How multimorbidity relates to road traffic accident among older adults and elderly population: insights from longitudinal aging study in India (1st wave)

Background: Multimorbidity and road traffic accidents increase with increasing age. Supplemented with increasing life expectancy at birth, both multimorbidity and RTAs will contribute significantly to the growing disease burden of the country. The objective of the study was to determine the association between multimorbidity and RTAs among older adults (above 45 years) and the elderly (above 60 years) population in India. Methods: A secondary data analysis was conducted using the Longitudinal Ageing Study in India (LASI)-1st wave data (April 2017 to December 2018). Participants having at least two chronic health conditions were described as multimorbidity. Road traffic accidents (RTAs) was taken as the outcome variable. Univariate followed by multivariable logistic regression was conducted between the outcome variable and each explanatory variable. Results: Data extracted consisted of 34704 (51.1%) older adults and 31902 (47.9%) elderly. Multimorbidity was present in 25054 (37.6%) individuals. Among the RTA group, 325 (26.5%) individuals had multimorbidity. The elderly with multimorbidity (at least two) were associated with the RTA with an adjusted odds ratio (CI) of 0.55 (0.45-0.67) and p value of <0.001 in comparison to older adults. Clerical and skilled individuals with multimorbidity were associated with RTA in comparison to unemployed individuals with multimorbidity with an adjusted odds ratio (CI) of 1.40 (1.10-1.79) and p value of 0.007. Conclusions: The RTA was evident among males aged 45-60 years with multimorbidity. Clerical and skilled individuals with multimorbidity were more prone to RTA. These individuals should be encouraged to take necessary measures to promote healthy living and adhere to them.

Determinants of anaemia among adolescent girls in rural Varanasi, Uttar Pradesh

Background: India is home to 253 million adolescents 10-19 years of age, among the largest cohorts globally. This age group comprises of individuals in a transient phase of life requiring nutrition, education, counselling and guidance to ensure their development into healthy adults. Adolescent girls are the most vulnerable group of population due to different reasons especially anaemia. Anaemia is a major public health problem worldwide. The aim of this study was to assess the prevalence of anaemia and associated factors among adolescent girls (10-19 years) in rural Varanasi, Uttar Pradesh. Methods: The present study was a community-based cross-sectional study conducted among 369 adolescent girls in rural Varanasi with a semi-structured and pretested questionnaire. Results: Study shows that the overall prevalence of anaemia among adolescent girls was 67.8% out of which 41.5% and 24.4% were mild and moderately anaemic respectively. Anaemia was significantly associated with age groups, birth order, menarche status, no. of days of menstruation, gap between two cycles, use of clothes/sanitary pads and no. of pads used during menstrual cycle. Conclusions: Study found some preliminary factors significantly associated with anaemia like low socio-economic status, higher birth order, and knowledge about menstrual hygiene practices. Anaemia continues to be a major public health problem in India despite multiple initiatives to address it among adolescent girls.

An exploratory study using the OMI scale to assess the opinion toward mental illness among young adults

Background: Public perception of mental illness is critical for successful treatment seeking behaviour as well as for early diagnosis and surveillance of disease. Two hundred eleven young patients were interviewed at Department of psychiatry, Sir Sunderlal Hospital, Varanasi with the help of consecutive sampling method. Objective: To assess the opinion towards mental illness among young adults by using the opinion on mental illness scale (OMI). Methods: Data was collected using the opinion about mental illness scale (OMI) which consists of 51 questions out of which, 15 questions directly related to the cause, care, and management of mental illness were randomly selected and analyzed. Analysis was done showing Percentage and chisquare tests to see the significance of scores between the respondents. Results: The finding shows that more than 70% of respondents believe that mental illness is a consequence of bad behavior, lack of willpower, or negative beliefs and gap in the treatment seeking behavior and understanding the cause of disease was found. Conclusions: Opinions on Mental health have received increasing attention as a useful strategy to promote early identification of mental illness, reduce stigma and enhance help-seeking behaviors. As part of the National Mental Health Programme, there is a need to raise awareness in order to enhance understanding of mental illness in facilitating early diagnosis and treatment of disease.

Factors affecting disclosure of HIV-positive serostatus among people living with HIV/AIDS attending an antiretroviral therapy center of Eastern India

Background: HIV serostatus disclosure plays an important role in reducing the risk of HIV transmission. However, its negative effects may include rejection, assault, separation, divorce, stigma, and discrimination. Objectives: This study was undertaken to find out the proportion of HIV-positive serostatus disclosure to any family member and different factors influencing disclosure among people living with HIV/AIDS (PLWHA). Methods: A cross-sectional study was conducted among all patients aged 18� years with confirmed HIV infection registered at the antiretroviral therapy center of a tertiary care hospital in eastern part of Uttar Pradesh, India, for the duration of 1 year, from July 2017 to June 2018. Results: Most of the respondents were aged 30� years (79.9%), male (63.2%), married (85.4%), rural residents (60.4%), Hindu (96.5%), literate (84%), employed/driver (61.8%), and belonged to lower/lower middle class (62.6%). The rate of disclosure of HIV-positive status to any family member was quite high in this study (238/288 or 82.6%), among which 92.9% (221/238) to the spouse only. The number of sexual partners before disclosure, educational status, and socioeconomic status of the respondents were found to be independent predictors of disclosure of HIV-positive status to any family member (P < 0.05). Conclusions: This study indicates the need of giving more emphasis on creating awareness regarding the importance of HIV serostatus disclosure to any family member, especially to spouse, and encourage all PLWHA in the community to disclose their status. Effective strategies also need to be evolved that will target those not likely to disclose their status to anybody.

Treatment Seeking in Reproductive Age Women with RTIs/STIs : A Community based Cross-sectional Study.

The socio-cultural and economic contexts in developing countries influence the epidemiology or STls and helps in making them an important public health priority. This study was carried out to explore the health care seeking pathway of the women suffering from RTls/STls. influence or major socio-demographic variables on treatment seeking pattern. This cross sectional study was carried out comprising or eight hundred reproductive age (15-49 years) women selected following a multistage sampling procedure. The information pertaining to health seeking behaviour were collected from them using a pre-designed pretested interview schedule. Quantum of RTls/STls in the study group was estimated and symptomatics were asked specially about time lag between appearance of symptoms and seeking acre; reason for not seeking care; outcome of treatment they have taken if any. Out of total 359 subjects with symptoms of RTls/STls only about one-third (37.3%) had sought treatment. Only a few (4.5%) had sought treatment within 1 month of appearance of symptoms. Considering it to be physiological about half of the subjects (45.3%) did not seek treatment. The treatment seeking pattern was highly associated with the level of education (p=0.000). Reluctance in seeking treatment, delay in its initiation, prelerencc for unqualified practitioners in first consultation and significant association between education and treatment seeking pattern emphasize BCC and service provision for control and prevention of RTls/STls.

Brain stem glioma--a study of 111 patients.

The study analyses 111 patients of brain stem glioma; seen in neurosurgery Dept., AIIMS, N. Delhi, India, from Jan '83 to March '97; 60% of the patients were under the age of 15 years, with two peaks in age distribution, 6-10 years & 36-45 years & there was slight male preponderance in all age groups. Most common site of tumour was pons both in adults & children. Pyramidal & cerebellar signs were more frequently seen in children. Duration of symptoms was usually less than six months (in 65.5% of cases). Surgical management was attempted in 72 patients with post of radiotherapy & chemotherapy, rest of the 39 cases were treated with radiotherapy, chemotherapy & antitubercular treatment (if indicated). Improvement was seen in 30% patients postoperatively. Outcome was better in patients who were treated surgically. Astrocytoma was most common histological diagnosis (62%) & glioblastoma was not uncommon & was seen in 10 (13.8%) cases.] We conclude that the patients with brainstem glioma can be helped by surgical decompression, followed by adjuvant radiotherapy & chemotherapy.

Unusual complication--VP shunt coming out per rectum and brain abscess.

VP shunt is the most common pediatric neurosurgical procedure. It has been shown to result in variety of complications, which may have devastating consequences. Discussed below is one of the rare complications and the strategy to manage it successfully.