Does Vitamin D3 Supplementation Improve Depression Scores among Rural Adolescents? A Randomized Controlled Trial.

BACKGROUND: Contemporary evidence has been established demonstrating that stunted vitamin D levels are associated with depression, poor mood, and other mental disorders. Individuals with normal vitamin D levels have a much lower probability of developing depression. Improving vitamin D levels by supplementation has shown betterment in depressive patients among different age groups. The objective of this study was to assess the effect of vitamin D supplementation on depression scores among rural adolescents. MATERIAL AND METHODS: This study was a cluster randomized controlled trial carried out for a period of 3 years among adolescents from rural Kolar. The sample size was calculated based on previous research and was determined to be 150 for each group. The intervention arm received 2250 IU of vitamin D, and the control arm received a lower dose of 250 IU of vitamin D for 9 weeks. To assess sociodemographic status, a pretested, semi-structured questionnaire was used, and, to assess depression, the Beck Depression Inventory (BDI-II) was used. A baseline assessment was carried out for vitamin D status and depression status, followed by a post-intervention assessment. From the start of the trial, the participants were contacted every week by the pediatric team to investigate any side effects. RESULTS: Out of 235 school students in the vitamin D supplementation arm, 129 (54.9%) belonged to the 15 years age group, 124 (52.8%) were boys, and 187 (79.6%) belonged to a nuclear family. Out of 216 school students in the calcium supplementation arm, 143 (66.2%) belonged to the 15 years age group, 116 (53.7%) were girls, and 136 (63%) belonged to a nuclear family. By comparing Beck depression scores before and after the intervention, it was found that the vitamin D intervention arm showed a statistically significant reduction in Beck depression scores. CONCLUSIONS: The present study showed that vitamin D supplementation reduced depression scores, showing some evidence that nutritional interventions for mental health issues such as depression are an excellent option. Vitamin D supplementation in schools can have numerous beneficiary effects on health while mutually benefiting mental health.

To determine the survival, prevalence and associated factors of exclusive breastfeeding practices in South India.

Context: Exclusive breastfeeding (EBF) provides protection to the child from risk of obesity, overweight, type II diabetes and helps in enhancing brain development, learning capabilities and also reduces gastrointestinal infections. Breast problems, societal barriers, insufficient support, poor knowledge, mode of delivery and community beliefs are associated. Aim: To determine the survival and prevalence of exclusive breast-feeding practice and their associated factors. Settings and Design: An ambispective community-based observational study was conducted. Materials and Methods: A sample of 441 mothers was estimated with a prevalence of EBF of 54.9% based on the National Family Health Survey 2015-16. Study Procedure: The selected mothers with an infant less than one year of age and those with infants less than six months were interviewed retrospectively and prospectively and information on the duration of EBF, demography and factors associated were collected. Statistical Analysis Used: The data were analysed using IBM SPSS, version 22. The Chi-square test and binary logistic regression were used to determine the associated factors for EBF. A P value of <0.05 was considered significant. Results: EBF survival rate was good till three months and decreased drastically after five months. EBF practice in the present study was 69.4%. Birth order, maternal age, birth weight, paternal education and religion were significantly associated with EBF. Conclusion: Primary health care providers in the community should also consider the cultural factors and educate the mothers on the practice of EBF to reduce morbidity and mortality and promote better health for a healthy, strong, younger population.

Is Sunshine Vitamin Related to Adolescent Depression? A Cross-Sectional Study of Vitamin D Status and Depression Among Rural Adolescents.

BACKGROUND: Adolescence is the phase of rapid transition of the body. The requirement of all minerals and vitamins changes in this phase of life so does Vitamin D. Despite Vitamin D being abundantly available, its deficiency, which can cause innumerable side effects on the body, is extremely common among the general population.  Material and methods: The present study was a cross-sectional study carried out from January 2021 to July 2022 for two years at various government rural high schools in Kolar, Karnataka, India. All adolescents who were aged 11-18 years and studying in 9th and 10th standards were included in the study after consent and assent. Adolescent boys and girls with any pre-existing mental health illness were excluded from the study. To assess depression, Beck's Depression Inventory (BDI-II) was used. Vitamin D3 levels were assessed by using VITROS Immunodiagnostic products using a 25-OH Total reagent pack. All data were entered in a Microsoft Excel sheet (Redmond, USA) and analyzed using IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. To check for the association between factors, Chi-square was applied with a level of significance defined as a p-value less than 0.05. RESULTS: Out of 451 students, 272 (60.3%) belonged to the 15-year age group, 224 (49.7%) were boys, 235 (52.1%) were studying in 10th standard, 323 (71.6 %) belonged to nuclear families, 379 (84%) were non-vegetarian by diet, 222 (49.2%) had sun exposure in the afternoon, and 156 (34.6%) had a sun exposure of fewer than 60 minutes, 133 (29.5%) had severe depression according to Beck's Depression Inventory-II. One hundred sixty-two (35.9%) had insufficient Vitamin D3 levels (12-20 ng/ml), and 66 (14.6%) had deficient levels of Vitamin D3 (less than 12 ng/dl). There was a statistically significant association between depression and Vitamin D3 levels. CONCLUSION: There are innumerable causes of adolescent depression. The present study shows Vitamin D levels were statistically associated with depression among adolescents. Vitamin D supplementation of at least 600 international units, which is the recommended dietary allowance (RDA), could be beneficial in tackling Vitamin D to sufficiency status (20-100 ng/ml) and also indirectly address Adolescent Depression. Better study designs, like randomized control trials showing Vitamin D intervention and its possible curative role in adolescent depression, are required to establish the causal association.

Outcome of Treatment in Locally Advanced Upper Alveolar Carcinoma Extending to Infra-temporal Fossa.

Squamous cell carcinoma of oral cavity has a high prevalence in our region. Upper alveolar cancers are uncommon but present with locally advanced disease extending to infra temporal fossa. The outcome of treatment in these tumors is poor. Surgery followed by adjuvant therapy is the mainstay of treatment. We are presenting a retrospective analysis of outcome of treatment in 20 patients with locally advanced (T4b) upper alveolar carcinoma treated by infra-structure maxillectomy with compartment resection of infra-temporal fossa and neck dissection followed by adjuvant radiotherapy or radiotherapy with chemotherapy. Study period was from 2013 to 2018. Minimum follow up was 12 months and mean follow up 30 months. 12 patients are alive and disease free, 6 patients had local recurrence and 2 patients had regional recurrence with one having pulmonary metastasis. We observed that positive or close margins (< 5 mm after formalin fixation) predisposed to early recurrence. Erosion of pterygoid plates was a poor prognostic factor. Cervical lymph node metastasis occurred late in disease, but carried poor prognosis. Compartment resection of infra temporal fossa gave better outcome compared to other studies which reported outcome of treatment in upper alveolar cancers.

Awareness, practices, and myths related to coronavirus disease-19 among rural people in Kolar District, South India: A community-based mixed-methods study.

BACKGROUND: Capturing the baseline information on awareness, practices, and prevailing myths related to the ongoing coronavirus disease-19 (COVID-19) pandemic in rural India will help in planning interventions to improve the health literacy on COVID-19. The aim of the study was to assess the level of awareness, practices, and myths regarding COVID-19 among rural population of Kolar district in South India. MATERIALS AND METHODS: A concurrent mixed-methods study with a quantitative community-based cross-sectional analytical design and a qualitative phenomenological design was conducted in five randomly selected villages during June 2020. A prevalidated and pretested semi-structured questionnaire was administered to one adult in the households selected using systematic random sampling to capture the sociodemographic details and their awareness, practices, and myths related to COVID-19. The supervisors additionally and concurrently used a nonparticipant observation technique to record the real-time behaviors and preventive practices adopted by the villagers. Quantitative analysis was done using STATA and included multivariable regression analysis, and the association was reported using prevalence rates along with their 95% confidence intervals (CIs). Qualitative analysis was done manually as per discussion and concordance among supervisors and reported as categories along with supporting statements. RESULTS: Among the 298 respondents, "poor awareness" was seen in 128 (43.0%, 95% CI: 37.5%-48.6%). Among the responders, 89 (29.9%) believed in the myth that "Corona disease is due to God's wrath or curse." The field observations were categorized under three categories - "avoidance of masks," "nonexistent social distancing," and "rampant spitting." CONCLUSION: About two in five villagers were found to have "poor awareness" to COVID, and practices related to COVID were found to be largely unsatisfactory. Lower level of education and belonging to nuclear family were associated with "poor awareness." Various myths were identified that has to be debunked on priority basis by the government, especially targeting the people having low level of education in rural India.

How Did the Village Community Perceive and Draw Strategies Against the COVID-19 Pandemic? A Qualitative Exploration.

Objectives There is a lack of evidence about the difficulties faced by the villagers and the mechanisms they adopt to cope with the ongoing coronavirus disease 19 (COVID-19) pandemic. In this study, we tried to explore the various stressors experienced by the villagers and the coping mechanisms. We also tried to document the future strategies that could be adopted to address the current pandemic situation. Methods An exploratory, descriptive qualitative study was conducted in five purposively selected villages in the Kolar district of South India. We conducted face-to-face in-depth interviews among nine key informants, including personnel across various health, education, and administrative domains. Two investigators carried out a manual descriptive content analysis to identify the codes and categories under three broad themes. A hybrid approach was used for coding the respondents' views in the most appropriate words/phrases. Results A total of 146 codes were identified and grouped into 19 different categories under three broad domains viz. 'stressors', 'coping strategies' and 'suggestions for future actions' for the existing COVID-19 pandemic. The stressors mainly were due to household level problems like finance management and familial disruptions. Coping mechanisms adopted include social capital, government support, judicial resource management, child marriages and apathetic attitude. The suggestions for future actions included an emphasis on the involvement of gram panchayats, adoption of the 'stay in village' concept, better communication framework and financial pooling for future exigencies. Conclusion The stressors due to COVID among villagers were mostly related to household level issues. The mechanisms adopted to cope up with the stressors included both positive and negative mechanisms. The suggestions for future actions mainly emphasized the involvement of gram panchayats.

Urinary protein carbonyl levels and its correlation with protein misfolding in preeclampsia.

OBJECTIVE: To evaluate the association of protein carbonylation with preeclampsia and its correlation with urinary protein misfolding. METHOD: Protein carbonyl and misfolded protein levels were measured in the midstream urine sample (58 preeclamptic and 44 normotensive pregnancy) by ELISA and Congo Red Dot assay respectively. RESULTS: Significant difference was observed in the levels of protein carbonyls (P = 0.002) and misfolded proteins (P = 0.001). Correlation between protein carbonyl and misfolded proteins levels was significant but weak (r = 0.3; P = 0.018). CONCLUSION: Urinary protein carbonyl level is elevated in preeclampsia but plays a minor role in proteins misfolding.

Novel association of oral squamous cell carcinoma with GSTP1 Arg187Trp gene polymorphism.

AIMS: Glutathione S-transferase subtype pi 1 (GSTP1) is an enzyme that is involved in the detoxification of carcinogenic substances. Arg187Trp is a functional polymorphism in the corresponding GSTP1 gene that reduces the enzymatic activity by 45%. We evaluated, for the first time, the association of Arg187Trp with the risk of oral squamous cell carcinoma and compared it with other established GSTP1 polymorphisms viz, Ile105Val and Ala114Val. MATERIALS AND METHODS: We carried out a 1:2 case-control study by recruiting 100 patients with oral squamous cell carcinoma and 200 age and gender-matched healthy individuals. Ile105Val, Ala114Val, and Arg187Trp polymorphisms were genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and their distribution in the study groups was compared by chi-squared test (Fisher's exact). RESULTS: The minor allele of Ala114Val and Arg187Trp were more common in patients than in controls. In contrast, the distribution of Ile105Val minor allele was similar in the two groups. The differential distribution was also significant at the level of genotypes. CONCLUSIONS: These results indicate that GSTP1 Arg187Trp is associated with the risk of developing oral squamous cell carcinoma. Our study underlines the importance of detoxification pathway in the risk of carcinogenesis.

Urinary congophilia in preeclampsia: Experience from a rural tertiary-care hospital in India.

OBJECTIVES: To evaluate the presence of urinary congophilia amongIndian patients with preeclampsia. STUDY DESIGN: A prospective case control study in which congophilia of urine samples from preeclamptic pregnant women (n = 62) and normotensive pregnant women (n = 65) was compared by using Congo Red Dot Blot assay. MAIN OUTCOME MEASURES: Presence of urinary congophilia. RESULTS: Mean percentage of Congo Red Retention was 37.9 ±â€¯4.1 in the normotensive pregnant group and 77.9 ±â€¯11.5 in the preeclamptic pregnant group (P < .001). The mean percentage of Congo Red Retention in both early-onset (70.5 ±â€¯9.0) and late-onset (82.7 ±â€¯10.3) groups were significantly higher than in normotensive controls (P < .001). The mean percentage of Congo Red Retention in mild (61.2 ±â€¯3.2) and severe (82.4 ±â€¯8.4) types of preeclampsia were also as significantly higher than in normotensive controls (P < .001). The mean percentage of Congo Red Retention in preeclampsia superimposed by eclampsia (89.4 ±â€¯2.0) and preeclampsia complicated by intrauterine growth restriction and intrauterine death (74.6 ±â€¯5.8) were significantly higher than in normotensive controls (P < .001). CONCLUSIONS: The results of this study confirms the presence of urinary congophilia in Indian pregnant women with preeclampsia. Furthermore, our study shows that urinary congophilia is not affected by clinical variables like gestational age of onset, severity, superimposition by eclampsia and complication by intrauterine growth restriction and intrauterine death. Urinary congophilia can be used to differentially identify preeclamptic pregnant women from normotensive pregnant women.

Prospective study on prevalence of anemia of pregnant women and its outcome: A community based study.

BACKGROUND: Anemia is one of the most common nutritional deficiency disorders affecting the pregnant women in the developing countries. Anemia during pregnancy is commonly associated with poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus. OBJECTIVE: The objective of the study was to estimate the prevalence of anemia among pregnant women and to determine its association with maternal and fetal outcomes. SETTINGS AND DESIGN: This study design was a prospective, observational, community-based study. SUBJECTS AND METHODS: Four hundred and forty-six pregnant women were included in the study from three primary health centers in Kolar district by multistage sampling technique and were followed up till 1 week after delivery. STATISTICAL ANALYSIS: The data were analyzed using SPSS version 22; correlation coefficient, Chi-square test, and logistic regression were used. RESULTS: There was a significant overall improvement in the hemoglobin levels of pregnant during the follow-up (10.3-10.72 gm%). About 35.6% of the women had maternal or fetal morbidity. Anemia was one of the main pregnancy-related complications (62.3%), other complications include difficult labor (3%), postpartum hemorrhage, and preeclampsia 1.6% each abortions/stillbirths (3.5%). The fetal complications include low birth weight (25.5%) followed by premature delivery (0.2%) and birth asphyxia (0.5%). CONCLUSIONS: A high prevalence of anemia in pregnant women apparently increases the maternal and fetal risks. To improve maternal and fetal outcome, it is recommended that the primary health care has to be strengthened, prevention, early diagnosis, and treatment of anemia in pregnancy to be given priority.