Misconceptions Regarding Essential Oral Health Care Amongst Pregnant Women Visiting a Tertiary Care Hospital in the State of Goa, India: A Descriptive Study.

Background of the Study: Myths regarding oral health are extensively prevalent and have considerable impact on pregnant women's dental behaviour and practices. Thus, this study sought to understand misconceptions (pregnancy and early childhood oral care) and their determinants amongst pregnant women. Methods: A questionnaire designed to assess the participants' demographics, parity, oral health behaviour and misconceptions was administered to 305 pregnant women attending antenatal care. Oral health (DMFT, bleeding on probing and periodontal pocket) was examined. Independent t test, analysis of variance and linear regression were used for statistical computations. Results: Early childhood myths (5.54 ± 1.87) were more prevalent amongst the study population than pregnancy-related myths (3.28 ± 1.89). Bivariate analysis exhibited that myths were significantly more prevalent in mothers who were ≤ 30 years of age (8.79 ± 2.565), primi parous (8.90 ± 2.141), illiterate (9.07 ± 2.764) and who had never visited a dentist (8.46 ± 2.016). Both pregnancy and early childhood myth scores were positively correlated to DMFT (p = 0.00; p = 0.031). Educational status and age were significant negative predictors of myths with p values of 0.00 and 0.34, respectively. Parity emerged as the only significant positive predictor (p = 0.002). Conclusion: The high prevalence of myths in the present study advocates that standardized, culturally appropriate and simple educational messages need to be developed and delivered to break these misconceptions. Minimum one visit to a dental surgeon during second trimester should be advocated and encouraged for all pregnant women.

Surveillance on Adverse Events Following COVISHIELD (ChAdOx1 nCoV-19) vaccination in Goa, India: An Observational Study.

BACKGROUND: COVISHIELD, ChAdOx1 nCoV- 19 Corona Virus Vaccine was granted emergency use authorization (EUA) as the first vaccine in India in January 2021. Knowing what to anticipate after vaccination will reduce vaccine hesitancy in the public. This study aimed to identify and measure the adverse events following COVID-19 vaccination. MATERIALS AND METHODS: A cross-sectional observational study was conducted at Goa Medical College, starting on February 21 till May 23, 2021. A total of 418 people were enrolled. We collected the data using the Microsoft Form and analyzed using Microsoft Excel and R-program. RESULTS: Of the 418 vaccine recipients, the incidence rate of AEFI (Adverse Events Following Immunization) was 54.31%. Fever, fatigue, and headache were the most commonly reported systemic AEFIs. Among these, 54.7% of AEFI were mild, 42.38% were of the moderate category, and only 2.96% were of grade 3 severity. None of the AEFIs were severe enough for hospitalization. Most of them developed symptoms within 24 hours of the first dose. Complete recovery from AEFIs took a median time of 24 hours. CONCLUSION: Most of our study findings were consistent with the phase 1, 2/3 trials findings of Oxford-AstraZeneca's ChAdOx1 vaccine. The AEFI symptoms were considered immune reactions to the vaccine. The AEFIs were more common among younger individuals and females. The chance of missing a serious adverse event like a thromboembolic phenomenon cannot be ruled out. We observed low AEFI rates with COVISHIELD in the Indian population compared to Oxford- AstraZeneca's ChAdOx1 vaccine in the UK-based population, which can be explained by preexisting immunity against adenovirus in the Indian population. However, based on the study findings, we may interpret that the COVISHIELD, Serum Institute of India, carries a good safety profile overall.

A study of road traffic injury victims at a tertiary care hospital in Goa, India.

Background: While road traffic accidents are declining in many developed countries, fatalities are still on the rise in many developing countries including India. More than half of the road traffic injury (RTI) victims are in the age group of 20-55 years, which constitutes the key wage-earning and child-raising age group. Objective: To study the socio-demographic profile of RTI victims and to study the pattern of injury among them. Methods and Material: The RTI victims brought to the casualty of Goa Medical College and Hospital were interviewed using a predesigned questionnaire following transfer to in-patient wards after initial stabilisation in the casualty. Data are expressed as proportions and presented using graphs and charts. Results: A majority of the RTI victims, i.e., 134 (30.45%) were in the age group of 30-40 years. The findings reveal that 33 (13.04%) RTI victims did not have a valid driving licence, while the use of alcohol within 6 h before accident was seen in 38 (12.75%) RTI victims; 234 (65.36%) victims were not using a seat belt or helmet and 350 (79.55%) victims had grievous injuries. Conclusions: A high number of drivers were driving without a valid driving licence while a good number of RTI victims consumed alcohol putting themselves as well as other commuters at risk. There is a need for increasing awareness among the road users and community regarding road safety. Government authorities should ensure consistent and strict implementation of traffic rules as well as accelerate the implementation of road-safety preventive measures.

Prevalence of Dog Bite among Field Workers at a Primary Health Care Level in Goa.

This study was undertaken in 121 field workers in a primary health care set up in Goa to estimate the lifetime and annual incidence dog bite, and to assess their knowledge and practices regarding post-exposure prophylaxis. The annual and lifetime incidence of dog bite was 3.3% and 22.3%, respectively. Based on the comparable figures from studies in general population, Dog-bite seems to be an occupational hazard among these workers. Only 28.9% completed the full course of anti-rabies vaccine with its cost as the major reason for discontinuation. More than 90% consulted traditional healers and wound toilet was done by 70%. The overall knowledge and practices seemed better than those reported in other studies, but continued orientation of the field workers and access to free vaccination at the workplace is of paramount importance.

Concurrence of erectile dysfunction and coronary artery disease among patients undergoing coronary angiography at a tertiary Medical College Hospital in Goa.

The paper is based on the data from 92 males less than 45 years of age who underwent coronary angiography at Goa Medical College during the period July 2018 to February 2019. The objectives include to estimate the prevalence of erectile dysfunction (ED) and its risk factors, and to evaluate the pattern of coronary artery disease (CAD) among these patients. The ED prevalence was 46.2%. Diabetes, hypertension and alcohol intake showed significant association with ED; and these patients were almost three more likely to have a coronary blockade compared to those not reporting ED. This concurrence between ED and CAD makes a strong ground for routine inquiry in sexual history of young males with one or more cardiovascular risk factors.

Geospatial clustering, seasonal trend and forecasting of Kyasanur Forest Disease in the state of Goa, India, 2015-2018.

INTRODUCTION: Five states in India are reporting sporadic outbreaks of Kyasanur Forest Disease (KFD). Goa experienced an outbreak of KFD in 2015. It remains as an important differential diagnosis for tropical fever in the endemic regions. Few studies among neighboring two states (Karnataka and Kerala) have described the epidemiological characteristics of KFD. However, there is no study which describes the same among cases in the state of Goa. Hence, we planned to understand the epidemiology (time, place, and person distribution) of the disease including seasonal pattern with forecasting using zero-inflated negative binomial regression and time series models. We also explored geo-spatial clustering of KFD cases in Goa during 2015-2018 which would help design effective intervention to curb its transmission in Goa. RESULTS: Blood samples of all suspected cases of KFD during 2015 to 2018 were tested using reverse transcriptase-polymerase chain reaction technique. Reports of these results were periodically shared with the state surveillance unit. Records of 448 confirmed cases of KFD available at the State Integrated Disease Surveillance Programme were analyzed. The mean (SD) age of the patients was 41.6 (14.9) years. Of 143 cases with documented travel history, 135 (94.4%) had history of travel to forest for cashew plucking. Two thirds of cases (66.3%) did not receive KFD vaccine prior to the disease. Case fatality rate of 0.9% was reported. Seasonal peaks were observed during January to April, and forecasting demonstrated a peak in cases in the subsequent year also during January-April persisting till May. Around 40 villages located along the Western Ghats had reported KFD, and affected villages continued to report cases in the subsequent years also. Case density-based geographic maps show clustering of cases around the index village. CONCLUSION: Most of the confirmed cases did not receive any vaccination. KFD cases in Goa followed a specific seasonal pattern, and clustering of cases occurred in selected villages located in North Goa. Most of the patients who had suffered from the disease had visited the forest for cashew plucking. Planning for public health interventions such as health education and vaccination campaigns should consider these epidemiological features.

Kyasanur Forest Disease vaccination coverage and its perceived barriers in Goa, India-A mixed methods operational research.

BACKGROUND: Kyasanur Forest Disease (KFD) is a highly infectious viral illness transmitted by infected ticks through contact with monkeys and other forest animals. Till date there is no definite treatment available for KFD. Hence, vaccination is considered to be an important public health intervention to control KFD. This study aimed at estimating the vaccination coverage for primary and booster doses of KFD vaccine and exploring the perceived barriers to vaccination in the affected villages of Goa, India during 2015-18. METHODOLOGY & PRINCIPAL FINDINGS: In this explanatory mixed methods study, vaccine coverage was estimated bydata obtained from the KFD vaccination registers maintained at the health centers catering to the KFD affected villages. To understand the barriers to vaccination,key informant interviews were conducted among implementing health officers, medical officers and nurses involved in vaccination. Perceptions of vaccinees and community members were studied through in-depth interviews and focus group discussions. Out of the 35,500 targeted population (6-65 years)for KFD vaccination, 32% received one dose and 13.2% received two doses. The coverage for first booster and annual booster was 4.9% and 0.5% respectively. The drop out from first to second and third doses was 57% and 85% respectively. 69% of doses were delivered during community outreach programmes and remaining at health facilities. Inadequate vaccine stock, inappropriate timing of vaccination campaign, lack of awareness and misconceptions related to indications of vaccines, travel distance for follow up doses given at community health centre and pain due to injection were perceived as reasons for poor vaccination coverage. CONCLUSIONS: KFD vaccination coverage was poor in the villages affected by KFD in Goa. Both left-out and drop-out phenomena were observed in KFD vaccination. Vaccine implementation plan has to consider suitable time for the local people, maintain adequate vaccine stock and encourage community-based vaccination campaigns instead of facility-based to achieve optimal vaccine coverage.