Mental and Behavioural Disorders of Childhood and Adolescence: An Observational Study.

BACKGROUND: There is overlap of symptoms in psychiatric disorders, especially in mental and behavioural disorders of childhood and adolescence. Half of all lifetime psychiatric disorders tend to arise by age 14 years and three fourths of them arise by age 24 years. AIM: To study the various types of mental and behavioural disorders of childhood and adolescence, and to find out comorbidities within and across the types. METHODS: An observational cross-sectional study was carried out over a period of one year in the psychiatry department of a tertiary care general hospital. The psychiatric diagnoses according to the World Health Organization's (WHO) tenth revision of the International Statistical Classification of Health and Related Problems (ICD-10) were categorised into type 1 (depression, anxiety, obsessive-compulsive disorder, and somatoform disorder), type 2 (attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder), type 3 (mental retardation, developmental disorders of speech and language, and scholastic skills, and pervasive developmental disorders). Descriptive statistics was used with frequency and percentage. RESULTS: Total sample size was 137. Children and adolescents were almost equally distributed. Boys were more than girls. Type 3 disorders were maximum. Adolescents had mostly type 1 disorders. Children had mostly type 3 disorders. Girls had almost same number of type 1 and type 3 disorders. Boys had mostly type 3 disorders. Within group comorbidity was mostly with type 3 disorders. Across group comorbidity was highest in type2-type 3 disorders. CONCLUSION: Mental and behavioural disorders in childhood and adolescence do vary according to age and sex, and their recognition will help in the early diagnosis and proper management.

Comparison of diagnostic performance of single and multiple fecal sampling in the detection of soil-transmitted helminths in school-aged children.

Soil-transmitted helminths (STHs) are widely distributed globally and India is a significant contributor to the overall global burden of the disease. Microscopic methods like Kato-Katz (K-K) thick smear and direct smear microscopy by wet mount (DSM) are widely used for STH diagnosis due to their ease in performance. Still, low sensitivity proves to be a significant limitation of these methods. This study explores the diagnostic performance of two and three consecutive-day stool samples compared to the common practice of single stool sample examination. We observed that the three consecutive-day stool examination technique increased overall helminth positivity from 12% to 16.3% in K-K and 11.5-15.9% in DSM, indicating that multiple sampling can diagnose intestinal helminthiasis more accurately. A significant increase in the intensities of hookworms (by 37.5%; p value: 0.001) and Trichuris trichiura (by 47.8%; p value: 0.037) (measured in terms of fecal egg count) was also observed. The methods undertaken in the current study are comparable in detecting the helminths as the marginal increase in positivity by K-K (16.32% vs. 15.86%) was statistically insignificant.

Sociodemographic factors and their association with menstrual hygiene practices among adolescent girls in Urban slums of Dibrugarh town, Assam.

Introduction: For good physical and mental health in adolescent girls, menstrual hygiene practices play an important role. Adolescent girls are incredibly susceptible to various physical and mental issues during this period, and sociodemographic factors play a crucial function in menstrual hygiene practices; thus, it is very critical to preserve good menstrual hygiene practices. Aim and Objectives: 1) to assess the knowledge and menstrual hygiene practices among adolescent girls and 2) to assess the sociodemographic factors influencing knowledge and menstrual hygiene practices. Materials and Methods: A cross-sectional study was conducted in July-September 2019 among 150 adolescent girls. A predesigned, pretested questionnaire was used in the study. Descriptive statistics were applied in data analysis, and multivariate analysis was applied to find out the association. Results: Out of 150 adolescent girls, 78% belong to the Hindu religion and 76.7% are of nuclear family. In total, 28.7% mothers of adolescent girls are illiterate, and most of the adolescent girls (50%) belong to the 14-16-years age group; 38.7% adolescent girls belong to class V socioeconomic status. Multivariate analysis shows that Muslim religion has a significant association with knowledge regarding menstrual hygiene practices (OR: 2.846, P < 0.05) and sanitary disposal of absorbent by adolescent girls (OR: 2.528, P < 0.05). There is a significant association between joint family (type of family) and absorbent used by adolescent girls (OR: 0.253, P < 0.05). Conclusion: It is usually essential to enhance information and practices of good menstrual hygiene among adolescent girls so that they can lead a healthy productive life. Improvement of mothers' knowledge is also a major area to be focused on.

YouTube as a Source of Medical and Epidemiological Information During COVID-19 Pandemic: A Cross-Sectional Study of Content Across Six Languages Around the Globe.

Introduction The current coronavirus disease 19 (COVID-19) outbreak has been declared to be a pandemic by the World Health Organization (WHO). It is evolving daily and has jeopardized life globally across social and economic fronts. One of the six key strategic objectives identified by the WHO to manage COVID-19 is to communicate critical information to all communities and prevent the spread of misinformation. We analyzed content on YouTube.com, a widely used web-based platform for medical and epidemiological information. Methods YouTube search results using two keywords were analyzed each in six languages - English, Arabic, Bengali, Dutch, Hindi, and Nigerian Pidgin on April 8, 2020. Forty videos in each of the six languages (i.e., a total of 240 videos) were included for analysis in the study. Two reviewers conducted independent analyses for each language. The inter-observer agreement was evaluated with the kappa coefficient (κ). Modified DISCERN index and Medical Information and Content Index (MICI) scores were used for the reliability of content presented in the videos and information quality assessment, respectively. Analysis of variance, Kruskal-Wallis, Mann-Whitney test, and chi-square tests were done appropriately for data analysis. A p-value of less than 0.05 was considered statistically significant. All calculations were performed using SPSS Statistics for Windows, Version 21.0 (IBM Corp, Armonk, NY). Results The videos cumulatively attracted 364,080,193 views. Altogether, 52.5% of videos were Informative, 23.75% were News Updates, and 8.33% were Personal Experiences. Ten percent of videos were found to present medically misleading information. Independent Users contributed 75% of the misleading content. The overall Mean DISCERN score, an index of content reliability, was 2.62/5. The overall Mean MICI Score was 5.68/25. Videos had better scores in the Transmission component of the MICI scale and scored low on the Screening/Testing component. Conclusion The reliability and quality of the content of most videos about COVID-19 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were found to be unsatisfactory. Videos with misleading content were found across all six languages, and sometimes garnered a higher percentage of views than those from credible sources. The share of videos contributed by Government and Health Agencies was low. Medical institutions and health agencies should produce content on widely used platforms like YouTube for quality medical and epidemiological information dissemination.

Correlation between the arm-span and the standing height among males and females of the Khasi tribal population of Meghalaya state of North-Eastern India.

INTRODUCTION: The estimation of relationship between the arm span and the standing height has been an important tool in anthropometric measurements especially in cases where direct measurement of stature is not possible. OBJECTIVE: To find the relationship between the arm-span and the standing height of both males and females in the population of Khasi tribal population of Meghalaya. MATERIALS AND METHODS: The study involved 400 numbers (272 males and 128 females) of healthy human volunteer subjects belonging to Khasi tribe of Meghalaya. The standing height and arm-span were measured for each individual and analyzed. RESULT: Of the 400 healthy volunteers, 272 (68%) were males and 128 (32%) were females with age ranged from 25 to 45 years. Height and arm span in males (159.68 ± 4.12 cm and 166.30 ± 4.27 cm, respectively) werefound to be significantly (p < 0.001) higher than females (149.96 ± 3.04 cm and 155.77 ± 3.13 cm respectively). The Pearson correlation coefficient (r) between height (cm) and arm span (cm) showed significant positive correlation in both male (r = 0.988, P < 0.001) and female (r = 0.991, P < 0.001) study subjects. The regression equation was Height = 1.060 + 0.954 (Arm span); R2 = 0.976; SEE = 0.646 for male. For female subjects the regression equation was found as Height = 0.150 + 0.962 (Arm span); R2 = 0.983; SEE = 0.400. CONCLUSION: Arm-span can be used as one of the most reliable parameter in both males and females for obtaining the stature of an individual in alternative to the height.

Body mass index and body fat percentage in assessing obesity: An analytical study among the adolescents of Dibrugarh, Assam.

BACKGROUND: Body mass index (BMI) is one of the most commonly used indices to measure the weight status of an individual. However, it takes only height and weight of individual into account. The relative body composition can be calculated regardless of height and weight by body fat percentage (BF%). OBJECTIVES: The objectives of the study are (1) To assess the prevalence of obesity using BMI and BF% among early adolescents studying in schools of Dibrugarh. (2) To assess the relationship between BMI and BF%. METHODS: A cross-sectional analytical study was conducted among 1200 school going adolescents of 10-14 years in Dibrugarh town for 1 year. Weight status was assessed using the World Health Organization-2007 reference for BMI and the McCarthy's body fat reference. Data were presented using percentages and mean with standard deviation. The correlation between the anthropometric variables was calculated using Pearson's correlation coefficient. Kappa statistics was used to analyze the agreement. RESULTS: Total participants included in the analysis were 1096 with a response rate of 91.3%. The prevalence of overweight and obesity by BMI was 20.9% and 10.2%, respectively. According to BF%, overweight was present in 16.4% participants and 10.9% were obese. Of the 625 normal weight participants (according to their BMI), 9.0% were overweight and 1% were obese under BF% criteria. Again, of 682 participants who were normal by BF%, 15.2% were categorized as obese by BMI criteria. BMI and BF% had a significant high positive correlation (r = 0.70 and P < 0.001). The measurement of agreement by Kappa statistics was 0.621 which was significant (P < 0.001). CONCLUSIONS: BMI and BF% positively correlate with each other. BMI accompanied by BF% in the studies might give a better picture of the adiposity of an adolescent.

Risk factors of diabetes mellitus amongst the executives of an industrial area of North East India: A community based cross sectional study.

AIM: To assess risk factors of diabetes mellitus amongst the executives of an industrial area of North East India. MATERIAL AND METHOD: Executive the aged 20 to 60 years were selected by simple random sampling in a community based cross-sectional study. The sample size was 340. Data was collected by a predesigned pretested proforma to know about different risk factors. Fasting capillary blood glucose and 2h capillary blood glucose were taken to assess diabetes mellitus. RESULTS AND OBSERVATION: 30.7% of the male and 18.4% of the female participants had family history of DM. 29.3% of the male and 39.5% of the female had family history of hypertension. 24.7%, 0.6% and 2.9% smoked regularly, occasionally and in the past respectively. 2.9% subjects consumed chewed tobacco regularly, 0.3% consumed occasionally and 1.6% consumed tobacco in the past. 44.5%, 10.7%, 2.3% of the study subjects took alcohol regularly, occasionally, in the past respectively. 44.5%, 47.4% and 8.1% of the participants were involved in sedentary work, active work and heavy work respectively. Prevalence of diabetes mellitus was significantly associated with advancement of age, family history of diabetes mellitus, family history of hypertension and sedentary life style. No significant association of diabetes mellitus with gender, tobacco consumption and alcohol intake. CONCLUSION: A package for the early diagnosis and management of diabetes may be initiated to bring down the morbidity and mortality in industrial population.

A Comparative Study to Assess the Determinants and Outcomes of Sepsis Treated in Medical Wards and ICU in an Indian Teaching Hospital.

INTRODUCTION: Sepsis is the primary cause of death from infection worldwide. In resource-limited countries, increasing number of sepsis is managed in non-ICU settings, in Medical Wards (MW). AIM: To compare the burden, aetiology and short term outcome of sepsis treated in MW with ICU. MATERIALS AND METHODS: Prospective, observational, analytical study in sepsis patients in general MW and medical ICU in a tertiary care hospital. Two hundred forty five sepsis patients (MW=150, ICU=95), ≥18 years, selected randomly, were studied to compare aetiology, co-morbidities, clinical & microbiological profile and short-term outcome between MW and ICU sepsis. Sepsis following surgery, trauma, those transferred to/from ICU, those with other life threatening diseases were excluded. Chi-square test/Fisher's-exact test was used for comparing ratios. A 'p-value' <0.05 was considered statistically significant. RESULTS: Sepsis was more common in elderly males, both in MW and ICU (median age: 56.7, 59.2 years; male: female ratios = 1.34:1, 1.63:1 respectively). Frequency of presenting symptoms, co-morbidities and sources of sepsis were similar in both groups (p>0.05). Frequency of positive microbiological culture, pattern of microbial flora and antimicrobial resistance patterns were similar in both groups (p>0.05). Number of antibiotics used was significantly higher in ICU compared to MW (p<0.01); multi-organ dysfunction and mortality were significantly higher in ICU settings (55.8% vs. 38.7%, p=0.04; 48.4% vs. 32.6%, p=0.041 respectively). While sepsis and severe sepsis were significantly higher in MW (34.6% vs. 22.1 %, p=0.03; 47.3% vs. 26.3%, p<0.01 respectively), septic shock was significantly higher in ICU (51.6% vs. 18.0%, p<0.01). Mortality in both settings was highest in septic shock (55.5% and 61.2%, p>0.05) and multi-organ dysfunction (55.1% and 64.2%, p>0.05). Duration of hospital stay was significantly shorter in MW than ICU (7.3 vs. 11.0 days, p<0.01). CONCLUSION: Our study aimed to identify determinants and outcome of sepsis in MW and compare with ICU settings. Antibiotic usage in the two settings differed: concurrent use of ≥3 antibiotics, and carbapenems & linezolid usage were significantly higher in ICU compared to MW. Sepsis in MW had significantly lower incidence of multi-organ failure, lower mortality and shorter hospital stay compared to ICU.