SARS-CoV-2 seroprevalence in patients with autoimmune rheumatic diseases versus family controls: a multi-city cross-sectional survey.

There is uncertainty regarding the effect of the SARS-CoV-2 infection on patients with autoimmune rheumatic diseases (AIRD) who are on immunosuppressive drugs. We did a multicity cross-sectional seroprevalence study conducted in five different cities in India before COVID-19 immunization. Patients with a diagnosis of AIRD and DMARDs were included. Relatives of the patients, preferably staying in the same household with no known rheumatic diseases served as controls. Serum IgG antibodies to SARS-CoV-2 Receptor Binding Domain (RBD) of the spike protein and nucleoprotein (NP) were assayed in eight hundred and eighty nine sera (subjects with disease = 379 and in subjects without disease = 510). IgG antibodies to either RBD and/or NP were positive in 135 (36%) subjects with AIRD as compared to 196 (38%) controls. The seroprevalence of anti-RBD and anti-NP varied between different cities but was not significantly different between subjects with and without disease in Mumbai, Ahmedabad, Bengaluru and Bhubaneswar. However, the occurrence of IgG antibodies to RBD was significantly (p < 0.05) lower in subjects with disease (28/65;43%) as compared to subjects without disease (42/65;65%) in Kolkata, where the positivity rate was lower in connective tissue disease group than in inflammatory arthritis group. Overall, patients with rheumatic diseases on DMARDs have IgG antibodies to RBD and NP of SARSCoV-2 at a comparable level with that of subjects without disease, but the level of antibodies to RBD is lower in patients with connective tissue disease on immunosuppressive drugs in one centre.

Barriers in Dental Care Utilization-An Explorative Study among Transgender Community of Bhubaneswar, Odisha.

Introduction: Transgenders (TGs) are one of the vulnerable groups in our society. Trans people experience substantial health disparities and barriers to appropriate health care services that keep them from achieving the highest possible health status. Methodology: The study was conducted over the course of 12 months at the Transgender Shelter Home. Focus group discussion (FGD) took place with 6-12 participants and the researcher acted as moderator. The questions were asked under four domains; sociodemographic variables, behavioral variables, medical and health status variables, and access and utilization of dental services barrier variables. Transcripts were coded and data analysis was concurrent with data collection to allow to know new insights. The data analysis was done by MAXQDA software 2022.0.0. It is being developed and distributed by VERBI Software based in Berlin, Germany. Results: The barriers and facilitators explored were categorized at three levels: (1) the personal level, relating to those barriers and facilitators that the individual faced for their oral health care, and the perspectives regarding the delivery of care; (2) the inter-personal level; and (3) the system level, for identifying the wider elements and their influence. Discussion: Social stigma and marginalization have been linked to adverse health effects, including personal attributes, structural and environmental factors, and personal perceptions of stigmatization. Conclusion: It is evident that lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities have specific but varied health care needs, and the greatest way to treat these necessities is via exposure to professional, health care coverage.

Assessment of Quality of Life Among the Geriatric Population in an Urban Slum Settlement of Bhubaneswar, Odisha.

BACKGROUND: Multidimensional components of quality of life such as well-being, satisfaction, and lifestyle together ensure an improvement in longer life expectancy. Therefore, it is important to emphasize the assessment of the quality of life (QoL) of the elderly population and its association with various background characteristics. METHODOLOGY: A community-based cross-sectional study was carried out from April to September 2017 among 270 consenting elderly people residing in urban slums under the field practice area of a medical college, using a well-structured, globally validated World Health Organization Quality of Life Brief Version (WHOQOL-BREF) tool. The scores were computed for the different domains of WHO QoL, and the mean score of these domains was compared among the different socio-economic and demographic factors. RESULTS: The majority (67.41%) of the sampled population belonged to the 60- to 69-year-old age group; females (63.70%) outnumbered males. The total QoL score was 47.52 ± 15.06 showing that the average population had a fair QoL. The environmental domain had a poor QoL (43.15) score, and the rest of the domains showed a fair QoL. Higher age groups, persons other than self-employed, and the upper class were seen to have significantly lower QoL scores in all four domains. Females had a lower QoL score in the physical as well as social domains as compared to males. CONCLUSION: Aging is associated with a decrease in social and economic participation. In areas of compromised living conditions, like slums, the environmental domain adds to the decrease in quality along with the other domains. Ageing, employment status, socio-economic class, and the female gender had significantly lower QoL scores in all four domains.

Assessment of Post-operative Complications in Patients Undergoing Thyroid Surgery in a Tertiary Care Hospital in Eastern India.

Background Thyroid surgeries, among the most common surgical procedures globally, present with varied complications. This study is aimed at identifying the complications and selected variables associated with thyroid surgery. Methods In this cross-sectional, retrospective, record-based study, a total of 107 patients who underwent thyroidectomies and satisfied the inclusion criteria, were recruited using convenience sampling technique. This study was conducted at a tertiary care hospital from January 2021 to December 2021. Data were collected from medical records using a researcher-created data extraction form after ethical approval from the institutional ethics committee. The data were analyzed using Epi Info software (Atlanta, GA: Centers for Disease Control and Prevention), with a p-value of <0.05 considered to be statistically significant. Results Of the 107 patients who underwent thyroidectomies, 92 (85.9%) reported one or more complications. Complications were most common (90.2% of patients) in the 25-34 years age group and among females (83.3%). The most common complications were dysphagia (30.84% of patients), voice change (21.50%), and respiratory obstruction (8.41%). Temporary hypocalcemia developed in 3.74% of these patients, while tracheal injury and hematoma were documented in 3.74% and 1.87%, respectively. Tobacco users (14.9%), alcohol users (16.8%), those eating a non-vegetarian diet (61.9%), and those eating saturated fats (13.0%) suffered more complications. Family history (p=0.03) was found to be significantly associated with complications. Conclusion The most common post-thyroidectomy complications in this group of patients were dysphagia and voice change, while hypocalcemia, tracheal injury, and hematoma were rare complications. Tobacco users and alcohol users reported more complications. Complications were more common in those with a family history of thyroid disease and those who were underweight.

Assessment of the Diagnostic Reliability of Modified Alvarado Scores and Abdominal Ultrasonography in Acute Appendicitis.

Introduction Acute appendicitis is a common surgical emergency. Clinical assessment plays a major role; however, subtle clinical features in early stages and atypical presentation makes diagnosis challenging. Ultrasonography (USG) of the abdomen is a usual investigation that aids in diagnosis, however, it is operator dependent. A contrast-enhanced computed tomography (CECT) of the abdomen is more accurate; however, it exposes the patient to hazardous radiation. The study aimed to combine clinical assessment and USG abdomen in the reliable diagnosis of acute appendicitis. Objectives The objective of this study was to assess the diagnostic reliability of the Modified Alvarado Score and ultrasonography of the abdomen in acute appendicitis. Material and methods All patients with right iliac fossa pain, clinically suspected of having acute appendicitis, admitted to the department of general surgery, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, between January 2019 and July 2020, who gave consent were included. Clinically, Modified Alvarado Score (MAS) was calculated, after which patients were subjected to USG abdomen, where findings were noted and a sonologic score was calculated. The study group was the patients who needed appendicectomy (n=138). Operative findings were noted. Histopathological diagnosis of acute appendicitis was deemed as confirmatory in these cases and was correlated with MAS and USG scores to determine diagnostic accuracy. Results A combined clinicoradiological (MAS + USG) score of seven showed a sensitivity of 81.8% and a specificity of 100%. The specificity of score seven or above was 100%; however, the sensitivity at 81.8%. The diagnostic accuracy of the clinicoradiological was 87.5%. The negative appendicectomy rate was 4.34%, with a diagnosis of acute appendicitis being confirmed for 95.7% of patients upon histopathological examination. Conclusion The MAS and USG of the abdomen, which is an affordable and non-invasive tool, showed increased diagnostic reliability, and hence it can help reduce the use of CECT abdomen, as CECT abdomen is considered as a gold standard for confirmation or exclusion of diagnosis of acute appendicitis. Use of the combined scoring system of MAS and USG abdomen can be used as a cost-effective alternative.

Gendered Pattern and Predictors of Tobacco use in India: Evidence from the Second Round of Global adult Tobacco Survey.

Background: India has completed the second round of the Global Adult Tobacco Survey (GATS) to monitor adult tobacco use and progress in tobacco control efforts. This study assesses the gendered pattern of tobacco use and its predictors in the second rounds of GATS. Material and Methods: Publicly available GATS-2 (2016-2017) data was analyzed which contains self-reported tobacco use information of ≥15 years Indians (n = 74,037). The independent predictors of "smoking only," "smokeless only," and "dual use" among current male and female tobacco users were assessed using the multinomial regression model. Results: The burden of "smoking only," "smokeless only," and "dual-use" of tobacco were 8.9% (8.74-9.15), 16.69% (16.42-16.96), and 3.89% (3.75-4.03), respectively, in the second round with wide regional variation as well as male dominance in use. Region, age, education, caste, and religion were significantly and consistently associated with different types of tobacco use in both genders. Other contextual predictors of tobacco use were residence, marital status, occupation, awareness, and wealth index (WI). Conclusions: Tobacco use predictors and their gendered patterns are contextual. Monitoring the predictors for tobacco use, which may change over time, should be given priority in the national tobacco control program.

Challenges and barriers to immunization during COVID-19: An experience of parents/caregivers from a well-baby clinic of a tertiary care hospital of Eastern India.

Background: Immunization in children is one of the best methods of preventing vaccine preventable diseases.With the onset of the COVID-19 pandemic,there have been disruptions in vaccine supply,its uptake and perception towards routine immunization, globally and in India. This study was planned to identify the challenges faced by the parents, the perceived barriers towards childhood immunization and perception regarding vaccination during the ongoing pandemic. Methods: A cross-sectional study was carried out in the well-baby clinic, providing immunization services. The informants were parents/caregivers of under-five children accompanying their children to the well-baby clinic within the study period. Data was collected using a semi-structured interviewer administered questionnaire and analysed using Epi-info software and p value less than 0.05 was considered to be statistically significant. Results: Delay in immunization was noted in 62% of the children. The challenges stated by respondents for delay in immunization during this pandemic mostly were "fear about getting infected" (30%) and "someone instructed them not to take the child to the hospital if not ill" (13%). The most common perceived barriers were 'no vaccination sites were open' or 'did not know where the baby can be vaccinated'. 'Child should receive all vaccines'(99%) and 'safety is more important than vaccination' (83%)was the perception of respondents about immunization during the pandemic. Conclusion: Though the respondents were aware of the need for timely vaccinations of their children, still a substantial delay was seen among majority of them due to fear of getting infected and unavailability of vaccines.

Perceived Barriers in Delivering Optimal Healthcare Services in a Dedicated COVID-19 Hospital: Perspectives of Health-Service Providers.

Background The coronavirus disease 2019 (COVID-19) pandemic challenged the healthcare infrastructure, with health-service providers (HSPs) offering unconditional and unprejudiced service to admitted patients. During the first wave, due to the novelty of the disease and the lack of clarity regarding its transmission in the initial phases of the evolution of the disease, the predominant fear was of contracting the disease while caring for patients. With the prevailing uncertainty in knowledge and management, this study was planned to identify the barriers to delivering optimal healthcare to COVID-19 patients. Methodology A cross-sectional study was conducted among HSPs working in the first phase of a dedicated 500-bed government COVID-19 hospital at Kalinga Institute of Medical Sciences using an online questionnaire with the following five aspects: workplace guidelines and support, protective equipment, access to information regarding updates on the epidemic, overall self-reported stress and workplace stress about self-infection with COVID-19 and family being infected, and demographics. All HSPs aged 18 years or above, who were working either on a full- or a part-time basis, were able to understand the English language, and who were working in the COVID-19 hospital and gave digital informed consent (via Google Forms) were included in the study. All data were collected, coded, tabulated, and analyzed using Google Forms in an Excel format and Epi Info software version 7.2.5.0. Results Of the 144 respondents contacted, 132 completed the survey, with a participation rate of 91.67%. About 52.27% of respondents were aged 21-30 years, 68.18% were females, and 56.06% were nurses. Challenges faced were "working in a new context" (40.91%), "the uncertainty and fear of being infected and infecting others"(31.06%), and "exhausted by the workload and protective gear" (18.94%). Moreover, 64.12% were aware of a workplace policy. Only 0.75% felt that their workload needed to be reduced; 2.27% felt the need for a penalty policy for hiding travel history, lack of quarantine compliance, avoiding the accumulation of face masks, and price inflation of face masks. The overall self-reported stress level was significantly associated with a lack of awareness of workplace policies and the fear of getting infected. Furthermore, 93.94% reported that they had an adequate supply of personal protective equipment. As high as 81.06% of the HSPs were "worried about being infected from COVID-19 during work," and 94.69% were "worried about their family being infected from COVID-19 due to their working in COVID-19 hospitals." Conclusions HSPs' perception of barriers in providing healthcare gave an insight into the problems being faced and helped improve the quality of services. The study highlighted the need of increasing awareness regarding the existing workplace policies among HSPs to promote preparedness during crisis management.

Impact of environmental temperature and relative humidity on spread of COVID-19 infection in India: a cross-sectional time-series analysis.

Purpose: Coronavirus disease 2019 (COVID-19) has become a serious public health problem worldwide. This study sought to examine the associations of daily average temperature (AT) and relative humidity (ARH) with the percent increase in COVID-19 cases. Methods: Daily confirmed cases and meteorological factors in 38 districts of India were collected between 1st April 2020 to 30th April 2020. Taking a 5-day time lag of average values of the variables and multiple days-samples, we ran multiple models and performed appropriate hypothesis tests to decide the single preferred model for each sample data. Suitable fixed effects (FE) and random effects (RE) models with cluster-robust standard errors were applied to quantify the district-specific associations of meteorological and other variables with COVID-19 cases. Results: All FE models revealed that every one-degree rise in AT led to a decrease in 3.909 points (on average) in percent increase in COVID-19 cases. All RE models showed that with one unit increase in the malaria annual parasite index, there was a significant increase in 10.835 points (on average) in percent increase in COVID-19 cases. In both FE and RE models, ARH was found to be negatively associated with a percent increase in COVID-19 cases, although in half of these models the association was statistically insignificant. Conclusion: Our results indicate that mean temperature, mean relative humidity, and malaria endemicity might have an essential role in the stability and transmissibility of the 2019 novel coronavirus.

Supervised hospital based pulmonary rehabilitation outcome in long COVID-experience from a tertiary care hospital.

Introduction: Some patients suffer from various multisystem symptoms even after active process of COVID-19 illness has settled lasting more than four weeks called as long COVID. Pulmonary rehabilitation therapy is the proposed option in those patients. This study aims to study the impact of pulmonary rehabilitation on outcome of long COVID patients through improvement in mMRC dyspnea scale, oxygen saturation, cough score, six-minute walk distance and biomarkers of inflammation. Materials and Methods: A retrospective observational study was carried out from the data of electronic medical records among 71 Long COVID patients. Parameters like Spo2, MMRC scale, cough score, six-minute walking distance along with blood levels of D-dimer, C-reactive protein (CRP), leucocyte count at the time of admission and after three weeks of pulmonary rehabilitation were collected. The outcome among the patients was divided into full recovery and partial recovery group. Statistical analysis was done using SPSS software version 19.0. Result: Among 71 cases in our study 60 (84.50%) where male with mean age was 52.7 ± 13.23 years. Biomarkers like CRP and d-Dimer were elevated in 68 (95.7%) and 48 (67.6%) patients, respectively, at the time of admission. After 3 weeks of pulmonary rehabilitation mean SPO2, cough score, 6MWD showed significant improvement and normalization of biomarkers in recovered group of 61 out of 71 which was statistically significant. Conclusion: Significant improvement of oxygen saturation, mMRC grade, cough score, six-minute walk distance and normalization of biomarkers were marked following pulmonary rehabilitation. Thus, pulmonary rehabilitation therapy should be offered to all long COVID cases.

An epidemiological study on depression among women during postpartum period in an urban slum of Bhubaneswar.

BACKGROUND AND AIMS: Depression accounts for the greatest burden of all mental health problems, and is expected to become the second-highest among all health problems by 2020. Postpartum depression (PPD) is a major public health problem with a peak incidence at 4-6 weeks postpartum, affecting 22% of women within a year of childbirth in India. It has an impact on the mother, her partner, the family, mother-baby bonding and the long-term emotional and cognitive development of the baby. The aim of the study was to: 1.To find out the prevalence of depression among women during the postpartum period 2.To identify the factors associated with depressive symptoms among them. METHODS: A cross-sectional study was conducted in an urban slum of Bhubaneswar from July 2017 to January 2018, among a sample of 60 postnatal mothers who had delivered in the last six months; selected by simple random sampling technique. Edinburgh Postnatal depression scale (EPDS) was used to identify mothers at risk of postnatal depression. A score of ≥13 was considered as positive for depressive symptoms. RESULTS: The prevalence of PPD was found to be 8.57%. Religion was found to be a statistically significant factor associated with PPD. Other factors like literacy status, socio-economic status, high parity, sex of the newborn, mode of delivery were also found to have an association with PPD. CONCLUSION: This study identified certain socio-demographic and obstetric risk factors for postnatal depressive symptoms in a community setting of an urban slum; screening of risk factors will help in designing preventive strategies for identifying PPD.

Morbidity pattern and healthcare seeking behavior among the elderly in an urban settlement of Bhubaneswar, Odisha.

BACKGROUND: Population aging is inevitable. Old age is marked with health problems because of aging process, long-term chronic illnesses, also associated with social and mental problems. OBJECTIVES: To determine the pattern of physical morbidities in geriatric population and to study the utilization of health services among them. METHODS: A cross-sectional study was undertaken from April to September 2017, among 270 consenting elderly people, residing in urban slums under field practice area of a medical college, using a structured interview schedule. RESULTS: Among the 270 elderly, 36.30% were males, 80% belonged to nuclear families. A total of 262 reported of some morbidity, 61.85% had hypertension, 45.19% had diabetes, 37.78% had acid peptic disease, and 51.08% reported to have 1--3 morbidities. Majority (41.85%) of them had visited a physician on an average of 4--6 times in the preceding year. A total of 84.81% went to the urban health center, whereas 24.81% to a government hospital for treatment. Reasons cited for preference of health facility were "free consultation" and "nearby location" (85.19%). A total of 90.74% received allopathic medicines. CONCLUSION: Prevalence of morbidity was found to be high, which can be attributed to their compromised living conditions. Health-seeking behavior was found to be good.

A study on the health seeking behavior among caregivers of under-five children in an urban slum of Bhubaneswar, Odisha.

BACKGROUND: The under-five children are a vulnerable age group; their mortality reflecting a country's overall development. Timely and appropriate healthcare seeking behavior, if practiced by caregivers, can have a significant impact on survival. The slum dwellers have poor health-seeking behavior due to their lower socioeconomic status, prevailing malnutrition, poor immunization status, overcrowding, poor sanitation, personal and cultural practices, beliefs, and attitude toward healthcare providers. OBJECTIVES: (1) To assess the health-seeking behavior among caregivers of under-five children during acute childhood illness (2) To find out the factors associated with their treatment-seeking behavior. MATERIALS AND METHODS: A community-based cross-sectional study, among 260 caregivers, in the field practice area of Urban Health and Training Centre of a medical college was undertaken from September 1, 2016 to February 28, 2017, using a pretested semistructured questionnaire after obtaining a list of under-fives from the female health worker. RESULTS: In total, 260 caregivers with mean of 26.61 ± 4.31 years participated in the study, 77.69% reported of some health morbidity. Around 21.92% of the caregivers gave primary care at home, 33.46% visited a chemist, and 33.08% attended health facility nearby. About 79.23% sought healthcare immediately following illness. Of the remaining 20.77% who did not seek medical advice, 75.93% used home remedies. Significant association was found between the age of the mother, educational status of the mother, religion, birth order of the child and socioeconomic status of the caregivers, and appropriate treatment seeking behavior during an episode of acute illness. CONCLUSION: This study attempted to identify health-seeking behavior of caregivers for children under-five and the determinants of appropriate treatment-seeking behavior. The knowledge of signs and symptoms of ill-health can reduce morbidity and mortality; however, continuous education of caregivers for recognition of symptoms and the need to seek appropriate medical care is needed. Government facility was the preferred choice for the population in the sampled slum. Treatment-seeking behavior was good among the respondents with majority having appropriate behavior. Measures can be taken to help promote awareness among those who did not have appropriate treatment seeking behavior.

Human immunodeficiency virus/acquired immunodeficiency syndrome-related discriminatory practices among health-care providers in apex health institutions of Bhubaneswar, Odisha.

CONTEXT: Stigma and discrimination in health-care settings, against human immunodeficiency virus (HIV)-positive patients, not only affects patient care but also creates an unnecessary culture of secrecy and silence based on ignorance and fear. AIMS: This study was designed to determine if there were any such discriminatory practices against people living with HIV/acquired immunodeficiency syndrome (AIDS) by health-care providers at apex hospitals in the city of Bhubaneswar, Odisha. SETTINGS AND DESIGN: A cross-sectional study was designed in clinical departments, among all doctors and paramedical workers who had been providing health services to patients with HIV/AIDS for at least a year in the three large multidisciplinary tertiary care teaching hospitals in Bhubaneswar. MATERIALS AND METHODS: A semi-structured questionnaire was used to collect data through in-person interviews after obtaining informed consent. STATISTICAL ANALYSIS USED: Data were entered into Microsoft Excel spreadsheet and were analyzed using Epi Info 7 (version 7.1.2.0); results represented using frequencies, proportions, Z-tests, and Chi-square tests. RESULTS: Around 76.73% of the participants agreed that they were personally aware of discrimination that occurred in health-care settings. About 92.86% of the doctors, 78.12% of the nurses, while 38.09% of other health-care providers (HCPs) agreed to the fact there were some form of discriminatory practices at health facilities; this was also found to be statistically significant. As high as 88.10% of the doctors, 90.62% of the nurses, and 80.96% of other HCPs agreed that there were discriminatory practices against HIV/AIDS patients by HCPs, although this difference was not statistically significant. CONCLUSIONS: Existence of discriminatory practices in these healthcare settings was due to the lack of correct information about HIV/AIDS and lack of protective materials needed for prevention of infection transmission.

Breastfeeding awareness and perception among antenatal mothers: A cross-sectional study in urban slum population of Bhubaneswar, Odisha.

INTRODUCTION: Breast milk provides nutritional, immunological, behavioral, and economic benefits and helps to build mother-infant bonding. Antenatal mothers need to be sufficiently aware about the benefits of breastfeeding. OBJECTIVES: The aim of this study is to assess the awareness and perception of breastfeeding among antenatal mothers and to find out any association between sociodemographic factors and breastfeeding awareness. METHODOLOGY: A cross-sectional study was conducted among 250 antenatal women residing in the urban slums of field-practice area of urban health and training center; using a predesigned, pretested, semi-structured interview schedule. Antenatal checkup followed by one to one counseling for the women regarding breastfeeding was provided. Data were represented by frequencies, proportions, and associations using Chi-square, and the P < 0.05 was considered statistically significant. RESULTS: Most (55.6%) of the women were in the age group of 18-24 years. The mean age at marriage was 19.2 ± 2.5 years. 81.2% of them were Hindus, 13.2% had adequate, 49.6% had moderately adequate, whereas 37.2% women had inadequate awareness about breastfeeding. About 100% intended to breastfeed their children, but only 64% said that they intended to exclusively breastfeed. 66.4% knew about the importance of colostrum. Age-group, religion, literacy, occupation, type of family, gravida, and number of antenatal visits showed highly significant (P < 0.001) association with awareness of breastfeeding. CONCLUSION: Nearly one-third of the antenatal mothers lacked awareness on breastfeeding practices. Although all intended to breastfeed, still only 64% knew about exclusive breastfeeding. These gaps need to be addressed by awareness generation activities during antenatal counseling.

Health impact on women using solid cooking fuels in rural area of Cuttack district, Odisha.

BACKGROUND: Around 3 billion people use solid fuels (biomass and coal) for cooking and heating, and this number is expected to grow until at least 2030. Around 73.7% of households in rural Odisha use wood for cooking. This current study is an attempt to evaluate the impact of solid cooking fuels on health of rural women in age group of 20-40 years and to study the relationship between the duration of exposure to cooking fuels and various health problems. MATERIALS AND METHODS: This cross-sectional study was carried out in a village which is under the field practice area of the rural health and training centre, under Department of Community Medicine, Kalinga Institute of Medical Sciences. Universal sampling technique was adopted for sample selection. Chi-square test was used to find the association between cooking fuel usage and self-reported symptoms. RESULTS: Dry cough was the most common presenting symptom (15.03%), followed by eye and nose irritation present in nearly 12% each among the study participants. Headache, dry cough, and hypertension (HT) was found to associated with number of cooking years and was also found to be statistically significant (P = 0.03, 0.02 and 0.0065, respectively). DISCUSSION: Our study clearly indicated that the exposure to biomass fuel smoke is significantly associated with the prevalence of symptoms of headache, dry cough, and HT. Further research is required for improving information on dose-response relationships between indoor air pollution and various health effects. Conclusion: The morbidities were increased with increase in duration of cooking . Knowledge related to health effects of cooking fuels seems to be poor among the participants.

A study on awareness and utilization of Mission Indradhanush in an urban slum of Bhubaneswar.

BACKGROUND: India records 5 lakh child-deaths annually due to vaccine preventable diseases. As a strategic endeavor, the Ministry of Health and Family Welfare, Government of India, launched Mission Indradhanush in December 2014 to achieve more than 90% full immunization coverage by the year 2020. OBJECTIVES: To assess the awareness of the respondents about Mission Indradhanush, to assess their attitude and practices regarding childhood immunization, and to determine the association between knowledge and practice with selected variables. MATERIALS AND METHODS: A cross-sectional study was undertaken from June to September 2017 among mothers with children aged 12-23 months in urban slums under field practice area of Community Medicine Department, Kalinga Institute of Medical Sciences, Bhubaneswar. RESULTS: Mean age of the children was 17.23 ± 3.43 months; 65% were males and 35% females. Mean age of the respondents was 24.48 ± 3.97 years; 68% were literate and 94% were Hindus. Majority (76%) belonged to upper-lower Kuppuswamy socio-economic status scale. Only 10% had heard about Mission Indradhanush; health worker (90%) being the most common source of information. A total of 91% believed that vaccination prevented disease. A total of 96% believed that immunization was important for their children. A total of 73% had the maternal and child protection card with them. A total of 72% of children were fully immunized. Of the 28% partially vaccinated children, only 12.5% had heard about Mission Indradhanush. Reasons stated for partial immunization were mother too busy, child illness, and lack of information. CONCLUSION: Very few participants had heard about Mission Indradhanush in this study although most of them were aware of immunization services. Strengthening of Information, Education, Communication (IEC) activities regarding the program-Mission Indradhanush-needs attention. The immunization coverage was satisfactory.