Household-level food insecurity and its correlates in rural Bihar: A cross-sectional study.

Introduction: Bihar has experienced high nutritional public health problem among children and women over the years. In this background, this study was planned to find the level of food insecurity and identify contributing factors in rural Bihar. Material and Methods: We conducted community-based cross-sectional study among 255 families residing in villages catered by RHTC, Naubatpur. A pretested semi-structured interview schedule and HFIAS were used. Result: A total of 27.8% of the 255 households were food insecure, of which 73.3% were severely food insecure. Kutcha houses, dispossession of agricultural land, and lower SES were found to be predictors. Conclusion: Around one in three families experienced food insecurity, and it was more among families residing in kutcha houses, without possession of agricultural land and belonging to lower socioeconomic status.

Internet addiction and nomophobia among medical undergraduates of a tertiary care teaching institute in Patna, Eastern India.

BACKGROUND: Excess use of the internet and gadgets for learning, gaming, and socialization has resulted in addictive behavior and nomophobia, especially among college-going students. Thus, this study was designed to find out the proportion and predictors of internet addiction and nomophobia among medical undergraduates. MATERIALS AND METHODS: This cross-sectional study conducted on 367 medical undergraduates of a teaching hospital was carried out using a standard tool: the Internet Addiction Test Short Form for screening internet addiction and the Nomophobia Questionnaire for nomophobia. Results were tabulated and multivariable binomial logistic regression analysis was performed to find out the predictors of internet addiction and nomophobia. RESULTS: A total of 116 (31.6%, 95% CI: 27%-36.5%) students were addicted to the internet and 247 (67.3%, 95% CI: 62.3%-71.9%) were screened to have moderate-to-severe nomophobia. The age of the student (adjusted odds ratio (AOR): 0.83 [0.69-0.99]), male gender (AOR: 2.24 [1.33-3.79]), screen time (AOR: 1.24 [1.14-1.34]), checking the phone first in the morning (AOR: 1.98 [1.107-3.54]), non-leisure time usage of phone (AOR: 2.07 [1.25-3.4]), and altered reading habit (AOR: 2.51 [1.26-5.01]) were independent predictors of internet addiction. Increased screen time (AOR: 1.103 [1.016-1.23]), checking the phone first in the morning after waking up (AOR: 1.68 [1.05-2.81]), altered academic performance (AOR: 1.99 [1.079-3.68]), and presence of internet addiction (AOR: 8.17 [3.56-18.76]) were independent predictors of moderate-to-severe nomophobia among medical students. CONCLUSION: One and two out of every three medical students were found to have internet addiction and moderate-to-severe nomophobia, respectively. Increased screen time, altered academic performance, and the presence of internet addiction were independent predictors of moderate-to-severe nomophobia.

Awareness of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana in the Rural Community: A Cross-Sectional Study in Eastern India.

Background Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is one of the flagship programs intended to provide financial protection to people availing of secondary and tertiary level health care. It's been nearly three years since the implementation of AB-PMJAY in Bihar, yet the level of awareness, especially in rural communities, is unknown. So, this study was planned to explore the awareness and utilization of AB-PMJAY in the selected rural area of Bihar. Methodology This community-based cross-sectional study used a multistage sampling strategy to select 802 households within a radius of 5 Km from the rural health training centre, Naubatpur. A pre-tested, semi-structured questionnaire was used to collect the necessary data regarding awareness of AB-PMJAY. The association between category, occupation, education, age group, and ration card with the awareness of AB-PMJAY was assessed using Pearson's chi-square test. Results The awareness of the AB-PMJAY was 68.6% (95% CI: 65.30%-71.7%), while out of 459 eligible study participants, 362 (78.9%) were aware of the AB-PMJAY. Utilization of AB-PMJAY was only 1.3% among the eligible study participants. There was a statistical significance between the category of eligible study, ration card, and employment status with the awareness of the AB-PMJAY. Conclusion Every two out of three rural individuals and three out of every four eligible participants were aware of the AB-PMJAY scheme, while the level of utilization was found to be very low at 1.3%; hence, training of the healthcare workers at the grass-root level, like accredited social health activists (ASHA) and Anganwadi workers (AWW), should be done regularly to improve the connection in the community and for effective utilization of the Ayushman Bharat-PMJAY.

Effect of COVID-19 on Stress and Biomarkers: An Exploratory Cross-Sectional Study.

Background Anxiety and stress in COVID-19 lead to continual pro-inflammatory cytokine activity resulting in excessive inflammation. Levels of different bio indices of COVID-19 may predict clinical outcomes and the severity of COVID-19 disease and may correlate with anxiety and stress levels. Objectives To measure the level of anxiety in COVID-19 patients using the coronavirus anxiety scale (CAS) as an assessment of psychological stress. To measure the levels of blood biomarkers and biochemical and hematological markers of inflammation in COVID-19. To record and measure the indices of short-term HRV in COVID-19 patients to assess their physiological and psychological stress levels. To determine the relationship between anxiety scores, levels of laboratory indices (blood biomarkers), and HRV parameters across mild, moderate and severe cases of COVID-19. Material and method A total of 300 COVID-19 patients aged between 18 and 55 years were included. A questionnaire-based CAS was used to assess anxiety levels. Short-term HRV was recorded to measure stress. Blood biomarkers: Biochemical and hemato-cytological markers of inflammation were measured. Statistical analyses were performed using the SPSS software version 20.0. Results Anxiety and stress increased with the severity of COVID-19. A positive correlation was detected between anxiety and serum ferritin, IL-6, MCV, and MCH levels, and a negative correlation between the corona anxiety score and RBC count. The increase in the severity of COVID-19 showed elevated levels of WBC count, neutrophil%, platelet count, neutrophil/lymphocyte ratio, serum ferritin, D-dimer, C-reactive protein, procalcitonin, interleukin-6, and lactate dehydrogenase, and decreased lymphocyte and monocyte percentages. The increase in the severity of COVID-19 decreased lymphocyte, monocyte, and eosinophil counts. Conclusion The Corona Anxiety Scale and heart rate variability can be used as complementary tools to index COVID-19-related anxiety and stress. An association exists between immune dysregulation and heart rate variability, which can be used to predict the inflammatory response and prognosis of COVID-19.

Determinants of awareness on pictorial health warnings on tobacco products in an Eastern state of India.

Background: Pictorial health warnings (PHW) are an effective strategy to deter or reduce tobacco use. This study was conducted to determine the level of awareness of PHWs on tobacco products and their correlates among adults attending the outpatient department (OPD) of a tertiary care facility in Eastern India. Materials and Methods: This cross-sectional study was conducted over a period of 3 months among 307 patients aged 18 years to 65 years. A pre-tested semi-structured questionnaire was used for the collection of data and inferential statistics were performed using JAMOVI version 2.3.21. Results: About 84% (95% CI, 78.9-87.2) of the participants were aware of PHW on tobacco products, 82.4% (95% CI, 77.8-86.3) for smoked forms and 51.8% (95% CI, 46.2-57.3) for smokeless forms. More than half of the participants felt that the current PHW were ineffective. Male [AOR, 3.13; 95% CI, 1.33-7.37], being educated [AOR, 3.37; 95% CI, 1.29-8.76], employment [AOR, 5.65; 95% CI, 1.21-26.30] and ever-tobacco use [AOR, 3.23; 95% CI, 1.43-7.2] were found to be independent correlates of PHW awareness for smoked tobacco products, whereas as being male [AOR, 2.01; 95% CI, 1.02-3.95] and being young (18-30 years) [AOR, 2.51; 95% CI, 1.08-5.84] were found to be the independent predictors of PHW awareness for smokeless tobacco products (SLT). Conclusion: Four out of every five individuals were aware of pictorial health warnings (PHW) on tobacco products; however, it was much less for SLT compared to smoked tobacco products. Male, being educated, employment and ever-tobacco use were independent correlates of awareness for the smoked form of tobacco products, whereas being young (18-30 years) was an independent predictor of awareness for SLT.

Semen Quality in Males Suffering From COVID-19: A Pilot Study.

Background It is well known that some viral infections may affect male fertility. Coronavirus disease (COVID-19) can lead to multiorgan damage through the angiotensin-converting enzyme-2 receptor, abundant in testicular tissue. However, little information is available regarding the shedding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in semen and its impact on spermatogenesis and fertility potential. We planned to investigate the presence of SARS-CoV-2 in the semen of COVID-19 males and to study the effect of COVID-19 on semen quality and sperm DNA fragmentation index. Material and method Thirty COVID-19 male patients aged 19-45 registered to AIIMS Patna hospital participated in the survey between October 2020 and April 2021. We conducted a real-time reverse transcriptase test on all the semen samples. Detailed semen analysis, including the sperm DNA Fragmentation Index, was done at first sampling that is during COVID-19. After 74 days of the first sampling, we obtained the second sampling and repeated all the above tests. Results All semen samples collected in the first and second sampling tested with real-time reverse transcription-polymerase chain reaction (RT-PCR) were negative for SARS-CoV-2. In the first sampling, semen volume, vitality, total motility, sperm concentration, total sperm count, % normal morphology, % cytoplasmic droplet, and fructose were significantly lower. In contrast, semen agglutination, % head defect, DNA Fragmentation Index, liquefaction time, semen viscosity, and leukocytes were increased. These findings were reversed at the second sampling but not to the optimum level. All these findings were statistically significant (p < 0.05 for all). Thus, COVID-19 negatively affects semen parameters, including sperm DNA fragmentation index. Conclusion Although we could not find SARS-CoV-2 in the semen, the semen quality remained poor until the second sampling. Assisted reproductive technology (ART) clinics and sperm banking facilities should consider assessing the semen of COVID-19 males and exclude men with a positive history of SARS-CoV-2 until their semen quality returns to normal.

Geographical Information System-Aided Noise Pollution Mapping of Urban Puducherry, South India.

Context: Noise pollution and its influence on environmental and quality of human life are a major concern and hot topic of scientific research in the twenty-first century. Aims: Spatial analysis of noise pollution in urban Puducherry, South India. Settings and Design: Cross-sectional study conducted in 36 locations of urban Puducherry. Methods and Material: Noise measurements were taken using a calibrated NOR 132 digital sound level meter using the prescribed parameters set by the Central Pollution Control Board. Geo coordinates were taken using Garmin Oregon 550 GPS. Noise measurements were classified according to the Bureau of Indian Standards for town planning into five zones. Statistical Analysis Used: Noise pollution map of urban Puducherry for three time points of the day was generated using ArcGIS Desktop v10.3 with Geo-statistical module and Inverse Distance method. Results: Seventeen percent of the sites are high noise sources (80-90 dB), two thirds (65%) of the study sites fall into concentrated average noise zones (70-80 dB), and less than one fifth (18%) of the study sites are in relatively quiet zones across different measurement time slots. Conclusions: Long-term strategy for noise control should be incorporated in the development of new townships and other infrastructures in accordance with the noise control norms. Implications for future research include monitoring noise pollution levels in rural areas and health effects of noise pollution in bystanders and drivers.

Sero-epidemiological survey of SARS-Cov2 in urban slums of a capital city: A cross- sectional study.

Introduction: Slums are the most vulnerable settlements for COVID-19 infection due to overcrowding and unsanitary conditions. Thus, this study was undertaken to determine the level of seroprevalence for SARS-CoV-2 infection among slum dwellers. Material and Methods: A community-based cross-sectional seroepidemiological survey was conducted at several slums of Patna over four weeks, that is, January 20-February 20, 2021. A total of 650 participants were recruited in the study by applying a two-stage random sampling technique. Results: Seroprevalence for SARS-CoV-2-specific IgG antibody was found to be 31.5% (95% Confidence Interval (CI): 27.9-35.1). The seropositivity prevalence was found to be statistically higher among participants belonging to the age group of 18-30 years (41.1%), male gender (67.9%), high-risk occupation (70%), below poverty line (BPL) economic status (62.1%), and residing in a hut (51.2%) and kutcha house (42.4%). Further, 262 participants reported having COVID-like symptoms in the preceding 1 month of the survey, which was found to be significantly associated with the seropositivity status. Conclusion: The finding of the study reflects that a moderate seroprevalence level of COVID-19 infection was acquired in the slum settings of Bihar. Unchecked spread in these informal communities will pose a serious threat to the rest of the bigger sections of urban populations. This indirectly calls for early intervention in the form of preference in the roadmap of COVID-19 vaccination.

Awareness and Readiness To Implement the Pradhan Mantri Jan Arogya Yojana: A Cross-Sectional Study Among Healthcare Workers of a Tertiary Care Hospital in Eastern India.

Background The Indian government announced "Ayushman Bharat" for a New India 2022 during the 2018-19 parliament budget sessions, which includes the national health protection scheme presently known as "Pradhan Mantri Jan Arogya Yojana (PMJAY)" to facilitate access to secondary and tertiary healthcare services. This study aimed to see how well healthcare workers (HCWs) understood the PMJAY and how prepared they were to administer it. Materials and methods With an anticipated sample size of 411, this hospital-based analytical, cross-sectional study was done among treating faculty, resident doctors, and nursing officers as study participants. Participants completed a self-administered, pre-tested, semi-structured questionnaire to determine their level of awareness and readiness to adopt PMJAY. SPSS Version 22 software (SPSS Inc., Chicago, IL, USA) was used to analyze the data. Results The overall mean (SD) awareness score and mean readiness score among HCWs were found to be 5.52 (1.82) and 18.49 (4.5), respectively. There was a significantly high awareness score among doctors compared to nursing officers. The relation between awareness score and readiness score showed a weak positive significant correlation (r=0.174, p=0.001). The linear regression model demonstrated an increase of 0.432 units in readiness for every unit increase in awareness score. Conclusion The doctor's mean awareness score was little over half of the maximum attainable score. Faculty members were more aware of the scheme than the residents and nursing officers. The readiness to implement PMJAY improves as the awareness grows. Frequent workshops on PMJAY for stakeholders are required for better readiness.

Efficacy of Lipid Ratios and Platelet Distribution Width for Assessment of Liver Fibrosis in Patients With Non-alcoholic Fatty Liver Disease.

Introduction The clinical course of non-alcoholic fatty liver disease (NAFLD) in its long term may follow a benign course or have an adverse outcome leading to hepatocellular carcinoma (HCC) or end-stage liver disease requiring liver transplantation. Such patients represent only a small proportion of all NAFLD cases, making case finding a real challenge. Aims This study was planned to test the efficacy of simple laboratory parameters for their ability to screen advanced cases of NAFLD who need early attention to extricate them from the cumbersome outcome. Material and method The study protocol enrolled 129 diagnosed cases of NAFLD. Patients were categorized as group I with mild/moderate fibrosis (MF) comprising of F0 to F2 and group II with advanced fibrosis (AF) comprising of F3 and F4 based on Fibroscan kPa (kilopascal) score. Results Group I consisted of 96 MF patients, while group II included 33 AF patients. Mean values of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), triglyceride (TG), triglyceride/high-density lipoprotein (TG/HDL) ratio, total cholesterol/high-density lipoprotein (TC/HDL) ratio, and platelet distribution width (PDW) were significantly higher in patients with AF (group II), while platelet count (PC) was significantly lower in group II. The area under the receiver operative characteristic (AUROC) curve was highest for PDW [0.730 (0.644-0.815)] and TG/HDL ratio [0.719 (0.612-0.827)]. TG/HDL ratio at a cut-off of >2.4 had a sensitivity and specificity of 84.85% and 34.38%, respectively, and PDW at a cut-off of >16.40 had a sensitivity and specificity of 84.85% and 54.17%, respectively. Conclusion Decent sensitivity at particular cut-offs for TG/HDL ratio and PDW makes them suitable to be applied for screening advanced cases of NAFLD that require early ministration and medication to block its further progression to its intricate form.