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Background: A substantial proportion of tuberculosis patients either take treatment from private care providers or first-time visit private hospitals to diagnose tuberculosis. Hence the role of private providers is too essential to ignore to realize the ambition of tuberculosis elimination in India. Aim and Objectives: To understand the perception of private practitioners of Sonepat district of Haryana state regarding. Setting and Design: A cross-sectional study was done among the private practitioners of the Sonepat district of Haryana Methods and Material: 78 randomly selected practitioners from the list provided by the district health authority were interviewed using a pretested semi-structured questionnaire. The ethics committee of the study institute approved the study. Statistical analysis used: Descriptive analysis in terms of proportion and percentages was conducted. Results: One-third of the study participants were in the age group of 30-40 years. Half of the practitioners were reportedly practicing medicine for less than twenty years. A significant proportion agreed that the government could not single-handedly eliminate tuberculosis without collaborating with private providers. Mostly agreed on the effectiveness of Tuberculosis regimens under the program; however, over-relying on the sputum examination was perceived as a negative component of the program. Conclusions: Private providers understand their pivotal role in tuberculosis-related programs. However, their full participation has not been realized in the program.
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Background: Since the outbreak of global pandemic, wearing face mask not only protects the individual but also limits the spread of corona virus infection in the community. However, certain sociocultural and personal factors have created hinderance in wearing face mask by general people against COVID-19 virus. Aims and Objectives: The aim and objective of this study is to assess the knowledge, intension, and practice of wearing face mask among common people. Materials and Methods: It was a cross-sectional study conducted among general people in a part of Western Odisha after ethical approval. A total of 1050 adults above 18 years participated in this study. The data were collected from different locality of the town using a pretested self-administered questionnaire by all authors and research assistants of this project. The period of study was from July 2021 to December 2021. The results were tabulated, processed, and analyzed using SPSS-20. Results: Regarding knowledge score, we observed that 57% had average, 18% had poor, and 25% had good knowledge. Furthermore, we found 42% participants had positive intention and 58% had negative intention. Again we assessed that 35% of participants were practicing face mask appropriately and 65% practicing inappropriately. Conclusion: In this study, the score of knowledge, intention, and also the practice of wearing face mask against COVID-19 was lower than the average as compared to previous researches. Hence, health authorities should promote the people to wear mask and encourage awareness programs for the benefit of the society.
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Background: Laryngoscopy and endotracheal intubation are usually associated with tachycardia and hypertension. Pre-administration of melatonin has anxiolytic and sedative property which can reduce the tachycardia and hypertension during the surgical procedures. Aims and Objectives: The present study aimed to evaluate the melatonin effect on hemodynamic changes during laryngoscopy and intubation. Materials and Methods: This prospective study was done in the department of anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka. Total 80 patients were included in the study based on the inclusion and exclusion criteria. Patients were divided into two groups. Group-A treated with placebo and Group-B treated with melatonin (6 mg) and demographic, clinical, and hemodynamic parameters were recorded. The data were analyzed with unpaired t-test with the use SPSS (20.0) version software. Results: Comparison of number and percentage of age, gender, and blood groups between the Group-I and Group-II not showed any significant difference. Group-I and Group-II mean age, height, and weight not showed any significant difference. Mean heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were compared between the Group-I and Group-II at basal, during, after 1, 3, 5, and 10 min showed significant difference. Conclusion: Pre-administration melatonin showed significant reduction of hemodynamic changes compared to placebo group.
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Background: On 18th June 2013, India banned pioglitazone, a peroxisome proliferation activator gamma agonist, and a popular anti-diabetic drug used in the treatment of type 2 diabetes mellitus (T2DM), but on 21st August 2013, ban was revoked after stiff opposition from diabetologists and pioglitazone was reintroduced to the market again. Aim and Objective: The aim of this study was to assess the efficacy and safety of low-dose pioglitazone compared to standard dose pioglitazone in adults with T2DM. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, 50 patients with T2DM who were not under adequate glycemic control with metformin and glimepiride combination therapy were included in the study. The patients were randomly assigned (1:1) into pioglitazone 7.5 mg group and 15 mg group as an add on treatment to the existing therapy. Results: All the glycemic parameters such as Fasting blood sugar (FBS), post prandial blood glucose (PPBS), Glycosylated Hemoglobin (HbA1c) are significantly reduced in both groups from baseline to the end of 12 weeks. FBS reduced from 183.64 ± 20.9 to 152.08 ± 15.2 in the Pioglitazone 7.5 mg group and from 177.32 ± 16.89 to 145.2 ± 11.6 in the pioglitazone 15 mg group (P < 0.05), PPBS was reduced from 260.2 ± 31.09 to 213.8 ± 29.5 and from 256.24 ± 43.72 to 203.52 ± 27.5 (P < 0.05) in 7.5 mg and 15 mg group, respectively. HbA1c was reduced from 8.969 ± 0.88 to 8.508 ± 0.9 in 7.5 mg group (P < 0.05) and in 15 mg group, it was reduced from 8.796 ± 0.79 to 8.19 ± 0.72 (P < 0.05). In the study, Pioglitazone 7.5 mg efficaciously reduced glycemic parameters similar to pioglitazone 15 mg and there was no statistically significant difference between the groups. Three patients reported with pedal edema as adverse effect in pioglitazone 15 mg therapy, whereas only one in 7.5 mg pioglitazone therapy complained of ankle edema. Conclusion: Low-dose pioglitazone offers an attractive alternative option to standard dose pioglitazone as an add on therapy for T2DM due to its effectiveness in reducing glycemic markers and also fewer side effect profile.
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Background: A physically active lifestyle is the cornerstone of good health. A sedentary lifestyle is emerging as a global threat to public health and physical activity is being recommended as an important intervention for the prevention and control of non-communicable diseases. Aim and Objectives: The present study aims to assess the level of physical activity and duration of sitting time among medical undergraduates to guide the formulation of strategies for healthy lifestyles. Material and Methods: A cross-sectional study was conducted among medical undergraduate students of a teaching hospital in North India. Data were collected using a structured questionnaire regarding the demographic profile, anthropometric parameters, physical activity, and sitting time. The level of physical activity and time spent sitting was assessed using International Physical Activity Questionnaire. R software was used for data analysis. Results: A total of 250 medical students were included with a response rate of 83.3%. Overall, 67.6% of students engaged in moderate levels of physical activity, 21.2% engaged in high levels, and 11.2% engaged in low levels of physical activity. The mean time spent sitting was 8.8 hours/day (males: 8.5 and females: 9.1). It showed a significant association between physical activity and body mass index, with the low prevalence of obesity among students engaged in moderate and high levels of physical activity. Conclusion: The study highlights prolonged sitting as an emerging public health problem where three-fourths of students were spending more than 7 hours/day sitting. However, the majority of students were engaged in moderate to high levels of physical activity.
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Background: Hypertension (HTN) is a serious public health problem. Good control of the disease has always been considered to be essential for reducing its morbidity and mortality. Poor adherence to treatment is the single most important reason for uncontrolled blood pressure, serious complications, and wastage of health-care resources. Aims and Objectives: This study aims to assess the antihypertensive medication adherence level among hypertensive study participants, and identify and evaluate the barriers to antihypertensive medication adherence. Materials and Methods: A hospital-based descriptive cross-sectional study was conducted in tertiary care medical college hospital in Madurai, Tamil Nadu, involving 332 patients and the collected data were presented as means (standard deviations) and percentages. Comparison of data was performed using Pearson’s Chi-square test. For all statistical analyses, commercially available computer program was used. Results: Among 332 study participants having age range of 31–78 years with a mean age of 57.49 ± 9.20 years, female (approx. 60%) were more than male (40%) participants. About 96.7% of respondents were aware that HTN could cause severe consequences with regard to their health and daily activity but more than half were taking medium salt (56.0%) and more than one-third (32.8%) were taking fatty rich diet. Only one-fourth (25.6%) had good medication adherence. Male participants (34.8%) were more adherent to medication than female (20.2%) and this was statistically significant with P = 0.003. Conclusion: Around 3/4th of study participants (72.9%) were poorly adherent to antihypertensive medication. Hence, there should be improvement in awareness for both the patients and the care providers.
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Monoclonal antibodies (mAbs), which are commonly used to treat rheumatoid arthritis (RA), have been linked to a variety of adverse events (AEs). The objective of the study was to compare the safety profiles of six FDA approved mAbs (sarilumab, tocilizumab, adalimumab, golimumab, infliximab, and rituximab) marketed for the treatment of RA. A systematic review of the literature was conducted using the databases PubMed, Cochrane Library, and Science Direct. The manuscript comprised a total of 23 clinical studies. The percentage of patients who had AEs was calculated and presented using box-whisker and forest plots. Infections and infestations were found to be the most common AEs in RA patients treated with mAbs. Raised alanine aminotransferase (ALT), aspartate aminotransferase (AST), upper respiratory tract infection (URTI), and nasopharyngitis were frequently reported. The most common AEs were reported with adalimumab. The highest percentage of patients reporting AEs was associated with golimumab (52%), while rituximab had the fewest AEs (4.9%). In conclusion, rituximab appears to be a safer treatment option for RA as it is found to be associated with a lower risk of AEs, particularly respiratory infections.
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ABSTRACT Introduction: Good wound closure is an important step in management of distal femur fracture to prevent infection and faster rehabilitation. Knotless barbed sutures can save time and distribute wound tension evenly. However, its role in terms of functional outcome, closure time, and postoperative complications has not been studied in a distal femur fracture. Material and methods: A total of 47 patients aged more than 18 years of distal femur fracture treated with distal femur locking plate were randomized either into either barbed or traditional suture groups. in the barbed group, capsular wound closure was carried out with 2-0 bidirectional barbed knotless sutures (Quill SRS® PDO, Angiotech, Vancouver, BC, Canada). In patients assigned to group B, capsular closure was done with 1-0 Vicryl® (Ethicon inc. Somerville, NJ) and 5-0 Ethibond® alternatively. Results: The mean flexion at the knee joint was 105.7±15.6 degrees in the study group while it was 110.4±13.7 in the control group (p= 0.2133). Mean estimated closure time was significantly shorter in the study group as compared to the control group (p<0.05). Cases of needle prick injury were higher in traditional suture group. Patients developed stitch abscess and superficial infection in both groups. However, the difference in incidence between the two was not statistically significant Conclusion: Barbed suture is an efficient method of wound closure. It reduces wound closure time with similar complication rate as with use of conventional sutures. Evidence Level II; Randomized Clinical Trial.
RESUMO Introdução: O fechamento adequado da ferida é um passo importante no manejo da fratura distal do fêmur a fim de evitar infecção e permitir uma rápida reabilitação. Suturas farpadas sem nós podem poupar tempo e distribuir uniformemente a tensão da ferida. Entretanto, seu papel em termos de resultado funcional, tempo de fechamento e complicações pós-operatórias não tem sido analisado em casos de fratura distal do fêmur. Material e métodos: Um total de 47 pacientes com mais de 18 anos de idade com fratura distal do fêmur tratados com placa de fixação distal do fêmur foram aleatorizados em grupos de sutura farpada ou tradicional. No grupo de farpados, o fechamento da ferida capsular foi feito com suturas sem nós farpados bidirecionais 2-0 (Quill SRS® PDO, Angiotech, Vancouver, BC, Canadá). Em pacientes designados para o grupo B, o fechamento capsular foi feito com Vicryl®1-0 (Ethicon inc. Somerville, NJ) e Ethibond® 5-0 respectivamente. Resultados: A flexão média na articulação do joelho foi de 105,7±15,6 graus no grupo de estudo e 110,4±13,7 no grupo controle (p= 0,2133). O tempo médio estimado de fechamento foi significativamente menor no grupo de estudo em comparação com o grupo controle (p<0,05). Os casos de ferimento por perfuração da agulha foram maiores no grupo de sutura tradicional. Os pacientes desenvolveram abscesso de pontos e infecção superficial em ambos os grupos. Entretanto, a diferença na incidência entre os dois não foi estatisticamente significative Conclusão: A sutura farpada é um método eficiente para o fechamento de feridas. Ele reduz o tempo de fechamento das feridas com uma taxa de complicação semelhante à utilização de suturas convencionais. Evidência Nível II; Ensaio Clínico Randomizado.
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Objectives: Several studies have shown that air displacement plethysmography (ADP) has excellent reliability, accuracy and precision in body fat percentage (BF%) measurement, but its reliability has not been assessed in the Indian population. Thus, this study aimed to determine the test-retest reliability of BF% by ADP in healthy Indian men. Materials and Methods: A total of 74 healthy Indian men (>18 years old) belonging to different parts of India voluntarily participated in the study and completed multiple trials to determine BF% immediately after the initial measurements. All tests were performed according to the manufacturer’s instructions. Results: A paired t-test showed no significant differences in body volume (BV) (P = 0.53), body density (BD) (P = 0.39) and BF% (P = 0.27) between trials 1 and 2. However, there was a significant decrease in body mass (BM) observed between trials 1 and 2 (P = 0.0001) which did not influence reliability. A significant intraclass correlation was observed for BM (intraclass correlation 1 [ICC1] = 1, P <0.001), BV (ICC1 = 1, P < 0.001), BD (ICC1 = 0.996, P < 0.001) and BF% (ICC1 = 0.995, P < 0.001) between the initial test and retest trial. The third assessment of BF% was performed when the initial trial difference was greater than 1% point. Significant intraclass correlations were also observed for pairs with maximum and minimum differences. Conclusion: ADP appears to be a reliable measure for determining the BF% of the Indian adult male population, and conducting multiple trials are necessary to detect small differences.
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Objectives: There are many multifactorial causes for Congenital Heart Defects (CHDs) in which both genetic and non-genetic factors play role. MTHFD1 and CBS are two of the key enzymes that plays pivotal role in the metabolic pathway of homocysteine. Most of the studies revealed that genes involved in folate/homocysteine pathways are involved in the occurrence of CHDs. The present study was planned to investigate the role of common polymorphisms in MTHFD1 and CBS gene in children with CHD in Jammu region of Jammu and Kashmir UT. Material and Methods: A total of 160 (80 CHD patients and 80 controls) children were enrolled for the present case-control study. After extraction of genomic DNA genotyping of SNP MTHFD1 G1958A(rs2236225) was done by PCR-RFLP and CBS 844ins68 polymorphism was done by PCR technique. Results: Our results show that there is no significant association between MTHFD1G1958A and CBS 844ins68 polymorphism with CHD. In case of SNP MTHFD1 G1958A allele A found to be higher in both patient and control group and inCBS 844ins68 polymorphism frequency of risk allele ‘I’ found higher in cases (0.06) as compared to controls (0.04). The homozygous genotype for 844ins68 (II) was found absent in both the patients and control group. Conclusion: We conclude that both MTHFD1 G1958A and CBS 844ins68 polymorphism were not found to be genetic risk factor in the development of CHD in population of Jammu region of Jammu and Kashmir UT
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Background: The five-year survival rate of oral cancer remains 50% or less despite the treatment advances. An effective screen- ing test is necessary for early detection of oral cancer. Aim: To assess the efficacy and diagnostic accuracy of centrifuged liquid-based cytology in comparison to conventional exfolia- tive cytology in normal oral mucosa and oral squamous cell carcinoma. Materials & Methods: The study population comprised of 40 individuals, equally divided into two groups: healthy individuals and previous histopathologically proven oral squamous cell carcinoma cases. Exfoliative cytology was done and the samples were processed by conventional cytology as well as by centrifuged liquid-based cytology and stained with Papanicolaou stain. Seven cytological parameters were analysed to assess the quality of slides prepared. A cytological diagnosis of the case group was also made and was compared with histopathological diagnosis to evaluate the diagnostic accuracy. Results: The present study revealed statistically significant superior results in all the cytological parameters evaluated by centri- fuged liquid-based cytology compared to conventional exfoliative cytology (P ?0.05). There was an ‘almost perfect agreement’ found between centrifuged liquid-based cytology diagnosis and histopathology (k=0.89) while only a ‘substantial agreement’ was found between conventional exfoliative cytology with histopathology (k=0.79). Conclusion: The present study summarizes that centrifuged liquid based cytology is more effective than conventional oral exfoliative cytology in screening oral cancer. Further studies with larger sample size in different oral lesions are necessary to validate the use of this cytology technique.
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We report a case of isolated duodenal tuberculosis (TB) in a patient who presented with features of gastric outlet obstruction. The diagnosis was made on repeat endoscopic duodenal biopsy after initial histopathology failed to reveal the diagnosis. The patient recovered with antitubercular therapy. The index of suspicion has to be high in TB endemic countries as clinical, radiological, and endoscopic features are nonspecific.
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Background: Herbs used in medicinal practices by the indigenous healers are found to be of great importance in the management of diseases that are yet to have a cure by the available drugs. Practice of using herbs available in the vicinity by the locals as medication for ailments is a universal phenomenon. Dendropthoe falcata, an arboreal parasitic plant used in the indigenous medicine for the management of diabetes, is explored here for its acute hyperglycemic model adult zebrafishes. Aim and Objectives: The aim of the study was to determine the hypoglycemic effect of the methanolic extract of Dendrophthoe falcata leaves in alloxan-induced acute diabetic adult zebrafish. Materials and Methods: Adult zebrafishes were grouped into five groups with six fishes in each group exposing them to alloxan to induce acute hyperglycemia and then treating them with two test doses of 40 mg/dl and 60 mg/dl of the methanolic extract of the plant extract. Another group was treated with metformin with a dosage of 20 micro moles. Body mass index, blood glucose, and histopathological examination pre- and post-treatment for a period of 14 days were studied. Results: The effect of the herbal extract in both the doses was promising when compared with the standard drug metformin; however, the cytoprotective effect was very predominant with the both doses of the extract. Acute hypoglycemic was comparatively good when compared with the standard group treated with metformin. Conclusion: The antidiabetic effect of the arboreal parasitic plant has been established with a need for further exploration of this plant for a potential drug for diabetes mellitus.
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Plants have been the main source of therapeutic agents in world’s most ancient system of medicine, the Ayurveda. Nimb (also known as Margosa tree) is one of the most commonly used plants in Ayurveda for the management of a large number of ailments. It is a member of the Meliaceae family, found commonly in India, Africa and America. Nimb has been used exclusively by mankind to treat various diseases since even before the availability of manuscripts that recorded the beginning of history. Nimb is well described in Charak Samhita, Sushrut Samhita, Ashtang Hridayam, Chikitsa grantha and Nighantus. It is having Laghu guna, Tikta kashaya rasa, Sheeta virya and Katu vipaka, due to which it has been considered as Kapha-pitta shamaka. Acharya Bhav Mishra considers it Tridosh Shamak. It is traditionally used in the treatment of various ailment i.e., Krimi, Kushtha, Jwara, Kandu, Shopha and many more. All the parts of the plant have been used in the preparation of therapeutic formulations. Nimb contains various bioactive compounds like Nimbinin and Nimbidin, due to which it shows antibiotic, antiulcer, anti-inflammatory, antihelmenthic, antifungal, diuretic, antihistaminic, nematicidal and spermicidal properties and other biological activities. Present paper is an effort to validate pharmacological properties of Nimb described in Ayurveda through reverse pharmacology.
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Background: Three or more waves of COVID 19 pandemic have hit the different parts of world including India very hard, taking toll on the lives of people both in terms of morbidity and mortality. Keeping this in mind, the present study was conducted with an aim to determine the socio-demographic and clinical profile of laboratory confirmed COVID 19 cases and to determine their association with oxygen requirement and outcome of disease at the time of discharge. Methods: The present cross-sectional study was conducted on lab confirmed COVID 19 cases admitted in tertiary care hospital in Jammu from June-July 2021.Data was collected using convenient sampling method. The self-designed questionnaire used for data collection obtained information regarding socio-demographic characteristics of patients as well as clinical features of the disease. Results: Out of total 161 patients studied, 60.8% were males and 39.2% were females. Mean age was 51.2 ± 17.5 years. Comorbid conditions were present in 37.8% patients, with hypertension being the most common ( 36%). Cough, Fever, breathlessness and myalgia were the main presenting symptoms (90%, 81%, 57.7% and 56% respectively). The variables which were found to have statistically significant association with oxygen requirement and the outcome of disease at the time of discharge were age, gender and presence of co-morbidity (p <0.05). Conclusions: Advancing age, male gender and presence of underlying co-morbidity were found to be significant risk factors for the requirement of oxygen and poor outcome of the disease.
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Background: One of the most common endocrine disease is hypothyroidism which is usually associated with mental retardation, lack of concentration, motor dysfunction, memory deficits, visual, and hearing impairment. These symptoms suggest the involvement of nervous system, where the processing efficiency and sensory motor association is affected, which can be assessed by reaction time. Aims and Objective: The aim of the study was to compare the auditory reaction time in controls, newly diagnosed hypothyroid patients and in hypothyroid patients after attaining euthyroid status. Materials and Methods: Auditory reaction time was recorded from 35 subjects from general population, who formed the control group and 35 newly diagnosed hypothyroid patients who were selected from OBG and Medicine department, RRMCH, Bangalore. These patients were followed up and reaction time recording was repeated after they attained euthyroid status. Results: Statistically significant increase in ART values was observed in newly diagnosed hypothyroid patients compared to controls. The values were significantly reduced in hypothyroid patients after the treatment on attaining euthyroid status. There was no significant difference in both ART values between controls and hypothyroid patients after the treatment on attaining euthyroid status. Conclusion: The present study showed a significantly prolonged auditory reaction time in hypothyroid patients which improved with treatment. We also demonstrated a positive correlation between ART and thyroid stimulating hormone levels. Hence, we conclude that auditory reaction time tests could be added to the routine thyroid dysfunction tests to know the early recognition of the neuronal involvement, prompt treatment, and assess prognosis of hypothyroid patients.Department of Obstetrics and Gynaecology, GMERS Medical College, Gandhinagar, Gujarat, India
Department of Obstetrics and Gynaecology, GMERS Medical College, Junagadh, Gujarat, India
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The incidence of kidney disease patterns diagnosed by kidney biopsy depends on age, gender, race, socioeconomic, nutritional, and environmental factors. The present study was performed at a tertiary care teaching hospital in central India to show the current frequency of different types of kidney diseases through histopathological findings. Materials and methods: We carried out a retrospective analysis of kidney biopsies done in our institute between January 2016 and June 2021, and clinical and histopathological correlation was done from the available medical records. Results: Of the 411 kidney biopsies evaluated, 56.7% were females and the mean age of patients was 31.65 years. The elderly population (age ?60 years) constituted 5% of patients. The most common indication for kidney biopsy was nephrotic syndrome (NS) (49.9%). On analysis of histological patterns, 59.3% of patients had primary glomerular disease (PGD), 28% had secondary glomerular disease (SGD), 5.2% had tubulointerstitial disease (TID), and 6.7% had vascular disease. In our study, focal segmental glomerulosclerosis (FSGS) was the most common PGD (28.9% of all PGD) followed by membranous nephropathy (MN) (19.7%), minimal change disease (MCD) (16.5%), and IgA nephropathy (IgAN) (15.4%). The most common SGD was lupus nephritis (LN) (23%) followed by diabetic nephropathy (DN) (1.99%). In patients aged ?18 years, MCD was the most common PGD (26.5%) and FSGS was the most common PGD (30%) in patients aged between 19 and 59 years. In the elderly population (age ?60 years), MN was the most common (38%) PGD. Conclusion: This is the largest study of kidney biopsies patterns from the central part of India, and it presents the combined analysis of the clinical, histopathological, and immunofluorescent features of biopsy-proven kidney diseases in our population.
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Background: Medical education is an extensively evolving field. Not only the medical curriculum keeps changing with time, so does the requirements for the students and teachers. Chalk and board is traditionally the most commonly used method of teaching whereas PowerPoint (PPT) presentation is the new generation most commonly used method. Aim and Objective: This study was conducted to evaluate the preference and perspectives of the undergraduate MBBS students’ pertaining to the two most commonly used audiovisual teaching aids namely chalk and board verses PPT presentation. Materials and Methods: An observational cross-sectional study was conducted involving two batches of MBBS undergraduate students. Results: A total of 144 students participated in the study. Eighty-four students were from 2nd year and 60 students from final year MBBS. In our study, we got favorable responses (Likert scale 4 and 5) for chalk and board method in 84 (58%) and for PPT presentation in 60 (41.9%) of students. One hundred and nineteen (82.6%) students preferred class notes over handouts. Most of the parameters were comparable among the two methods except the statements of lecture being interesting, interactive, better problem-solving, and emphasis on important points being in favor of chalk and board; and those of clarity, better diagrams ad flowcharts, covering more topics, and clinical case demonstration were in favor of PPT. Conclusion: No single aid is perfect in all aspects. Hence, a suitable aid should be chosen depending on the topic, clinical scenario, level of complexity of topics, and understanding that is required.
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Background: Although a good number of individual household latrines have been constructed in Bihar during the past few years, still, a huge task remains to be completed. The paper is based on the study of “concurrent monitoring of LSBA/SBM [G] in select districts of Bihar”. Objectives: The aim is to understand different dimensions of the sanitation situation in Bihar. The objective is to suggest policy based on the findings. Materials and Methods: This study is based on primary data collected at the household level and public institutions in six districts of Bihar. Results: The analysis reveals that except a few categories, socioeconomic indicators such as religion, economic condition, or educational attainments have no significant impact on having a latrine at the household level. The variations in the construction of latrines among different districts emphasize that the public program needs to be implemented more effectively. It is also found that women are more vulnerable in a situation of open defecation. Conclusion: The challenge is to encourage people for the sustained use of the constructed latrines. This puts emphasis on changing the behavioral pattern of the people. This requires organizing a continuous awareness generation program with the aim to change the behavior.