Determinants of substance use among young people attending primary health centers in India.

Background: Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods: A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results: The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions: High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.

A Smartphone-Based Assessment of Hearing Impairment among Students of a Medical College, Delhi, India- A Cross-Sectional Study.

Introduction: The burden of hearing impairment in India is substantially high, largely preventable, and avoidable. The present study aimed to estimate the prevalence of hearing impairment using a smartphone-based tool among medical students and to study the factors associated, including personal audio device usage in a medical college hospital in Delhi, India. Material and Methods: We conducted a cross-sectional study among undergraduate medical students. The study participants were enrolled via. Stratified random sampling. We assessed hearing impairment via-HearWHO application with scores ranging from a minimum of 0 to a maximum of 100 with categorization into i) above 75 ii) 50-75 iii) below 50. A p-value less than 0.05 was considered statistically significant. Results: A total of 96 study participants were included, with the mean age of study participants as 20.3±1.4 years. On assessment with HearWHO, 36 (37.5%) were in the category of score above 75, 51 (53.1%) in score category 50-75, and 9 (9.4%) in score below 50. The overall mean score of the hearing assessment was 68.9±13.4 (Range: 12 to 94). Among the earphone device users, 27.1% do not comply with volume alerts on user devices. Conclusion: Among the study population, 9.4% of the study participants were likely to be having hearing loss and 53.1% should be screened regularly for hearing impairment. Addressing hearing loss remains crucial among the young population, especially the medical professionals, which is feasible and imperative in the current scenario.

Contraceptive use and its consistency among eligible couples in a peri-urban area of Delhi, India: A secondary data analysis.

Background: Contraceptive use is important to stabilize population growth by reducing the net reproduction rate. The effectiveness of a contraceptive method is decided mainly by its consistent and correct use. Methods: A record-based study was undertaken with the aim to study the contraceptive usage and its consistency among eligible couples in a peri-urban area of Delhi, India. Data of 946 eligible couples were analysed. Descriptive analysis was performed and odds ratios were calculated. Results: Mean age of females was found to be 30.3 ± 5.5 years and males was 33.5 ± 6.4 years. About 56.2% (532) eligible couples have used contraceptive at least once in the past 6 months and 54.7% (517) used them consistently for 6 months of the study period. There were 12.3 pregnancies per 100 non-users, 2.2 pregnancies per 100 ever users and 1.9 per 100 consistent users (1.7 for condoms and 0.2 for OCPs). Couples having two or more children, having two or more male children and with less than five years of age difference between husband and wife were found to have significantly higher odds of ever and consistent contraceptive use compared to other eligible couples (P < 0.05). Conclusion: More than half of the eligible couples were found to be using contraceptives ever in past 6 months, and 54.7% of eligible couples were using them consistently. There is a need to explore social, cultural factors, awareness levels associated with the ever and consistent use of contraceptives for improving overall couple protection rate and enhancing the consistency in usage.

Determinants of substance use among young people attending an urban primary health center in Delhi.

INTRODUCTION: Substance abuse remains one of the major challenges in young people, as it is one of the top five causes of disability-adjusted life years (DALY). The present study aims to find the prevalence and determinants of substance use among young people attending an urban primary health center in Delhi. METHODOLOGY: Systematic random sampling was used to enroll the calculated sample size of 190. Substance use was assessed using ASSIST (an Alcohol Smoking Substance Involvement Screening Tool) and brief intervention was given based on the standard guidelines of ASSIST. The total score among the substance users is calculated and divided into Grades 1, 2 or 3. Log binomial regression was performed to quantify the association between substance use and covariates such as age, sex, education, occupation, family history of substance use, socio-economic status and family type. The association was expressed in odds ratio (OR) with 95 percent confidence interval (CI). RESULT: The mean age of study participants was 18.6 ± 4.1, ranges from 10 to 24 years. Out of 48 substance users, 43.7% were consuming only tobacco, 22.9% were consuming only alcohol and 33.3% were polysubstance users. The history of substance use among family members of participants was found to be 46.3%. Median substance involvement score of tobacco, alcohol and cannabis users was 19 (IQR: 14.5-22), 19 (IQR: 13.5-25) and 22.5 (IQR: 22-23), respectively. Among tobacco users, 2.7% were Grade 1 and 7.2% were Grade 2. Four (16%), 20 (80%) and one (4%) of alcohol users were Grades 1, 2 and 3, respectively. Among the cannabis users, four (100%) were in the Grade 2 category. The median age of initiation of substance use among users was 16 (range 13-21) years. The analysis shows substance use was almost 25 times (adjusted OR = 25.84, 95% CI 5.65-118.09) more common among males and it increase by 2.5 times with a decrease in socio-economic status (adjusted OR = 2.52, 95% CI 1.27-5.02) and the result is significant. The substance use was almost 7 times higher when there is a family history of substance usage (adjusted OR = 7.40, 95% CI 2.15-25.4). Residential and marital status were not significantly associated with substance use. CONCLUSION: Male sex, lower socio-economic status, participants currently not going to school/college, family history of substance use were found to be significant predictors of substance use among the study participants.

Role of antibiotic class in the rate of liberation of endotoxin during therapy for experimental gram-negative bacterial sepsis.

To evaluate the role of antibiotic class in the rate of liberation of endotoxin during therapy for sepsis caused by gram-negative bacteria, we obtained serial blood samples from rabbits with sepsis caused by Escherichia coli and treated with chloramphenicol, gentamicin, or moxalactam. The concentrations of viable bacteria, free endotoxin, and total endotoxin in each blood sample were measured. In rabbits treated with chloramphenicol, the geometric mean levels of free endotoxin remained proportional to the geometric mean levels of bacteremia, a result indicating the absence of antibiotic-induced endotoxin liberation. In contrast, levels of free endotoxin increased rapidly while levels of bacteremia declined after treatment with gentamicin or moxalactam, a result indicating antibiotic-induced release of endotoxin. Despite similar rates of bacterial killing, mean levels of free endotoxin were as much as 20-fold higher in rabbits treated with moxalactam than in paired rabbits receiving gentamicin (P less than .05). These results indicate that endotoxin liberation during therapy for sepsis caused by gram-negative bacteria is dependent upon the class of antibiotic administered and is not necessarily correlated with the rate of bacterial killing.

Kinetics of endotoxin release during antibiotic therapy for experimental gram-negative bacterial sepsis.

For study of the kinetics of endotoxin release from bacterial cells during therapy for gram-negative bacterial sepsis, serial blood samples were obtained from rabbits with Escherichia coli sepsis that were treated with either antibiotic or placebo. The concentrations of viable bacteria, free endotoxin, and total endotoxin in each blood sample were quantitated. In animals treated with placebo the concentration of free endotoxin was proportional to the level of bacteremia. In contrast, in animals treated with antibiotic the plasma levels of free endotoxin increased 10- to 2,000-fold, in spite of decreasing levels of bacteremia. Free endotoxin that was present in the plasma following antibiotic treatment appeared to be derived in part from the breakdown of circulating bacteria and in part from the disintegration of bacteria in tissues other than the blood. The results of this study demonstrate that significant amounts of endotoxin are released from bacterial cells following administration of antibiotics in vivo.