General Population In India Research Articles

Liver fat analysis using optimized support vector machine with support vector regression.

Fatty liver disease is a common condition caused by excess fat in the liver. It consists of two types: Alcoholic Fatty Liver Disease, also called alcoholic steatohepatitis, and Non-Alcoholic Fatty Liver Disease (NAFLD). As per epidemiological studies, fatty liver encompasses 9% to 32% of the general population in India and affects overweight people. An Optimized Support Vector Machine with Support Vector Regression model is proposed to evaluate the volume of liver fat by image analysis (LFA-OSVM-SVR). The input computed tomography (CT) liver images are collected from the Chennai liver foundation and Liver Segmentation (LiTS) datasets. Here, input datasets are pre-processed using Gaussian smoothing filter and bypass filter to reduce noise and improve image intensity. The proposed U-Net method is used to perform the liver segmentation. The Optimized Support Vector Machine is used to classify the liver images as fatty liver image and normal images. The support vector regression (SVR) is utilized for analyzing the fat in percentage. The LFA-OSVM-SVR model effectively analyzed the liver fat from CT scan images. The proposed approach is activated in python and its efficiency is analyzed under certain performance metrics. The proposed LFA-OSVM-SVR method attains 33.4%, 28.3%, 25.7% improved accuracy with 55%, 47.7%, 32.6% lower error rate for fatty image classification and 30%, 21%, 19.5% improved accuracy with 57.9%, 46.5%, 31.76% lower error rate for normal image classificationthan compared to existing methods such as Convolutional Neural Network (CNN) with Fractional Differential Enhancement (FDE) (CNN-FDE), Fully Convolutional Networks (FCN) and Non-negative Matrix Factorization (NMF) (FCN-NMF), and Deep Learning with Fully Convolutional Networks (FCN) (DL-FCN).

Quality of life after traumatic thoracolumbar spinal cord injury: a North Indian perspective.

Cross-sectional study. To determine the Quality of Life (QOL) in individuals with traumatic Spinal Cord Injury (SCI) of thoracolumbar region in Indian population, the factors affecting QOL and to compare this to other SCI populations. Tertiary level hospital in low-middle income country. 93 individuals with SCI of minimum 1 year duration since injury were included in the study. Baseline demographics, socioeconomic parameters, and incidence of complications were ascertained. World Health Organisation Quality of Life-BREF (WHOQOL-BREF) score was used for measurement of QOL and was then compared to healthy Indian population and other SCI studies. Subgroup analysis was done to find out impact of variables on different domains of WHOQOL-BREF. The median (IQR)age of the study participants was 35 (25, 45) with a male predominance. The median (IQR) duration since injury in the study population was 50 (26, 70) months. Lowest mean(SD)score was observed in the psychological domain -50.3 (12.1) and comparison to healthy Indian and high-income SCI populations revealed drastically decreased scoresacross all domains (p < 0.01). Employed individuals and housewives had significantly higher scores across all domains than unemployed individuals (p < 0.05). American Spinal Injury Association Impairment Scale (AIS) grade, socioeconomic status, pain and presence of complications all had significant impact on domain scores (p < 0.05). Multiple regression analysis revealed that mobilisation status and pain had the greatest effect on QOL. Individuals with SCI have low QOL scores as compared to general Indian population as well as SCI individuals from a high resource setting. Pain and dependent mobilisation were found to be most significant predictors of poor WHOQOL-BREF domain scores. Housewives were found to have domain scores comparable to employed individuals. Presence of complications negatively impacts QOL.

Impact of economic shocks on mental health during COVID-19: A longitudinal study of adult residents of Indian metropolitan cities.

The causal impact of income shocks on mental well-being in developing countries is an under-researched area. The COVID-19 pandemic, along with the economic recession caused by the lockdowns to reduce transmission, provides a natural experimental setting to examine the causal impact of a decline in monthly per capita expenditure (MPCE) on mental health of the general population in India during the pandemic. To evaluate the impact of income shocks on mental health of adults in metro cities during the COVID-19 pandemic. The data were collected using the abridged version of the Depression Anxiety Stress Schedule administered through a telephonic survey on adult residents of six metropolitan cities in September-August 2020 and July-August 2021. In the present study, 994 adults participated from six metropolitan cities. Average treatment effects were estimated using Propensity Score Matching. The mean normalized scores are significantly higher for respondents whose MPCE had fallen (treated) vis-à-vis respondents whose MPCE had remained same or increased (control): anxiety (0.21 for treated vs -0.19 for control), stress (0.16 vs -0.14), and depression (0.04 vs -0.19). Propensity score matching reveals that the normalized scores for anxiety, stress, and depression were 33 (95% confidence intervals, CI: 20.0-46.7), 25 (95% CI: 12.9-36.9), and 36 (95% CI: 18.6-53.1) higher among the treated group vis-a-vis control group. The ATET was 34 (95% CI: 18.9-48.9), 26 (95% CI: 10.1-42.9), and 32 (955 CI: 12.3-50.7) for these three outcomes, respectively. The post-estimation tests indicated that the results are valid. The study advocates that policies to ensure income security should be made an integral part of the response packages to tackle pandemics like COVID-19.

AN OBSERVATIONAL STUDY OF PRACTICE OF COVID-19 VACCINATION AMONG HEALTHCARE WORKERS AT A TERTIARY HEALTHCARE CENTRE: A SURVEY BASED ANALYSIS.

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid and extensive spread of the COVID-19 pandemic has become a major cause of concern for the healthcare profession. Development of SARS-CoV-2 vaccine is considered as the only way to signicantly reduce the threat of this pandemic in view of no proper treatment available against COVID-19 till date. However, the success of COVID-19 vaccination in India is dependent upon the acceptance of vaccine among general population, besides the proven safety and efcacy of the Indian COVID-19 vaccines (Co vishield and Co vaxin). In view of that, we conducted an online survey among the rst to be vaccinated priority group (healthcare workers) in India who are at high risk of exposure, with the aim to assess the beliefs and experiences related to Indian COVID-19 vaccines and to project that upon the general population of India. Method: This cross sectional study was conducted using a validated self administered online questionnaire that was distributed through emails, online social networking platforms (online survey) and also printed form of questionnaire in both English and Hindi languages (paper survey). The participants of the study were informed about the objectives of the study and after obtaining an informed consent, they completed the questionnaire on their background and vaccinationbehaviour related variables (including past vaccine compliance, risk factors for severe COVID-19, and COVID-19 vaccine perceptions and experience). Results: Our study included 750 healthcare workers (HCW) of which 415 were doctors, 286 were medical students and 49 were paramedical staff, Of the total number of participants, n=617 (82.3%) have received the COVID-19 vaccine. 75.6% of the study population (n=504) were not hesitant for getting vaccination against COVID-19. Majority of the HCWs believed in the safety and efcacy of COVID-19 vaccine and wanted their family members to get vaccinated. Conclusions: Our study concludes that Health Care Workers show acceptance and condence in the vaccination programme against Covid 19. This can contribute to general population compliance and willingness to accept Covid 19 vaccine.

Geographical Analysis of the Challenges and Opportunities Facing Jharkhand's Irrigation Sector

India is a land of rivers having prevalently a farming-based economy. Agriculture is the fundamental supporter of most of the general population in India and water is the most significant contribution to crop generation. The accomplishment of agriculture relies on the sufficiency and timely event of precipitation. Yet, the precipitation in India is frequently meagre, uneven and there is indeed, even all out disappointment in certain districts and during certain periods. Downpour is bound to a couple of months in a year and it shifts from year to year and district to-area which makes enormous pieces of the nation defenceless against drought. In this manner, natural distribution of water is lacking both spatially and transiently. Aside from the distinction in money saving advantage of good irrigation in various mouzas and diverse irrigation systems, the spatial example is likewise uneven at small scale level for example one irrigation framework to another irrigation framework. The Z-Score an incentive if there should be an occurrence of Co-employable RLI (+1.80) scored most astounding which shows the greatest net benefit for boro development. The most minimal score which is seen in the STW (leased) (- 1.42) poor inundated zone shows minimal benefit for boor development.

A Prevalence Study of Post-Traumatic Stress Disorder and Its Sociobiological Determinants During Second Wave of COVID-19 Pandemic Among General Population of National Capital Territory of Delhi

Introduction: Nationwide lockdown during COVID-19 pandemic, rapid transmission of SARS-CoV-2 and more intense second wave of pandemic in terms of high caseload, reduced essential supplies and scarcity of beds, and unpredictable mortality had a huge impact on mental health of general population. Objectives: This study aimed to estimate the prevalence and determine the factors of Post-Traumatic Stress Disorder (PTSD) among the general population of India during the second wave of pandemic. Methodology: An online survey was conducted to estimate the prevalence and assess the factors responsible for PTSD among 614 participants who were above 18 years of age. The prevalence of PTSD was measured using PTSD checklist for Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5). Results: In the present study, there were a total of 614 participants and the mean age of the participants was 23.64 years. More than half of the participants were female and majority of them were unmarried (76.7%). The prevalence of PTSD was 30.62%. A significant association was observed between occupation and PTSD prevalence. Also, COVID-19 illness, COVID-19 infection among the family members, work outside the home, hospital admissions, difficulty in acquiring the required medication were significantly associated with PTSD. Conclusion: COVID-19 pandemic and nationwide lockdown led to increased prevalence of psychological effects like PTSD. This highlights the importance of focusing on mental health during the pandemic.

Efficacy Of Shleshmatakadhya Agad Ghanvati on Non-Alcoholic Fatty Liver Disease(NAFLD): A Case Study

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is an emerging disease associated with metabolic dysfunction. The term Non-alcoholic Fatty Liver Disease (NAFLD) refers to a broad spectrum of conditions characterized by fatty infiltration of the liver, steatosis, steatohepatitis, and cirrhosis. Epidemiological studies suggest prevalence of NAFLD in around 9% to 32% of the general population in India with a higher prevalence in those with obesity and diabetes. Shleshmatakadhya Agad ghanvati is a classical preparation mentioned in Yogratnakara as a Sarva Vishani. Although specific mention has not been given about neither NAFLD nor of this preparation in Ayurveda, yet we have correlated it with Aamvishjanya yakrit vikaras regarding the same. Ghana (solidified aqueous extract) tablets were prepared for the easy usage and dispensing of drug. In the present study, an effort was made to evaluate the effect of Shleshmatakadhya agad Ghanavati, diet and lifestyle modification on NAFLD. Combined therapy of Shleshmatakadhya Agad Ghanavati along with diet and lifestyle changes led to the relief of most of the symptoms, with no adverse sign and symptom observed. Shleshmatakadhya Agad Ghanavati along with diet and lifestyle modifications was observed to be effective in management of NAFLD which was confirmed through Haematological profile and USG of the patient . Materials and methods: Subject were a pre-diagnosed case of NAFLD and were administered Shleshmatakadhya Agad Ghnavati in Adhobhugta kala for 3 months along with pathya-apathya ahara vihara. Subjects were assessed every 15 days for a period of 3 months and with 1 month of follow up with no medications in that duration. The progress was assessed through blood tests and USG of the subject after the full completion of treatment. Results: It was detected that almost all of the clinical symptoms of the subject were reduced slowly during the duration of treatment. By the completion of the treatment ,the symptoms were lessened entirely with the blood investigations and sonography report affirming the improvement.

Parental knowledge, attitude, and perception toward dental treatment during COVID-19 pandemic

Background: Dental caries in pediatric dentistry is considered very alarming to parents considering its impact on the permanent dentition. Knowledge regarding caries in primary teeth and its impact on permanent dentition is limited. Aim: The aim was to evaluate the knowledge and perception of parents toward pediatric dental treatment during covid era and to check if there is a change in practices pertaining to the COVID-19 outbreak. Materials and Methodology: One hundred and twenty copies of the questionnaire were distributed through a Google Form to parents in the general Indian population. The questionnaire consisted of 16 questions. The first segment of the survey was about the knowledge of parents regarding caries and their consequences. The second segment was about the influence of COVID on the dental treatment of children. The third segment was about the influence of COVID on the preventive dental care of children. The results obtained were tabulated and analyzed using SPSS software. Results: Results suggest that 80%–95% of parents have good knowledge about tooth decay in the pediatric population and feel COVID is a barrier to visiting the dentist and feel the availability of the COVID vaccine to children would increase confidence to break this barrier. Conclusions: COVID pandemic has been a barricade for neglecting dental treatment. If adequate information about the etiology and consequences of tooth decay along with the availability of the COVID vaccine, no barrier can be seen between the dentist and the child's dental treatment.

Association between ABO, Rh blood group, and COVID-19 illness

Background: The world is struggling still with the coronavirus disease 2019 (COVID-19) pandemic 3½ years since the first case was reported in December 2019 in a small province in China. Researchers and the global health community have been working tirelessly to ascertain all possible ways to treat and before that identify and protect any susceptible populace. Among many plausible factors, blood groups have also been hypothesized as one of the associated key risk factors. Aims and Objectives: This study was conducted to check for possible association if any between blood groups and COVID-19 illness. Materials and Methods: The present study was a cross-sectional, questionnaire-based study involving general population after approval by the Institutional Ethics Committee. A total of 434 individuals participated in this study. It was a Google form-based survey shared with general Indian population consisting of questions based on demography, status of COVID-19 positivity, illness if any, requirement of hospitalization. SPSS version 28 was used to analyze the data. Chi-square or Fisher’s exact test was used to assess the association between various parameters. Results: Our study shows that blood groups A and B are more disposed to COVID-19 infection, whereas blood groups O and AB are at a significantly lower risk of COVID-19 infection. The study did not show significant impact of the Rh types. Both group system, age, sex show non-significant impact on the susceptibility, progression of disease and are not associated with susceptibility to severity. Conclusion: There is a significant association between blood groups A and B and the development of COVID-19 illness. No significant association was found with Rh type and all other parameters.

Prevalence of anxiety and depressive symptoms during COVID-19 pandemic among the general population in India: A systematic review and meta-analysis.

The novel coronavirus (n COVID-19) has affected every walk of life across the world including India. Several studies have been available on the COVID-19-related anxiety and depressive symptoms in the public health context. However, there is a dearth of evidence of a meta-analysis regarding the pooled estimates of anxiety and depressive symptoms related to this pandemic based on the existing studies conducted among the general population of India. The aim of the study was to estimate the pooled prevalence of COVID-19-related anxiety and depressive symptoms among the general population in India. We searched the following electronic bibliographic databases: PubMed, Ovid, Science Direct, and Wiley online library for studies conducted from the onset of the COVID-19 pandemic and until September 25, 2021. We separately analyzed the outcome measures based on the risk of bias assessment. The publication bias was evaluated by funnel plots and Egger's test. We used a random-effect model due to the significant heterogeneity between the studies (Anxiety symptoms - I2 = 99.40% and Depressive symptoms - I2 = 95.3%). According to the index meta-analysis, the pooled estimates of anxiety and depressive symptoms among general population of India during COVID-19 pandemic are 23.5% (95% CI: 17.4-29.6%; n = 21 studies) and 20.2% (95% CI: 17.2-23.2%; n = 17 studies), respectively. In subgroup analyses, good-quality studies (Score ≥7/9) had a significant effect on the pooled prevalence. About one-fifth of the general population of India reported having anxiety and depressive symptoms during the COVID-19 pandemic. The pooled estimates varied with the methodological quality of included studies. The present study provides a comprehensive picture of the overall magnitude of anxiety and depressive symptoms due to the COVID-19 outbreak which will guide the policy makers to measure the burden of similar pandemics more judiciously in the future.

Knowledge, Attitude, and Practice Regarding Antibiotic Use and Resistance for Upper Respiratory Tract Infections among the Population Attending a Mass Gathering in Central India: A Cross-Sectional Study.

Good knowledge and appropriate attitude and practice about antibiotic use and resistance among the general population, are significant contributors to minimize the development of antibiotic resistance. We aimed to study the knowledge, attitude, and practice (KAP) regarding antibiotic use, resistance to upper respiratory tract infections (URTI), and associated factors with KAP, among the population attending a mass gathering in India. A cross-sectional study was conducted in 2016 during a mass gathering held in Ujjain city of Central India. A self-administered, pre-tested questionnaire consisting of 28 questions was used to collect data on demographic characteristics, KAP related to antibiotic use, resistance, and URTI. Descriptive analyses were used to describe participants' responses. Participants were divided into poor or good knowledge and appropriate or inappropriate groups of attitude and practice. Multivariable logistic regression models were used to examine the associations between demographic characteristics, URTI knowledge, and each domain of KAP. All statistical analyses were performed using Stata 16.0. The significance level was set at 5%. A total of 1915 participants consented to participate (response rate 92.7%) with a mean age of 39.3 (±14.7). Complete data on socio-demographics were available for 1619 participants. Of these, 59% were male, and 61% had an education level below high school. Eighty-nine percent of participants had poor knowledge about URTI. A majority of the respondents defined antibiotics incorrectly (93%) and were classified as having poor knowledge (97%). Most of the participants (63%) could not mention any contributors to the irrational use of antibiotics. Appropriate attitudes were observed in 40% of participants, 87% denied to comply with the prescribed course of antibiotics and 88.5% had inappropriate responses for practice. Age of the respondent, sex, education, occupation, and knowledge about URTI, were the main factors associated with the KAP. KAP about antibiotic use and resistance among the general population in India was poor. Knowledge about URTI is strongly associated with KAP. Community interventions, i.e., educational campaigns, should be designed and implemented promptly considering the differences in demographics of the target audience.

Willingness to receive COVID-19 vaccine booster among general population of India: an online cross sectional study

Background: Booster dose for COVID-19 vaccine is being administered by many countries and has recently been started by India for special groups. Hence, it is important to understand the willingness of people to receive the booster dose and factors associated with it.Methods: The present study was a community based Online Cross-sectional study done by using internet based social media applications for a period of 10 days from 6th January to 15th January 2022.Results: Out of which 70.6% were willing to receive the booster, 7.6% were not willing and 21.8% were undecided. Reasons for willingness were the belief to boost immunity (61.3%), protection from new variants (45.9%), reduced severity of infection (43.2%) or hospitalization (42.8%).Conclusions: The main reasons for unwillingness were, being unsure about its benefits (59.7%), fear of side effects (26.5%) and no trust on vaccine for protection against new variants (26.5%). People with higher education, history of COVID-19 infection or hospitalization among family and those perceiving more severe infections by new variants were more willing to get the booster.

Legislation, activism and power play – Medical education policies in colonial and post-colonial India

ABSTRACT Colonial medical education and public health policies emerged from an intriguing discourse of negotiation between the government and the people. These ‘structured conflicts’, rooted in the politics and the debates of the colonial institutions not only provided opportunities for creative thinking about public health but also for imposing constraints. The colonial and post-colonial India medical legislative debates revealing a new language of protest, assumed greater significance with the growing nationalist movement and the general (though variegated) intellectual polarisation – western and indigenous systems of medicine. Problematising the historiographic assertion of medical modernisation in colonial India to be a part of ‘civilising mission’, this paper argues that legislature emerged as a platform of activism and protest against the colonial and post-colonial State’s appropriation of modernity. While some members appealed for extending the benefit of ‘modern’ western medicine to the general Indian population, some debated in favour of introducing the indigenous medical systems to the terms of modern professionalisation. The post-colonial policies reveal the true significance of the legislative debates in reviving the position of indigenous systems of medicine in the context of professional modernity.

Effect of Nonalcoholic Fatty Liver Disease (NAFLD) on COVID-19: A Single-Center Study of 3983 Patients With Review of Literature.

BackgroundThe presence of metabolic syndrome (MS) is associated with increased disease severity in patients with coronavirus disease 2019 (COVID-19). Non-alcoholic fatty liver disease (NAFLD) associated with or without MS may be related to increased morbidity and mortality in COVID-19, but large Indian studies are lacking. The present study was carried out to assess the impact of NAFLD on the clinical outcomes in patients with COVID-19 infection.MethodsAll patients with COVID-19 hospitalized at a tertiary care hospital in eastern India from April 4 to December 31, 2020, were included in the study. Patients who underwent non-contrast CT (NCCT) chest were evaluated for the presence of hepatic steatosis based on a validated criterion liver attenuation (HU) value lower than the spleen, absolute liver attenuation lower than 40 HU, and liver to spleen attenuation ratio less than 1. Patients were divided into two groups, those with or without fatty liver. Baseline characteristics including age, sex, liver function tests, and outcomes including duration of hospital stay and mortality were compared.ResultsA total of 6003 COVID-19-positive patients were admitted during the study period. Of these patients, 214 children (<18 years) with COVID-19 infection were excluded. One hundred and eight patients with a history of significant ethanol abuse were excluded from the analysis. NCCT scan was not done in 1698 patients. Finally, 3983 patients were included in the study. They were divided into two groups depending on the presence or absence of NAFLD. Of the 3983 patients, 814 (20.4%) had NAFLD. Overall in-hospital mortality among the study group was 6.4%. The mortality rate among patients with NAFLD was 6.7% while that in patients without fatty liver was 6% (P=0.381). Similarly, the mean duration of hospital stay was also comparable between both the groups (10.63±7.2days vs 10.65±6.6 days;P=0.66). Prevalence of NAFLD was similar in survivors and non-survivors; 759 of 2981 patients (25.4%) and 55 of 188 patients 29.2% (P=0.381), respectively. On univariate analysis, male sex, older age, elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) along with low serum albumin and low absolute eosinophil counts (AEC) were associated with higher mortality. However, on multivariate analysis, only older age, male sex, and low albumin levels were associated with higher mortality. Surprisingly, a sub-group analysis showed that females without NAFLD were at a higher risk of mortality than those with fatty liver (4.9% vs 12.3%; P=0.006). Similarly, patients with lower AST levels had higher mortality compared to patients with significantly elevated AST levels (more than two times the upper limit of normal (ULN)), irrespective of the presence of fatty liver.ConclusionsThe prevalence of fatty liver in severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infected patients is similar to the general population in India, the presence of which is not a predictor of severe disease. However, mortality is higher in males and elderly patients.

Prevention and to stop the progression of fatty liver diseases: Evidence of ayurveda in hand

Fatty liver disease is a spectrum of liver disease, from a "bland" fatty infiltration to chronic hepatitis (steatohepatitis or NASH), that can result in cirrhosis, hepato cellular carcinoma and organ failure. The prevalence of fatty liver in India is 9-32% with an average of 25% in general population in India. There is no pharmacological agent being officially approved. Therefore, prevention and stop the progression of fatty liver by life style modification and Ayurveda medication are very acceptable by people now a day. Ayurveda treatment involves diet, yogic intervention, Panchakarma therapy and drug therapy. Ayurveda medication can improve the hepatic lipid metabolism, stop hepatic lipogenesis, regulate the mitochondrial dysfunction, modulate lipid metabolism by bile synthesis, modulate the hepatic inflammation through apoptosis and autophagy, correction of gut bacterial composition. The few evidences suggested to practice and generate more data for prevention and arrest the progression of fatty liver diseases.

Contrasting Association Between COVID-19 Vaccine Hesitancy and Mental Health Status in India and Saudi Arabia-A Preliminary Evidence Collected During the Second Wave of COVID-19 Pandemic.

BackgroundVaccine hesitancy is a global public health threat. Understanding the role of psychological factors in vaccine hesitancy is often neglected and relatively less explored.Aim and ObjectivesTo analyze the relationship between mental health and COVID-19 vaccine hesitancy before and after the advent of COVID-19 vaccines (AC19V) in the general population of India and Saudi Arabia (KSA) which vary in severity of the pandemic and vaccine mandates.Materials and MethodsA total of 677 adult participants from India and KSA participated in this cross-sectional online web-based survey. Sociodemographic details and current COVID-19 status pertaining to infection and vaccination were collected. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and perceptive need for mental health support (MHS) were assessed before and after AC19V. A newly constructed and validated COVID19 vaccine hesitancy scale-12 (COVID19-VHS12) scale was used to evaluate the COVID-19 vaccine hesitancy.ResultsPrevalence and levels of depression and anxiety symptoms decreased significantly in Saudis but not in Indians after AC19V. PTSD symptoms showed a significant reduction in both India and KSA. Anxiety symptoms were higher in KSA than India before AC19V while PTSD was higher in India before and after AC19V. Except for the place of residence and employment status, the subgroups of sociodemographic variables which were at higher risk of negative mental health before AC19V showed improvement in their mental health after AC19V. The prevalence of COVID-19 vaccine hesitancy in India and KSA was 50.8% (95% CI 45.73–55.89%) and 55.7% (95% CI 50.16–61.31%), respectively. A bidirectional association between vaccine hesitancy and mental health was observed in KSA but not in India. Higher vaccine hesitancy favored higher levels of depression, anxiety, and perceptive need for MHS and vice versa in KSA. None of the mental health parameters predicted vaccine hesitancy in India, while higher vaccine hesitancy increased the risk of anxiety.ConclusionVaccine hesitancy has a negative impact on mental health and vice versa over and above the impact of sociodemographic factors and COVID-19 vaccination and infection status which shows variations between India and KSA.

Relevance of ratio of neck circumference to thyromental distance in predicting difficult intubation

Background and Objectives: Airway assessment is the most important aspect of anaesthetic practice as a difficult intubation may be unanticipated. A study was done to know the relevance of ratio of neck circumference to thyromental distance in predicting difficult intubation in general Indian population coming for surgery. Materials and methods: 500 Patients with ASA PS I&amp; II were enrolled in the study were preoperatively assessed for airway parameters such as Modified mallampati classification, thyromental distance, sternomental distance, neck circumference to thyromental distance ratio and Wilson score. Intra-operatively all patients were classified according to Cormack and Lehane laryngoscopic view. Results: The mean age, Weight, Height and BMI of patients in our study was 34.43 years, 61.07 kg,69.2cms and 21.2 respectively. In our study we had a total of 15 difficult intubation with all of them belonging to Cormack-Lehane grade III. In our study we noted that among 15 patients with CLIII/IV only 4 had a SMD≤15.75 cm. With that we noted a sensitivity, specificity, PPV and NPV of 26.7%,75.1%,3.2% and 97.1%. Among 15 patients with CLIII/IV only 2 of them had Wilson score of more than 3.

IDF21-0105 Serum Vitamin B12 In Relation To Anemia And Neuropathy By MNSI Among Type 2 Diabetes Mellitus Adults On Metformin

Background: Type 2 diabetes mellitus (T2DM) patients on metformin (the first line therapy to treat T2DM) are prone to have low serum B12 as evident from western literature. There is limited evidence from India regarding the same. Symptoms of B12 deficiency can manifest as hematological and neurological manifestations. The study was planned to understand the association of B12 deficiency, anemia and neuropathy among T2DM patients on metformin. Aim: To assess the magnitude of B12 deficiency and study it in relation to anemia and peripheral neuropathy (PN) among T2DM patients on metformin. Method: A hospital based cross sectional survey of 245 T2DM adults on metformin from a tertiary health care hospital of Delhi was conducted for PN assessment by Michigan Neuropathy Screening Instrument (MNSI). After meeting the inclusion and exclusion criteria, 155 subjects gave fasting blood samples for estimation of Vitamin B12, HbA1c,Hemoglobin and cell morphology by chemiluminescent enzyme immunoassay (C.L.I.A), HPLC and C.B.C respectively. Results: The prevalence of B12 deficiency (B12≤200pg/ml) was 52% among T2DM adults on metformin. Odds Ratio of B12 deficiency and vegetarian diet was 2.33(C.I. 1.22-4.47) (p<0.05). Anemia was present in 40% but it was not associated with B12 deficiency as there were no cases of macrocytic anemia. The prevalence of PN was 38% by PN score ≥2.5 and the mean PN scores was 2.14 ± 1.98.There was 39.2% low grade PN (PN score > 0 ≤ 2.5) followed by high grade PN (34.3%) (PN score >2.5).By Receiver Operating Curve (ROC) analysis serum B12 has shown fair test performance in predicting PN scores of 2.25 (p<0.001). Discussion: The prevalence of vitamin B12 deficiency in T2DM adults on metformin in our study is higher than that reported in other countries. The higher prevalence of B12 deficiency in our study (52 %) is not stunning owing to the higher prevalence of vitamin B12 deficiency in general population in India. The prevalence of B12 deficiency in T2DM patients in our study is more than other Indian studies on metformin. This study showed that though metformin lowers serum B12 but this had no impact on hematological parameter (hemoglobin and cell morphology) assessed in our study. Similar results have been reported by an Indian study and study from the other country. In our study the vitamin B12 deficiency was associated with PN in T2DM adults on metformin which is similar to the finding of a multi centric study from an Asian country Pakistan and several studies from other countries It can be said from our study that vitamin B12 test has fair chance of predicting PN among T2DM patients on metformin and taking a decision regarding which patients should be referred to a neurologist for electrophysiological studies. Conclusions: Metformin use was associated with biochemical B12 deficiency but not with clinical B12 deficiency as none had macrocytic anemia. Those who were B12 deficient were probable to have PN scores of 2.5 by MNSI physical assessment score. Serum B12 screening and use of MNSI for PN is recommended in T2DM patients on metformin.

COVID-19: A crisis or fortune? Examining the relationship between nature relatedness and mental wellbeing during the pandemic

With the progression of the coronavirus disease (COVID-19), lockdowns were introduced, movements were restricted, and the people were confined to their homes. On the other side, the social distancing measures and the shutdown of movements showed a significant impact on the ecosystem resulting in an explicit revamp of nature. These nature rejuvenation and home confinement measures were presumed to improve the human-nature connection and affect the wellbeing of the individuals. Guided by this aspect, the present study attempted to examine nature relatedness and mental wellbeing of the Indian population during the COVID-19 pandemic. We further tried to investigate the relationship between the two considering age and gender as moderators. In addition, the association between nature relatedness and various socio-demographic factors were also inquired. A three-week online survey was conducted among the general Indian population with the age group ranging from 18 to 65 years. Results exhibited a higher nature relatedness and moderate mental wellbeing among the individuals. The association between nature relatedness and mental wellbeing produced a significant positive relationship among the sample. Meanwhile, individuals with higher nature relatedness were found to be female, unemployed, research scholars, and possessing ‘very liberal’ political ideology. When assessed for potential moderators, neither gender nor age influenced the relationship between nature relatedness and mental wellbeing. Possible explanations of our findings were discussed that shall provide constructive directions for future research in the area of human-nature connection and public health.

Practices, awareness, and perception towards home-based COVID-19 management among the general population in Mangalore city in south India.

Background: Most patients with COVID-19 experience mild illness, which can be managed in a home environment. This study was done to assess the perception, awareness, and practices regarding home-based management of COVID-19 among the general population in India. Methods: This cross-sectional study was done in May and June 2021. Data were collected using a Google Form. Results: Mean age of the 294 participants was 36.6 ± 12.1 years. Of these participants, 45 (15.3%) were diagnosed with COVID-19 anytime in the past. Among them, 37 (82.2%) underwent home-based management for COVID-19. Monitoring body temperature and oxygen saturation were performed just once a day by 15.2% and 5.9% of COVID-19 patients respectively. Self-medication was practiced by 11 (29.7%) patients. Disposable face masks were worn by 23 (62.2%) patients beyond eight hours of continuous usage. The disposable type of face mask was not discarded despite becoming wet, and cloth masks were worn by eight (21.6%) patients. Disposable gloves were only worn by 14 (37.8%) caregivers of COVID-19 patients. As many as 10 (27%) patients were tested for COVID-19 after completion of home isolation. Awareness of all mild symptoms and signs of the disease was known to only 19 (6.5%) participants. Normal oxygen saturation in the blood was known to 40 (13.6%) participants. Just six (2%) participants were aware of the correct duration of home isolation in a symptomatic patient with COVID-19. The recommended duration of handwashing with soap and water was known to 102 (34.7%) participants. As many as 17.4% and 32.7% of participants were not confident in using thermometer and pulse oximeter respectively. Conclusion: Practices, awareness, and perception regarding certain essential measures in COVID-19 home management were found lacking among several participants. These need to be addressed by suitable training programs among the general population.