Phytonano silver for cosmetic formulation- synthesis, characterization, and assessment of antimicrobial and antityrosinase potential.

Novel formulations of silver nanoparticles remain exciting if it is applicable for cosmetic purposes. This study proposes a value-added brand-new nanomaterial for improving skin complexion by inhibiting melanin development. This work aims to develop cost effective, efficient, natural silver nanoparticles phytomediated by aqueous extract of leaf sheath scales of Cocos nucifera (Cn-AgNPs) having potential as tyrosinase inhibitors hindering melanin synthesis. The formation of Cn-AgNPs was assessed spectrophotometrically and confirmed by the sharp SPR spectrum at 425 nm. The chemical composition profiling was characterized by X-ray diffraction (XRD) and Fourier Transform Infrared (FTIR) spectroscopy. The morphology was confirmed by Field Emission Scanning Electron Microscopy (FESEM) and the thermal stability was assessed by Thermogravimetric analysis (TGA). Pharmacological application studies supported the materialization of Cn-AgNPs with significant antityrosinase potential and considerably improved antibacterial and antioxidant properties. Cn-AgNPs showed potential antibacterial effects against gram-positive and negative strains, including prominent infectious agents of the skin. Antioxidant capacity was confirmed with an IC50 of 57.8 µg/mL by DPPH radical scavenging assay. Furthermore, in vitro melanin content determination was performed using SK-MEL cells. Cell line studies proved that Cn-AgNPs decrease the melanin content of cells. The IC50 value obtained was 84.82 µg/mL. Hence Cn-AgNPs is proposed to be acting as a whitening agent through lessening cellular melanin content and as a significant inhibitor of tyrosinase activity. The antioxidant properties and antibacterial effects can contribute to skin rejuvenation and can prevent skin infections as well. This evidence proposes the development of a new nanostructured pharmaceutical and cosmetic formulation from Cocos nucifera leaf sheath scales.

Rationale for declined child sex ratio across Perambalur district in Tamil Nadu-A qualitative study.

Background: Child sex ratio signifies the proportion of girls compared with boys in 0 to 6 years of age group. It is an important indicator for any population and most significantly about the status of the girl child in the society. The study tried to approach in a qualitative manner to study the rationale behind the declining of child sex ratio. Materials and Methods: We conducted a qualitative study using five focus group discussions and 12 in-depth interviews among various age groups, pregnant women, and other stake holders. The participants were approached with a semi-structured open-ended interview guide regarding the rationale of declined child sex ratio and measures to normalize it. After a thematic analysis, main themes and subthemes were selected after consensual agreement. Results: The study showed that male child preference is the main theme identified in the rationale part with subthemes of female vulnerability, socioeconomic status, literacy, cultural, and caste and religion as subthemes. The theme of female child preference also came up with as second child, care taking, affectionate, and cultural factors as subthemes. In the area of suggestions/interventions, education, counseling, government policies and media along with suggestions regarding sex determination and female feticide were identified. Conclusion: The decline in child sex ratio should be taken as an active social issue thus focusing more into female upliftment and enlightening into the issues of patriarchal nature, with reduction of cultural/religious beliefs.

Preventive Health Checkup: Utilization, Motivators, and Barriers Among the General Population in a Rural District in Tamil Nadu, India.

BACKGROUND: The main goals of preventive health care include the early detection of disease by screening, identifying and reducing disease risk factors, and improving the current disease processes. Moreover, early disease discovery in the latent stage facilitates prompt intervention, reducing morbidity and death. OBJECTIVE: To estimate the proportion of people who have availed preventive health check-ups in Perambalur and to determine the motivators and barriers to health check-ups among adults (age group: 18 years and above). MATERIALS AND METHODS: We conducted a cross-sectional study among the general population from September 2021 to November 2021. A total of 436 participants were included in the study. A structured questionnaire was used to collect the socio-demographic characteristics and preventive health check-up details, along with the motivators and barriers. The data were entered in Microsoft Excel (Microsoft, Redmond, WA), and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY). RESULT: The mean ± SD of the age of the general population was 52.27 ± 21.09. Out of 436 participants, only 130 (29.82%) had undergone preventive health check-ups in the past. The subjects with young age (p = 0.006), those who obtained COVID-19 vaccination (p = 0.001), subjects with stable occupation (p = 0.002), and those with higher education (p < 0.001) (chi-square test) had preventive health check-ups. A significant association was found between motivators and barriers for age, gender, education, occupation, marital status, the presence of comorbidities, and vaccination status against COVID-19. CONCLUSION: Preventive health check-up is still not up the ladder of health care for the general population. The health programmes should orient the public towards the concept of individual responsibility in health.

Regulating Enzyme Catalysis by Tailored Silver Nanocrystals Fabricated with Holigarna arnottiana-Synthesis, Characterization, and Performance Optimization.

Modification of catalytic expression of enzymes and regulating their in vivo activity are the goals of novel treatment strategies. A green synthetic nanostructured silver with potent trypsin inhibitory properties has not yet been developed, despite the fact that silver nanoparticles possess unique properties that allow them to efficiently block enzymes. The present study demonstrates for the first time a facile, safe, economic, and eco-friendly synthetic route for silver nanoparticles using an aqueous extract of Holigarna arnottiana bark engineered to interact with trypsin and hinder its activity effectively. The studies carried out to examine the interaction between these biofabricated AgNPs (HaAgNPs) and trypsin by UV-visible spectrophotometry and FTIR spectroscopy suggest that the formation of trypsin-HaAgNP complex is responsible for diminishing the catalytic efficiency of trypsin. In vivo studies on Aedes aegypti larval serum support these instrumental results of HaAgNP-induced trypsin inhibition and proves its application as a biopesticide. It is noteworthy that the bioengineered HaAgNPs were also found to have good inhibition potential against pepsin and urease as well. A variety of methods have been employed to characterize the synthesized biocompatible HaAgNPs and it possesses a characteristic absorption maximum of 420 nm. Their shelf life of above 7 years is noticeable, since none of the reported green synthesized AgNPs possess a shelf life of more than 1 year. Altogether, this work demonstrates that biofabricated HaAgNPs are multifunctional and cost-resilient biological tools that can be used as enzyme regulators possessing antioxidant, antimicrobial, and insecticidal features.

Variations and Associated Factors in Symptom-to-Balloon (STB) Time and Door-to-Balloon (DTB) Time Before and After the COVID-19 Lockdown: A Hospital-Based Cross-Sectional Study.

INTRODUCTION: During the COVID-19 lockdown, India saw a major restriction in the movement of people. Patients with acute myocardial infarction (MI) required early interventions and follow-up of independent predictors like symptom-to-balloon (STB) time and door-to-balloon (DTB) time. This study aimed to determine changes in STB and DTB time before and after the COVID-19 lockdown and its associated risk factors. METHODS: A hospital-based cross-sectional study of 105 patients admitted to the cardiac care units (CCU) of two tertiary care centers in a district of Southern India for six months was conducted to compare the changes in STB and DTB time before and after the COVID-19 lockdown (three months before March 2020 and three months after March 2020), and data was collected from medical records. The data collected was then entered into Microsoft Excel (Microsoft Corporation, Washington, USA), numerically coded, and analyzed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). The Chi-square and Mann-Whitney U tests assessed the association between the dependent and independent variables. The STB/DTB time (before and after the COVID-19 lockdown) was the dependent variable, while the age, gender, co-morbidities, smoking status, and date of admission of patients (before and after the COVID-19 lockdown) were taken as the independent variables. A p-value of <0.05 was considered statistically significant. The predictor variables were identified using the regression method, where all variables with a significance of <0.2 were taken. RESULTS: The overall mean (±SD) STB time was 408.7 (±307.1) minutes, and the mean (±SD) DTB time was 161.7 (±261.6) minutes. The pre-lockdown mean STB time was 404.6 minutes, and the mean DTB time was 153 minutes, whereas the post-lockdown mean STB and DTB time were higher at 413.3 minutes and 171.6 minutes, respectively. Out of the total 105 patients, 95 (90.5%) had an STB time of ≥120 minutes, and 77 (73.3%) had an ideal DTB time of <90 minutes. There was no statistically significant variation in the STB and DTB time before and after the lockdown. Only the age group >60 years (38 (97.4%)) was found to be statistically significant with an STB time of ≥120 minutes after the lockdown (p-value=0.040), and patients referred from primary and secondary care centers (AOR (95% CI)=4.669 (1.129-19.298)) were found to be an independent factor in reducing DTB time before and after the COVID-19 lockdown. CONCLUSION: The efficiency of the health system, irrespective of the COVID-19 lockdown, was observed; nevertheless, a delay in the overall recognition of symptoms of MI was perceived. The importance of time factors in identifying the symptoms of non-communicable diseases (NCDs), especially MI and stroke, has to be ascertained among the general population.

Effectiveness of video role play with PowerPoint lecture on knowledge domain among medical students-An open label randomized control trial.

BACKGROUND: Video is an effective teaching and learning tool as it is one of the few mediums that has been used effectually in all facades of medical education both with face-to-face teaching and at a distance. During a specified amount of space and time, video description can provide more details, converting complex concepts into simpler ones. The aim of the study is to assess the effectiveness of video role play (VRP) on knowledge domain among medical students. MATERIAL AND METHODS: The study was done as an open label randomized control trial among first-year medical students in a private medical college in a rural district in Tamil Nadu, where the subjects were randomized into two groups. The intervention group was given video role-play demonstration of the specified topic with a minute description. The control group was given PowerPoint lecture of the same topic. Baseline pretest and posttest score after two weeks was done to assess the effectiveness of video role play on knowledge domain among the students. RESULTS: The mean age of the population was 18.72 (0.71) years. The gender distribution showed that 70 (47.3%) were males and 78 (52.7%) were females. The result showed that Mean ± SD score of VRP posttest [9.36 ± 0.92] was significantly more in comparison with that of post score of PowerPoint [5.16 ± 1.98]. CONCLUSION: This concludes that VRP can act more effectively in understanding a lecture than using PowerPoint method. It is an interesting and exciting teaching-learning method involving the active participation of the students and the faculty.

Guts, Resilience, Integrity, and Tenacity (GRIT) Among Mid Adolescent School Students in a District of South India: A Cross-Sectional Study.

Background: Guts, Resilience, Integrity, and Tenacity (GRIT) is an optimistic character that mixes passion and dedication. It is a driver of achievement and success, independent of and beyond what intelligence and talent contribute. The study aimed to assess GRIT and factors influencing it among mid-adolescent school students (13-18 years) in the Perambalur district, Tamilnadu, India. Methods: A cross-sectional study was conducted among mid-adolescent school students. We used a self-reported questionnaire to collect the data on sociodemographic characteristics and parents' details and the standard eight-item GRIT questions. Analysis was done with the total and subscale scores. Results: Among the 1663 participants, 966 (58.1%) were males. The mean (SD) age was 15.6 (1.19) years. The mean GRIT score was 26.65 (4.12). Most students (755) showed medium (45.4%) GRIT scores. The age factor had a weak negative correlation with GRIT (r = -0.052, p = 0.033) and females had higher scores (t = 9.13, p = 0.002). Perseverance of effort was significantly more in those from a rural background (t = 1.9, p = 0.012), while consistency of interest was more in those from urban background (t = 0.63, p = 0.03). Conclusion: Most students had average or medium GRIT scores, with higher GRIT among females. The concept of GRIT should be properly addressed among children during their school years in order to inspire them to dream with passion and perseverance.

Anxiety and Stress During the COVID-19 Lockdown Among the General Population in Perambalur: A Cross-Sectional Study.

Background The coronavirus disease 2019 (COVID-19) pandemic and lockdown had a significant impact on mental health during the last two years. However, the majority of studies do not concentrate on the risk and protective factors that influence the relationship between COVID-19 and subjective well-being. Therefore, the present study aims to identify such stressful experiences and the influence of COVID-19 and various stressors. Methodology We have conducted this community-based, cross-sectional, analytical study in the Perambalur district of Tamil Nadu for four months. After obtaining approval from the Institutional Ethics Committee, we gathered data for the study. Two field practice areas were involved in data collection. A convenient sampling procedure was used to select 291 households for the study. The lead investigator interviewed one individual from each household, preferably the head of the family. A semi-structured questionnaire was used to collect the pertinent information. The Coronavirus Anxiety Scale (CAS), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder (GAD) scale were used to assess anxiety and stress. All collected data were entered into Microsoft Excel (Microsoft Corporation, Redmond, WA), and SPSS software version 21 (IBM Corp., Armonk, NY) was used to analyze the results. Results Among the participants, 34% had a history of COVID-19 infection, and 58.4% of the families had at least one chronic comorbidity among the family members. The CAS score was significantly associated with the residence (p = 0.049), marital status (p = 0.001), and previous history of COVID-19 (p = 0.016) of the study participants. The study found that gender was the only factor associated with both the PSS score (p = 0.022) and the GAD scale score (p = 0.010) of the study participants. Conclusions Even though doctors can treat many mental health illnesses for a comparatively minimal cost, there is still a wide disparity between those who require care and those who have access to it. Governmental programs and regulations that conduct routine surveys to identify anxiety and stress can lead to successful preventative strategies.

Water, Sanitation, and Hygiene (WASH) Practices Among Households in Perambalur District: A Cross-Sectional Study.

Background Sanitation, cleanliness, and access to clean water are essential for maintaining human health and well-being. Poor water, sanitation, and hygiene (WASH) practices are linked to diseases that lead to poor health outcomes, such as pneumonia and diarrhea, trachoma, infestations of soil-transmitted helminths, respiratory tract infections, and pulmonary tuberculosis. The aim of this study is to evaluate household WASH practices in the rural and urban field practice areas of the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, India, and identify the factors that influence them. Methodology We conducted a five-month cross-sectional survey with 278 households in the rural and urban field practice areas of a tertiary care center in Perambalur district. We gathered data using the core questions developed by the World Health Organization-United Nations Children's Fund (WHO-UNICEF) Joint Monitoring Programme (JMP), which is affiliated with UN-Water. Data analysts used a Pearson chi-square test to assess the relationship between WASH practices and several independent covariates, and we regarded P < 0.05 to be statistically significant. Results Among the 278 households, 118 respondents were from rural areas and 160 (57.7%) from urban areas. For drinking water, 31.4% of rural households used tube wells or boreholes, while 56.8% of those used public taps. In metropolitan areas, 25.6% of people used bottled water and 54.4% used water from tanker trucks. In terms of sanitation, 25.2% of households lacked a toilet and 72.7% used the flush/pour flush technique. Water, sanitation, and hygiene practices have been found to be associated with a population's socioeconomic status and place of residence. The Pearson chi-square test revealed that the rural population has 99.1% more improved drinking water sources than the urban population, which was statistically significant (P < 0.001). Conclusion In rural areas, nearly 92% of households used improved sources of drinking water compared to only 55% of households in urban areas. On the other hand, just 47.5% of households in the rural area had improved sanitation compared to 95% of households in the urban area. Therefore, the Indian government should take steps to enhance urban drinking water quality and rural sanitation infrastructure.

The Use of Sanitary Latrines and the Practice of Open-Air Defecation in a Rural Setup in Perambalur District: A Cross-Sectional Study.

Background Public health initiatives aim to decrease infectious diseases by enhancing sanitation, which is their primary goal. The practice of sporadically contaminating the environment with human feces has been around for generations and is embedded in the cultural behavior of villagers in India. This study aimed to estimate the proportion of people with access to latrine facilities and the proportion of people who practice open defecation in the villages of Perambalur, Tamil Nadu. Methodology This community-based, cross-sectional, analytical study was conducted in two rural villages in the Perambalur district for six months. After obtaining approval from the institutional ethics committee, we informed participants about the study's purpose. We conducted the study in selected rural areas and included every single residence in the hamlet, irrespective of whether the residents were permanent or temporary. We did not include families that were not reachable at any point during the survey. A convenient sampling procedure was used to select 330 houses for the study. The lead investigator interviewed one individual from each household, preferably the head of the family. A semi-structured questionnaire was used to collect the pertinent information. All collected data were entered into Microsoft Excel (Microsoft Corp., Redmond, WA, USA), and SPSS software version 21 (IBM Corp., Armonk, NY, USA) was used to analyze the results. Results Only around 3.6% of the study participants lived in kutcha households, and about 99.1% of participants identified as Hindu. The proportion of household latrines used was 64.1% among the study participants. Of them, 52.3% engaged in open defecation. Only 4.7% of participants had access to an underground drainage system. Most participants gained knowledge from medical professionals (84.8%). Social media was the second most used source, accounting for about 60.7% of the total. The most frequent reason given for practicing open-air defecation was the perception that constructing restrooms would be expensive (76.3%), while the second most frequent reason was a lack of land (53.4%). An independent t-test found no statistically significant relationship between the availability of household latrines and the number of girls or boys, age, or family income. Compared to those living in semi-pucca and kutcha households, most participants (77.3%) who lived in pucca houses had household latrines. The chi-square test revealed that this proportional difference was statistically significant (p = 0.0001). Conclusions The study participants used household latrines 64.1% of the time. Of the participants, 52.3% engaged in open defecation. The government's initiative to build toilets has only helped a quarter of the population, which needs to be improved. Only 5% of people living in rural areas have access to an underground drainage system. The results of our study provide a justification for the government program's mandate that healthcare practitioners must deliver health education. Therefore, a personalized approach is required to overcome the behavioral barrier among rural people and achieve behavior change.

Gender divides in the clinical profiles of patients with acute myocardial infarction at a tertiary care center in South India.

BACKGROUND: Early identification of myocardial infarction (MI) is a determinant in the provision of appropriate treatment modalities. The focus of the present study is on the identification of gender-based differences in risk factors, clinical manifestations, and coronary angiography findings in patients presenting with MI. MATERIALS AND METHODS: A cross-sectional study was conducted among patients admitted with MI at a tertiary care center in South India during March 2016 to June 2017. Selected 120 male and 120 female consecutive patients admitted with acute MI, who had survived and been stabilized. Data was collected using a pre-tested structure data sheet. Appropriate parametric and nonparametric tests were used to analyze the data. RESULTS: Participants were homogenous as regards age (P < 0.107); majority of men and women were from the rural areas. About 32.5% of the men interpreted the pain as due to a cardiac problem or indigestion, whereas 60.8% of the women thought it was fatigue/muscle pain. The self-interpretation or perception of pain in both genders was statistically significant (P < 0.001). Compared to the men, the females increasingly presented with atypical symptoms (P = 0.005). Regarding ST-elevated MI, male preponderance was noted (P = 0.004)). Considering the anatomical location of MI, the presentation of Inferior Wall Myocardial Infarction (IWMI) was predominant in females compared to men (P = 0.003). The majority of men had increased presentation of single-vessel disease compared to women (P = 0.02), whereas normal coronaries and double-vessel disease were found statistically significantly higher in females (P = 0.03 and P = 0.008, respectively). CONCLUSION: Public education is needed on the atypical presentations which are common with women than in men. The public should, therefore, be informed of those symptoms and how to recognize them so that they may seek medical care promptly.

Assessment of Stress, Resilience, and Coping Style among Medical Students and Effectiveness of Intervention Programs on Stress Level in South India: A Non-randomized Control Trial.

BACKGROUND: Uncontrolled stress can be made at ease through resilient emotions and higher coping skills. The study aimed at assessing the level of stress, resilience, and coping among medical students and to study the effect of stress intervention programs on the stress level. MATERIALS AND METHODS: This was a nonrandomized control trial among 526 medical students which used medical student stress questionnaire, and perceive stress scale (PSS), resilience assessment using a 25-item resilience scale, and coping using a modified Pareekh scale. After the completion of the preintervention assessment, the students were assigned nonrandomly into two groups (intervention group n = 272 vs. nonintervention group n = 254), and the stress intervention programs were done for one group without any programs for the other group. RESULTS: The study concluded that 246 (46.8%), 274 (52.1%), and 277 (52.7%) showed higher stress higher resilience and lower coping, respectively. The study showed that, with stress intervention programs, stress levels by PSS got significantly reduced by 2.64 scores. CONCLUSIONS: The study showed the presence of higher stress and resilience and lower coping among medical students. The inclusion of programs to reduce the stress among students showed a positive result and can be replicated.

Immunofluorescence and molecular diagnosis of bovine respiratory syncytial virus and bovine parainfluenza virus in the naturally infected young cattle and buffaloes from India.

Pneumonia in bovines is a multifactorial disease manifestation leading to heavy economic losses. Infections of bovine respiratory syncytial virus (BRSV) and bovine parainfluenza virus-3 (BPI-3) are among the important contributing factors for the development of pneumonia in young animals. These viral agents either primarily cause pneumonia or predispose animals to the development of pneumonia. Although, the role of BRSV and BPI-3 in the pathogenesis of pneumonia is well established, there are no reports of involvement of BRSV and BPI-3 from Indian cattle and buffaloes suffering from pneumonia. In the present investigation, we performed postmortem examinations of 406 cattle and buffaloes, which were below twelve months of age. Out of 406 cases, twelve (2.95%) cases were positive for BRSV and fifteen (3.69%) cases were positive for BPI-3, screened by reverse transcriptase polymerase chain reaction (RT-PCR). Further, positive cases were confirmed by sequence analysis of RT-PCR amplicons and direct immunofluorescence antibody test (d-FAT) in paraffin-embedded lung tissue sections. BRSV positive cases revealed characteristic findings of bronchiolar epithelial necrosis, thickened alveolar septa by mononuclear cells infiltration and edema; alveolar lumens were filled with mononuclear cells and numerous syncytial cells were seen having intracytoplasmic inclusions. The BRSV antigen distribution was found to be in bronchiolar and alveolar epithelium and syncytial cells in the lung sections. In fifteen cases, where BPI-3 was detected, bronchointerstitial pneumonia in the majority of cases with thickened alveolar septa by mild macrophage infiltration, hyperplasia of type-II pneumocytes and bronchiolar necrosis along with syncytial cells having intracytoplasmic inclusions in the majority of cases were observed. The BPI-3 antigen distribution was found to be in bronchiolar and alveolar epithelium and syncytial cells in the lung sections. RT-PCR amplicons of BRSV and BPI-3 obtained were sequenced and their analysis showed homology with already available sequences in the NCBI database. It is the first report of detection of BRSV and BPI-3 from pneumonic cases by RT-PCR and d-FAT from cattle and buffaloes of India, indicating the need for more epidemiological studies.

Evaluation of Serum Ferritin as a Prognostic Marker in Acute Hemorrhagic Stroke.

Background Acute hemorrhagic stroke (AHS) resulting from intracerebral hemorrhage (ICH) is a rampant neurological disorder with devastating consequences, particularly in Indians. Recently, serum ferritin levels have been related to adverse cardiovascular and stroke outcomes. We aimed to evaluate the prognostic utility of serum ferritin in AHS. Materials and Methods Admission serum ferritin levels were estimated in 50 AHS patients with primary supratentorial hemorrhage. Study subjects were categorized based on their prognostic scores in modified Rankin scale (mRS) assessment. Ferritin levels were compared across the study groups, correlated with mRS and other ICH severity indicators. Results Serum ferritin and other ICH severity indices such as Glasgow coma scale (GCS) and ICH volume were significantly altered in the mRS groups by the end of 7th and 30th days of hospitalization. Elevated ferritin levels, ICH volume together with decreased GCS, characterized the groups with adverse prognosis. Serum ferritin moderately correlated with GCS ( r = -0.643), ICH volume ( r = 0.562), and had significantly higher correlations with long-term prognostic scores of 7th day mRS ( r = 0.802) and 30th day mRS ( r = 0.916). Conclusion Elevated admission serum ferritin levels indicate poor AHS short-term and long-term outcomes, thereby making serum ferritin a possible prognostic index for the same.

Study of Pre and Post Operative Videostroboscopic Evaluation of Benign Vocal Cord Lesions.

To determine pre and postoperative vocal fold vibratory changes using videostroboscopy (VS) and effect of surgery on functional, physical and emotional levels of voice using voice handicap index (VHI). To determine correlation between VHI and VS in patients with benign vocal fold pathology. This is a prospective study done at Pushpagiri Medical College. 40 patients in the age group of 14-75 years who presented with complaints of voice change were included. VS and VHI of patients done preoperatively in 40 patients. Patients were re-evaluated postoperatively at 1 month by VHI and VS. All patients underwent microlaryngoscopic excision of the benign vocal cord lesion with biopsy under GA in the conventional manner. One month postoperatively, these patients were evaluated by VS and VHI and the findings noted. There was statistically significant improvement in the stroboscopy ratings and VHI scores post operatively (p < 0.0001). The mucosal wave was diminished or absent in 100% of the studied TVC cysts and present in approximately 60% of vocal polyps. There was no significant correlation found between preoperative VHI scores and stroboscopy ratings except for mucosal waves. Whereas there was significant correlation noted between the VHI subscales and total scores with stroboscopic scores postoperatively except for symmetry. All but 6 patients in this study benefitted from surgery and 85% had a normal voice post-operatively. Pre and post operative assessment of patients with benign vocal fold lesions by stroboscopy and VHI is a useful way to determine the degree of improvement following surgery.

Effectiveness of Color Coded Diabetic Control Monitoring Charts among Elderly Diabetics Attending Outreach Primary Care Geriatric Clinics in Rural Karnataka: An Open Label Randomized Control Trial.

INTRODUCTION: Type 2 diabetes mellitus problem is progressively rising every day. The adherence to the treatment approaches and health-seeking make major difference in case of diabetics particularly elderly. Visual tools improve the involvement of patients in their care, especially among populations with low health literacy. OBJECTIVE: To evaluate the effectiveness of color-coded diabetic control monitoring charts on glycemic control among elderly diabetics. METHODOLOGY: 144 elderly diabetic patients attending rural primary care geriatric clinics were randomized into two groups. Those randomized to the intervention group received the color-coded diabetic monitoring chart and a health education package in addition to the usual consultation services. Baseline and 1-year follow-up glycated hemoglobin (HbA1C) values were used to assess the effectiveness of the intervention. RESULTS: The results of multivariate linear regression analysis showed that there was an average reduction of 0.265% in HbA1C value in the intervention group when compared to the nonintervention group when adjusted for baseline HbA1C and number of visits during the intervention period (ß coefficient = 0.265, P < 0.05). CONCLUSION: Color-coded diabetes charts are effective in achieving glycemic control among elderly diabetics, and steps should be made to inculcate visually appealing management approaches in case of elderly diabetic patients.

Assessment of hashtag (#) campaigns aimed at health awareness in social media.

INTRODUCTION: The use of social media to disseminate major communications, particularly for campaigns related to days of health importance, is becoming much popular. The use of Twitter, Instagram, and Facebook is gaining an integral place in public life online with hashtag campaigns. OBJECTIVES: The objectives of this study were to assess the characteristics of hashtag campaigns related to health in social media and to compare three different campaigns in three commonly used social media platforms, namely, Twitter, Instagram, and Facebook. METHODOLOGY: This was a cross-sectional study which analyzed contents of three health-related campaigns in Instagram, Facebook, and Twitter. The campaigns were #let's talk (World Health day 2017), Hands up #HIV prevention (World AIDS day 2016), and #No tobacco (World No Tobacco Day 2017). Public posts related to each were searched from three platforms and assessed separately. Source, publicity, credibility, reach outs, and other characteristics were assessed among each campaign and comparison was also done among the three social media. RESULTS: Out of 812 posts, 507 (62.4%) were related to the study. Facebook posts were more related (67.33%), popular (45.05%), and authenticated (28.22%). Among the campaigns, # let's talk was more credible (96.33%) and authenticated (33.94%). Also in that, 57.79% from individual source and 79.82% were awareness related. CONCLUSION: Posts in social media related to hashtag campaigns are more credible, related, and less popular. These factors have to be considered for the campaigns to become an effective tool.