Sleep Attributes Influencing Cardiovascular Morbidity Among Young Adults Pursuing Professional Courses in Dehradun, India: A Cross-Sectional Study.

Cardiovascular diseases (CVDs) are evolving as a cause of mortality and morbidity among young adults. Young adults, particularly those pursuing professional courses in colleges, face unique challenges that may influence their risk of developing CVD. Despite screening guidelines, CVD risk factors often go undetected in the young population, highlighting the need for increased awareness among adolescents. Sleep is an essential indicator of well-being, and its impact on cardiovascular risk factors is increasingly being recognized. An observational cross-sectional study was conducted among young adults aged 18 to 24 years pursuing professional courses in Dehradun, Uttarakhand, India. A total of 156 participants were recruited through multistage, systematic random sampling, and snowball sampling. Data on sleep patterns and cardiovascular morbidity were collected using a pretested questionnaire. Among the study participants, 46.8% reported having less than four hours of sleep on average, and 25% were suffering from sleep problems. The prevalence of diagnosed CVDs was low, with 6.14% reporting arrhythmias and 3.84% reporting hypertension. An association was found between sleep duration, sleep problems, and the presence of CVDs. Participants with shorter sleep durations and more severe sleep problems had a higher prevalence of CVDs. The findings suggest that sleep duration and sleep problems may be modifiable risk factors for CVDs among young adults. Effective health promotion activities focusing on behavior and lifestyle modifications are essential to preventing CVDs from an early age. The study emphasizes the importance of early intervention and health promotion strategies to reduce CVD risk factors in this population. Community-based research and behavior change communication initiatives are recommended to promote healthy sleep habits and prevent cardiovascular diseases among young adults beyond the college setting.

Assessment of Communication Skills in MBBS Interns with Objective Structured Video Examination (OSVE).

Background: Medical graduates enter work force with substantial knowledge but are they prepared for practice in diverse settings? To train medical interns in communication skills using Demonstration Observation Assistance and Performance (DOAP) and to assess communication skills in medical interns using objective structured video examination (OSVE). Methods and Materials: DOAP sessions of all 27 interns posted in Community Medicine and Pediatrics departments during the duration of the study were conducted in six clinical scenarios followed by two OSVEs. Methods and Material: Interns performed selected activity independently twice for assessments. Videos submitted by interns were assessed by Gap Kalamazoo assessment forms (OSVE). Data analysis was done by appropriate methods. Percentages and proportions and calculation of median scores with interquartile ranges. Results: Seventy one point four percent of faculty and 96.3% of interns were satisfied with module implementation. More than = 57.8% marks were scored by 94.45% interns in self-assessment and faculty assessment and by 100% interns in patient assessment. Median scores of all second assessments were higher. Conclusions: DOAP method is good for training of interns in communication skills. OSVE may be an appropriate assessment tool as it leads to progression in learning.

Epidemiological Correlates of Substance Abuse Among In-Facility Clients of De-addiction and Rehabilitation Centres of District Dehradun: A Cross-Sectional Study.

Background The increasing production, distribution, promotion, and availability of substances contemporaneous with the changing values of society have resulted in rising substance abuse as an emerging public health concern in India. A prevalence of 32-37% has been reported for substance abuse in various studies conducted in Uttarakhand but there is a dearth of data on socio-epidemiological factors affecting substance abuse. Materials & methods A facility-based observational cross-sectional study was conducted in selected de-addiction and rehabilitation centers of district Dehradun. Data were collected using multistage systematic random sampling from clients admitted to the facility. Results The mean age of in-facility participants was 28 ± 8 years and most of them started taking drugs after the age of 18 years. The most common substance of abuse was alcohol (61.7%) followed by tobacco smoking (15.6%). Both 'peer pressure' and 'curiosity' play a major role in predisposition to substance use. Further, we found that age (p=0.002), and level of education (p <0.001) were important determinants for substance abuse. At the same time, among other factors, the influence of occupation notably did not have a statistically significant association. Conclusion Sensitization and capacity building of both providers and the community is integral to effective strategizing for the prevention and control of substance abuse. Regional studies including the current study can be of help in framing drug policies and management guidelines including prioritizing the importance of the establishment of de-addiction and rehabilitation centers at the district level.

Knowledge, Attitude and Practices of Postpartum Females Regarding the Acceptance of Immediate Postpartum Contraception: A Cross-Sectional Study From North India.

The immediate postpartum period is a great time to encourage the acceptance of contraceptive methods; the time is influenced by both emotional and physical factors. At this stage, the administration of intrauterine contraceptives is relatively easier with lesser complications due to the prior obstetric event. A single-center cross-sectional study was conducted using a self-constructed questionnaire-based interview on 331 women in their immediate postpartum period who had delivered a healthy live-born infant. The majority (59.8%) of study participants had unplanned pregnancies. We conducted behavior change communication sessions for postpartum family planning which resulted in 89% of participants accepting the methods with the prime reasons for acceptance being temporary child spacing (41%) and a definitive desire for no more children (34%). The odds were higher in women with more than five pregnancies [adjusted odds ratio (AOR) = 1.951, 95% CI = 1.389-2.925] and women whose last pregnancy was planned [AOR = 1.248, 95% CI = 1.002-3.215].The hindrance to adopt and adhere to postpartum contraception stems from a variety of socio-economic factors which are unique to low-income countries. Individually tailored behavior change communication/counseling approaches may help overcome misconceptions and meet the heterogeneous needs for family planning in the immediate postpartum phase.

Thyroid Function Abnormalities in the Acute Phase of COVID-19: A Cross-Sectional Hospital-Based Study From North India.

Introduction Viral illnesses like mumps, cytomegalovirus (CMV), and Cocksakievirus have been shown to affect the endocrine system, specifically the thyroid as a product of their systemic inflammatory process. The thyroid gland, having high levels of angiotensin-converting enzyme 2 (ACE2) is also predisposed to dysfunction due to coronavirus disease 2019 (COVID-19). Methodology A cross-sectional study was conducted using retrospective data of thyroid function tests in patients with COVID-19. Results The majority of patients with COVID-19 had normal thyroid function while low serum T3, seen in 47.3% of patients with severe disease, stood out as the most common thyroid abnormality in the acute phase of the disease. The disease severity was seen to correlate with the extent of thyroid function abnormalities, with severely diseased patients having lower T3 values and normal to low thyroid-stimulating hormone (TSH) values. Furthermore, a significant negative correlation was seen between TSH and the bio-inflammatory marker, C-reactive protein (CRP). Conclusion The acute phase of COVID-19 affects thyroid function in direct correlation with the severity of the disease.

Predictors of Stroke Subtype and Severity in Patients of a Tertiary Care Hospital, Dehradun.

CONTEXT: Stroke caused 6.7 million deaths worldwide in 2013. In India, the cumulated incidence of stroke was 105-152/100,000 persons per year in last decade. Dearth of data on predictors of stroke subtype and severity in India lead to this study. AIMS: (1) To categorize presenting stroke patients by subtype and severity. (2) To establish association of risk factors with above. (3) To predict subtype and severity by risk factors. SETTINGS AND DESIGN: Hospital-based cross-sectional analytic, retrospective study. SUBJECTS AND METHODS: A predesigned, pretested, semi-structured questionnaire with standard tool (National Institute of Health Stroke Scale Score), informed consent after prior approval of institutional ethics and research committees. STATISTICAL ANALYSIS USED: Percentages, proportions, Chi-square trends, linear regression, independent t-test, and analysis of variance (ANOVA). RESULTS: Mean age of 102 patients was 62.1 (±12.8 years). Stroke subtype associated with socioeconomic status (χ2 = 6.38775, P = 0.0115) and stroke severity (χ2 = 18.98, P = 0) and stroke severity associated with stroke subtype (χ2 = 9.79366, P = 0.0018). Stroke subtype could be predicted by stroke severity and stroke severity by subtype, sex, and dyslipidemia (regression models). Independent t-test revealed excessive alcohol intake was a significant predictor and one-way ANOVA revealed education was a significant predictor of severe stroke. CONCLUSIONS: Stroke subtype is significantly associated with higher socioeconomic status and severe stroke. Stroke severity is significantly associated with hemorrhagic stroke. Stroke subtype, sex, dyslipidemia, alcohol intake, and education may act as predictors of stroke severity.

Medical students' perspective on online teaching during pandemic: Experience from a Government Medical College in Uttarakhand, India.

BACKGROUND: COVID-19 pandemic has forced medical education to undergo sudden metamorphosis from the traditional face-to-face education to distance online learning. This transition was dealt with a lot of infrastructure and technical difficulties from both teacher and learner ends, especially in a developing country like India. This study was conducted with the aim of analyzing students' perspective and problems faced in the live online teaching. MATERIALS AND METHODS: This was a prospective longitudinal study conducted on medical students enrolled in the 1st, 2nd, and 3rd years of Bachelor of Medicine and Bachelor of Surgery courses at a government medical college located in hilly state Uttarakhand, India. Clearance from the institutional ethical committee was obtained. The students were invited to voluntarily participate in online survey by filling Google Forms which was E-mailed as well as shared in social media platform. A total of 237 medical students participated. The first survey was conducted at the time of initiation of online mode of teaching, during May 1-7, 2020, and second, after completion of 6 months of regular online teaching, during November 1-7, 2020. The questionnaire comprised initial section on demographic details and consent followed by 27 and 30 sets of statements pertaining to online medical education experience in the first and second questionnaires, respectively. A 5-point Likert scale was used. Data were analyzed using IBM SPSS version 24.0. Chi-square test was applied for association, and P ≤ 0.05 was considered statistically significant. RESULTS: A total of 237 students participated in the study. The response rate was 52.7%. Majority of respondents had suitable devices (89.1%) and Internet facilities (62%) for online classes. The students accepted the new method of teaching very well, but for practical sessions and clinics, traditional classes were necessary. Long screen time, lack of student-teacher interaction, and interaction with peers were major concerns of students. However, over the study period, the availability of resources, friendliness toward technology, and inclination toward virtual classes increased. CONCLUSIONS: The pandemic has introduced to a new normal where online teaching cannot be ignored. Despite challenges faced during online learning, 65.5% of students preferred hybrid teaching in future for delivering medical education. Acceptance for online education by students increased over time in the study.

Prevalence of Internet Addiction, Poor Sleep Quality, and Depressive Symptoms Among Medical Students: A Cross-Sectional Study.

OBJECTIVES: This objective of the study was to report the prevalence of internet addiction, sleep quality, depression, anxiety, and stress in undergraduate medical students. METHODS: A cross-sectional, questionnaire-based study was conducted among 221 undergraduate medical students at Government Doon Medical College, Dehradun, Uttarakhand. Data pertaining to internet addiction, sleep quality, and depressive symptoms were also collected using validated and reliable questionnaires (Young Internet Addiction Test, Pittsburgh Sleep Quality Index, and Depression Anxiety Stress Scale 21). RESULTS: The prevalence of poor sleep quality, severe anxiety, and severe depression was 33.9%, 7.3% and 3.6%, respectively. The place of residence was significantly associated (p = 0.006) with internet addiction. The mean Young Internet Addiction Test score was higher in students residing in hostels compared with students staying with families. Stress was associated with age. The mean stress score was higher in the age group 17-20 compared with the 21-24 age group. Stress and depression were independent predictors of sleep quality. CONCLUSION: Quality sleep is the key for good health. Based on limited samples, this study showed that poor sleep quality was associated with stress and depression. Hence, continuous counselling is suggested for supporting students managing their stress and depression.