Key drivers of hysterectomy among women of reproductive age in three states in India: comparative evidence from NFHS-4 and NFHS-5.

PURPOSE: According to the 4th and 5th rounds of National Family Health Survey (NFHS), there is high prevalence of hysterectomies in the three states of Andhra Pradesh Telangana and Bihar. The three said states have more than double the number of hysterectomies taking place than the national average. Our purpose is to analyse whether these rates are increasing, decreasing or have stabilized and their reasons thereof. Such an analyses will help the policy makers in recommending good clinical practices within their states. MATERIAL AND METHODS: We used data from NFHS-4 (2015-16) and NFHS-5 (2019-2021) rounds. We calculated the differences in predicted probabilities for various factors, performed a Fairlie Decomposition analyses to quantify the positive and negative contributors in the prevalence of hysterectomy across the three states over two time points, and assessed the association of various socio-demographic characteristics to hysterectomy through a multilevel logistic regression model. RESULTS AND CONCLUSION: The results show that out of a total of 80,976 eligible respondents from the states under study, 5826 respondents self-reported that they had a hysterectomy done. It was found that older age, living in rural areas, belonging to other backward classes and higher wealth quintile, and higher parity positively contributed to the increased prevalence of hysterectomies in the three states. Higher educational attainment and previous use of family planning methods acted as protective factors. Characteristics at the household level had the highest intra-class correlation value in the prevalence of hysterectomy among women, followed by the Primary Sampling Unit and District levels, indicating high clustering in the prevalence of hysterectomy at the household level in all three states. Heavy menstrual bleeding/pain was the leading cause of hysterectomies in all three states, followed by fibroids/cysts in Andhra Pradesh and Telangana and Uterine disorder/ prolapse in Bihar. Over 80% of hysterectomies took place in the private hospitals. RECOMMENDATIONS: The study recommends better, more efficient and accountable hysterectomy surveillance to ensure more sustainable woman's reproductive health services in India. Government should adopt and implement standard regulatory guidelines to prevent provider-driven avoidable hysterectomies. Moreover, we recommend informing primary care professionals about the long-term health effects of hysterectomy and promoting alternate therapies for treating uterine fibroids and heavy bleeding.

Genomic characterization and evolutionary analysis of dengue virus from Aedes mosquitoes in Telangana, India.

BACKGROUND & OBJECTIVES: Entomological surveillance for mosquito-borne viruses is vital for monitoring disease transmission and vector control programs. The vector control program is reliant not only on vector density but also on the timely detection of mosquito-borne infections. In the present study, we conducted an entomological surveillance in different locations of Hyderabad, Telangana, India during 2017-2018 and the collected mosquitoes were screened for dengue virus. METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR) was used for the identification and serotyping of the dengue virus. Bioinformatics analysis was performed using Mega 6.0 software. Followed by phylogenetic analysis, which was based on CprM structural genome sequence, was performed by using the Maximum-Likelihood method. RESULTS: The TaqMan RT-PCR assay was used to analyze the serotypes of 25 pools of Aedes mosquitoes and found that all four serotypes are circulating in Telangana. DENV1 (50%) was the most commonly detected serotype followed by DENV2 (16.6%), DENV3 (25%), and DENV4 (8.3%). Moreover, DENV1 has the highest MIR (16 per 1000 mosquitoes) compared with DENV2, 3, and 4. The CprM structural gene sequence was used for phylogenetic analysis, revealing that all four strains have a close relationship with strains isolated from India, Pakistan, China and Thailand. Similarly, two variations in amino acid sequence DENV1 at position 43 (K-R) and 86 (S-T) and a single mutation DENV2 at 111 amino acid position were observed. INTERPRETATION & CONCLUSION: The results of the study provide an in-depth transmission dynamic of the dengue virus and persistence of this emerging pathogen in Telangana, India that needs appropriate prevention programs.

Hydrochemical characteristics and nitrate health risk assessment of groundwater through seasonal variations from an intensive agricultural region of upper Krishna River basin, Telangana, India.

Seasonal variations in hydrogeochemical characteristics of groundwater were assessed from an intensive agricultural region to identify contaminants of concern that are a potential risk to human health. A total of 116 groundwater samples were collected grid-wise from an intensive agricultural region of confined Wanaparthy watershed to evaluate seasonal variations in hydrogeochemical processes of dissolved ions, nitrate health risk assessment and water quality during pre-monsoon (PRM) and post-monsoon (POM) seasons. The major ions concentration found in ascending order as PRM: F- < NO3-< SO42-< HCO3-< Cl- and K+< Mg+2< Ca+2< Na+ while POM: F- < NO3-< SO42-< Cl-< HCO3- and K+< Ca+2< Mg+2< Na+ respectively. Piper diagram for water-types shows PRM; Na-Cl type (70.68%) while POM; Ca-Mg-Cl type (39.66%) and Ca-HCO3 type (31.03%). Gibbs diagram explained the favorable environmental conditions as rock and evaporation dominance in both seasons. Spatial distribution map shows samples with higher and above permissible limits are found at/near to adjoining to higher-order streams and streams origin. As per the water quality index (WQI), 36.21% (PRM) and 60.34% (POM) fall in poor to unfit for drinking class. Hazard quotient (HQ) values of nitrate reach as high as for infants 1.31E + 01, children 1.23E + 01 and adults 4.68E + 00 respectively. Subsequently, HQ>1 with 68.97% of infants and 72.41% of children are in danger for non-carcinogenic ingestion of nitrate contaminated groundwater than in adults.

Prevalence of Stroke Cases in Warangal, Telangana Region, India: A Hospital-Based Case Study.

Stroke is becoming a main cause of early death and disability in developing countries like India, and it is mostly enhanced by increased predominance of major risk factors. A detailed knowledge about the nature and magnitude of the stroke cases in this particular area is not only important for acute treatment but also it helps to prevent hospital admissions due to reoccurring stroke. The present study was conducted in the Department of Stroke at MGM Hospital, Warangal, India, to study the patterns of stroke admissions. All the collected data were compiled and analyzed using appropriate statistical tools. The mean age of study population was found to be 58.9 ± 18. Only 2.7% of stroke incidents occurred in people aged ≤40 years old, 4.9% of cases concerned people between 41 and 50 years old, 18.2% of the incidents happened when the subjects were between 51 and 60 years old, and in 74.2% of the cases, the individuals were ≥60 years old. The frequencies of ischemic (IS), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH) in Warangal region were 57.9%, 7.3%, and 29.2%, respectively. A statistically significant association was found for both smoking (χ2 = 419.1 and p < 0.001) and alcohol (χ2 = 68.7 and p < 0.001) as risk factors in stroke. From this study, it was apparent that in Telangana region, there is a need to provide structured clinical management in treating emergency stroke cases and implement stroke care services with organized multidisciplinary teams.

Genomic diversity of the Muslim population from Telangana (India) inferred from 23 autosomal STRs.

AIM: This study aimed to investigate the genomic diversity and population structure in the Muslim community of Telangana, India, using 23 autosomal microsatellite genetic markers. We also examined genetic relatedness between Muslim and non-Muslim populations of India. SUBJECTS AND METHODS: A sample of 184 randomly selected unrelated healthy Muslim individuals from the Telangana state were included in this study. The genotyping of 23 autosomal STR markers included in PowerPlex® Fusion 6 C multiplex system (Promega)was done. RESULTS: A total of 273 alleles were observed in the studied population, and locus SE33 showed 37 observed alleles, which is the highest number of observed alleles among all the studied loci. Among all the studied loci the most polymorphic and discriminatory locus was SE33, with the values of polymorphic information content (PIC) = 9.411E-01 and power of discrimination (PD) = 9.865E-01. Observed heterozygosity ranged from 6.630E-01 (D22S1045) to 9.239E-01 (SE33). Discrimination power, exclusion power, matching probability and paternity index for all the studied loci were 1.00E + 00, 1.00E + 00, 2.01E-28, and 5.68E + 09, respectively. The studied Muslim population showed genetic relatedness with non-Muslim populations i.e. populations of central India, Jharkhand, and Uttar Pradesh, suggesting the conversion of Hindus during the Muslim invasion. CONCLUSION: Neighbor-joining (NJ) tree and principal component analysis (PCA) revealed that the studied population showed genetic affinity with communities of Jharkhand, Madhya Pradesh and Uttar Pradesh states. The genetic data of this study may be useful for forensic, medical, and anthropological studies.

Identification and Development of a High-Risk District Model in the Prevention of ß-Thalassemia in Telangana State, India.

The burden of ß-thalassemia (ß-thal) is largely underestimated in India with a carrier frequency of 3.0-4.0% in general, whereas highly stratified frequencies of up to 17.0% are reported in local endogamous subpopulations. We have no idea whether ß-thal carrier frequencies or ß-thal major (ß-TM) births are increasing or decreasing in the population. The cross-sectional nature of all carrier screening programs including large-scale task force and micro level, lack of registration of ß-TM births and mechanism to modulate knowledge, awareness programs in a long-term perspective, all preempt impact assessment of preventive programs. During the implementation of a Telangana State Government-sponsored program on 'Micro profiling of ß-thalassemia mutations in Telangana,' we documented extensive in-depth demographic information on each ß-TM child of the study sample that included age-sex distributions, parental and grand-parental ethnic affiliations (local endogamous group level), birth places, marital migrations, endogamy and consanguinity to identify high-risk districts as ethno-geographic regions. In Telangana State, we found ß-thal is widely prevalent in 31 districts and 48 local endogamous subpopulations. The present study provided a method of identification of four 'high-risk districts' and developed a district model for prevention on high priority in Telangana State. The model has the advantage of impact-assessment of all preventive programs in the district.

Viability of power distribution in India - Challenges and Way Forward.

Energy is a key component for economic growth as well as for human development. India is the third-ranking electricity generator in the world but ranks 106th in terms of per capita consumption. Specifically, the distribution of power is the most important link in the value chain of the power sector since it is the cash register for the entire sector. In India, electricity is a concurrent subject shared between the Central and State Governments. While the generation of power has been deregulated since 2003, the supply of power to the consumers is generally carried out by Government-owned power Distribution Companies (DISCOMs). In this paper, the authors analyze the financial distress of DISCOMs in India, and explain how the supply-demand mismatch due to over-ambitious demand projections, the fixed and energy charges of thermal power plants, and the excess procurement of "must-run" renewable sources together contribute to the high cost of power procurement that drives the financial stress faced by DISCOMs. The authors support their assertion with a study of nine DISCOMs supplying electricity to 155 million people in three States and propose policy recommendations for a turnaround of such DISCOMs which can be rolled out with suitable modifications across India.

Progressive disability in elderly population among tribals of Telangana: a cross sectional study.

BACKGROUND: The tribal population of Telangana, India, lives in remote and difficult conditions. This study was carried out to find out estimate, the prevalence and progression of disability in elderly population among tribals of Khammam District, Telangana state, India. METHODS: A population based cross sectional survey was conducted in villages of Tribal Sub Plan area. Elderly people who are 60 years or older were chosen with a two stage sampling procedure: (1) probability proportion to size was used to select clusters and (2) in each selected cluster households were selected by systematic random sampling. The participants were interviewed with the 36 item Telugu version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire. Socio- demographic information, behavioral measurements, health and social benefit indicators were also assessed. Descriptive analytical methods were used for prevalence estimation and logistic regression was used to examine the associations of progressive age over disability among elderly. RESULTS: A total of 506 elderly people from 1349 households in 20 villages across 31mandals of Khammam were interviewed. Majority of elderly population among tribals were illiterate (men 88.94%; women 99.33%), used tobacco (men 81.25%; women 57.72%), consumed alcohol (men 80.77%; women 47.32%) and were hypertensive (men 53.85%; women 63.42%). The prevalence of disability was higher in women. Maximum disability in the interviewed elderly population was seen in domains of performing house hold activities, and mobility. In comparison with men, women expressed more disability for majority of domains. As age progressed, the disability for self-care domain increased to a maximum of 2.6 times in men and 6.6 times in women and for mobility domain increased to a maximum of 9.7 times in men and 7.2 times in women. CONCLUSIONS: Although present disability modifying mobility Assistive Devices (AD) can help elderly in overcoming disability, these are primarily designed for built environments. As the needs, cultural sensitivities, and living environment of elderly population in tribals are unique, newer innovative assistive devices should be designed and developed.

Near visual impairment and spectacle coverage in Telangana, India.

IMPORTANCE: The study highlights the burden of near visual impairment (NVI) in India. BACKGROUND: NVI is a common condition that can be addressed through provision of spectacles. The study aims to assess the prevalence of NVI and spectacle coverage among those aged ≥40 years in south Indian state of Telangana. DESIGN: Population-based cross-sectional study using a rapid assessment methodology. PARTICIPANTS: Five thousand one hundred forty participants enumerated from 123 clusters in two districts and have presenting distance visual acuity of ≥6/18 in the better eye. METHODS: Presenting near vision was assessed binocularly at a fixed distance of 40 cm using a log MAR chart with tumbling E optotypes in ambient lighting conditions. If the presenting near vision was worse than 6/12 (log MAR 0.3), then it was re-assessed with addition lens appropriate to the age. NVI was defined as binocular presenting near vision worse than 6/12. MAIN OUTCOME MEASURES: Prevalence of NVI and spectacle coverage. RESULTS: The mean age of the participants was 51.1 years (standard deviation: 9.3 years), and 46.5% (n = 2392) were women. About 80% (n = 4142) of them had no education, and 21.9% (n = 1126) were using spectacles for near vision. Nearly half of the participants were from Adilabad district (n = 2665). The prevalence of NVI was 58.3% (95% confidence interval: 56.9-59.6). NVI was associated with older age groups, male gender and no education. The spectacle coverage was 26.5%. CONCLUSIONS AND RELEVANCE: NVI is common in rural Telangana with low spectacle coverage. Service delivery programs should use a multi-pronged approach to address the burden of NVI.

Effective Cataract Surgical Coverage in Four Large Districts in Telangana, India - Results from Rapid Assessment of Visual Impairment Study.

PURPOSE: To report cataract surgical coverage (CSC) and effective Cataract Surgical Coverage (eCSC) from four districts in Telangana, India. METHODS: Individuals aged ≥40 years were recruited from Adilabad, Mahbubnagar, Warangal and Khammam districts using two stage cluster sampling methodology. All participants had detailed eye examinations including visual acuity assessment using a standard Snellen chart at a distance of six meters, anterior segment examination and fundus imaging by trained professionals. CSC and eCSC were calculated for persons using a 6/12 visual acuity cut-off. RESULTS: Of 12,150 individuals enumerated from four districts 11,238 (92.5%) were examined. The mean (standard deviation) age of the participants was 54.1 (±11.2) years (range: 40 to 102 years) and 54.6% (n = 6137) were women. Overall, the CSC (%) was 54.2%. It ranged from a highest of 59% in Khammam followed by 57.5% in Adilabad, 51.7% in Warangal, and a least of 49.7% in Mahbubnagar district. Overall, the eCSC (%) was 39.9%. It ranged from a highest of 46.1% in Adilabad followed by 43.2% in Khammam, 36.2% in Warangal district and a least of 35.8% in the Mahbubnagar district. CONCLUSIONS: CSC and eCSC varied across the districts. A significant gap between CSC and eCSC is noted suggestive of challenges with quality of services. District-wise planning of cataract surgical services with a focus on quality care is recommended to improve coverage and contribute towards achieving the goal of universal eye health coverage in the Telangana State in India.

Designing a productive, profitable integrated farming system model with low water footprints for small and marginal farmers of Telangana.

In the years 2021-2022 and 2022-2023, an experiment was carried out at the IFS Unit, College of Agriculture, PJTSAU, Rajendranagar in order to determine the best one-acre integrated farming system model for Telangana's small and marginal farmers. Seven farm models among which six models were developed by combining the various components i.e., cropping systems, fruit cropfodder crops and livestock components, in different proportions, and compared with rice-groundnut system which is a major farming approach in Telangana using randomized block design. The seven models were as follows: M1: Rice-Groundnut; M2: Rice-Groundnut, Pigeonpea + Sweetcorn (1:3)-Bajra, Bt cotton + Greengram (1:2)-Maize; M3: Rice-Groundnut, Pigeonpea + Sweetcorn (1:3)-Bajra, Pigeonpea + Maize (1:3)-Sunhemp; Napier grass, Sheep (5 + 1); M4: Rice-Groundnut, Pigeonpea + Sweetcorn (1:3)-Bajra, Bt cotton + Greengram (1:2)-Maize, Pigeonpea + Maize (1:3)-Sunhemp, Poultry unit; M5: Guava, Hedge Lucerne, Napier grass, Bt cotton + Greengram (1:2)-Maize, Sheep (5 + 1); M6: Guava, Bt cotton + Greengram (1:2)-Maize, Rice-Groundnut, Poultry; M7: Rice-Groundnut, Pigeonpea + Sweetcorn (1:3)-Bajra, Pigeonpea + Maize (1:3)-Sunhemp; Napier grass, Hedge lucerne, Poultry (100), Sheep (5 + 1). Based on a 2-year average, the Model M7 system produced 9980 Rice Grain Equivalent Yield(RGEY)kg of output per acre, with gross and net returns of ₹210,439 and ₹124,953 respectively, and recovered a B:C ratio of 2.46. It has recorded highest sustainable yield index (SYI) of 0.673 and value index of 0.772 with the lowest water footprint of 259.0 L/kg. This study reveals that adopting an integrated farming system is the optimal approach for effectively combining productive, financially rewarding, and diversified enterprises within a single acre of land.d. This system should be recommended for maximum benefits to smallto small and marginal farmers in Telangana's southern hills and plateau.

Population-based assessment of awareness of diabetes and diabetes related eye diseases in rural areas in Telangana, India - implications for eye health promotion.

CLINICAL RELEVANCE: Understanding the awareness level of diabetes and diabetes-related eye diseases will help in developing better eye health education programmes and improve health-seeking behaviour in the community. BACKGROUND: Diabetes and diabetes related eye diseases are increasing in numbers both in urban and rural areas in India. There are limited data on awareness of diabetes and diabetes-related eye disease in rural communities of India. This study reports on awareness of diabetes and diabetes-related eye diseases in people aged ≥40 years from two rural districts of Telangana, India. METHODS: A structured questionnaire was used to determine the awareness of diabetes and diabetes-related eye diseases among participants aged ≥40 years in the Khammam and Warangal districts of Telangana, India. Social investigators visited the participant's households and conducted the interviews. A positive response to a question on having heard about diabetes was considered as 'awareness'. For those aware, follow-up questions were asked about the effect of diabetes on vision, frequency of eye examination and source of information. A positive response on a question that diabetes could cause loss of vision was considered as awareness of diabetic eye disease. RESULTS: A total of 3273 participants were interviewed. Among them, 56.2% (n = 1840) were women, 60.6% (n = 1985) had no formal education, and 50.2% (n = 1645) were from the Khammam district. The mean age of the participants was 55.3 years (standard deviation: 11.7 years). Awareness of diabetes was 52.5% (n = 1719). Among them, 1056 participants (61.4%) were aware that diabetes could affect vision. CONCLUSION: Only half of the participants were aware of diabetes and of this substantial proportion of individuals was unaware of potential vision loss due to diabetes. Improving awareness about diabetes and its impact on vision is recommended to prevent potential vision loss in this population.

Potential toxic element contamination and non-carcinogenic risk assessment of groundwater from rapidly growing urban areas in Telangana, India.

Groundwater is a critical resource for drinking purposes that is under pressure and polluted with multiple inorganic contaminants. Among various contaminants, potentially toxic element contamination in groundwater has significant public health concerns due to their toxicity at a low level of exposure. This investigation aimed to assess the toxic element contamination and associated non-carcinogenic human health risk at rapidly growing urban centers in Telangana to ensure potable water and to generate baseline data in the study province. Thirteen potential toxic trace elements (Al, As, B, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Se, and Zn) were determined in 35 groundwater samples collected from the Karimnagar and Siddipet smart cities in lower Manair River basin using inductively coupled plasma mass spectrometry (ICP-MS). The trace element concentration is found in the range for Al (1-112 µg/L), As (2-8 µg/L), B (34-438 µg/L), Cd (bdl-2 µg/L), Co (bdl-17 µg/L), Cr (bdl-4 µg/L), Cu (bdl-216 µg/L), Fe (4-420 µg/L), Mn (bdl-3311 µg/L), Ni (5-31 µg/L), Pb (bdl-62 µg/L), Se (1-18 µg/L), and Zn (3-1858 µg/L). Analytical data of groundwater revealed the occurrence of toxic elements observed as above the acceptable limits of Bureau of Indian Standards for drinking purposes found in the order of Al > Ni ≥ Mn > Se ≥ Cu ≥ Pb > Fe with 26% > 14% ≥ 14% > 9% ≥ 9% ≥ 9% > 6% of samples, respectively. The non-carcinogenic health risk to humans upon groundwater ingestion has been evaluated and found to be non-hazardous for all the individual elements studied except for aresenic. However, cumulative hazard quotient observed as > 1 in the category of infants and children might be a major potential health concern. This study provided baseline data and suggested implementing preventive measures to protect human health around the urban areas of lower Manair river basin, Telangana, India.

Prevalence, pattern, and compliance with spectacles use among the elderly in homes for the aged in South India: The Hyderabad Ocular Morbidity in Elderly Study (HOMES).

Purpose: This study was conducted to report on the pattern of spectacles use and compliance among the elderly (aged ≥60 years) in homes for the aged in Hyderabad region in Telangana State, India. Methods: Participants were recruited from 41 homes for the aged centres for comprehensive eye health assessments. A questionnaire was used to collect information on current and past use of spectacles, type of spectacles, spectacles provider and amount paid for the spectacles. For those that reported using spectacles in the past, information was collected on the reasons for their discontinuation. Compliance with spectacles use was assessed after eight months of provision of the spectacles. Results: A total of 1182/1513 participants were examined from 41 homes for the aged in Hyderabad, India. The mean age of the participants examined was 75 years (standard deviation (SD): 8.8 years; range: 60-108 years); 764 (64.6%) of them were women and 240 participants (20.3%) had no formal education. The prevalence of spectacles use was 69.9% (95% confidence interval [CI]: 67.1-72.4; n = 825). Bifocals were the most commonly used type of spectacles (86.7%) followed by single vision glasses for distance vision (7.4%). Private eye clinics were the largest service provider (85.5%) followed by local optical outlets (6.9%) and other service providers (7.7%). The prevalence of spectacles compliance was 81.5% (211/259). Conclusion: Use of spectacles and compliance are high among the elderly living in residential care homes in the Hyderabad region. Spectacles use can be further improved by periodic eye assessments along the lines similar to school eye programs, which can immensely benefit this vulnerable, aged population.

Population-based assessment of barriers for uptake of eye care services among elderly people: Findings from rapid assessment of visual impairment studies from Telangana, India.

Purpose: To report the barriers for seeking eye care among the elderly population aged ≥60 years with avoidable vision impairment (VI) in the South Indian state of Telangana. Methods: A total of 3640 participants aged ≥60 years were recruited using cluster-random sampling. Demographic information, including presenting visual acuity, was measured using the standard Rapid Assessment of Visual Impairment (RAVI) protocol. "Avoidable VI" was considered if the VI was due to cataract or uncorrected refractive error (URE). A detailed interview was conducted using a validated questionnaire to report the barriers for not seeking eye care. Data were analyzed using the Stata statistical software version 14. Results: Prevalence of avoidable VI was 30.2% (95% CI: 28.02-31.06; n = 1102). Among those who noticed decreased vision (n = 1074), only 392 participants (36.4%) reported that they felt the need for seeking eye care. The major barriers for not seeking eye care were: cannot afford the consultation fee and services (42.0%) and no escort (25.7%). Overall, the personal barriers (57.9%) were the major reason for not seeking care, followed by economic barriers (42.0%). No significant difference was reported in barriers between the participants with unilateral and bilateral VI (>0.05). Conclusion: Overall, among the elderly people, personal and economic barriers were the major reason for not seeking eye care. Health care providers and policymakers should focus on newer models of eye care delivery to ensure better accessibility and uptake of care by the elderly people.

Understanding community perception and disability weights - A qualitative exploration of reasons associated with values in two states of India.

Background: Health state valuation attempts to evaluate health states based on the perception of individuals. The values are used to derive disability weights (DWs) -an important metric for estimation of disability-adjusted life years and thereby calculation of the burden of diseases. Several studies have calculated DWs using different methods of valuation, however, very few have attempted to explore the underlying cause for assigning values to different health states. This study aims to document the perceptions, preferences, and social context in assigning DWs to given health states. Methods: A total of 42 community members and 21 service providers (from public and private sectors) across urban and rural Odisha and Telangana were interviewed between July to September 2018. A face-to-face in-depth interview and a rank ordering technique through card sort exercise was employed to explore reasons and perceptions of individuals in the context of health states using the thematic framework approach. Findings: Six themes emerged through analysis: awareness of the health state, nature of the disease, disease consequences, treatment-related issues, social implications, and case burden. Each theme captured an individual's reason for valuing one health state as different from the other, with differences and/or similarities between community members and service providers. Conclusion: Our study provides a comprehensive comparison between contrasting groups of individuals, thereby suggesting mere acceptance of 'experts' reasoning may not always suffice. Further research studies in the future need to be conducted for a better insight into the health perspective of a culturally diverse community. It can also help estimate the burden of disease for decision making and resource allocation in developing countries.

Population-based Assessment of Vision Impairment in the Elderly Population in Telangana State in India - Policy Implications for Eye Health Programmes.

PURPOSE: To investigate the prevalence, causes and risk factors for vision impairment (VI) among the elderly population in Telangana State, India. METHODS: A population-based cross-sectional study were conducted in four districts. All participants had eye examinations including visual acuity assessment for distance and near, anterior segment examination and non-mydriatic fundus imaging by trained personnel. VI was defined as presenting visual acuity worse than 6/18 in the better eye. Individuals aged ≥60 years were considered as elderly. RESULTS: In total, 11,238/12,150 (92.5%) individuals aged ≥40 years were examined. Of this, the dataset of 3,640 individuals (32.4%) elderly participants was used for analysis. Among the 3,640 participants, 53.1% were women and 78.1% had no education. The mean age of the participants was 67.8 years (standard deviation: 7 years; range: 60 to 102 years). The age and gender-adjusted prevalence of VI was 32.1% (95% CI: 29.5-34.8). On multivariable analysis, the odds of VI was significantly higher in older age groups, and among those with no education. Gender and district of residence were not associated with the prevalence of VI. Cataract (54.8%) was the leading cause of VI followed by uncorrected refractive errors (37.6%). CONCLUSIONS AND RELEVANCE: VI was common and largely avoidable in the elderly population in Telangana state in India. Elderly centric eye care including screening for vision loss, provision of cataract surgery and spectacles can be used as strategies to address VI in the elderly.

COVID-19's lockdown effect on air quality in Indian cities using air quality zonal modeling.

The complete lockdown due to COVID-19 pandemic has contributed to the improvement of air quality across the countries particularly in developing countries including India. This study aims to assess the air quality by monitoring major atmospheric pollutants such as AOD, CO, PM2.5, NO2, O3 and SO2 in 15 major cities of India using Air Quality Zonal Modeling. The study is based on two different data sources; (a) grid data (MODIS- Terra, MERRA-2, OMI and AIRS, Global Modeling and Assimilation Office, NASA) and (b) ground monitoring station data provided by Central Pollution Control Board (CPCB) / State Pollution Control Board (SPCB). The remotely sensed data demonstrated that the concentration of PM2.5 has declined by 14%, about 30% of NO2 in million-plus cities, 2.06% CO, SO2 within the range of 5 to 60%, whereas the concentration of O3 has increased by 1 to 3% in majority of cities compared with pre lockdown. On the other hand, CPCB/SPCB data showed more than 40% decrease in PM2.5 and 47% decrease in PM10 in north Indian cities, more than 35% decrease in NO2 in metropolitan cities, more than 85% decrease in SO2 in Chennai and Nagpur and more than 17% increase in O3 in five cities amid 43 days pandemic lockdown. The restrictions of anthropogenic activities have substantial effect on the emission of primary atmospheric pollutants.

Indoreonectes telanganaensis, a new species of loach (Teleostei: Nemacheilidae) from the Godavari Basin of India.

A new species of hill-stream loach, Indoreonectes telanganaensis, is described from a seasonal tributary of the Godavari River at Maisamma Loddi, within the Kawal Tiger Reserve, Telangana State, India. The new species is distinguished from its congeners by a combination of characters including caudal peduncle as long as deep; eye large, its diameter about one-fifth head length; pectoral fin as long as head; nasal barbel reaching the middle of the eye; dorsal-fin origin on vertical through pelvic-fin origin; and bars on the lateral side of the body well defined and wide. We also provide multivariate morphometric, and DNA analysis based on the mitochondrial cytochrome b gene sequence to support the distinction of the new species.

Temporal trends in the prevalence of spectacle use and spectacle coverage in India.

BACKGROUND: This study aims to assess the temporal trends in the prevalence of spectacle use and spectacle coverage for refractive errors in population-based studies conducted during 2011-2012 and 2017 among those aged ≥ 40 years in the state of Telangana, India. An intervention in the form of 10 vision centres and a secondary centre was established in one district (Khammam) after the 2011-2012 study and another district (Warangal) was left to secular trends. METHODS: In both the studies, multi-stage cluster random sampling methodology was used to select the participants. In addition to a clinical examination, a questionnaire was used for collecting information on current and previous use of spectacles, type of spectacles and details of the spectacle providers. The same questionnaire was used in both the studies. RESULTS: In total, 2,485 participants were examined in the 2011-2012 study and 2,711 participants were examined in the 2017 study in Khammam. Similarly, 2,438 and 2,646 participants were examined in Warangal in the two studies, respectively. In Khammam, the age and gender-adjusted prevalence of current spectacle use increased from 30.0 per cent (95% CI 28.2-31.9) to 34.8 per cent (95% CI 33.0-36.6) in the 2011-2012 and 2017 studies, respectively (p < 0.01). However, in the Warangal district, the age and gender-adjusted prevalence of current spectacle use declined from 32.8 per cent (95% CI 31.0-34.7) to 27.6 per cent (95% CI 25.9-29.3) during the 2011-2012 and 2017 studies, respectively (p < 0.01). In Khammam, the spectacle coverage increased from 26.9 per cent to 35.6 per cent, but it declined from 43.8 per cent to 35.7 per cent in Warangal between the studies in 2011-2012 and 2017. CONCLUSIONS: An increase in spectacle use and coverage was observed in Khammam where the secondary centre and vision centres were established, compared to Warangal where there was no such intervention. The results suggest a positive impact of the intervention in the Khammam district and suggest replication of the model to address the burden of uncorrected refractive errors.