Mental health issues and lifestyle changes associated with the COVID-19 pandemic in adolescents: A cross-sectional study in selected schools of Eastern India.

BACKGROUND: Due to coronavirus disease 2019 (COVID-19), adolescents from all over the world have higher rates of anxiety, depression, and stress. This study attempts to assess the effect of the COVID-19 pandemic on adolescent mental health and lifestyle issues. The study also focuses on coping strategies adopted by the participants during the pandemic. MATERIALS AND METHODS: It was a cross-sectional study performed among school-going adolescents studying from classes VII to X of selected schools in Bhubaneswar. A semi-structured questionnaire was formed and validated by faculty members of the Departments of Pediatrics, Psychiatry and Community Medicine, IMS and SUM Hospital, Bhubaneswar, to obtain a detailed history regarding lifestyle changes, mental health issues, and coping strategies. Randomly, three schools were selected in Bhubaneswar. Permission from the principal, informed written consent from parents, and assent from students were obtained before the study. A total of 711 participants were enrolled in the study. All data were entered in an Excel spreadsheet and analyzed using Statistical package for social sciences (SPSS) version 26. RESULTS: Middle and high school students also experienced lifestyle changes; however, it was revealed that high school students experienced higher mental health problems, such as mood swings. Additionally, compared to males, girls substantially more frequently experienced academic stress, sleep difficulties, and worry, as well as the development of unhealthy habits. Various coping strategies developed by the students included development of a new hobby (45.4%), spending time with family members (12.8%), learning by playing indoor games (8.4%), computer skills (3.9%), and meditation (2.25%). CONCLUSIONS: The lockdown, apprehension of pandemic and associated morbidity, fear of losing loved ones, academic and peer pressures, and sudden adjustment to new study methods contributed to the changes experienced by adolescents physically and mentally; hence, all of these issues were addressed in this study. This study pointed toward the need for the propagation of adolescent mental health awareness during pandemics.

Effect of lifestyle interventions to reduce depression, anxiety and stress among married women of reproductive age group: A non-randomised controlled trial in urban slums of Bhubaneswar.

BACKGROUND: Women are more prone to develop mental disorders as compared to men and the role of physical activities to reduce its burden by improving self-esteem is appreciable. This study aimed to evaluate the effect of lifestyle interventions to reduce depression, anxiety and stress among women in urban slums. MATERIALS AND METHODS: This study was a non-randomized controlled trial carried out in two slums of Bhubaneswar in married women of reproductive age group (15 years-49 years) from June 2019 to September 2021 after approval from the institutional ethics committee. A total of 128 married women were recruited, 64 women in each arm. DASS-21 was used for assessing depression, anxiety, and stress of all participants. The lifestyle intervention program was provided to 64 women in the intervention group and educational materials were provided to the control arm. DASS score was assessed again and compared with follow-up scores in both groups. Descriptive statistics were expressed as frequency, mean, median, and standard deviations. Independent t-test and paired t-tests were done where applicable. RESULTS: There was no significant difference in socio-demographic factors and DASS-21 scores in both groups during baseline. Depression, Anxiety, and stress score were significantly lower in the intervention arm than control arm in the follow-up (P < 0.05). There was a significant difference between the pre-intervention and post-intervention levels of depression, anxiety, and stress among the intervention group (P = 0.05). CONCLUSIONS: Simple community-based physical activities as in our intervention program focusing on the reduction of depression, anxiety, and stress levels in women may prevent the rising problems of common mental disorders.

Mapping Concurrent Wasting and Stunting Among Children Under Five in India: A Multilevel Analysis.

Objectives: The study aims to examine the coexisting forms, patterns, and predictors of concurrent wasting and stunting (WaSt) among children under five in India. Methods: We used data from the National Family Health Survey to understand the trend and association of WaSt among children under five-year-old in India. Univariate analysis and cross-tabulations were performed for WaSt cases. The association was determined using multilevel binary logistic regression and multilevel regression, and the results were provided as adjusted odds ratios (aOR) with 95% confidence intervals at the significance level of p < 0.05. Results: The prevalence of WaSt has decreased from 8.7% in 2005-06 to 5.2 percent in 2019-2020. The proportion of WaSt children grew rapidly from 6 to 18 months, peaked at 19 months (8%), then dropped after 24 months. The prevalence of concurrent wasting and stunting is higher among boys compared to girls. Compared to children of different birth orders, those in the higher birth order are 1.2 times more likely to be WaSt cases (aOR = 1.20, 95% CI = 1.09, 1.33). The education of the mother is strongly correlated with WaSt instances, and children of more educated mothers have a 47% lower chance of being WaSt cases (aOR = 0.63, 95% CI = 0.57, 0.71). Children from wealthy families are 52% less likely to be WaSt cases (aOR = 0.48, 95% CI = 0.43, 0.55). Conclusion: This study emphasizes the importance of concurrent wasting and stunting and its relationship with socioeconomic factors among children under five in India.

Effectiveness of lifestyle related interventions to improve quality of life among postmenopausal women in selected slums of Bhubaneswar: A community based quasi experimental study.

BACKGROUND: Postmenopausal women considered as risk population, due to estrogen deficiency, 80% of women reduce physical and mental well-being in their menopausal years. Menopausal symptoms are not always reasons for any life-intimidating situations, but it disturbs quality of life (QoL) of middle-aged women. MATERIALS AND METHODS: This non-randomized control trial was conducted among slum women in the age group of 40 to 60 years who were in their postmenopausal period (within 5 years). Study group was intervened by lifestyle-related interventional module about concept of menopause, symptoms, health issues, dietary habit for reducing menopausal symptoms with a practical demonstration of yoga, exercises and pranayama, group and individual counseling to the participants. Independent t-test, paired t-test, Chi-squared test, and Fisher's exact test were analyzed by SPSS software version 28 licensed to the institute. RESULTS: The mean age of the participants was 51.02 ± 2.94 years ranging from 47 to 58 years. As per anthropometric and blood pressure measurements data, significant differences were found in weight (P < 0.02), body mass index (P < 0.001), waist/Hip Ratio (P < 0.001), SBP (P < 0.001) and DBP (P < 0.001) between both the groups. Comparing the mean difference score of vasomotor, psychosocial, physical and sexual domains of the MENQOL questionnaire pre- and post-intervention found that, there was significant reduction of QoL score in study group. CONCLUSION: The lifestyle related interventions as an alternative therapy are safe, free from side effects, cost-effective and government program may be implemented for the betterment of the menopausal women.

Socioeconomic Inequalities in the Prevalence of Non-Communicable Diseases among Older Adults in India.

Understanding socioeconomic inequalities in non-communicable disease prevalence and preventive care usage can help design effective action plans for health equality programs among India's aging population. Hypertension (HTN) and diabetes mellitus (DM) are frequently used as model non-communicable diseases for research and policy purposes as these two are the most prevalent NCDs in India and are the leading causes of mortality. For this investigation, data on 31,464 older persons (aged 60 years and above) who took part in the Longitudinal Ageing Survey of India (LASI: 2017-2018) were analyzed. The concentration index was used to assess socioeconomic inequality whereas relative inequalities indices were used to compare HTN, DM, and preventive care usage between the different groups of individuals based on socioeconomic status. The study reveals that wealthy older adults in India had a higher frequency of HTN and DM than the poor elderly. Significant differences in the usage of preventive care, such as blood pressure/blood glucose monitoring, were found among people with HTN or DM. Furthermore, economic position, education, type of work, and residential status were identified as important factors for monitoring inequalities in access to preventive care for HTN and DM. Disparities in non-communicable diseases can be both a cause and an effect of inequality across social strata in India.

Translation, Reliability, and Validity Test of Odia Version of Menopause-Specific Quality of Life Questionnaire Among Postmenopausal Women for Menopausal Symptoms.

Introduction: The Menopause-specific Quality of Life (MENQOL) questionnaire was developed in 1996 to assess the health-related quality of life (QOL) in the menopausal transition and it addresses the degree to which menopausal symptoms had bothered women. The objective of this study was to translate the MENQOL questionnaire in the Odia- regional language of India and validate it for usage in the Odia-speaking menopausal women. Methods: The original English questionnaire MENQOL with 1-month recall period was translated by the researchers. According to instructions by Mapi Research Trust, the questionnaire was forward and backward translated, followed by participant testing and proofreading. Validity and reliability were evaluated by the following tests: internal consistency (reliability), stability (test-retest reliability) with Cronbach's alpha correlations, Pearson's correlation coefficients, and content validity index. Results: A total of 80 postmenopausal women participated in the study. The ICC score and Cronbach's alpha value of all the four domains such as vasomotor, psychosocial, physical, and sexual of both MENQOL English and Odia (MENQOL-E and MENQOL-O) versions recommended excellent homogeneity. The internal consistency using the Cronbach's alpha showed high reliability (0.993) between the MENQOL-E and MENQOL-O questionnaires. Conclusion: The MENQOL-O questionnaire will be used at the individual to community health-care settings to measure QOL and those identified with lower menopause-related QOL, they may get support and care.

Gender difference in prevalence of hypertension among Indians across various age-groups: a report from multiple nationally representative samples.

BACKGROUND: Prevalence of hypertension increases with age, but there is a general perception in India that women are less affected at every stage of life, although empiric evidence hardly exists regarding gender difference in hypertension in Indians of different ages. Therefore, we aimed to examine the gender difference in hypertension among Indians across various age-groups; and the contribution of variation in body mass index (BMI) to this difference. METHODS: Data were analysed after combining National Family Health Survey 4 (n = 294,584 aged 35-49 years) and Study of Ageing and Health wave 2 (n = 7118 aged 50 + years) datasets (NFHS-SAGE). Longitudinal Ageing Study of India (LASI) dataset (n = 65,900 aged > 45years) was analysed to replicate the results. Hypertension was defined if systolic and diastolic blood pressure was > 89 and/or > 139 respectively and/or if there was a history of anti-hypertensive medication. Descriptive summaries were tabulated and plotted to examine the gender difference in hypertension in various age-groups (35-39,40-44, 45-49, 50-54, 55-59, 60-64, 65-69, ≥ 70). Odds Ratios (ORs) from logistic regression models estimated the age gradient of hypertension and their male-female difference, adjusted for Body Mass Index (BMI). RESULTS: Males had a higher prevalence of hypertension up to 50 years; after that, females had higher rates. The estimates of age gradient, expressed as ORs, were 1.02 (1.02, 1.02) in males versus 1.05(1.05, 1.06) in females (p < 0.001) in NFHS-SAGE and 1.01(1.01, 1.02) in males versus 1.04(1.03, 1.04)in females (p < 0.001) in LASI;these differences marginally changed after adjustment with BMI. CONCLUSION: This is perhaps the first study to comprehensively demonstrate that cardio-metabolic risk in Indian females surpasses males after 50 years of age, "busting the myth" that Indian females are always at much lower risk than males; and this evidence should inform the Indian healthcare system to prioritise older women for screening and treatment of hypertension.

Effectiveness of Mobile Application for Promotion of Physical Activity Among Newly Diagnosed Patients of Type II Diabetes - A Randomized Controlled Trial.

Background: Mobile health intervention shows the positive effects on the management of chronic diseases. Therefore, the study was planned to study the effectiveness of a mobile-based application promotion of physical activity among newly diagnosed patients with type II diabetes. Methods: The present study was a parallel-design randomized controlled trial conducted over 2 years. The participants were type II diabetes patients between 18 and 60 years within 3 months of diagnosis who attended the endocrinology outpatient department having knowledge of using smart phone. The sample size was calculated to be 66 and 33 for each arm. The block random design method was adopted for allocation into different arms. A pretested interview schedule was used for the collection of data. Outcomes included body mass index, waist circumference, body fat percentage, and changes in the physical activity was obtained by global physical activity questionnaire (GPAQ). The information thus collected were processed and analyzed using SPSS v 20. Results: The study included 66 patients aged between 18 and 60 years, out of which 33 were enrolled into control and 33 into intervention group. The mean age of the participants was 42.29 ± 9.5 years ranged from 25 years to 59 years, 65.2% were males and 34.8% were females. It was observed that a higher proportion of intervention participants met WHO recommendations of physical activity level. Total metabolic equivalent of task (MET) value per minute (Mean ± SD) was 1347.27 ± 1028.5 in the control group and 1223.03 ± 584.87 in intervention group at baseline and was not different (P = 0.538). The total MET value per minute was found to be higher among the intervention group in all follow-ups. There was a significant decrease in weight, BMI, waist circumference, hip circumference, body fat percentage, and systolic blood pressure (SBP) in the intervention group. Conclusions: Cost-effective, simple mobile applications may help in routine clinical practice to encourage the patients for the promotion of physical activity.

Out-of-pocket expenditure and its predictors for illness of under-five children: A cross-sectional study in urban slums of Eastern India.

INTRODUCTION: Out-of-pocket (OOP) expenditure influences the access to the healthcare of the marginalized and vulnerable population including under-five children (U5C). The aim of the study is to estimate the OOP expenditure and its predictors in Bhubaneswar, a region of eastern India. METHODS: A cross-sectional study was conducted using a semi-structured interview schedule in 20 urban slums of Bhubaneswar. The survey was carried out by using the National Sample Survey Office (NSSO) health consumption schedule 25.0 in which mothers of U5C with illness (n = 530) were interviewed. For data analysis, the nonparametric Wilcoxon rank-sum test and Kruskal-Wallis test were used as tests of significance. RESULTS: The study revealed that the mean OOP expenditure for outpatient department (OPD) care was ₹375.9 (₹219.48). The mean approximated expenditure was ₹1669.8 (₹1131.9) for inpatient department (IPD) care. In OPD care, doctors' fee and medicine cost constituted 65.01% and 50.46% of OOP expenditure, respectively. In IPD care, medicine cost and doctors' fee contributed to 36.62% and 30.54% of OOP expenditure, respectively. The major significant predictors that contributed to increased OOP were gender and delay in approaching the source of treatment in OPD, whereas in IPD no such predictors were observed. CONCLUSIONS: This study prominently sheds light on the issue of accessibility and affordability of health services without a comprehensive health insurance scheme for U5C illness among the vulnerable urban slum dwellers to achieve universal health coverage.

Vaccination against Hepatitis B: A Scoping Review.

OBJECTIVE: Elimination of viral hepatitis by 2030 as one of the international Sustainable Development Goals puts the hepatitis B vaccination on the forefront. However, barriers to vaccination reported in various studies are of concern. This study explores the global barriers for effective uptake of Hepatitis-B vaccination. METHODS: A scoping review of studies reporting hepatitis B vaccination barriers was done using PMC data base and Google scholar search engine. About 803 journal articles and reports on hepatitis B barriers were retrieved but only 36 most relevant items during last 10 years were identified, pile sorted, grouped and analyze. RESULTS: Overall 74 barriers have been identified for effective uptake of hepatitis-B vaccines. Most studies focused on non-zero dose of hepatitis B vaccine, One-third of the barriers are related to system issues, one-fourth of the barriers were related to caregiver education or awareness, fear of side effect, migration etc., one-fifth barriers were related to service provider issues like poor out-reach, home visits, poor communication and/relation with the caregivers, failure to identify unimmunized children etc., and other barriers were social-cultural issues. The review reveals limited availability and accessibility to health-facility based immunization, lack of awareness among caregivers, poor communication by the healthcare workers and negative relationships with the beneficiaries, cost of vaccine in private sector, inconvenience time and place of vaccination etc. as the major barriers for hepatitis B vaccination. Barriers varied from country to country. CONCLUSION: Myriad barriers for reduced hepatitis-B vaccine uptake need to be addressed contextually as countries are at different stages of hepatitis-B vaccination implementation.

Assessment of stress among parents of neonates admitted in the neonatal intensive care unit of a tertiary care hospital in Eastern India.

BACKGROUND: An infant admitted to the neonatal intensive care unit (NICU) is a potentially stressful event for parents. Severe stress is experienced by parents, affecting their mental health and relationship, and infants' development. The current study aims to assess the stress levels among parents of neonates admitted to NICU and to identify the factors influencing their stress levels. MATERIALS AND METHODS: A cross-sectional study was conducted in a tertiary care hospital of Eastern India over 2 months. Stress levels were assessed using Parental Stressor Scale: NICU questionnaire among 100 NICU parents (mother or father) with more than 24 h of admission. Stress was quantified using the Likert scale. The statistical analysis was performed using the SPSS software. RESULTS: In this study, 60.8% parents experienced severe and extreme stress level for overall stress. The mean for overall stress experienced was 3.71 ± 0.70. There was no significant difference in overall stress between father and mother (P = 0.65). The highest levels of stress experienced were in sight and sound subscale (3.23 ± 0.41) followed by relationship with the baby and parental role," i.e., 2.46 30. There was no significant association in overall stress score with maternal age, parity, education level, previous baby being admitted to the NICU (P > 0.05). Stress in sight and sound domain was statistically significantly higher (P = 0.009) among parents of babies with stay of ≤7 days. CONCLUSION: These results support wider use in research and clinical practice to identify parental stress. Interventions can be developed to ameliorate its negative effects on individual, interpersonal, and societal levels. The stress score was not significantly different between fathers and mothers of neonates admitted to NICU and the length of stay was significantly associated with sight and sound domain. Appropriate counseling should be targeted toward both parents. Future intervention studies should be planned to decrease the stress level among parents.

Anabolic Androgenic Steroid Abuse and their Health Impacts: A Cross-sectional Study among Body Builders in a City of Eastern India.

BACKGROUND: Anabolic-androgenic steroids (AASs), when taken in supraphysiologic doses, increase muscle strength and athletic performance. Evidence suggests that long-term use of AAS in supraphysiologic doses have adverse effects on health. Therefore, the study was conducted to find crude estimate of the prevalence of AAS use among attendees of the gymnasium, the factors that could have influenced them for AAS abuse and to assess the short- and long-term side effects as perceived by them. METHODS: A cross-sectional study was conducted in selected gymnasiums of a smart city of India using a predesigned and pretested questionnaire. Snowball sampling method was undertaken. The study was from July 2015 to June 2016. Informed written consent was taken. The analysis was done using SPSS v. 20.0. RESULTS: Of 84 bodybuilders approached, 74 participants used AAS. All users were male with mean age of 26.5 + 0.55 years. The mean age of initiation of AAS abuse was 23 years, and 66.2% (49) were unmarried. Eighty-five percent (63) preferred injectable. Seventy percent (52) abusers were influenced by trainers for abuse. Most commonly abused was Nandrolone decanoate (55.4%). Seventy-three percent were not aware of any legal ban on steroids. Reported benefits include increased strength, muscle size, and power, while harms were increased acne, deepening of voice, swelling of feet, increased irritability, depressive thoughts, impaired judgment, panic disorder, and withdrawal effect. CONCLUSIONS: Frequency of ASS use was substantial among young bodybuilders. Awareness about side effects was not a deterrent factor. Abusers were highly influenced by coaches. Efforts should be made for preventing easy access to AAS.

End-of-life Care and Social Security Issues among Geriatric People Attending a Tertiary Care Hospital of Eastern India.

CONTEXT: The care of sick members is the hallmark of a civilized society. End-of-life care and social security for elderly are emerging issues nowadays. AIMS: The aim of this study is to explore the desires of the elderly regarding the end-of-life care decisions along with to find out social security measures among the study population. SETTINGS AND DESIGN: The cross-sectional study conducted in the geriatric outpatient department of a tertiary care hospital. SUBJECTS AND METHODS: The study period was 4 months from August to November 2017. The geriatric patients attending geriatric outpatient department were interviewed using a predesigned and pretested questionnaire. Convenient sampling was used and a total of 138 participants were included in the study. STATISTICAL ANALYSIS USED: Proportions were used in the study. RESULTS: A total of 63.77% participants expected to die at home surrounded by their family members during their time of death followed by hospital (31.88%). Majority (63.77%) stated their opinions to die a senile death. Organ donation after death was the willingness shown by as high as 70.3%, but registered organ donors were 6.5%. 94.2% participants expected to be cremated after their death while others buried in accord to their religious practices. Only 7.24% of participants had a legal will of their financial establishments. It was observed that even half of the population (47.8%) did not have any form of health or life insurance. CONCLUSION: Home-based care of the elderly is needed so that they can live their last days of life peacefully. Awareness about health and life insurance should be increased by urgent intervention.

Internet use for patient care and health research: A cross-sectional study among physicians in a teaching hospital of Eastern India.

BACKGROUND: Internet is the world's largest network of information and communication services. The internet is widely used in medicine and had a significant impact on research, training, and patient care. OBJECTIVES: (1) To assess internet use to obtain health information for patient care among physicians of a medical college hospital. (2) To investigate the utilization of the internet during their daily practice and to know the reasons for its use and nonuse. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted for a period of 2 months of May and June 2015 in a Medical College Hospital of Eastern India. A convenient sample of 200 physicians was included in the study. Data regarding access of internet in workplace, time spent on the internet for medical and nonmedical purposes, opinions regarding use of the internet to update medical knowledge, obstacles that affect its use, etc., were collected. The data were analyzed using SPSS software version 20. RESULTS: It was seen that 47% doctors use laptop for accessing internet, followed by mobiles (34%). E-mail was the main purpose (41%) of internet use, followed by research (32.5%). Majority told that e-mail was the main purpose of last internet use (46.5%), followed by browsing medical resources (23%), research (15.5%), and patient care (12.5%). 97.5% agreed that they had ever browsed internet for patient care and 85.5% doctors agreed that they had obtained relevant information. 26.5% told that they need training for accessing free full-text electronic journals and 25% need training to access the sources for best clinical evidence for patient care. Other training needs were literature search (18%), downloading textbooks and other resources (15.5%), and searching internet sites for medical information (10%). CONCLUSION: Providing training for improvement of searching skills for obtaining up-to-date medical information, and evidence-based medicine from internet will improve their practice of medicine.

Contraceptive behavior of couples undergoing sterilization in an Eastern State of India.

BACKGROUND: As a part of a larger study for evaluating the effectiveness of a community-based family welfare program, this study assessed the contraceptive behavior of couples preceding sterilization and termination of pregnancies, if any during the interim period. METHODS: During May-June 2013, a cross-sectional study was undertaken in three districts of Odisha, an eastern state of India with poor maternal health indicators. Using a 15 × 14 cluster design with probability proportionate to size sampling 15 village clusters from each district were selected. Seven beneficiaries from the catchment area of two Accredited Social Health Activist of the selected villages were interviewed (14 respondents from each village) using a pretested predesigned questionnaire. RESULTS: A total of 630 clients with either of the partner having undergone sterilization were interviewed. Male partner having undergone vasectomy was < 1% (n = 3). The mean age (standard error mean [SEM]) of the respondent women was 34.54 ± 0.26 years. The mean age of the women at the time of sterilization was 27.12 (standard deviation [SD], 3.8, SEM 0.15 and median 26.83 years) years. Women as young as 22 years had undergone sterilization. Average family size was 2.81 with about 29 respondents (4.5%) having 5 or more children. The average duration between the last childbirth (LCB) to the date of sterilization was 18.37 months (range: 1-142 months, SD: 24 months, SE: 10 months). Seventy-two percent of the respondents did not use any method of contraception during this period. Methods adopted for contraception among the users was pill (20%) followed by condom (7%), and intrauterine contraceptive device (IUCD) was least used (0.2%). Ten percent of the women had undergone abortion before sterilization either once (7.9%) or more than once (2.1%). CONCLUSION: There was a gross delay in sterilization after LCB. Postpartum sterilization or IUCD were also not used frequently.

Socio-clinical profile of married women with history of induced abortion: A community-based cross-sectional study in a rural area.

BACKGROUND: Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of the availability of contraceptive services. OBJECTIVES: (1) To study the sociodemographic profile of abortion seekers. (2) To study the reasons for procuring abortions by married women of reproductive age group. MATERIALS AND METHODS: It was a cross-sectional community-based study. All the married women of reproductive age group (15-49 years) with a history of induced abortion were selected as the subjects. RESULTS: The most common reason for seeking an abortion was poverty (39.4%), followed by girl child and husband's insistence, which accounted for 17.2% each. More complications were noted in women undergoing an abortion in places other than government hospitals and also who did it in the second trimester. CONCLUSIONS: To reduce maternal deaths from unsafe abortion, several broad activities require strengthening such as decreasing unwanted pregnancies, increasing geographic accessibility and affordability, upgrading facilities that offers medical termination of pregnancy (MTP) services, increasing awareness among the reproductive age about the legal and safe abortion facilities, the consequences of unsafe abortion, ensuring appropriate referral facilities, increasing access to safe abortion services and increasing the quality of abortion care, including postabortion care.

Validating Neck Circumference and Waist Circumference as Anthropometric Measures of Overweight/Obesity in Adolescents.

OBJECTIVE: To measure neck circumference and waist circumference, to compare it between normal and overweight/obese adolescents, and to validate these with body mass index. METHODS: This cross-sectional study was conducted in 1800 school-going adolescents. Body mass index, waist circumference and neck circumference were measured. Independent samples t-test and Pearson's correlation were used as tests of significance to analyze quantitative data. RESULTS: Positive correlation of neck circumference and waist circumference with body mass index was observed. The neck circumference and waist circumference in overweight/obese adolescents were significantly higher than adolescents with normal body mass index (P<0.001). Area under curve of waist circumference was more than area under curve of neck circumference. Cut-off values of neck circumference for screening adolescent obesity in boys and girls were 30.75 cm, and 29.75 cm, respectively, and waist circumference cut-off value were 70.75 cm for boys and 69.25 cm for girls at fairly good levels of sensitivity and specificity. CONCLUSION: Neck circumference and waist circumference may be used in clinical practice and epidemiological studies as an index of overweight/ obesity among school-going adolescents.

Overweight and Obesity among Adolescents, A Comparative Study Between Government and Private Schools.

OBJECTIVE: To compare prevalence of overweight/obesity among adolescent school children of government and private schools. METHODS: A school-based cross-sectional study was conducted in 1800 children aged 10-16 years. Body mass index (BMI), Waist circumference (WC), Hip circumference (HC), and Neck circumference (NC) were measured using standard guidelines. RESULTS: The prevalence of overweight obesity was 27.8% (private schools 45.2%, government schools 10.5%). BMI, WC, NC, and Waist-hip ratio were significantly higher among private school students. CONCLUSION: A differential strategic plan may be needed to prevent and control obesity among adolescent school children.

Mobile phone-based education and counseling to reduce stress among patients with diabetes mellitus attending a tertiary care hospital of India.

BACKGROUND: Stress among diabetic patients is much more as compared to normal individuals. A delayed recognition of stress undoubtedly worsens the prognosis for survival for many diabetic patients. Hence, this study was planned to develop an intervention model for the reduction of stress among diabetic patients and to evaluate the developed intervention model in the proposed group. METHODS: This study was conducted in endocrinology outpatient department of a tertiary care hospital. Starting at random, the patients were allocated to control group and test group. Controls were given printed educational materials. Test group were counseled with intense lifestyle education using both printed materials and computers; they were contacted by telephones by the investigator every 3 weeks for 3 months and SMS were sent every week containing some educational tips. RESULTS: Mean age was 54 ± 11.5 years overall ranging from 30 years to 80 years. About two-third of participants were males with similar distribution in both the groups (intervention = 66%, control = 64%). Half (50%) of the participants lived in joint families, followed by nuclear families (40%). Most (83%) were married and with either graduate or above graduate education (n = 39%). No significant difference was observed in socio-demographic characteristics among both control and intervention groups (P > 0.05). The average stress scores were similar (18.9) at baseline for control and intervention arms. At 3-month follow-up, however, these scores reduced to 17.05 in the intervention arm while they increased to 20.7 in the control arm. At 3 months follow-up, higher proportion of stress reduction was seen in the intervention group. CONCLUSIONS: Intervention in the form of intensive lifestyle education and phone calls and SMS significantly decrease their stress score. Mobile-based education has great potential to improve their mental status and increase patient-provider communication, and to decrease stress.