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Background: Globally, anemia is one of the biggest public health challenges. The highest prevalence of anemia is seen among adolescents. Tribal communities are especially at a disadvantage, with several studies documenting a high prevalence of anemia among tribal adolescents. We investigated the prevalence of anemia and its associated risk factors among the tribal residential adolescent school students in Odisha. Material and Methods: In a cross-sectional survey, the prevalence of anemia was estimated by spectrophotometry among adolescents of residential schools in three predominantly tribal districts of Odisha. The severity of anemia was defined as per the World Health Organization classification for adolescents. Results: The mean age of 953 subjects was 13.07 ± 1.48 years. The prevalence of anemia was found to be 37.3%. As per the World Health Organization classification, 19.9% had mild anemia, 16.3% had moderate, and 1% had severe anemia. Consumption of Iron Folic Acid (IFA) was associated with the level of hemoglobin at a statistically significant level. Conclusion: We found that the prevalence of anemia was lower than in similar studies conducted in other parts of the country. Despite poor coverage of beneficiaries with iron and folic acid at the national level, our study showed better compliance and was associated with a significantly higher level of hemoglobin among those who consumed IFA.
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Physical inactivity (PI) is a risk factor for mortality and morbidity. PI and its predictors among the urban population in Bhubaneswar, India, were unknown. Finding out the contribution of PI as a cause of existing noncommunicable diseases (NCD) is difficult without following up with a cohort. The study was hence done to find out the prevalence, patterns, and predictors of physical inactivity in an urban population, and simultaneously investigate its causal relationship with NCD from this cross-sectional study. Cluster random sampling was used with a sample size of 1203 with a design effect of three. Socio-demographic, health profile, physical activity levels, and stage of change for physical activity behavior were collected. Logistic regression and marginal structural model analysis (by inverse probability of treatment weighting {IPTW} using a generalized estimating equation {GEE} to investigate the relationship between physical activity and prevalence of NCDs) were done using IBM SPSS v20 software (Armonk, NY: IBM Corp.). Statistical significance was tested at p=0.05. A total of 1221 subjects participated. The mean age was 35.25 years and 71.9% were physically inactive. General caste, presence of NCD, and being in a static stage of change influenced physical activity positively. PI was found to be a risk factor for NCD with 1.54 times higher odds in this population. The study concluded that the prevalence of physical activity was low and PI was a causative factor for NCD.
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Introduction The scope of anesthesia has shifted from general anesthesia (GA) and spinal anesthesia (SA) for below-knee surgery to peripheral nerve blocks (PNB). Combined sciatic-femoral nerve block (SFNB) with ultrasound (USG) guidance can be a better format for use. Objectives The primary objectives were to compare the duration of onset of sensory and motor blockade, total duration of sensory and motor blockade, and time of first analgesic requirement between both groups. Methods A prospective, randomized comparative study was carried out at a tertiary care teaching hospital in Odisha, India, from April 2019 to April 2021 in the Department of Anaesthesiology. Patients admitted for elective below-knee surgeries with American Society of Anesthesiology (ASA) grade II or less were divided into two groups (Group A receiving USG-guided SFNB and group B receiving SA) by computer-generated sampling. The block randomization method was used to ensure equal samples in both groups. Data collection was done using the Magpi software (Magpi, Inc., Washington, D.C., United States) on android-based mobile phones. Data were analyzed using Stata Statistical Software: Release 12 (2011; StrataCorp LP, College Station, Texas, United States) for analysis. Relevant statistical tests were used to compare the results between the groups (independent sample t-test or Wilcoxson signed-rank test). Repeated measures ANOVA (RM-ANOVA) was used to check the hemodynamic stability within the groups. Results Thirty-seven subjects were enrolled in each arm (Group A and Group B). Baseline parameters in both groups were comparable. The most common indication among the study subjects was single or multiple meta-tarsal fractures (20, 27.0%) followed by malleolus (15, 20.3%) and calcaneum fractures (13, 17.6%). Most of the study subjects were from ASA grade I (around 80%). The time of onset of sensory and motor block was found to be more for USG-guided SFNB (8.08±2.11 minutes and 11.35±1.84 minutes, respectively) as compared to the SA group (3.03±0.50 minutes and 4.89±0.52 minutes, respectively) (p<0.001). Total anesthesia and time to first analgesic requirement were, however, more in USG-guided SFNB (349.43±53.49 minutes and 339.73±54.24 minutes, respectively) as compared to the SA group (137.30±34.21 minutes and 137.30±34.21 minutes, respectively) (p<0.001). The mean time to first urination in USG-guided SFNB (178.92±20.92) was significantly less (p<0.001) compared to the SA group (419.19±40.30). There were no adverse events (0%) in USG-guided SFNB while 64.9% of the subjects in the SA group experienced adverse events (p<0.001). The most common adverse events were nausea/vomiting and hypotension (around 50% for both). Hemodynamic stability was present in both the groups of anesthesia subjects, though fluctuations in blood pressure may be seen more frequently in cases of SA. All the subjects in both the groups had achieved a Bromage score of 3 universally. The grand mean score of pain by SA (2.347±0.044) was more (p<0.001) in comparison to that in subjects with USG-guided SFNB (1.961±0.073) and this was significant in both the groups. The mean increase in pain score at 24 hours in comparison to baseline was, however, significantly more (p<0.05) in the SA group (1.784±0.111) in comparison to those receiving USG-guided SFNB (1.324±0.190). Conclusion USG-guided SFNB is a better option for below-knee surgeries as compared to SA.
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BACKGROUND: Fascia iliaca block (FIB) is an established procedure for postoperative pain relief in femur fracture surgeries. Dexmedetomidine was found to be a useful additive to local anesthetics (LA) for peripheral nerve blocks resulting in a prolonged anesthetic effect. We evaluated the impact of the addition of dexmedetomidine to an equal concentration of levobupivacaine and ropivacaine for FIB. Methods: The present study is a double-blind, randomized trial conducted on 60 patients in the age group 18-70 years. The patients were divided into two groups: Group LD received 30 ml of an LA solution (29.5 ml 0.25% levobupivacaine and 0.5 ml dexmedetomidine 50 µg), and group RD received 30 ml of another LA solution (29.5 ml 0.25% ropivacaine and 0.5 ml dexmedetomidine 50 µg). The outcomes observed were the duration of analgesia (DOA) and total analgesic requirement (TAR). RESULTS: The DOA was found to be slightly longer in group LD (955.3 ± 114.5 minutes) than in group RD patients (894.6 ± 91.3) with p = 0.027. The TAR was found to be statistically different though clinically irrelevant (group LD: 112 mg; IQR: 105-122 vs. Group RD: 115 mg; IQR: 104-118, p = 0.034, where IQR stands for interquartile range). There were no signs of neurotoxicity in any of the participating patients. CONCLUSION: Addition of 50 µg dexmedetomidine to 0.25% levobupivacaine extends DOA slightly as compared to when dexmedetomidine is added to 0.25% ropivacaine. However, TAR remains clinically the same for both cases in fascia iliaca block.
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BACKGROUND: Village Health and Nutrition Day (VHND) is a community-based health service package delivered on a fixed day approach. Services like early registration of pregnancy, regular antenatal care and postnatal care, growth monitoring and referral of sick children, discussion of health topics to generate awareness, and convergence between health and ICDS, are delivered every month at VHND at the Anganwadi Center. This study explores the awareness, perception and practice of service providers, and beneficiaries, regarding VHND. MATERIALS AND METHODS: It was a cross-sectional study conducted in Odisha during December 2009-November 2010. Personal interviews were conducted at the VHND sessions with 111 beneficiaries and 45 service providers using a semi-structured schedule to know their awareness, perception and practice regarding VHND sessions. Data analysis was done and reported as simple percentages. RESULTS: Most of the health worker females and anganwadi workers considered health awareness as a key component of VHND. 52% of HWFs and 41% of AWWs had misconception about additional roles and responsibilities. 34% of beneficiaries had knowledge regarding fixed day approach of VHND, while 24% did not have knowledge regarding any of its purpose. Only 8% of referral cases had complete knowledge on the reason of referral. There was significant difference in between awareness and practice among the blocks. CONCLUSION: Service providers' orientation should be improved. Behavior change communication activities should also be increased by the state. Referral cases should be properly counseled. The community believed that such a program should continue with better package and quality of services.
