Sexual health problems and health-seeking behavior of men who have sex with men in Agra City, Uttar Pradesh.

BACKGROUND: Men who have sex with men (MSM) are at high risk of acquiring sexually transmitted illnesses. The gross stigmatization of homosexuality and discrimination has always affected their health-seeking behavior. OBJECTIVES: The study aimed to assess the magnitude of sexual health problems, factors associated, and their health-seeking behavior. METHODS: Descriptive cross-sectional study was conducted in Agra city, Uttar Pradesh during December 2017 and November 2019 among a sample of 52 MSM. The Snowball technique of sampling was used to recruit the eligible subjects. Data were collected by interview and analyzed using MS excel. RESULTS: Overall prevalence of any sexual health problem in past 1 year was 71.2%. Anal/perianal problems (26.9%) and genital/oral vesicles (26.9%) were the most commonly encountered illnesses MSM who had all their sexual encounters with men (completely homosexual), those MSM who used to play both insertive and receptive roles, had 5 or more sexual partners, used condom irregularly had significantly higher chances of having sexual health problems. Most (70.3%) MSM sought treatment for their sexual health problem from an Allopathic doctor; 29.4% took treatment from a government health facility. The majority (94.1%) of them were reportedly satisfied with the health care facility. Most (79.4%) respondents preferred not to disclose their sexual behavior during interaction with their sexual health care provider. CONCLUSION: High prevalence of sexual health problems was found among MSM who engage in high-risk sexual behavior. MSM requires access to STIs screening. Behavior change communication is needed to improve their health-seeking behavior.

Phytoremediation of sewage sludge by Cymbopogon martinii (Roxb.) Wats. var. motia Burk. grown under soil amended with varying levels of sewage sludge.

Sewage sludge used as agriculture fertilizers contains a conspicuous amount of potentially toxic metals. In order to prevent the contamination in the food chain, there is an urgent need for the development of sewage sludge clean up technology. The use of non-food, multi-harvest aromatic crops for phytoremediation of sewage sludge has many benefits. Besides the eco-friendly approach, plant biomass generated can be used to extract economically important essential oil free of heavy metals. Cymbopogon martinii was grown in soil (s) amended with different ratios of sewage sludge (ss), that is, 100s:0ss (control), 80s:20ss, 60s:40ss, 40s:60ss, 20s:80ss, and 0s:100ss. The experiment was conducted in a plastic sack under an open environment for 1 year and harvesting was done thrice. Plant growth and essential oil yield were significantly increased with the increasing dose of sewage sludge. Accumulation of toxic metal (Cd, Cr, Pb, Ni) and micronutrient (Fe, Zn, Cu, Mn) increased significantly in the shoot tissues confirmed by estimation of bioaccumulation and bioconcentration, and scanning electron microscopy and X-ray microanalyses. Soil enzyme activities were significantly improved with the plant growth period and increased doses of sludge. Results showed C. martinii acts as hyper-accumulator and thus could be used for phytoremediation of sewage sludge.

Workplace violence against resident doctors: A multicentric study from government medical colleges of Uttar Pradesh.

According to the World Health Organization, between 8% and 38% of health workers suffer physical violence at some point in their careers. This multicentric study was conducted to find the prevalence, perceived risk factors, and measures to prevent workplace violence among doctors. The sample consisted of all 2nd- and 3rd-year resident doctors (n = 305) from three colleges in Uttar Pradesh. An anonymous, pretested in a similar setting, self-administered questionnaire was used. 69.5% of doctors reported to have experienced violence in one or other form in the past 1 year. In most incidents, relatives and attendants (69.3%) were involved in violence. No action was taken immediately in regard to violence in 35.3% of instances; 60.3% of study participants reported that they had repeated disturbing memories, thoughts, or images of the attack. Nonavailability of medicines (38.6%) and less staff (36.7%) were cited as top reasons behind violence.

Microbial Inoculants Assisted Growth of Chrysopogon zizanioides Promotes Phytoremediation of Salt Affected Soil.

Restoration of salt-affected soil through cultivation Chrysopogon zizanioides is a promising approach. The two way benefit of such an approach is that reclamation of salt-affected soil concomitant to improve plant growth and increased yield of essential oil produced in the plants roots. Earlier studies showed physiological changes and reduced growth of C. zizanioides under salinity. In the present study, plant growth promoting microorganisms viz. Pseudomonas monteilii, Bacillus megaterium, Azotobacter chroococcum and Rhizophagus intraradices were used as bio-inoculants for cultivation of C. zizanioides under salt-affected soil. Bio-inoculants in combination with vermicompost significantly increased the growth and productivity of C. zizanioides under salt-affected soil, and simultaneously improved soil health. When compared to control, the soil physico-chemical and biological properties of bio-inoculants treated plants was significantly improved. The reclamation of salt-affected soil was evident by the significant decrease in the level of soil pH (11.0%), electrical conductivity (23.5%), sodium adsorption ratio (15.3%), and exchangeable sodium percent (12.4%) of bio-inoculants treated plants. The improvement of soil cation exchange capacity indicated the decrease in soil salinity. Whereas increase in the microbial count (four-fold), AMF spores (447 spores), dehydrogenase (six-fold), acid (two-fold) and alkaline phosphatase (five-fold) activities in rhizosphere soil of bio-inoculant treated plants indicated the improved biological properties. A positive correlation of plant biomass production to soil organic carbon, total Kjeldahl nitrogen, available phosphorus and cation exchange capacity depicted improved nutrients content in rhizosphere soil of bio-inoculant treated plants. The findings of this study suggest that P. monteilii and R. intraradices with vermicompost can be effectively used as bio-inoculants for encouragement of phytoremediation in salt-affected soil.

Performance of rose scented geranium (Pelargonium graveolens) in heavy metal polluted soil vis-à-vis phytoaccumulation of metals.

An investigation was carried out to evaluate the effect of heavy metal toxicity on growth, herb, oil yield and quality and metal accumulation in rose scented geranium (Pelargonium graveolens) grown in heavy metal enriched soils. Four heavy metals (Cd, Ni, Cr, and Pb) each at two levels (10 and 20 mg kg-1 soil) were tested on geranium. Results indicated that Cr concentration in soil at 20 mg kg-1 reduced leaves, stem and root yield by 70, 83, and 45%, respectively, over control. Root growth was significantly affected in Cr stressed soil. Nickel, Cr, and Cd concentration and accumulation in plant increased with higher application of these metals. Chromium, nickel and cadmium uptake was observed to be higher in leaves than in stem and roots. Essential oil constituents were generally not significantly affected by heavy metals except Pb at 10 and 20 ppm, which significantly increased the content of citronellol and Ni at 20 ppm increased the content of geraniol. Looking in to the higher accumulation of toxic metals by geranium and the minimal impact of heavy metals on quality of essential oil, geranium can be commercially cultivated in heavy metal polluted soil for production of high value essential oil.

Are doctors feeling burnout? - Multicenter cross-sectional study on burnout syndrome and its determinants during the ongoing pandemic.

Background: Though the concept of burnout has been around for long, its significance is increasing nowadays owing to the demanding nature of jobs. The latest ICD-11 also provides a detailed description of Burnout syndrome. Physicians are at high risk for experiencing burnout and this becomes especially relevant in the ongoing COVID-19 pandemic. Aim: To determine the risk of burnout among medical faculty and its predictors, if any. Materials and Methods: This was a multicentric cross-sectional study that included medical faculty from four tertiary care government teaching hospitals in north India. A survey was conducted during the current COVID-19 pandemic to assess burnout using a structured online questionnaire based on Burnout Assessment Tool. The questionnaire also included relevant socio-demographic, professional, health, and lifestyle-related details. Descriptive statistics, Mann-Whitney U Test/Kruskal Wallis Test, and Kendall's tau-b Test were used for statistical analysis. Results: A total of 244 medical faculty completed the survey. 27.87% were at risk of burnout, out of which 11.89% were at a very high risk of burnout. Dissatisfaction with the job and dissatisfaction with sleep (P < 0.01 for both) were associated with greater burnout scores and a greater risk of burnout. Conclusion: Faculty members are at high risk of burnout, regardless of sociodemographic and work-related factors.

Diagnostic Accuracy of Cartridge Based Nucleic Acid Amplification Test (CBNAAT) in Stool Samples in Pediatric Tuberculosis.

OBJECTIVES: To find out the diagnostic accuracy of stool Cartridge-based nucleic acid amplification test (CBNAAT) as an alternate method as compared to CBNAAT in gastric aspirate (GA) samples in pediatric tuberculosis (TB). METHODS: This cross-sectional study was performed at Department of Pediatrics of a tertiary care hospital. Children aged 0-18 y diagnosed as presumptive tuberculosis were consecutively enrolled. Gastric aspirate and corresponding stool sample was subjected to CBNAAT and its performance was compared in both samples using appropriate statistical tests. RESULTS: Total 100 patients were enrolled in the study. Diagnostic accuracy of CBNAAT was 81% and 80% in gastric aspirate and stool sample respectively. On comparing gastric aspirate with corresponding stool sample there was 97% agreement, with Cohen's kappa value of 0.94. There was a statistically significant association observed between gastric aspirate CBNAAT and stool CBNAAT p <0.001 using chi square test. Sensitivity of gastric aspirate CBNAAT and stool CBNAAT was 75% and 73% respectively and specificity was 100% for both the samples compared against Composite Reference Standard (CRS). CONCLUSIONS: The diagnostic accuracy of stool CBNAAT is comparable to GA CBNAAT in children and can be used as a good alternative to gastric aspirate for diagnosis of pulmonary and disseminated tuberculosis in children.

Burden of stillbirths among women vaccinated with COVID-19 vaccines: A systematic review and meta-analysis.

OBJECTIVE: To estimate the global burden of stillbirths among pregnant women with the COVID-19 vaccination. DATA SOURCE: In this systematic review and meta-analysis, a literature search was carried out in PubMed, Cochrane and Scopus until February 4, 2023, with language restriction (English). STUDY SELECTION: Title-abstract screening followed by full text review was done independently by two authors, based on the research question, "What is the prevalence of stillbirths among the pregnant women vaccinated with COVID-19 vaccines?" DATA EXTRACTION: Two authors independently extracted the relevant data from every study. The third author resolved the conflicts. This study was registered in PROSPERO and followed the PRISMA guidelines. DATA ANALYSIS: A Random effects model was applied to assess the pooled estimate of stillbirths. The I2 test was used to assess the heterogeneity of the articles included in the study. For checking the publication bias, the Doi plot and the contour-enhanced funnel plot were utilized. RESULTS: The database systematic search yielded 168 articles; 11 of them were determined to be eligible for systematic review and 8 of them ended up being included for meta-analysis. The pooled prevalence of stillbirth in pregnant women vaccinated against COVID-19 infection was 0.00509 (5 per 1000 live births delivered by pregnant women vaccinated against COVID-19 (95% CI: 0.00003-0.01676). Statistically significant heterogeneity was reported across studies (I2 = 98%; p < 0.01). CONCLUSIONS: The study concluded that vaccination against COVID-19 among pregnant women had a low stillbirth rate. It adds to the existing evidence that the COVID-19 vaccine is safe and can be taken during pregnancy.

Osteogenic activity of constituents from Butea monosperma.

Phytochemical investigation from the stem bark of Butea monosperma, led to the isolation and identification of three new compounds named buteaspermin A (1), buteaspermin B (2) and buteaspermanol (3), along with 19 known compounds. The structure of compounds 1-22 were established on the basis of their spectroscopic data. The isolated compounds 2-17 were evaluated using neonatal (1-3 day old) rat calvaria derived primary osteoblast cultures. Five of these compounds 7, 10-13 showed promising osteogenic activity, attributed to increased osteoblast proliferation, differentiation and mineralization as evidenced by marked increase in expression of alkaline phosphatase, an early phase differentiation marker, and alizarin Red S staining of osteoblasts cultured for 48 h and von Kossa silver staining of nodules formed 15 days after culture with these compounds. Quantification of mineralization by optical density measurement of Alizarin Red S extracted from stained osteoblasts cultured for 7 days in presence of these compounds showed significant (P<0.05, vs corresponding vehicle control group) increase in mineralization. On the basis of biological results, structure-activity relationships are discussed.

Constituents of Cissus quadrangularis.

Two new iridoids 6-O-[2,3-dimethoxy]-trans-cinnamoyl catalpol (1) and 6-O-meta-methoxy-benzoyl catalpol (2) along with a known iridoid picroside 1 (3), two stilbenes quadrangularin A (4) and pallidol (5), quercitin (6), quercitrin (7), beta-sitosterol (8) and beta-sitosterol glycoside (9) were isolated from Cissus quadrangularis Linn. The compounds 3 and 7 are first reported from this plant. The structures were elucidated by analysis of their spectroscopic data and by direct comparison with literature. This is the first reported occurrence of iridoids in C. quadrangularis.

Immunosuppressive properties of flavonoids isolated from Boerhaavia diffusa Linn.

Plant extracts have been widely evaluated for possible immunomodulatory properties. We have earlier reported that ethanolic extract of Boerhaavia diffusa root, a plant used in Indian traditional medicine, has significant immunomodulatory potential. B. diffusa hexane, chloroform and ethanol extracts, and two pure compounds Bd-I (eupalitin-3-O-beta-D-galactopyranoside) and Bd-II (eupalitin) were evaluated in vitro for their effect on T cell mitogen (phytohemagglutinin; PHA) stimulated proliferation of human peripheral blood mononuclear cell (PBMC), mixed lymphocyte culture, lipopolysaccharide (LPS) stimulated nitric oxide production by RAW 264.7, PHA and LPS induced IL-2 and TNF-alpha production, in human PBMCs, superoxide production in neutrophils, human natural killer (NK) cell cytotoxicity and nuclear translocation of nuclear factor-(kappa)B and AP-1 in PHA stimulated PBMCs. The chloroform and ethanol extracts inhibited PHA stimulated proliferation of peripheral blood mononuclear cells, two-way MLR, NK cell cytotoxicity as well as LPS induced NO production by RAW 264.7; the hexane extract showed no activity. Bd-I purified from the ethanolic extract at equivalent dose, inhibited PHA-stimulated proliferation of peripheral blood mononuclear cells, two-way MLR and NK cell cytotoxicity as well as LPS induced NO production by RAW 264.7 equally or more effectively than the parent ethanolic extract. Bd-I inhibited production of PHA stimulated IL-2 at the protein and mRNA transcript levels and LPS stimulated TNF-alpha production in human PBMCs; it also blocked the activation of DNA binding of nuclear factor-(kappa)B and AP-1, two major transcription factors centrally involved in expression of the IL-2 and IL-2R gene, which are necessary for T cell activation and proliferation. Our results report selective immunosuppressive activity of B. diffusa leaf extracts and that this activity lies in eupalitin-3-O-beta-D-galactopyranoside (Bd-I) isolated and purified from the ethnaolic extract. Thus, Bd-I could be a candidate for development as an immunosuppressive agent.

Amritosides A, B, C and D: clerodane furano diterpene glucosides from Tinospora cordifolia.

Four new clerodane furano diterpene glucosides (amritosides A, B, C and D) were isolated as their acetates from Tinospora cordifolia stems. The structures of these compounds were established on the basis of spectroscopic studies.

The study of blood pressure profile among school going adolescents in urban Agra

Background: Hypertension once considered a problem of adults only in the high income countries, now dramatically is on the rise in low and middle income countries. An established predictor of adult hypertension and organ damage is childhood hypertension. Thus for the control, effective treatment and prevention of its complications, early diagnosis of hypertension in adolescents in an important strategy. The objective was to study the blood pressure profile and its socio-demographic determinants among school going adolescents in urban Agra.Methods: A cross-sectional survey was done among 534 adolescent in age group of 13-18 years studying in various government and private schools in urban Agra. Socio demographic details, anthropometric measurements and family history of hypertension were obtained. Also the dietary habits, physical activity, mode of transport to school were included in the present study. Blood pressure was measured at 0 and 30 minutes and average of two readings was taken as the final reading of that individual.Results: It was found that 49.82% of the study subjects had above normal blood pressure and among them 21.16% were hypertensive and 28.66% had pre-hypertension. Higher blood pressure showed a statistically significant (p<0.05) association with gender, age, dietary habits, physical activity, body mass index, and parental history of hypertension.Conclusions: Hypertension among the adolescent age group was very high. Prevalence of high blood pressure significantly associated with age, gender, family history of hypertension, physical activity, type of school and dietary habits.

Correspondence.

India is a signatory to the Alma Ata Declaration and is committed to attaining Health for All. Primary healthcare is the point of entry for a person to the national health system.1 A health subcentre is the most peripheral facility that connects the primary healthcare system and the community.2 While India lacks adequate healthcare infrastructure, it is also a fact that the available public health system remains largely underutilized, and curative treatment is mostly provided by underregulated private healthcare providers.3,4 Strengthening of the public health system for delivery of promotive, preventive and curative health services is required in India.5 To achieve universal health coverage, the primary healthcare system will need to reinvent itself. Thus, it is imperative to assess the functioning of subcentres which were established to serve people in rural areas. We did a cross-sectional study in the district of Jhansi, Uttar Pradesh from June 2011 to June 2013. Of the eight community development blocks, two—Badagoan and Chirgoan—were selected for the study. Ten subcentres from each block were selected to get a representative sample. The data were collected by the facility survey and interview technique on a schedule designed as per the Indian Public Health Standards (IPHS) norms for subcentres.2,6 The average population covered by each study subcentre was 4282 (median 4170, range 2012–6868), the average number of villages per subcentre was 2.5 (median 3, range 1–6) and the distance of two blocks from the medical college was 12 km and 30 km, respectively (Table I). No subcentre had separate utilities for men and women, nor did they have a suggestion and complaint box. A hand pump was the major source of water supply at most subcentres, and only 9 subcentres had functioning hand pumps. No transport facility was available for staff or patients at any of the subcentres. Only 3 (15%) subcentres had a second or additional auxiliary nurse midwife (ANM) and 4 (20%) had a safai karamchari (a person for cleaning) on a contractual basis. A male health worker was not present at any subcentre. Most ANMs cited lack of electricity, their husband staying at another location, and education of their children as the reasons for not staying at the subcentres.

Antidyslipidemic activity of polyprenol from Coccinia grandis in high-fat diet-fed hamster model.

Ethanol extract of Coccinia grandis (L.) Voigt showed significant triglyceride (TG) and cholesterol-lowering effects in dyslipidemic hamster model. Ethanolic extract was fractionated into chloroform, n-butanol and water-soluble fractions and were evaluated. Activity was proved to be concentrated in chloroform-soluble fraction. Chloroform-soluble fraction containing active component was subjected to repeated column chromatography, furnished a polyprenol characterized as C(60)-polyprenol (1) isolated for the first time from this plant. It significantly decreased serum TG by 42%, total cholesterol (TC) 25% and glycerol (Gly) 12%, accompanied HDL-C/TC ratio 26% in high-fat diet (HFD)-fed dyslipidemic hamsters at the dose of 50mg/kg body weight. Results are comparable to standard drug fenofibrate at the dose of 108 mg/kg. Based on these investigations, it was concluded that the compound polyprenol (1) isolated from leaves of C. grandis possess marked antidyslipidemic activity.