Impact of lockdown due to COVID-19 pandemic on neurobehavioral profile of children aged 6-12 years (NeuBeC study).

Background: The lockdown due to the COVID-19 pandemic has affected the lives of children and resulted in behavioral and emotional disturbances in children. This study was planned to identify the prevalence of these problems in Indian children. The aim of the study was to estimate the effect of lockdown on the neurobehavioral profile of children 6-12 years of age by using the Child Behavior Checklist (CBCL) scale. CBCL is the most widely used validated scientific tool to detect behavioral and emotional problems in children. Materials and Methods: All children 6-12 years of age who were fulfilling the inclusion criteria of the study were included from all over India through an online Google form link. The children attending the outpatient department (OPD) at our tertiary-level care medical college were also included in offline mode. Data were collected and entered in an Excel sheet and analyzed statistically. Results: A total of 173 children in the age group 6-12 years were enrolled. The mean standard deviation (SD) age of all children was 8.88 (1.84) years, out of which males were of a mean age of 9.2 (1.84) years and females were 8.44 (1.74) years. Total CBCL T-scores (mean (SD)) for internalizing, externalizing, and total scores were 63.07 (7.98), 63.95 (6.51), and 62.39 (4.9), respectively. Conclusion: Lockdown has resulted in neurobehavioral changes in normal children. The independent predictors found were the increase in screen-based media use, sleep issues, or behavioral changes like aggression due to restriction of their mobility or confinement. Females exhibited more internalizing problems, and males exhibited more externalizing problems.

Medical Trainees' Knowledge and Attitudes Towards Electronic Cigarettes and Hookah: A Multinational Survey Study.

BACKGROUND: The rising prevalence of electronic cigarette (e-cigarette) and hookah use among youth raises questions about medical trainees' views of these products. We aimed to investigate medical trainees' knowledge and attitudes toward e-cigarette and hookah use. METHODS: We used data from a large cross-sectional survey of medical trainees in Brazil, the United States, and India. We investigated demographic and mental health aspects, history of e-cigarettes and tobacco use, knowledge and attitudes toward e-cigarettes and hookah, and sources of information on e-cigarettes and hookah. Although all medical trainees were eligible for the original study, only senior students and physicians-in-training were included in the present analysis. RESULTS: Of 2,036 senior students and physicians-in-training, 27.4% believed e-cigarette use to be less harmful than tobacco smoking. As for hookah use, 14.9% believed it posed a lower risk than cigarettes. More than a third of trainees did not acknowledge the risks of passive e-cigarette use (42.9%) or hookah smoking (35.1%). Also, 32.4% endorsed e-cigarettes to quit smoking, whereas 22.5% felt ill equipped to discuss these tobacco products with patients. Fewer than half recalled attending lectures on these topics, and their most common sources of information were social media (54.5%), Google (40.8%), and friends and relatives (40.3%). CONCLUSIONS: Medical trainees often reported incorrect or biased perceptions of e-cigarettes and hookah, resorted to unreliable sources of information, and lacked the confidence to discuss the topic with patients. An expanded curriculum emphasis on e-cigarette and hookah use might be necessary because failing to address these educational gaps could risk years of efforts against smoking normalization.

Correlation between screen time and psychosomatic symptoms in children during COVID-19 pandemic-related lockdown.

Background: This study was planned to estimate the effect of lockdown on psychosomatic problems and sleep of children and their association with screen the time during the lockdown. Methods: A cross-sectional study was conducted among 1-12-year-old children at a tertiary care hospital in South India. A pre-validated questionnaire with 20 related questions was disseminated through pediatric OPD, telemedicine service, and social media to eligible parents. Results: A total of 278 children aged 1-12 years with a mean (SD) age of 6.92 (3.01) years were studied. Most under 5-year-oldchildren had screen time of ≤2 hours/day, whereas 58.16% of children between 5 and 12 years spent >4 hours/day (P < 0.000). A significant proportion of participants aged 5-12 years had vision problems (P = 0.019), whereas under 5-year-old children had significant associated behavioral changes (P = 0.016) and sleep problems (P = 0.043). Conclusion: Behavioral and sleep problems were significantly high and correlated with an increase in screen time among under 5-year-old children. Vision problems were more in 5-12-year-old children.

Vaping and Hookah Use Among Medical Trainees: A Multinational Survey Study.

The increased use of E-cigarettes and hookah among young consumers represents a public health concern. This study aimed to investigate the frequency and patterns of use of E-cigarettes and hookah among medical trainees. This cross-sectional multinational online survey included medical students, residents, and fellows in Brazil, the U.S., and India between October 2020 and November 2021. Information on sociodemographics; mental health; and E-cigarettes, hookah, tobacco, marijuana, and alcohol use were collected. Generalized structural equation models were used in 2022 to explore the factors associated with current vaping and current hookah use (ongoing monthly/weekly/daily use). People reporting previous sporadic/frequent use or those who never used/only tried it once were the reference group. Overall, 7,526 participants were recruited (Brazil=3,093; U.S.=3,067; India=1,366). The frequency of current vaping was 20% (Brazil), 11% (U.S.), and <1% (India), and current hookah use was 10% (Brazil), 6% (U.S.), and 1% (India). Higher family income (OR=6.35, 95% CI=4.42, 9.12), smoking cigarettes (OR=5.88, 95% CI=4.88, 7.09) and marijuana (OR=2.8, 95% CI=2.35, 3.34), and binge drinking (OR=3.03, 95% CI=2.56, 3.59) were associated with current vaping. The same was true for hookah use: higher family income (OR=2.69, 95% CI=1.75, 4.14), smoking cigarettes (OR=3.20, 95% CI=2.53, 4.06), smoking marijuana (OR=4.17, 95% CI=3.35, 4.19), and binge drinking (OR=2.42, 95% CI=1.96, 2.99). In conclusion, E-cigarettes and hookah were frequently used by Brazilian and American trainees, sharply contrasting with data from India. Cultural aspects and public health policies may explain the differences among countries. Addressing the problems of hookah and E-cigarette smoking in this population is relevant to avoid the renormalization of smoking.

Socio-Ecological determinants of myopia in rural school students in North India: Results from a nurse-led program.

Socio-ecological determinants of high myopia incidence among school students largely remain unexplored, especially in developing countries. A cross-sectional study was conducted in rural schools in North India to assess the relationship between these determinants and myopia among adolescent students. A public health nurse used a pre-tested questionnaire (demographics, family ocular status, and screen time) and Snellen's chart for testing visual acuity, and referred suspected cases for cycloplegic refraction assessment. Among the total of 955 students, the median (range) age was 14 (13-15) years. The prevalence of myopia was 5.03% (95% confidence interval [CI]: 4.99-5.07). Myopia was found to be associated with computer usage at school (P = 0.058), malnutrition (P = 0.001), and familial myopia (P = 0.079) in the bivariate analysis. Significant predictors of myopia in the regression model were females (odd ratio [OR]: 6.29; 95% CI: 2.69-14.72), higher maternal age (OR: 1.09; 95% CI: 1-1.17), and reading distance <20 cm (OR: 1.98; 95% CI: 1.01-3.87).

Bombay Begums-A treasure for social guidance films on determinants of women's mental health.

A woman's health should reach beyond the narrow perspective of maternal and reproductive health and should encompass physical as well as mental health across the life cycle. The focus should be shifted to a broader, social, legal, and economic factors rather than just immersing on lifestyle and individual factors. Recognition of mental health issues among women, education, training, and interventions at various levels would contribute to the improvement of mental health issues among women.

Men and menstruation in India: time for frank discussions.

In the twenty-first century, there is still a taboo on frank discussion of menstruation in Indian society, particularly with men. This inadvertently widens the gender/equity gap in families and in society. Even men in the healthcare sector are uncomfortable talking about this because the societal norms often overpower professional knowledge. Indian society needs to move forward and normalise menstruation in the perceptions of boys and men in all settings. We highlight below some salient points on the orientation of men regarding menstruation.

Mysterious Outbreak of Acute Neurological Syndrome in Eluru, Andhra Pradesh, India: A Post-outbreak Geo-Spatial Analysis.

BACKGROUND: An outbreak characterized by sudden-onset seizures, loss of consciousness, and complete recovery within a few hours was reported from Eluru town in Andhra Pradesh on December 6, 2020. This study was conducted to assess the environmental correlates of the outbreak using geo-mapping tools. METHODS: A post-outbreak survey was conducted among affected cases in January-February, 2021. A house-to-house survey tool collected information on demographics, clinical profile, and environmental and psychological aspects (Impact of Event Scale). Geo-mapping and news media content analyses were done using QGIS and Atlas.ti software, respectively. RESULTS: A total of 394 cases were studied. The median (interquartile range [IQR]) age of the participants was 27 (17-39) years and comprised mostly male students. There was no clustering of cases within 48 hours of illness onset in the spatial analysis. Loss of consciousness was the first (50.7%) and the most common symptom. All cases were taken to a health facility and were discharged after a median duration of 48 minutes. COVID-19-related and environmental practices were not associated with the clinical manifestations. Awareness about pesticides was low. The outbreak reportedly had a psychological impact on 24.4% of the participants. The most common co-occurring themes in the news media analysis were water contamination and pesticides. CONCLUSION: The geo-spatial analysis did not find case clustering or points of convergence during the incubation period. The geo-locations did not distribute around water bodies or suspected landmarks although news media projected water contamination and pesticides as probable causes of the outbreak.

New normal of academic virtual conference: Imperative during pandemic.

In COVID pandemic, attending the continuing medical education, workshops, and conferences with physical attendance is not possible. We designed, developed, and hosted the first of its kind academic virtual/online conference at par with an in-person academic conference to disseminate the expertise of the renowned subject experts along with researchers to present their research work due to the ongoing pandemic. We, in this article, had summarized the most critical steps in order to make the process easier for first-timers while providing our more comprehensive walkthroughs on each step. We choose a live session of the speakers on the Zoom meeting mode to retain the atmosphere of a live conference. WhatsApp, Google (Google Meet and E-mail), and Kahoot were other platforms to communicate with speakers, researchers, and participants to seamlessly participate. A number of advantages in terms of protection for delegates/speakers and their families came from the Virtual Conference on Nutrition and Health, restricting the spread of COVID-19, low budget for organizers, economically much cheaper alternatives both for speakers and participants, dissemination of knowledge, time productive, and meeting research paper presentation eligibility for a professional course. When one is new to technology, try adding an innovative aspect as a starting point to future virtual and in-person events, and seeing how it works is imperative. Ensuring Internet bandwidth, updated hardware, or webcam and/or microphone functionality at the participant end is critical.

Screen-Based Media Use Among Children During the COVID-19 Pandemic.

This questionnaire-based study was conducted to assess screen-based media use during the coronavirus disease 2019 (COVID-19) pandemic in children (n=278) aged between 1 to 12 years. Television was the most common media available for use (246, 88.5%), and mobile was the next most commonly available media (230, 82.7%). Daily screen time exposure and use of television (P<0.001), computer/Laptop (P<0.001), and tablet (P=0.001) were significantly more common in those aged 5-12 years. Majority (214, 76.9%) were using screen-based media for educational purposes.

Changes in reverse transcription polymerase chain reaction cycle threshold values of SARS-CoV-2 with topical povidone iodine use: A single-arm open-label interventional study.

Context: Repurposed povidone iodine (PVP-I) has been suggested as an effective adjuvant against coronavirus disease-2019 (COVID-19). Aim: The aim of this study was to assess the changes in RT-PCR cycle threshold (Ct) values of severe acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) genes with PVP-I intranasal and oral application. Settings and Design: A longitudinal (repeated measures) single-arm open-label interventional study was conducted for 200 samples of ten COVID-19 patients in South India. Methods and Material: Demographic and clinical information were collected. Intranasal application and oral gargle with 1% PVP-I solution was done four times a day for seven days. Nasopharyngeal and oropharyngeal samples were taken for RT-PCR test at hour-0, hour-2, hour-4 on Day-0, Day-3, Day-6, and hour-0 on Day-9. Methods and Material: STATA analysis software version 14.2 was used. McNemar Test was applied for paired samples. Skilling Mack Test was used to assess the association between PVP-I use (intra-day and inter-day) and E gene/N gene Ct values. Pearson correlation coefficients and Bland-Altman plots were used for further analyses. Results: Mean (SD) age of the patients was 41.5 (±8.82) years. A total of 100 pairs of nasopharyngeal and oropharyngeal samples were analysed. No significant difference was observed in the Ct values of asymptomatic and symptomatic patients. E gene Ct values (nasopharyngeal) at Hour-0 increased from Day-0 to Day-9 (P = 0.005). Ct value was higher at Hour-2 for most of the samples. Conclusions: RT-PCR results (qualitative) differed at various testing points in the same patients. Lower Ct values were found in the nasopharyngeal samples. Successive increase in E gene Ct values indicates reduced viral load with natural course of COVID-19. PVP-I may have an optimal impact within 2 h of usage. Clinical trial registration number: CTRI/2020/05/024962.

Minimally invasive surgery in India during the COVID-19 pandemic: A survey.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has posed an unprecedented challenge to the healthcare systems worldwide. This uncharted territory has changed the practices in modern healthcare delivery; this is particularly true in the case of minimally invasive surgery (MIS) where various changes are being adopted. This survey was conducted to determine the impact of the pandemic and the changes being adopted in the field of MIS, from a resource-limited developing country, India. MATERIALS AND METHODS: The survey was carried out from 27 July to 22 August 2020, amongst MIS surgeons in India using an online questionnaire generated on Google Forms. RESULTS: The survey was completed by 251 MIS surgeons nationwide. There was a proportional reduction of overall elective surgeries and MIS. Approximately 30% of the surgeons continued to use MIS, as during the pre-pandemic era. Pre-operative tests for COVID-19 (96.1%) and personal protective equipment (PPE, 66%-86%), including respirators (95.2%), are used uniformly across the nation. Almost half (43.1%) of the MIS surgeons are using ≥6 recommended intraoperative modifications in MIS to mitigate the COVID-19 transmission. CONCLUSION: MIS surgeons in India have adapted within a short time to the challenge of the pandemic by embracing pre-operative testing, PPE and new techniques/technologies to continue patient care. Innovations and low-cost indigenous customisations are the need of the hour for a developing country like India. Further studies are required to establish the true risk of viral transmission involved in MIS and the efficacies of the techniques/devices to reduce the spread of the virus.

Higher coronavirus disease-19 mortality linked to comorbidities: A comparison between low-middle income and high-income countries.

BACKGROUND: Global burden of disease (GBD) provides the estimates of mortality and morbidity, while case fatality rate (CFR) helps in understanding the severity of the disease. People infected with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) with underlying medical conditions have shown higher levels of unfavorable outcomes including mortality. We assessed the association of SARS-CoV-2 CFR with disability-adjusted life years (DALY) of various comorbidities in the low-middle income countries (LMIC) and high-income countries (HIC) to study the relationship of coronavirus disease-19 (COVID-19) mortality with GBDs and to understand the linkage between COVID-19 mortality and comorbidities. MATERIALS AND METHODS: This was an ecological study with secondary data analysis comparing the DALY of various morbidities from GBD with CFR of COVID-19. Gross domestic product was the basis of stratifying 177 countries into low-middle income (LMIC) and high-income groups (HIC). The mortality was analyzed using Pearson correlation and linear regression. RESULTS: The median global CFR of SARS-CoV-2 was 2.15. The median CFR among LMIC (n = 60) and HIC (n = 117) was 2.01 (0.00-28.20) and 2.29 (0.00-17.26), respectively. The regression analysis found that, in both LMIC and HIC, maternal disorders were associated with higher SARS-CoV-2 CFR, while tuberculosis, mental health disorders, and were associated with lower CFR. Further, in LMIC, musculoskeletal disorders and nutritional deficiencies were associated with higher CFR, while respiratory disorders were associated with lower CFR. CONCLUSIONS: SARS-CoV-2 infection appears to be a systemic disease. Individuals with comorbidities, such as maternal disorders, neurological diseases, musculoskeletal disorders, and nutritional deficiencies, have poorer outcomes with COVID-19, leading to higher mortality.

Prospective Study to Assess the Response to Therapy and Its Predictors in Children with Scrub Typhus.

Doxycycline is the drug of choice for pediatric scrub typhus (ST) while azithromycin is considered as an equally effective alternative. This study was undertaken to assess the response to therapy and its predictors in pediatric ST cases treated with doxycycline and azithromycin. Children ≤12 year with fever ≥7 days were screened for ST by IgM ELISA (positive if optical density >0.5). All positive cases were divided into two groups based on whether treated with doxycycline or azithromycin. Fever clearance time (FCT), duration of hospitalization and other clinical characteristics of cases in both groups were compared. Out of 2710 children admitted with fever for more than 7 days, 660 cases (24.35%) tested positive for ST by IgM ELISA. Cases treated with azithromycin and doxycycline were 316 (47.87%) and 344 (52.12%), respectively. In our study, the FCT (p = 0.004), mean duration of hospital stay (p = 0.011), persistence of fever for >48 h after starting antibiotic therapy (p = 0.001) and severe ST requiring ICU admission (p = 0.046) were significantly lower in children who received doxycycline. The logistic regression analysis revealed that the presence of splenomegaly (Adjusted Odds Ratio (AOR) 2.60; 95% Confidence interval (CI) = 1.49-4.53; p = 0.001) and lung crepts (AOR 2.02; 95% CI = 1.06-3.85; p = 0.032) in azithromycin-treated group and presence of meningeal signs (AOR 16.11; 95% CI = 5.47-47.45; p < 0.001), anemia (AOR 2.28; 95% CI = 1.02-5.08; p = 0.044), lung crepts (AOR 2.66; 95% CI = 1.16-6.05; p = 0.020) and absence of eschar (AOR 3.48; 95% CI = 1.70-7.13; p = 0.001) in the doxycycline group was significantly associated with prolonged FCT (>48 h). Doxycycline is superior to azithromycin in defervescing fever, reducing hospital stay and preventing severity in pediatric ST.

Global Change in Interest toward Yoga for Mental Health Ailments during Coronavirus Disease-19 Pandemic: A Google Trend Analysis.

BACKGROUND: With coronavirus disease (COVID)-19 pandemic, society is gripped with uncertainty and fear, inclining them toward Yoga to prevent mental health issues. Google Trends (GT) depicts the public interest of the community which may vary due to evolving policy dynamics of the COVID-19 pandemic. AIM: The aim was to study global public interest in Yoga for mental health during the COVID-19 pandemic. MATERIAL AND METHODS: Global time trends were obtained for Yoga, Anxiety, and Depression from November 1, 2019 to May 31, 2020 using GT. The time series analysis was done in three different time periods - pre-COVID-19 phase, transition period, and COVID-19 pandemic phase. Cross-correlation, Spearman rho, Friedman ANOVA test, and forecasting were used for analysis. RESULTS: GT found a global change in the search queries for Yoga, anxiety, and depression during the three time periods. High burden COVID-19 countries - Italy, Spain, Russia, and Brazil had an increasing search trend for Yoga. During the COVID-19 phase, there was a significant positive correlation between the search trends of Yoga with depression (r = 0.232; P < 0.05) and anxiety (r = 0.351; P < 0.05), but higher anxiety and depression searches lead to lower Yoga searches at lag +6. Forecast projected a continuous increase in Yoga searches and anxiety queries. CONCLUSION: Google Trends captured a significant rise in interest of Yoga among the global community but diminished with time. Hence, the need for interventions to promote Yoga to be part of routine life and for making sure that people adhere to the Yoga practices on a continuous basis.

Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India.

BACKGROUND AND AIMS: Police personnel have been key frontline workers throughout the coronavirus disease 2019 (COVID-19) pandemic. This study was conducted to assess the correlates and outcomes of critically ill police personnel. METHODS: This retrospective observational study analyzed key parameters of hospitalized police personnel who were critically ill with COVID-19 in Andhra Pradesh, India, between June and October 2020. Survival was analyzed for correlation with body mass index, ABO/Rh blood group, co-morbidities, treatment (oxygen therapy, prone positioning, mechanical ventilation, remdesivir, Ivermectin, oral and nasal topical povidone-iodine). We also performed Cox proportional hazard analysis with relevant function plots. RESULTS: The majority of the 266 patients were male (n = 259; 97.4%) and obese (75.2%). The overall mortality of patients was 38% (n = 101). COVID-19 mortality increased significantly with age (p = 0.019) and BMI (p = 0.030) in the bivariate analysis. There was no significant difference between blood group (p = 0.297), co-morbidity (p = 0.582) and COVID-19 outcome. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the risk factors for COVID-19 mortality were males (HR 4.89, 95% CI: 1.020-23.430) and ventilator therapy (HR 7.5, 95% CI: 4.527-12.296). The protective factors were symptom onset to reverse transcription polymerase chain reaction (RT-PCR) report interval (HR 0.36, 95% CI: 0.158-0.814), prone positioning (HR 0.43, 95% CI: 0.197-0.915), and use of povidone iodine (HR 0.43; 95% CI: 0.273-0.692). CONCLUSION: COVID-19 mortality among critically ill hospitalized police personnel was reduced by time to diagnostic test result, prone positioning, and povidone-iodine use and increased with male gender and mechanical ventilation.

COVID-19 preparedness among public and healthcare providers in the initial days of nationwide lockdown in India: A rapid electronic survey.

BACKGROUND AND AIMS: The COVID-19 Pandemic has been raging across continents in recent months. Public health measures are crucial in preventing COVID-19. The Government of India declared a nationwide lockdown on 24 March, 2020. The objective of this study is to assess preparedness among general public and healthcare providers against COVID-19 by way of adopting public health measures at the very beginning of the nationwide lockdown in India. SETTINGS AND DESIGN: A rapid cross sectional electronic survey was conducted across the country between 25 and 27 March, 2020. METHODS AND MATERIALS: Participants were general public and healthcare providers. Online questionnaire was generated in Google Forms. This included precautionary measures such as staying home, hand hygiene, wearing masks, cough hygiene and advisory against face touching. The web link to the form was shared through WhatsApp. STATISTICAL ANALYSIS USED: Descriptive data analysis was done using Epi Info software (version-7). RESULTS: A total of 226 persons (general public = 183; healthcare providers [HCPs] = 43) participated in the study. During the lockdown, HCPs spent more time outside than the general public (p = 0.009). Only 47% of the participants claimed to practise frequent hand washing and majority (72%; n = 163) did not wear masks while outdoors. Almost a half (45%) of the participants touched their face frequently and very few (8%) participants covered their mouth or nose while coughing or sneezing. There was no significant difference between HCPs and general public in frequent hand washing (p = 0.456), wearing masks (p = 0.255), face touching (p = 0.632) or covering mouth/nose while coughing or sneezing (p = 0.428). CONCLUSION: There is lack of preparedness among general public and healthcare providers against COVID-19 at the beginning of the nationwide lockdown in India.

Epidemiology of technology addiction among school students in rural India.

OBJECTIVE: Penetration of mobile technology is rapidly rising. Excessive use leads to Technology addiction, which often start early in adolescence. The purpose of the present study was to assess Technology addiction and its correlates among school students in rural India. METHODS: This cross sectional study was conducted among 885 school students in north India. Four schools were selected and participants aged 13-18 years, were enrolled randomly. A self-designed 45 item questionnaire was used to evaluate dependence syndrome (intense desire, impaired control, tolerance, withdrawal, persistence despite harm, neglect of alternate pleasure) as used for substance dependence in ICD-10. Screening for depression and anxiety was done by using patient health questionnaire (PHQ-9) and generalized anxiety disorder scale (GAD-7) respectively. Descriptive and logistic regression analyses were done. RESULTS: The mean age of the study participants was 15.1 years. Among the participants, 30.3% (95% Confidence Interval = 27.2%-33.3%) met the dependence criteria. One-third (33%) of the students stated that their grades had gone down due to gadget use. Technology addiction was more among male students (odds ratio = 2.82, 95% CI = 1.43, 5.59), those having a personal mobile phone (2.98, (1.52-5.83), use smart phone (2.77, 1.46-5.26), use one additional gadget (2.12, 1.14-3.94) and those who were depressed (3.64, 2.04-6.49). CONCLUSION: Increased mobile phone access in rural India is leading to technology addiction among school students. Certain demographic and gadget specific factors predict addiction. The technology addiction possibly contributes to poor academic performance and depression. This warrants studies on a larger scale, with interventions for judicious use of gadgets.

Mental health and environmental factors associated with falls in the elderly in North India: A naturalistic community study.

AIM: To determine the prevalence of falls and to assess its relationship with cognitive deficits, depression, visual impairment and self-reported hearing impairment among the elderly. METHODS: This was a community-based, cross-sectional study conducted in 52 villages in the Naraingarh and Barara block of Ambala district which involved 468 participants. A pretested predesigned questionnaire was used to collect data regarding demographic profile, falls, and physical morbidities. Geriatric Depression Scale-Hindi, Hindi-mini-mental state examination, Snellen chart, Katz- Activity of Daily Living were used to collect data for depression, cognitive decline, vision and activity of daily living respectively. RESULTS: The prevalence of falls was found to be 28.7%. An association was found between falls and slippery floors in the houses, hearing loss, vertigo, hypertension, use of multiple medications, depression and functional disability in univariate analysis. On multivariate regression analysis, slippery floors (OR = 2.28), use of multiple medications (OR = 1.71), hearing loss(OR = 1.83) and presence of depression (OR = 1.62) were found to be independent risk factors with falls. CONCLUSION: There is high prevalence of falls among the elderly and these are commonly related to preventable factors. Appropriate environmental modifications and exercise programs can help reduce the rate of falls as well as injuries related to falls among the elderly.