positions. The median age of the participants was 32 years. About 74% had no history of underlying health conditions. Before the booster dose, 29% of the participants tested negative for antibodies. However, all participants developed antibodies following the booster shot, and there was a significant increase in antibody levels, which was statistically meaningful with a p-value of less than 0.0001. Conclusion In conclusion, the administration of a booster dose effectively induced seroconversion and significantly increased antibody levels among healthcare providers, enhancing their immunity against COVID-19, essential in the face of a waning immune response to primary series vaccination.

Risk Factors of Pre-eclampsia: A Hospital-Based Case-Control Study.

Introduction Pre-eclampsia is a pregnancy-specific hypertensive disorder and is one of the leading causes of maternal and infant morbidity and mortality in India and worldwide. Evidence of the association between various risk factors and pre-eclampsia is scarce in developing countries. As pre-eclampsia remains a leading cause of maternal mortality and morbidity, focusing on the causes and risk factors of pre-eclampsia during antenatal surveillance would prevent maternal deaths and reduce the maternal mortality rate. Our study aimed to determine the risk factors of pre-eclampsia. Materials and methods An unmatched case-control study was conducted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, Odisha, taking 100 cases of pre-eclampsia and 100 controls without pre-eclampsia from January 2021 to January 2023. The study population included patients admitted to the Obstetrics & Gynecology labor room. Study participants were selected randomly from the labor room thrice weekly. Data were collected using a predesigned pre-tested questionnaire and case report format. Data were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). Appropriate statistical tests (Odds ratio, proportions, Chi-square test) were applied, and the final interpretation was made. Results Family history of hypertension (AOR = 4.2), history of chronic hypertension (AOR = 13.7), and AB blood group (AOR = 3.6) were found to be significant risk factors for pre-eclampsia. No significant association was found between pre-eclampsia and factors such as mother's age, caste, mother's education, type of family, socioeconomic status, education and occupation of husband, family history of diabetes mellitus, parity, history of abortion, and anemia. Conclusion Risk factors identified in the present study can be used to identify women at risk of pre-eclampsia during antenatal check-ups to minimize the complications of pre-eclampsia in both the mother and the fetus.

Placental Pathology and Maternal Risk Factors for Stillbirth: A Case-Control Study.

Background Fetal death is the delivery of a fetus with no sign of life, as indicated by the absence of breathing, heartbeat, pulsation of the umbilical cord, or definite movement of voluntary muscles. Nearly 2.6 million stillbirths are estimated to occur worldwide every year. Almost all of these (98%) stillbirths occur in low- and middle-income countries. About one-sixth of the stillbirths globally were recorded in India in 2019, making it the most burdened country in the world. In light of this, we conducted a study to identify the placental pathologies and maternal factors associated with stillbirth. Methodology A case-control study was conducted at the Department of Obstetrics & Gynecology, Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), from June 2022 to May 2023. Cases included pregnant women with a gestational age of 28 weeks or more who delivered a stillbirth infant at VIMSAR, and controls included gestational age-matched deliveries with live birth. Consent to participate in the study was obtained before enrolment. The final sample size was 79 cases and controls. The chi-square test was performed for bivariate analysis, and logistic regression was used for multivariate analysis. Results In our study, we found a significant association between maternal age of more than 30 years (odds ratio (OR) = 3.01, 95% confidence interval (CI) = 1.91-4.22, p = 0.012), maternal education (with up to the primary level or less: OR = 6.19, 95% CI = 2.92-7.87, p = 0.012), history of addiction (tobacco chewing: OR = 5.58, 95% CI = 3.71-7.11, p = 0.03), and the number of antenatal visits (no visit: OR = 6.87, 95% CI = 2.91-7.79, p = 0.019) with an increased risk of stillbirth. Among the obstetrical complications, pre-eclampsia/eclampsia (OR = 3.87, 95% CI = 1.98-5.11, p = 0.001), premature rupture of membranes (PROM)/preterm premature rupture of the membranes (PPROM) (OR = 2.49, 95% CI = 1.31-3.91, p = 0.03) and antepartum hemorrhage (APH) (OR = 2.66, 95% CI = 1.65-3.58, p = 0.02) were found to be significantly related with stillbirth. Among placental pathologies, uteroplacental vascular pathology (OR = 7.39, 95% CI = 3.01-8.97), acute chorioamnionitis (OR = 3.35, 95% CI = 2.11-5.21), chronic inflammation (OR = 2.33, 95% CI = 1.91 4.17), calcific changes (OR = 4.46, 95% CI = 2.56-6.01), and retroplacental clots (OR = 9.95, 95% CI = 4.39-11.71) were associated with stillbirth. Conclusions In our study, advanced maternal age, absence of antenatal visits, low level of education, tobacco addiction, pre-eclampsia/eclampsia, APH, and PROM in pregnancy were the major risk factors associated with stillbirth. Uteroplacental vascular pathology, chorioamnionitis, chronic inflammation, retroplacental hematoma, and calcific changes were the most significant placental lesions associated with stillbirth.

Complications of Total Laparoscopic Hysterectomy in a Tertiary Care Center.

Introduction Laparoscopic hysterectomy is a standard practice in developed countries and corporate setups in India but is a relatively new practice in government institutions; surgical audits are rarely done in our institutions. This study aims to determine the complications of total laparoscopic hysterectomy (TLH) in a tertiary care center in India. Methods This was a retrospective record review of patients admitted to the Obstetrics and Gynecology department of Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Odisha, India. Data were collected from case sheets of patients who underwent TLH, operated on between January 2018 and May 2022. Demographic and clinical data were extracted and analyzed. Results Of the 223 consecutive patients, 12 (5.3%) were converted to laparotomy. The mean age of patients was 44.34 years (±5.457), with a mean BMI of 24.24 kg/m2 (±2.181). The mean surgical duration was 1.895 hr (±0.487), with a mean blood loss of 140 ml and an average hospital stay of 3.25 (±0.821) days. Duration of surgery, blood loss, and hospital stay decreased with the surgeon's increasing experience. Reoperation was not needed in any case. Complications were recorded in about 18 (8.07%) cases. Also, major complications were less. Conclusion Total laparoscopic hysterectomy is a less invasive and safe alternative to total abdominal hysterectomy, offering the benefits of minimally invasive surgery, and is also ideal for candidates unsuitable for vaginal hysterectomy.

Epidemiology of Suicide in Western Odisha During COVID Pandemic: A Cross-Sectional Analysis.

Introduction Suicide is the act of deliberately killing oneself. It is a leading cause of mortality worldwide. Each year, more than seven lakh people end their lives globally. India is the worst-affected country in Southeast Asia. Both the genders and all age groups are affected. The COVID pandemic has led to the disruption of routine life and business. The proportion of deaths due to suicide was 9.4% among all deaths reported for autopsies by a study in the same mortuary over a seven-year period. Increased stress and anxiety have been postulated to lead to suicide. Our study objective is to describe the epidemiology of suicide during the early COVID pandemic (lockdown period). Methods This is a record-based cross-sectional study. We have analyzed the post-mortem reports for six months starting from April 1, 2020. Descriptive analysis was performed with Epi Info version 7 (Centers for Disease Control and Prevention, CDC, Atlanta, GA, USA). Results During the study period, 340 cases were classified as deaths due to suicide, out of a total of 891 mortalities. The median age for females was 26.5 and for males, it was 30. The male to female ratio was 1.8:1. Most of the deceased (39.8%) were in their third decade, followed by the fourth decade (18.9%), second decade (15%), and fifth decade (12.98%), respectively. Poisoning was the leading method used for suicide, accounting for 238 (70.1%) deaths, followed by hanging (11.8%), burns (6.8%), jumping from a height (6.5%), and jumping in front of the train (4.13%). Self-immolation (burning) was a common mode of suicide for females. Most of the suicides (71.4%) took place from the evening to midnight. Conclusion There was a fourfold rise in suicides during the period compared to previous data. Productive age groups are affected more. A large-scale multi-centric study in community settings for estimation of the true burden is the need of the hour. A multi-sectorial public health approach is needed to prevent untimely death due to suicide.

Evaluation of corneal topography, pachymetry and higher order aberrations for detecting subclinical keratoconus.

PURPOSE: To compare corneal topography, pachymetry and higher order aberrations in keratoconic and normal eyes; to investigate their association in keratoconic eyes; and to determine their diagnostic ability for detecting subclinical keratoconus in a Nepalese population. METHODS: Ninety-six eyes of 48 keratoconus patients and 50 normal eyes of 50 control subjects were included in this study. The eyes of keratoconus patients were classified into four different study groups: subclinical, stage 1, stage 2 and advanced stage keratoconus. In each eye, corneal topography, pachymetry and corneal aberrometry indices were measured using a Sirius corneal tomographer. The study parameters of keratoconic eyes were compared with normal eyes, and the possible association of corneal aberrometry with topography and pachymetry indices was investigated. The area under curve (AUC) of receiver operating characteristic (ROC) curves along with optimal cutoff values with best sensitivity and specificity were also determined for each index to detect subclinical keratoconus. RESULTS: All the indices except average keratometry measurements (Kavg and mmavg ) and spherical aberration (SA) were found to be significantly different in subclinical keratoconus compared to the control group (p < 0.05). In keratoconic eyes, all corneal aberrations were significantly correlated with the topography and pachymetry indices (range of ρ: -0.25 to 0.96; all p < 0.05) except for trefoil and minimum corneal thickness (Thkmin ). All the indices except Kavg , mmavg and SA showed excellent diagnostic ability (AUC > 0.90) in detecting subclinical keratoconus. The cutoff values proposed for the asymmetry index of the corneal back surface (SIb ), Strehl ratio of point spread function (PSF), coma and Baiocchi-Calossi-Versaci index of corneal back surface (BCVb ) each showed excellent sensitivity (100%) and specificity (≥97%). CONCLUSIONS: Corneal higher order aberrations were found to be significantly elevated in subclinical keratoconus compared to healthy controls. SIb , PSF, coma and BCVb were identified as the most powerful Sirius indices for the detection of subclinical keratoconus.

Waning of Anti-spike Antibodies in AZD1222 (ChAdOx1) Vaccinated Healthcare Providers: A Prospective Longitudinal Study.

Introduction Coronavirus disease 2019 (COVID-19) vaccines are nothing short of a miracle story halting the pandemic across the globe. Nearly half of the global population has received at least one dose. Nevertheless, antibody levels in vaccinated people have shown waning, and breakthrough infections have occurred. Our study aims to measure antibody kinetics following AZD1222 (ChAdOx1) vaccination six months after the second dose and the factors affecting the kinetics. Materials and methods We conducted a prospective longitudinal study monitoring for six months after the second of two AZD1222 (ChAdOx1) vaccine doses in healthcare professionals and healthcare facility employees at Veer Surendra Sai Institute of Medical Sciences and Research (included doctors, nurses, paramedical staff, security and sanitary workers, and students). Two 0.5-mL doses of the vaccine were administered intramuscularly, containing 5 x 1010 viral particles 28 to 30 days between doses. We collected blood samples one month after the first dose (Round 1), one month after the second dose (Round 2), and six months after the second dose (Round 3). We tested for immunoglobulin G (IgG) levels against the receptor-binding domain of the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by chemiluminescence microparticle immunoassay. We conducted a linear mixed model analysis to study the antibody kinetics and influencing factors. Results Our study included 122 participants (mean age, 41.5 years; 66 men, 56 women). The geometric mean IgG titers were 138.01 binding antibody units (BAU)/mL in Round 1, 176.48 BAU/mL in Round 2, and 112.95 BAU/mL in Round 3. Seven participants showed seroreversion, and 11 had breakthrough infections. Eighty-six participants showed a substantial decline in antibody titer from Rounds 2 to 3. Persons aged 45 or older had higher mean titer than people aged younger than 45 years. Overweight and obese (BMI ≥ 25 kg/m2) had a higher mean titer than average or underweight persons. The only significant predictor of IgG titers at six months was SARS-CoV-2 infection on mixed model analysis. Conclusion We found a substantial decline in antibody levels leading to seven cases of seroreversion in healthcare professionals who received the ChAdOx1 vaccine. History of prior COVID-19 was the only significant factor in antibody levels at six months. Seroreversion and breakthrough infection warrant further research into the optimal timing and potential benefits of booster doses of the AZD1222 (ChAdOx1) COVID-19 vaccine.

Effectiveness of measuring the central field with the Berkeley field test.

INTRODUCTION: There are several limitations of the Amsler chart as a screening tool due to its low sensitivity and high false-negative results. The Berkeley central visual field test (BCFT), which is a simple power-point presentation of a 50-point scoring system for the central 10-degree of the visual field, was devised as an alternative to the Amsler chart. OBJECTIVES: To compare the efficacy of measuring the central visual field using the Berkeley central field test (BCFT) and the Amsler grid test. MATERIALS AND METHODS: In a comparative and validity study, 30 subjects with maculopathy and 35 controls were recruited. The maculopathy subjects with the best corrected visual acuity of 20/200 or better and 2.5M for distant and near vision respectively, were included. All the subjects under went a complete eye examination where visual assessment was done using the distant and near vision Log MAR Chart. The subjects were assessed with the Amsler chart-II at a distance of 30 cm. The BCFT was used as a 50- point scoring system. The effectiveness of BCFT was compared with that of the Amsler grid regarding the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS: Out of 65 subjects, 30 subjects had maculopathy and 35 were normal. The mean age of the 65 subjects was 49.8±9.1 years. Of the 30 subjects with maculopathy, the majority (54%) had age- related macular degeneration. The sensitivity, specificity, PPV and NPV of the Amsler grid test were found to be 80%, 100%, 100% and 87%, respectively, whereas those of the BCFT were 71%, 99%, 98% and 82% (p=0.37). CONCLUSION: The BCFT test was as good as the Amsler grid test at detecting the presence of maculopathy.