Prevalence and predictors of vaccine hesitancy in an urbanized agglomeration of New Delhi, India.

BACKGROUND: The immunization program has been an important part of Indian public health policy for three decades; yet only 62% of children are being fully immunized. Vaccine hesitancy is a major contributor to the immunization gap that needs to be addressed. METHODS: A cross-sectional descriptive study of prevalence and predictors of vaccine hesitancy was conducted in 350 households having at least one child in the age group of 13-24 months. Statistical analysis was done using chi-square test and logistic regression. RESULTS: The prevalence of vaccine hesitancy was 28.9%. Fear of needles, concern about pain during vaccination, lack of family support, and apprehension regarding side effects were ascertained as reasons for vaccine hesitancy. The type of family, time taken to reach the health facility and antenatal care received by the mother were significant predictors of vaccine hesitancy. CONCLUSION: The prevalence of vaccine hesitancy was found to be high. In 2019, the World Health Organization earmarked vaccine hesitancy as one of the major roadblocks to better global health. A better understanding of the subject can help public health agencies enhance vaccination coverage, not just in children but also as a tool to protect entire populations in this age of re-emerging epidemics.

Case of pseudoaneurysm mimicking a soft tissue sarcoma: a diagnostic pitfall.

Pseudoaneurysms represent a pulsating encapsulated hematoma in communication with the lumen of a ruptured vessel. We present a 33-year-old male with a pseudoaneurysm of the profunda femoris artery. At presentation and on further evaluation, he was diagnosed with a possible soft tissue sarcoma of the distal thigh. Catastrophic haemorrhage occurred at the time of a planned, elective open biopsy. This case report emphasises the importance of considering pseudoaneurysm as a crucial differential diagnosis in atypical swellings and scrutinising all suspected soft tissue tumours with a contrast study or a Doppler ultrasound.

Acceptance and Commitment Therapy in Obsessive-Compulsive Disorder: A Case Study.

Recent years have witnessed an increased interest in the use of "third-wave" psychotherapies in treating psychiatric disorders. These newer therapies are fundamentally different from the existing techniques such as cognitive behavioral therapy in terms of their guiding principles and processes of change. Acceptance and commitment therapy (ACT) is the most prominent among these "third wave" psychotherapies. However, there have not been any reports from India, thus far, that have studied the use of ACT in treating obsessive-compulsive disorder (OCD). We describe a case of OCD that was successfully treated with eight sessions of ACT, with the results being maintained over a one-month follow-up period. Postintervention tests revealed a significant decrease in obsessive-compulsive symptoms and an associated increase in psychological flexibility. This case study highlights the possible utility of ACT as a therapeutic intervention in OCD, especially when combined with pharmacotherapy.

Translation, validation and cross-cultural adaptation of the geriatric depression scale (GDS-30) for utilization amongst speakers of Malayalam; the regional language of the South Indian State of Kerala.

BACKGROUND: The Geriatric Depression Scale (GDS-30) is a popular instrument that has been ratified and is being used around the world as a screening tool for over three decades. However, a validated version of the scale is not available for use among speakers of Malayalam. In this paper, we elaborate on the procedure involved in the translation and validation of the GDS-30 from the official English version into Malayalam, the hurdles encountered in the process, and how they were overcome. METHODS: The steps recommended by the World Health Organization (WHO) were applied for the translation of the original questionnaire. This involved initial forward translation of the English questionnaire, discussion by an expert panel, back-translation, pre-testing, and pilot testing of the final version. The Malayalam translation thus obtained was administered to 100 elderly persons in the community. These individuals were then examined by a qualified doctor, who had received the necessary training from a consultant psychiatrist in the diagnosis of depressive disorders. This doctor evaluated the study subjects clinically using theInternational Classification of Diseases-tenth revision (ICD-10) criteria for the diagnosis of depression, which is considered as the gold standard. Sensitivity, specificity, Cronbach'salpha, and split-half reliability were calculated to determine validity. RESULTS: The translated scale yielded a sensitivity of 87.20%, a specificity of 73.80%, an area under the Receiving Operator Curve (ROC) of 0.814, Cronbach's α of 0.920, and split-half reliability of 0.897, thereby proving to be a valid screening tool. CONCLUSION: The Malayalam translation of the GDS-30 is a valid instrument to screen for depression in an elderly Malayalam-speaking population.

Factors Affecting the Psychological Well-being of Health Care Workers During an Epidemic: A Thematic Review.

BACKGROUND: Health care workers (HCWs) constitute a vulnerable group in terms of physical, mental, and emotional health setbacks during an epidemic. An in-depth understanding of the effects of epidemics on HCWs is of utmost importance, in order to put in place measures for their well-being. The purpose of the review was to compile, compare, and contrast the available information so as to produce a lucid picture of how HCWs are impacted during an epidemic, and the factors that affect their mental health. METHODS: A literature search of MEDLINE and Google Scholar databases was conducted to uncover research pertaining to four major epidemic outbreaks over the last two decades. The search was carried out at three levels using pertinent key words. The records thus identified were narrowed down at three further levels, that is, by screening of the title, abstract, and full text, to obtain articles most relevant to the subject matter. Data extraction was done using a spreadsheet to compile the relevant data. Data synthesis was done by studying those factors found to affect psychological well-being of HCWs and separating them into suitable sub-groups. Recommendations to mitigate the psychological impact were proposed. RESULTS: Thirteen factors were identified, which were grouped under the broad categories of socio-demographic variables, individual characteristics, social characteristics, and psychological constructs. CONCLUSION: Epidemics have a profound impact on psychological well-being of HCWs. There is a pressing need to address the issue of the psychological health of this vulnerable group.

Prevalence of Pet Dog Ownership in an Urban Colony of East Delhi and Awareness Regarding Canine Zoonotic Diseases and Responsible Pet Ownership among Dog Owners.

BACKGROUND: India has lowly prioritized pet-associated zoonosis as a public health priority because data regarding the same and the susceptible population involved are sparse. OBJECTIVE: To find the proportion of pet dog ownership in a settled urban colony of East Delhi and to assess awareness regarding canine zoonotic diseases and responsible pet ownership. METHODS: This was a cross-sectional descriptive study of 700 participants in an urban colony of East Delhi. RESULTS: The proportion of pet dog owners was 5.4%. Only one-third (34.2%) of the respondents were aware that pets are a source of disease. A majority of pet owners (86.8%) identified rabies as a disease caused by the bite of only stray dogs. The proportion of responsible pet owners was 39.4%. Only one-tenth of surveyed households had registered their pet with the local municipal authorities, despite such registration being a compulsory requirement by law. CONCLUSION: This study provides us with a better understanding of the lacunae in awareness of zoonotic diseases and its preventive measures among pet owners. All pet owners have a responsibility to ensure that their pets are healthy and free from disease.