Untapped potential of commercial drivers in providing post-crash care to road traffic accident victims: A cross-sectional study from fast urbanizing city of Jodhpur, India.

Objectives: Most road traffic accident (RTA) deaths occur before victim reaches a definitive trauma care facility. The aim of the study was to determine the role of commercial drivers toward providing post-crash care to RTA victims in Jodhpur, Rajasthan. Materials and Methods: This cross-sectional study assessed the role of commercial auto-rickshaw and cab drivers for providing post-crash care in urban Jodhpur during 2019-2020. Eligible participants volunteering for the study were included from taxi and auto stands in urban Jodhpur. A pre-tested questionnaire was administered by a trained interviewer. Data analysis was done using SPSS v23.0. Summary measures in terms of frequencies, means, and range are reported. Chi-square test, Fisher's Exact test, and Multivariate Logistic Regression analysis were done for statistical associations. Results: Two hundred male participants completed the study with a mean age of 37.74 (8.96) years having an average work experience as commercial drivers of more than 10 years. Over 70% of participants witnessed RTA in the past year and 52% provided care to victims. The knowledge of post-crash care was most affected by their education level (adjusted odds ratio [aOR]: 1.778, 95% confidence interval [CI]: 0.958, 3.301), whereas the intended post-crash care practices were significantly better among participants with previous training (aOR: 15.376, 95% CI: 2.149, 110.017). Conclusion: The current study establishes the role of commercial drivers as first responders at accident sites in the fast urbanizing city of Jodhpur, Rajasthan. Systematic capacity building initiatives of commercial drivers to salvage RTA victims have potential to strengthen pre-hospital trauma care continuum in non-metro districts of India experiencing high burden of accidents.

Role of Short-Term Estradiol Supplementation in Symptomatic Postmenopausal COVID-19 Females: A Randomized Controlled Trial.

BACKGROUND: Protective role of estrogen in COVID-19 was speculated once the epidemiological studies reported increased susceptibility of estrogen-deficient population - males and postmenopausal females to severe disease category and involvement of angiotensin-converting enzyme 2 receptors and renin-angiotensin- aldosterone system in pathophysiology. MATERIALS & METHODS: An open-label randomized controlled trial was planned to assess the efficacy of short-course oral estradiol in preventing the clinical progression to severe disease and reduce case-fatality rate and the hospital stay duration in estrogen-deficient postmenopausal women. The intervention group (n = 40) received 2 mg per day of estradiol valerate per orally for 7 days along with the standard care, while the control group (n = 40) received only the standard care. RESULTS: A significant difference was observed in the rate of reverse transcriptase-polymerase chain reaction negativization in the intervention versus control group at day 5 and day 7 of admission (42.5% vs. 15%, P = 0.007; 72.5% versus 50%, P = -0.026). No significant difference was noted in the duration of hospitalization (P = 0.213). A significant decrease was noted in the mean values of inflammatory biomarkers - D-dimer, lactate dehydrogenase, and C-reactive protein on day 5 in the intervention group. Interleukin-6 also showed a declining trend on day 5 in the intervention group, while a rising trend was noted in the control arm. Only one case (2.5%) in the intervention group while seven in the control group (17.5%) progressed to the moderate category; however, the difference was not statistically significant (P = 0.057). CONCLUSION: Oral estradiol in postmenopausal females can be a novel and efficient option for managing nonsevere COVID-19 infection.

Anxiety Disorder in Homemakers of Kumaon Region of Uttarakhand, India.

BACKGROUND: Anxiety is graded as the sixth major contributor to nonfatal health loss worldwide and is included in the top ten causes of years lived with disability. National Mental Health Survey 2015-2016 too reported the prevalence of anxiety spectrum disorders as 3.5%, and way higher among females than males. The present study was undertaken to find the prevalence of anxiety disorders in homemakers aged 15-59 years and identify factors causing anxiety disorders in this population. METHODS: In the present cross-sectional study, a total of 324 ever-married, apparently healthy women aged less than 60 years were included using systematic random sampling from the four selected urban areas after applying proportional sampling. A generalized anxiety disorder-7 (Hindi version) questionnaire was used for screening the anxiety disorders. Additional information was collected using a pretested questionnaire for assessing determinants. The data so collected were coded and compiled in MS Excel and analyzed using IBM®SPSS® Statistics (version 17.0). RESULTS: Forty-four (13.6%) out of 324 women were screened positive for anxiety disorder. Moderate anxiety was present in 10.2% and severe anxiety in 3.4% of study subjects. Anxiety symptoms were significantly higher among women with perceived economic instability 4.3 (95% CI 1.5-12.2) and non-cordial relation with family members (11.5 [95% CI 2.4-55.5] with in-laws and 20.2 [95% CI 4.3-94.2] with husband) Health of the children was also seen to be major reason of anxiety (31.1 [95% CI 3.8-256.6]). CONCLUSION: Anxiety disorder is a significant mental health problem affecting over 13% homemaker women in the Kumaon region of Uttarakhand, India.

Smartphone use and the quality of life of medical students in the Kumaun Region, Uttarakhand.

BACKGROUND: Once a device for telecommunication, now a powerful device bringing the whole world in one's palm, smartphones are increasingly becoming a common commodity among the medical students. Smartphones foster social interaction and facilitate multitasking and learning, but they also have some adverse effects. Young people, especially students, who are always inquisitive towards new technology, are likely to be affected by both these positive and negative impacts. OBJECTIVE: To assess smartphone use and its association with the quality of life (QOL) of medical students. MATERIALS AND METHOD: A cross-sectional study was conducted among the undergraduate medical students of Government Medical College (GMC), Haldwani. All the students enrolled in MBBS course in GMC, Haldwani, who gave consent for participation and were present on the day of questionnaire administration, were included in the study. Smartphone addiction scale (SAS-SV), and WHO-BREF questionnaires for QOL were used for assessing smartphone use, and QOL of the medical students, respectively. RESULTS: A total of 395 medical students were included in the study; out of them, 42% considered themselves addicted to the smartphone. According to SAS-SV, smartphone addiction was found among 43.8% medical students. It was seen that the junior-most and senior-most batches were significantly less addicted to the smartphone (p-value < 0.001). Male students were more addicted (OR = 1.45, CI = 0.962-2.174) to the smartphone as compared to females. The QOL of the students was significantly affected by smartphone use in all domains assessed (p-value ranging from < 0.001 to 0.002). CONCLUSIONS: Smartphone addiction is high among medical students and it has a significant negative impact on their QOL.

Review of Lot Quality Assurance Sampling, Methodology and its Application in Public Health.

Rapid collection of data is of utmost importance in monitoring and evaluation of activities of public health importance. Among others techniques, 30 by 7 cluster sampling and Lot quality assurance sampling(LQAS) methods have been described in literature for this purpose. However, LQAS is often sparingly used in most settings, undermining its importance as a effective epidemiological tool in public health practice. To some extent LQAS is inadequately understood and even less emphasized method, especially in the postgraduate teaching and training. In this paper we aim to explain the use, method and application of LQAS in public health settings as well as discuss common pitfalls to avoid while planning and drawing inferences based on data collected through LQAS.

Coping mechanism used by homemakers in Kumaon region (Uttarakhand, India) to deal with stress in their day-to-day life.

CONTEXT: Chronic stress, if not appropriately addressed, can cause a variety of mental health disorders. In patriarchal societies like India, little is known about the coping mechanisms used by homemakers to deal with stress in their lives. AIM: To identify usual coping mechanisms used by the homemakers residing in Kumaon region, India, to deal with stress in their day-to-day lives. SETTINGS AND DESIGN: This is a population-based, cross sectional study done in the urban field practice area of a teaching tertiary care health facility in the Kumaon region of Uttarakhand, India. MATERIALS AND METHODS: A total of 324 ever-married, apparently healthy homemakers age 18-59 years residing in the area for at least 6 months were interviewed. Systematic random sampling along with population proportionate to size method was used to recruit study participants. Pretested, semi-structured questionnaire was used to elicit information on coping mechanisms used by the study participants. Standardized questionnaires were used to determine possible depressive or anxiety disorders. STATISTICAL ANALYSIS: Data were entered in Microsoft Excel Sheet followed by analysis in SPSS and Epi Info. Chi-square test, Chi-square for trend, and Fisher's exact test were used. RESULTS: Multiple ways including praying, watching TV, taking care of children, and talking to family and friends were identified as the usual coping mechanism used by study participants. Coping mechanism varied with the mental health status and other sociodemographic characteristics of the study participants. CONCLUSION: Coping strategy was predominantly "emotion-based" in the study population. Understanding of usual coping mechanism used by women may help counselors and clinicians in fine-tuning their therapeutic approach as per needs and preferences of such women.

Caregiver burden on wives of substance-dependent husbands and its correlates at a Tertiary Care Centre in Northern India.

BACKGROUND: Substance dependence is well recognized as a complex biopsychosocial phenomenon. Complications arising out of it not only impairs life of substance-dependent patient but also causes enormous burden on their caregivers. Little attention has been paid to the relationship between caregiver burden and substance use. OBJECTIVES: The study was conducted to assess and compare the quantum of burden on wives of alcohol and heroin-dependent patients and also to determine the correlation between sociodemographic factors and caregiver burden. METHODS: A cross-sectional study was conducted at a tertiary care center of North India to compare burden on wives of alcohol and heroin dependent husbands. Burden was assessed using burden assessment schedule (Sell et al.). Data obtained were analyzed using SPSS software. RESULTS: Wives of both alcohol and heroin dependent patients had moderate-to-high burden of caregiving (Score of 38.1 out of maximum 60), those of heroin dependent patients perceived more burden in the factors of "impact on marital relationship," "appreciation of caregiving," "impact on relation with others," and overall burden as compared to wives of alcohol-dependent patients. Significant negative correlation was found between "impact on marital relationship," "appreciation of caregiving," and "impact on relation with others" scores and patients' education status as well as between "appreciation of caregiving" score and wives' age where higher score denotes more burden. CONCLUSION: Significant burden exists on wives of substance-dependent patients; thus management plans must be devised aiming not only patients but also wives so as to reduce burden.