Gender differences in COVID-19 knowledge, risk perception, and public stigma among the general community: Findings from a nationwide cross-sectional study in India.

Introduction: Individual and community characteristics predictive of knowledge, perception, and attitude on COVID-19, specifically on gender, have not been adequately explored. Objective: To examine the gender differences in COVID-19 knowledge, self-risk perception and public stigma among the general community and to understand other socio-demographic factors which were predictive of them. Method: A nationally representative cross-sectional multi-centric survey was conducted among adult individuals(≥18 yrs) from the community member (N = 1978) from six states and one union territory of India between August 2020 to February 2021. The participants were selected using systematic random sampling. The data were collected telephonically using pilot-tested structured questionnaires and were analyzed using STATA. Gender-segregated multivariable analysis was conducted to identify statistically significant predictors (p < 0.05) of COVID-19-related knowledge, risk perception, and public stigma in the community. Results: Study identified significant differences between males and females in their self-risk perception (22.0% & 18.2% respectively) and stigmatizing attitude (55.3% & 47.1% respectively). Highly educated males and females had higher odds of having COVID-19 knowledge (aOR: 16.83: p < 0.05) than illiterates. Highly educated women had higher odds of having self-risk perception (aOR: 2.6; p < 0.05) but lower public stigma [aOR: 0.57; p < 0.05]. Male rural residents had lower odds of having self-risk perception and knowledge [aOR: 0.55; p < 0.05 & aOR: 0.72; p < 0.05] and female rural residents had higher odds of having public stigma [aOR: 1.36; p < 0.05]. Conclusion: Our study findings suggest the importance of considering thegender differentials and their background, education status and residential status in designing effective interventions to improve knowledge and reduce risk perception and stigma in the community about COVID-19.

Efficacy of Fluoride Varnish with Casein Phosphopeptide and Amorphous Calcium Phosphate vs Fluoride Varnish in Prevention of White Spots Lesion in fixed Orthodontic Patients: In Vivo Study.

AIM: The aim of the study is to compare the in vivo efficiency of Michigan (MI) varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) and Fluoritop containing sodium fluoride (5% NaF) in the prevention and remineralization of white spot lesions (WSLs) around orthodontic brackets at days 28 and 56 after bonding. MATERIALS AND METHODS: A total of 30 patients were selected and divided into two groups I (MI varnish) II (Fluoritop varnish) of 15 patients in each group. All the patients were bonded and then varnish was applied around the brackets. Right-side upper and lower first premolar teeth were taken as the control group and left-side upper and lower first premolar teeth as the experimental group. Also, 14, 24 teeth were extracted on day 28 after bonding and 34, 44 teeth after day 56 of bonding. Samples were collected and sent to laboratory for evaluation of surface microhardness (SMH). RESULTS: Based on the statistics results, there was a significant decrease in demineralization and an increase in remineralization of WSLs after the application of varnish. No statistical significance was found between the effectiveness of MI varnish and Fluoritop except in the cervical region. CONCLUSION: Through our study, we concluded that no statistical significance was found between the effectiveness of MI varnish and Fluoritop except in the cervical region where MI varnish was found to be more effective than Fluoritop in preventing WSLs. CLINICAL SIGNIFICANCE: The results from the above study concluded that CPP-ACP varnish can be an effective method in preventing WSLs in patients undergoing fixed orthodontic treatment.

Development of database structure and indexing for siddha medicine system - A platform for siddha literature analytics.

Background: Siddha Medicine system is one among the oldest traditional systems of medicines in India and has its entire literature in the Tamil language in the form of poems (padal in tamil). Even if the siddha poems are available in public domain, they are not known to other parts of the world because, researchers of other languages are not able to understand the contents of these poems and there exists a language barrier. Hence there is a need to develop a system to extract structured information from these texts to facilitate searching, comparing, analysis and implementing. Objective: This study aimed at creating a comprehensive digital database system that systematically stores information from classical Siddha poems and to develop a web portal to facilitate information retrieval for comparative and logical analysis of Siddha content. Methods: We developed an expert system for siddha (eSS) that can collect, annotate classical siddha text, and visualizes the pattern in siddha medical prescriptions (Siddha Formulations) that can be useful for exploration in this system using modern techniques like machine learning and artificial learning. eSS has the following three aspects: (1) extracting data from Siddha classical text (2) defining the annotation method and (3) visualizing the patterns in the medical prescriptions based on multiple factors mentioned in the Siddha system of medicine. The data from three books were extracted, annotated and integrated into the developed eSS database. The annotations were used for analyzing the pattern in the drug prescriptions as a pilot work. Results: Overall, 110 medicinal preparations from 2 Siddhars (Agathiyar and Theran) were extracted and annotated. The generated annotations were indexed into the data repository created in eSS. The system can compare and visualize individual and multiple prescriptions to generate a hypothesis for siddha practitioners and researchers. Conclusions: We propose an eSS framework using standard siddha terminologies created by WHO to have a standard expert system for siddha. This proof-of-concept work demonstrated that the database can effectively process and visualize data from siddha formulations which can help students, researchers from siddha and other various fields to expand their research in herbal medicines.

TB diagnostic cascade among patients registered under the Revised National TB Control Programme in Chennai, South India.

OBJECTIVE: To discern and quantify the TB diagnostic cascade among patients registered under the Revised National TB Control Programme, Chennai city, Tamil Nadu, South India. METHODS: This cross-sectional study was conducted in metropolitan Chennai from February 2017 to March 2018. We interviewed TB patients retrospectively on their diagnostic attempt in different health facilities. RESULTS: Of 455 TB patients, only 4.4% received their diagnosis at their first health facility. Of 1250 visits to health facilities, the vast majority (79.4 vs. 20.6%) was in the public rather than the private sector. 56% of patients went to a public facility as the first point of care, of whom 1.6% shifted to private facilities subsequently. The remaining 54.4% shifted between up to five government health facilities. Male patients and those with a higher family income were more likely to shift from private to public. CONCLUSION: Most shifts between diagnostic facilities occurred in the public sector. This necessitates interventions at public health facilities for strengthening and extending services to TB patients at their first point of care.

OBJECTIF: Discerner et quantifier la cascade de diagnostic de la TB chez les patients enregistrés dans le Programme National Révisé de lutte contre la TB, dans la ville de Chennai, dans le Tamil Nadu, dans le sud de l'Inde. MÉTHODES: Cette étude transversale a été menée dans la région métropolitaine de Chennai de février 2017 à mars 2018. Nous avons interviewé rétrospectivement des patients TB sur leur tentative de diagnostic dans différents établissements de santé. RÉSULTATS: Sur 455 patients TB, seuls 4,4% ont reçu leur diagnostic dans le premier établissement de santé visité. Parmi 1250 visites dans les établissements de santé, la grande majorité (79,4 vs 20,6%) était dans le secteur public plutôt que le privé. Parmi les 56% des patients qui sont allés dans un établissement public comme premier point de soins, dont 1,6% sont ensuite passés dans des établissements privés. Les 54.4 restants se sont déplacés entre cinq établissements différents de santé publics. Les patients de sexe masculin et ceux dont le revenu familial était plus élevé étaient plus susceptibles de passer du privé au public. CONCLUSION: La plupart des changements entre les établissements de diagnostic se sont produits dans le secteur public. Cela nécessite des interventions dans les établissements de santé publique pour renforcer et étendre les services aux patients TB à leur premier point de soins.

Effectiveness of TB sensitization initiatives in improving the involvement of self help group members in rural TB control in south India.

Background: The 'End TB strategy' has highlighted the importance of inter-sectoral collaboration and community mobilization for achieving zero TB deaths by 2020. Objective: The aim of the study was to develop and test a model TB sensitization programme involving self help groups (SHGs). Methodology: This experimental study was conducted in two blocks (intervention and control), in Tiruvallur district. The intervention content included short-lecture, musical story telling activity, role play, short film on TB. The impact was compared at baseline, third and sixth months in terms of SHGs' awareness, promotion of awareness, identification and referral of presumptive TB cases and provision of TB treatment. Results: A total of 764 vs 796 SHGs were enrolled in control and intervention groups, respectively. The knowledge attitude, and practice score (lower score indicated a better attitude and practice), from baseline to 6 months was significantly reduced (29 to 24) in the intervention group. Similarly, a significant difference was observed in identification and referral of chest symptomatics in the intervention group at 3 and 6 months. During the 3 month follow-up a significantly higher proportion of SHG members were involved in TB awareness activities in the intervention (623/748 [83.3%]) vs control group (471/728 [64.7%]; p<0.001). Conclusions: Findings from this study highlight the feasibility of involving SHGs through a model TB sensitization program for strengthening TB prevention and control activities.

Repository on maternal child health: health portal to improve access to information on maternal child health in India.

BACKGROUND: Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. METHODS: The portal 'Repository on Maternal Child Health' was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. RESULTS: The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). CONCLUSIONS: Efficient management of health information is imperative for informed decision making, and digital repositories have now-a-days become the preferred source of information management. The growing popularity of the portal indicates the potential of such initiatives in improving access to quality and essential health information in India. There is a need to develop similar mechanisms for other health domains and interlink them to facilitate access to a variety of health information from a single platform.