Does nutritional support under programmatic settings result in weight and body mass index changes among tuberculosis patients? Evidence on the impact of nutritional support through Pradhan Mantri Tuberculosis Mukt Bharat Abhiyan under national tuberculosis elimination programme from Ramgarh district of Jharkhand

Background: To increase community participation in tuberculosis (TB) elimination efforts, the government of India has launched ‘Pradhan Mantri TB Mukt Bharath Abhiyan’ (PMTBMBA) under the national TB elimination programme. The scheme allows interested parties (Ni-kshay mitras) to offer nutritional support to TB patients. This study aims to understand the impact of such a support in improving weight and body mass index (BMI) among TB patients as most available evidence comes from research settings. Methods: This is a retrospective cross-sectional study carried out in Ramgarh district of Jharkhand, India, for the period first quarter 2023. Relevant data was extracted from Ni-kshay web portal and TB treatment cards. The data is analyzed using excel 365. Results: Of the 114 participants, 69 received nutritional support during the entire duration of treatment and 45 received support partially. Single factor ANOVA on weight and BMI gain revealed statistically significant difference in mean weight/BMI between the two groups with F (1, 110)=35.4660, p=3.16×10-08 and F (1, 110)=22.9994, p=5.12×10-06. Correlation analysis showed a moderate correlation between the number of nutritional kits received and the weight/BMI gain with correlation coefficients r=0.5, p=1.07×10-07 and r=0.4, p=1.65×10-05 respectively. Conclusions: The study concludes that the impact of nutritional supplementation in programmatic setting is comparable with that of implementation research study settings.

Who found it easy to avail nutritional support through direct benefit transfer under national TB elimination programme in Eastern India: an early evidence from Jharkhand

Background: National TB Programme of India launched Nikshay Poshan Yojana (NPY) through Direct Benefit Transfer (DBT) in April 2018, to provide financial support for additional nutritional requirement during TB treatment. This study aims to understand the enabling attributes in availing Nikshay Poshan Yojana (NPY) through Direct Benefit Transfer (DBT) among notified TB patients from the Indian state of Jharkhand for the year 2019. Methods: This is a retrospective cross sectional descriptive study using secondary data obtained from Nikshay web portal for the Indian state of Jharkhand in the year 2019. State level data on TB Notification and NPY DBT scheme is downloaded from the Nikshay portal in excel format and analysed using Excel 2016 version. Odds Ratio and P value are calculated and analysed to prove any statistically significant associations. Results: The study found higher odds (1.08, 95% CI: 1.03, 1.14; P value 0.004) of having patients who belong to 15 to 65 years, female sex (odds ratio 1.05, 95% CI: 1.01, 1.09; P value 0.018), seeking care in public sector (odds ratio 4.05, 95% CI: 3.83, 4.27; P value <0.00001) and with drug sensitive TB (DS TB) (odds ratio 1.39, 95% CI: 1.1, 1.59; P value <0.00001), among those who received at least one instalment of DBT. Conclusions: TB patients belonging to productive age group, female sex, seeking care in public sector and with DS TB have higher odds of receiving NPY among the study population.

Impact of Nikshay Poshan Yojana on tuberculosis outcomes: preliminary evidence from eastern India

Background: National TB programme of India implemented Nikshay Poshan Yojana (NPY) through direct benefit transfer (DBT) in April 2018. This is to address the dual evils of under nutrition and unfavourable outcomes among tuberculosis patients in the country. This study aimed to understand the impact of Nikshay Poshan Yojana (NPY) through direct benefit transfer (DBT) on the outcomes of notified TB patients from the Indian state of Jharkhand for the year 2019. Methods: This was a retrospective cross sectional descriptive study using secondary data obtained from Nikshay web portal for the Indian state of Jharkhand for the year 2019. State level data on TB notification and NPY DBT scheme was downloaded in excel format and analysed using Excel 2016 version. Results: The study found higher odds (odds ratio 3.14, 95% CI: 2.97, 3.33; p value <0.00001) of having successful outcomes, among those who received at least one instalment of NPY. The risk of lost to follow up (LTFU) was 2.44 times (95% CI: 2.2-2.8, p value: 3.9×10-43) higher among those who did not receive any DBT payments as compared to those who received at least one DBT instalment. Conclusions: The ‘individual and health system enablers’ have a crucial role to play in successful TB treatment outcomes than NPY. However, LTFU rate reduces significantly with timely payment of NPY. This would facilitate improved treatment adherence and thus a favourable outcome.

Effect of Different Doses and Scheduling Time of Plant Growth Regulators and Defoliants on Growth and Yield of Cotton (Gossypium hirsutum L.) under High Density Planting System

A field trial to determine the effect of different dosages, Scheduling time of plant growth regulators and defoliators on growth and yield of cotton under high density planting system was conducted at Regional Agricultural Research Station, Warangal during kharif-2022. The experiment consisted of eleven treatments laid out in Randomized Block Design with three replications. The treatment details were T1: Application of Mepiquat chloride (M.C) 25 g a.i ha-1 @ 40 & 55 DAE + Ethereal 2000 ppm @ 40 % boll burst, T2: M.C 25 g a.i ha-1 @ 40 & 55 DAE + Ethereal 2000 ppm @ 60 % boll burst, T3: M.C 20, 30 g a.i ha-1 @ 40, 55 DAE respectively + Ethereal 2000 ppm @ 40% boll burst T4: M.C 20, 30 g a.i ha-1 @ 40, 55 DAE respectively + Ethereal 2000 ppm @ 60% boll burst T5: M.C 20 g a.i ha-1 @ 40,55 & 75 DAE+ Ethereal 2000ppm @ 40 % boll burst, T6: M.C 20 g a.i ha-1 @ 40, 55 & 70 DAE + Ethereal 2000 ppm @ 60 % boll burst, T7: M.C 25 g a.i ha-1 @ 40, 55 & 70 DAE + Ethereal 2000 ppm @ 40 % boll burst, T8: M.C 25 g a.i ha-1 @ 40, 55 & 75 DAE+ Ethereal 2000ppm @ 60% boll burst, T9: M.C 20, 25, 30 g a.i ha-1 @ 40, 55 and 70 DAE respectively + Ethereal 2000 ppm @ 40 % boll burst, T10: M.C 20, 25, 30 g a.i ha-1 @ 40, 55 and 70 DAE respectively + Ethereal 2000 ppm @ 60 % boll burst and T11: Control .(Water spray at 40, 55 and 70 DAE). Results revealed that foliar application of M.C @ 20 g a.i ha-1 @ 40, 55 & 70 DAE in conjunction with Ethereal 2000 ppm @ 60% boll burst recorded higher seed cotton yield. Plant growth, dry matter accumulation and stalk yield were recorded highest in control plot and lowest with spraying of M.C 20, 25 and 30 g a.i ha-1 @ 40, 55 and 70 DAE respectively + Ethereal 2000 ppm @ 40 % boll burst. Among similar doses of Mepiquat chloride, all the agronomic traits of cotton crop are positively influenced with application of 2000 ppm Ethereal @ 60% boll burst. The spraying of M.C @ 20 g a.i ha-1 at 40, 55 and 70 DAE + Ethereal 2000 ppm @ 60% boll burst would be economically ideal to the farming community.

Knowledge, attitude, perceptions and assessment of effectiveness of educational intervention on Pharmacovigilance among undergraduate medical students at Gulbarga Institute of Medical Sciences, Kalaburagi, India

Background: The Study was designed to assess the awareness of Pharmacovigilance and to evaluate the impact of an educational intervention.Methods: This was a questionnaire-based pre- and post-test educational interventional study. Students were given handouts containing information about pharmacovigilance one month before the educational intervention. A pre-validated 20-point questionnaire on (KAP) Knowledge, attitude, perception about Pharmacovigilance was distributed to second year medical students (n=115). An interactive educational intervention (Power point presentation) was designed. The chi-square test and unpaired paired t-test was used for statistical calculation.Results: The overall response rates were expressed as percentages, Mean±SD. The knowledge, attitude and perceptions of pharmacovigilance when compared before (pre-KAP) and after (post-KAP) the educational intervention, the correct response rates were found to be statistically significant (P<0.001). The feedback from the students was encouraging, handouts before the lecture classes helped them to easily grasp the pharmacovigilance concepts better during lectures.Conclusions: The study concluded that imparting the knowledge about pharmacovigilance and ADR reporting promotes drug safety and rational use of medicines in future.

Perceptions and practices of self-medication among undergraduate medical students at Gulbarga Institute of Medical Sciences, Kalaburagi, India

Background: Self-medication practice is widespread in many countries and the irrational use of drugs is a cause of concern. It assumes a special significance among medical students as they are exposed to knowledge about diseases and drugs. To assess practice and perception of self-medication among undergraduate medical students.Methods: It is a descriptive study in which study population was comprised of 2nd year undergraduate medical students of Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India. Total 134 students were included in the study. Written informed consent was obtained from each volunteer prior to the study. Students were given a questionnaire that included both open and close ended questions about self-medication practice. Data was analysed and presented as counts and percentages.Results: It was found that 72 (54%) students practiced self-medication. The principal morbidity for seeking self-medication was cold and cough as reported by 70 (53%) students. Antibiotics were most commonly self-medicated as reported by 55 (36%) students. Only 34 (25%) students opined that self-medication is part of self-care.Conclusions: Self-medication is widely practiced among under­ graduate medical students. In this situation, we should educate the students about advantages and disadvantages of self-medication.