Vaccine hesitancy among the nursing officers working in a tertiary care hospital, Puducherry - A mixed-method study.

Background: Vaccination was considered one of the vital moves in controlling the spread of highly infectious COVID-19 pandemic. But, the initial acceptance level was highly improbable among nursing professionals (57%) in India.1 Thus, it was necessary to explore the reasons behind this reluctance, as they can act as trusted advisors for general population in decision-making. Objectives: This study aimed to determine the proportion of nursing officers with COVID- 19 vaccine hesitancy during the phase one drive (15th January to 28th February 2021) of vaccination and the various factors contributing to it. Methods: A cross-sectional analytical mixed-method study was done among 422 nursing officers working in a tertiary care hospital, Puducherry. Data was collected using a pretested semi-structured questionnaire along with WHO -SAGE Vaccine Hesitancy Scale for the quantitative component and an interview guide for qualitative part. Results: More than half of the participants were found to be COVID- 19 vaccine hesitant based on the operational definition, with fear of side effects being the most reported reason. Factors like work experience of five years or less, previous history of COVID- 19 infection, and delayed receipt of the first dose of the vaccine were significantly associated with vaccine hesitancy. Conclusion: Improper flow of evidence-based information was identified as one of the major concerns related to vaccine acceptance. Measures should be taken for proper awareness generation through dependable channels and at the same time for the prevention of spread of infodemics pertaining to the new interventions for better penetration and utilization.

Functional Analysis of DNMT1 SNPs (rs2228611 and rs2114724) Associated with Schizophrenia.

A recent study showed the association of minor alleles of rs2228611 (T allele) and rs2114724 (T allele) of DNMT1 with schizophrenia (SZ) and suggested their effects on splicing of the transcripts. We performed a replication study using 310 controls and 304 SZ patients and confirmed the association of the homozygous minor allele genotypes with SZ (P = 0.04 for rs2114724 and P = 0.007 for rs2228611). This significant association persisted after Bonferroni correction when the previously published data of 301 controls and 325 patients were also considered (P ≤ 0.0002). In addition, we found that the proportion of male patients with homozygous minor alleles at rs2114724 was significantly higher than that of females (P = 0.002). When haplotype analysis of both loci was performed, we observed a significant association of T/T-T/T and T/T-C/T (P = 0.04) haplotypes with SZ. To gain insights into the functional effects of the two SNPs on the levels of DNMT1 transcripts, quantitative real-time PCR experiments were performed using peripheral blood monocytes from 10 individuals each with T/T-T/T (homozygous minor allele), C/T-C/T (heterozygous), and C/C-C/C (homozygous major allele) haplotypes. Independently, the levels of DNMT1 protein were also compared in three individuals each by immunofluorescence. These results suggest that neither DNMT1 transcript nor the protein levels were significantly different in the peripheral blood monocytes among the individuals studied for the three groups. Taken together, our results confirm that the two minor alleles in homozygosity are associated with SZ but with no discernible effects on transcript or protein levels of DNMT1 in the peripheral blood monocytes of the small number of samples tested.

Awareness and practices on eye effects among people with diabetes in rural Tamil Nadu, India.

BACKGROUND: Recently eye effects of Diabetes Mellitus (DM) are an important concern due to increase in its trend especially in developing countries. OBJECTIVES: To assess the awareness related to eye effects of DM and its prevention practices among people with diabetes. METHODS: This cross sectional study was conducted from January 2013 to April 2013 in Villupuram district of Tamil Nadu, India. All 105 people with diabetes from the service area of two sub-centres were included. Data on socio demographic details, history of DM, awareness on systemic complications of DM, effects of DM on eyes, practice on regular blood check-up, eye examination and source of information were collected by interview technique using a structured questionnaire. Univariate and multiple logistic regression analysis were done to assess the association of awareness of eye examination with socio-demographic variables. RESULTS: Mean age of the study population was 56.7 years. About 93 people with diabetes (88.6%) tested their blood sugar at least once in every 3 months. About 80 people with diabetes (76.2%) were aware of at least one systemic complication of DM. Although 78 (74.3%) people with diabetes were aware that DM could affect the eyes, majority of this group (68, 87.2%) did not know the specific effects of DM on eyes. In this group, about 28(35.9%) people with diabetes were not aware of the reasons for eye effects, while others mentioned that persistent high blood sugar level (n=26, 33.3%), longer duration of DM (n=14, 17.9%) and lifestyle (n=10, 12.8%) were the reasons for the eye effects of DM. Only 31 (29.5%) of them knew that their eyes must be regularly examined. People with diabetes who had post-secondary and above (>10th standard) level of education had significantly higher awareness on examination of eye (Adjusted OR=19.63). CONCLUSION: Although awareness of people with diabetes on systemic effects of DM was more, their awareness on specific eye effects and need for regular screening was low. Systematic efforts are required to increase awareness on eye effects and importance of regular screening in this population.

Improved Multiplex Ligation-dependent Probe Amplification (i-MLPA) for rapid copy number variant (CNV) detection.

BACKGROUND: In Multiplex Ligation-dependent Probe Amplification (MLPA), copy number variants (CNVs) for specific genes are identified after normalization of the amounts of PCR products from ligated reference probes hybridized to genomic regions that are ideally free from normal variation. However, we observed ambiguous calls for two reference probes in an investigation of the human 15q11.2 region by MLPA among 20 controls, due to the presence of single nucleotide polymorphisms (SNPs) in the probe-binding regions. Further in silico analysis revealed that 18 out of 19 reference probes hybridize to regions subject to variation, underlining the requirement for designing new reference probes against variation-free regions. METHODS: An improved MLPA (i-MLPA) method was developed by generating a new set of reference probes to reduce the chances of ambiguous calls and new reagents that reduce hybridization times to 30 min from 16h to obtain MLPA ratio data within 6h. Using i-MLPA, we screened 240 schizophrenia patients for CNVs in 15q11.2 region. CONCLUSION: Three deletions and two duplications were identified among the 240 schizophrenia patients. No variation was observed for the new reference probes. Taken together, i-MLPA procedure helps obtaining non-ambiguous CNV calls within 6h without compromising accuracy.

Prevalence and risk factors of hypertension among bank employees in urban Puducherry, India.

BACKGROUND: There is paucity of information on the prevalence of hypertension and its risk factors among bank employees at global level. OBJECTIVE: To assess the prevalence and risk factors of hypertension among bank employees in Puducherry, India. METHODS: A cross-sectional study was conducted on 192 (128 male and 64 female) bank employees from 12 nationalized banks in urban Puducherry, India. Blood pressure was measured and classified according to the Joint National Committee (JNC) VII criteria. Data on risk factors of hypertension, including consumption of extra salt while dining, eating high-salt food, junk food, servings of fruits and vegetables, smoking, alcohol use, physical activity, and body mass index, were obtained for each participant using a standard questionnaire. Stress level was assessed by Cohen's Perceived Stress scale. Data was analyzed by Chi-square test and multiple logistic regression analysis. RESULTS: The mean±SD age of the participants was 39.5±10.6 years. The prevalence of hypertension and pre-hypertension was 44.3% (95% CI: 37.2%-51.3%) and 41.1% (95% CI: 34.1%-48.1%), respectively. Of 85 participants with hypertension, 47 (55%) was known case and 38 (45%) were newly diagnosed. Multiple logistic regression analysis revealed that living in the 4th (OR: 3.13) or 6th (OR: 3.11) decade of life, consumption of extra salt (OR: 2.49), and physical activity ≥2 hours per day (OR: 0.21) were associated with hypertension among bank employees. CONCLUSION: Prevalence of hypertension is high among bank employees. There is a need for strengthening adoption of certain interventional measures in lifestyle such as reducing salt intake and promoting physical activity among this vulnerable group.

Pattern and outcome of Cleistanthus collinus (Oduvanthalai) poisoning in a tertiary care teaching hospital in South India.

There is paucity of information on human studies about Cleistanthus collinus (Oduvanthalai) poisoning at global level. The present study was done to find out the pattern and outcomes with acute poisoning of this plant poison. Retrospective record based study was conducted among acute C. collinus (Oduvanthalai) poisoning cases admitted between January 2010 and December 2010 in a tertiary care teaching hospital in South India. A total of 51 cases were analyzed with 52.9% of them being females and 51% belonged to 21-40 years age group. Interpersonal conflict was the stressor for poisoning in 76% cases. Mortality rate was 17.6% with a median duration of 3.5 days from time of ingestion. Majority of the patients who died during hospitalization had ingested decoction (77.8%), and had neurological manifestations (77.8%), hypokalemia (77.8%), neutrophilia (66.7%), leucocyotosis (55.6%) and elevated blood urea (77.8%). It was found that lower potassium level, white blood cell and neutrophil count were significantly associated with mortality due to poisoning.

Outcome of gestational diabetes mellitus from a tertiary referral center in South India: a case-control study.

BACKGROUND: Carbohydrate intolerance is the most common metabolic complication of pregnancy. Gestational diabetes mellitus (GDM) poses numerous problems for both mother and fetus. The objective of this study was to compare the maternal and perinatal outcome between women with gestational diabetes mellitus and non-diabetic women. STUDY DESIGN: A case-control study with 286 cases and 292 age-matched controls was conducted for a period of 11 months (August 2007-June 2008) in Sree Avittom Thirunal Hospital, Thiruvananthapuram, India. MATERIALS AND METHODS: Universal screening was applied by means of glucose challenge test (GCT) using 50 g of glucose. If GCT >130 mg%, the patients were subjected to oral glucose tolerance test with 100 g of glucose. National Diabetes Data Group criteria was taken to assign patients to study group. These women were further followed up and the maternal and perinatal outcomes were assessed. STATISTICAL ANALYSIS: Univariate analysis was done by means of t test, Odd's ratio, Chi-square test, and Fisher Exact test. P < 0.05 was taken as significant. RESULTS: The frequency of induction of labor was significantly higher than spontaneous labor (OR = 1.84, P = 0.001). 40.1 % GDM mothers and 35.8 % of non-diabetic mothers were delivered by Cesarean section. Premature rupture of membranes (PROM) was the most common complication of labor (OR = 1.66, P = 0.04). Babies of diabetic mothers had a positive trend toward prematurity (OR = 2.3, P = 0.007). Hypoglycemia was the most common neonatal complication (OR = 11.97, P < 0.001) and nine babies of diabetic mothers were macrosomic (OR = 5.2, P = 0.02). CONCLUSIONS: Maternal morbidities and neonatal complications such as neonatal hypoglycemia, macrosomia, and prematurity were significantly higher in GDM.

Prevalence and factor associated with current smoking among medical students in coastal South India.

BACKGROUND: Smoking among health care personnel such as medical students is an important public health issue. More effective measures to reduce tobacco smoking among medical students are needed worldwide. Very few studies had been conducted in past in India and other developing countries to understand the magnitude of problem. OBJECTIVES: To determine the prevalence and associated factors of current smoking among medical students. METHODS: Cross sectional study was conducted during January and February 2009 among 333 study subjects selected randomly from four batches of a teaching institution. Subjects were administered a self administered pre tested questionnaire and smoking status was assessed as per the criteria laid down by WHO. Proportion, chi square test and multiple logistic regression analysis were used for statistical analysis. RESULTS: The prevalence of current smoking was found to be 22.4% (67). There were widespread deficiencies in knowledge of smoking among students of different classes, as an important causal factor in many diseases like gastro intestinal malignancy, heart problems, asthma, and emphysema. It was found that only half of them were willing to quit smoking (33). Fourth year students (OR=2.54) and presence of peer pressure (OR=21.91) had independent significant association with current smoking. CONCLUSION: Prevalence of smoking among medical students is high that warrants adoption of comprehensive smoking control interventions among them.

Determinants of low birth weight: a case control study in a district hospital in Karnataka.

A Case-control study was conducted in District Lady Goschen hospital, Dakshina Kannada district, Southern Karnataka. Subjects were mothers who underwent normal delivery and their neonates. A total of 150 cases and 300 controls were selected. Significant risk factors identified in univariate analysis included pre pregnancy maternal weight (<45 kgs)(OR=6.77), anaemia in pregnancy (Hb<11 gm%) (OR=3.11), age less than 20 years (OR=2.96) and maternal height (<145 cms) (OR=2.79). Multiple logistic regression analysis revealed that pre pregnancy maternal weight (<45 kgs)(OR=7.02), anemia in pregnancy (OR=4.37) and maternal age less than 20 years (OR=3.96) were the significant risk factors of low birth weight of term babies. The strategy needs to focus attention on nutrition education to facilitate better weight gain during adolescent period. Discouraging teenage pregnancy is also essential in order to reduce the burden of LBW babies.

Determinants of Pre-eclampsia: A Case-control Study in a District Hospital in South India.

OBJECTIVE: The objective was to study the determinants of pre-eclampsia among pregnant women admitted for delivery in a district hospital. MATERIALS AND METHODS: A case-control study was conducted at District Lady Goschen Hospital, Dakshina Kannada district, Karnataka, South India. The group of pregnant women with pre-eclampsia comprised those with hypertension after the 20th week of gestation with associated proteinuria, and controls were pregnant women not diagnosed with pre-eclampsia. A total of 100 cases and 100 controls were selected for the year 2006. Study variables included mother's age, parity, body mass index, history of chronic hypertension, history of diabetes, history of renal disease, family history of hypertension, and history of pre-eclampsia in earlier pregnancy. STATISTICAL ANALYSIS: Chi-square test, and crude and adjusted odds ratio with 95% confidence intervals were used for statistical analysis. RESULTS: Significant risk factors identified in univariate analysis included prepregnancy body mass index (BMI > 25) (OR = 11.27), history of chronic hypertension (OR = 8.65), history of diabetes (OR = 11.0), history of renal disease (OR = 7.98), family history of hypertension (OR = 5.4), history of pre-eclampsia in earlier pregnancy (OR = 9.63), and multiple pregnancy (OR = 4.85). Multiple logistic regression analysis revealed that the prepregnancy BMI of >25 (OR = 7.56), history of chronic hypertension (OR = 6.69), history of diabetes (OR = 8.66), history of renal disease (OR = 5.6), family history of hypertension (OR = 5.48), and multiple pregnancy (OR = 5.73) are the significant risk factors of pre-eclampsia. CONCLUSION: Pregnant women at risk of pre-eclampsia should be identified and high-quality antenatal care should be given in order to minimize the complications of pre-eclampsia both for the mother and the fetus.