Unraveling Factors Shaping the Acceptance and Non-acceptance of Non-scalpel Vasectomy in Rural Central India: A Cross-Sectional Study.

Background India, with a population exceeding 1.43 billion, faces significant demographic challenges, necessitating effective family planning measures. Non-scalpel vasectomy (NSV) is a less complex and cost-effective male contraceptive, yet its acceptance remains low, especially compared to female sterilization. Understanding the determinants of NSV acceptance is crucial for informed decisions on family planning methods. Methods This cross-sectional study investigated NSV acceptance among males who underwent non-scalpel vasectomy (acceptors of NSV) and spouses of women who underwent tubectomy (non-acceptors of NSV). The study was conducted among 116 NSV acceptors and 116 non-acceptors from rural Central India. Data were collected over six months, employing a pre-designed questionnaire covering socio-demographic details, reasons for acceptance/non-acceptance, and information sources for the same. Statistical analysis was done utilizing Epi Info 7.2.6 (Centers for Disease Control and Prevention [CDC], Atlanta, GA), employing descriptive statistics and tests of association. Results Significant associations were found between NSV acceptance (p<0.05) and the age and education of study subjects, age of wife, duration since marriage, and total number of children. Incentives also played a significant role (p=0.014). Opposition to NSV, mainly from wives, was a key factor for non-acceptance (38%). Reasons for acceptance included a previous cesarean section (40.52%), the simplicity of the NSV procedure (26.72%), and the wife's illness (23.28%). Non-acceptance reasons comprised family/friend opposition (38%), lack of awareness/ignorance (25.00%), and fear of surgery (23.28%). Study subjects perceived community reluctance to NSV as mainly due to misbeliefs (30.17%), fear of surgery (27.58%), and illiteracy (26.29%). Conclusion The study highlights socio-demographic factors influencing NSV acceptance and identifies key reasons for acceptance/non-acceptance. Community-based interventions, increased advertisement, and health provider counseling were suggested for enhancing acceptance. Despite challenges, participant satisfaction with NSV was high. These findings contribute to understanding the complex dynamics surrounding NSV acceptance in rural Central India, informing future family planning strategies.

Smartphone Usage Patterns Among Postgraduate Medical Students: A Central India Perspective on Adaptive Learning in Medicine.

Introduction Technological developments are drawn on a path of continuous inventions. Smartphones have been used in educational activities to access course content, acquire information related to students' performance, and encourage discussion and sharing between students and teachers. Students as learners are the drivers of using new technology for their learning needs, and this is always evolving. Aim The aim of the study is to assess the usage of smartphones for academic learning among postgraduate medical students in a teaching institute in Central India. Materials and methods This cross-sectional, questionnaire-based study was conducted on 130 postgraduate medical students for a period of four months from 1 January 2022 to 30 April 2022. Results The mean age of the study subjects was 28.34 ± 3.22 years with the range being 23 to 44 years. Smartphones had a significant impact on the academic learning of postgraduate medical students. The major impacts of smartphones on academic learning were in the form of improved learning skills (60.91%), timely completion of assignments (40%), increased participation in discussions (34.55%), enhanced academic performance (33.64%), and development of critical and innovative thinking (29.09%). Conclusion A significant proportion of medical postgraduates are utilizing smartphones and social media for academic purposes. Although this new technology offers the potential to enhance learning and patient care, it has some inherent problems associated with its use. However, it may go a long way in redefining how we manage information in medicine.

Age-Old Dilemma of Pregnancy During Residency: A Cross-Sectional Study From Central India on Perceptions and Experiences of Female Medicos.

Introduction The integration of family and career poses a significant problem for women in the medical profession. Balancing residency program demands with burgeoning family issues has always been a dilemma for female medicos. Lack of support and sometimes hostility from life partners, program administrators, teachers, and other residents have been reported. The present study is an attempt to assess perceptions and experiences of female medicos regarding pregnancy during residency. Methods The present descriptive cross-sectional study was carried out in a government medical college and hospital, which is a tertiary care center as well as a public sector teaching and training institute located in central India. Data were collected by interview technique using a predesigned and pretested questionnaire. Data were analyzed using the statistical software Epi Info version 7.2.5 (CDC, Atlanta, Georgia). Mean and standard deviations were calculated for continuous variables and the chi-square test was applied for categorical variables. Results Of the 612 study subjects, 409 (66.8%) belonged to the clinical disciplines and 203 (33.2%) were from nonclinical and paraclinical disciplines. A total of 66 (32.5%) subjects from the paraclinical and nonclinical sides had experienced pregnancy during residency, whereas only 54 (13.2%) from the clinical side were pregnant during residency. Positive influences for pregnancy during residency were concerns about age and fertility, pressure from in-laws and parents, desire for family and pregnancy, etc., all with a mean score of 3.5 and above on a five-point Likert scale. Tight schedules, availability of childcare arrangements, support from faculty and other residents, etc. were relatively negative influences with a mean score of less than 3.5. Around 66% of those from nonclinical and paraclinical groups had conceived before 26 years of their age, whereas only 30% of residents from clinical departments had experienced pregnancy before that age. Thus, the age at conception was relatively lower in residents from nonclinical and paraclinical disciplines as compared to their counterparts from clinical disciplines, and this difference was found to be statistically significant (p < 0.001). The complications during pregnancy were more in clinical residents than in those from the nonclinical and paraclinical side. Conclusions This study concludes that concerns about age and fertility, pressure from in-laws and parents, desire for family and pregnancy, and enjoying children are relatively positive influences on the occurrence of pregnancy, whereas tight schedule, availability of childcare arrangements, support from faculty and other residents, and timing professionally are relatively negative influences.

Incidence of Japanese Encephalitis and Acute Encephalitis Syndrome Hospitalizations in the Medium-Endemic Region in Central India.

BACKGROUND: We estimated the incidence of Japanese encephalitis (JE) and acute encephalitis syndrome (AES) following routine immunization with the live-attenuated SA 14-14-2 JE vaccine. METHODS: We implemented enhanced surveillance of AES and JE hospitalizations in endemic districts in Maharashtra and Telangana States during 2015-2016 and 2018-2020. We estimated incidence and compared differences in the incidence of JE and AES between two states, and vaccinated and unvaccinated districts during two study periods. We also considered secondary data from public health services to understand long-term trends from 2007 to 2020. RESULTS: The annual AES incidence rate of 2.25 cases per 100,000 children in Maharashtra during 2018-2020 was significantly lower than 3.36 cases per 100,000 children during 2015-2016. The six JE-vaccinated districts in Maharashtra had significantly lower incidence rates during 2018-2020 (2.03, 95% CI 1.73-2.37) than in 2015-16 (3.26, 2.86-3.70). In addition, the incidence of both JE and AES in two unvaccinated districts was higher than in the vaccinated districts in Maharashtra. Telangana had a lower incidence of both JE and AES than Maharashtra. The AES incidence rate of 0.95 (0.77-1.17) during 2018-2020 in Telangana was significantly lower than 1.67 (1.41-1.97) during 2015-2016. CONCLUSIONS: The annual incidence rate of Japanese encephalitis was < 1 case per 100,000 children. It indicated accelerated control of Japanese encephalitis after routine immunization. However, the annual incidence of acute encephalitis syndrome was still > 1 case per 100,000 children. It highlights the need for improving surveillance and evaluating the impacts of vaccination.

Prevalence, Pattern, and Reasons for Self-Medication: A Community-Based Cross-Sectional Study From Central India.

Introduction Self-medication is an important public health problem, with varied prevalence across the world. The high prevalence of self-medication in India is one of the important factors contributing to the development of antimicrobial resistance. Self-medication without medical guidance can lead to inappropriate, incorrect, or undue therapy, missed diagnosis, delays in appropriate treatment, pathogen resistance, and increased morbidity. The growing trend of self-medication can be attributed to various factors like the urge for self-care, sympathy toward sick family members, inaccessible health services and nonavailability of drugs, time and financial constraints, ignorance, misbeliefs, extensive advertisement and availability of drugs in places other than drug shops. Methodology The present community-based descriptive cross-sectional study was conducted in an urban field practice area of a tertiary health care center (UHTC) in Central India. Individuals above 18 years of age and present at home at the time of the house-to-house survey comprised the study participants. A total of 400 participants were enrolled in the study. Data were collected using a predesigned and pretested questionnaire by the face-to-face interview technique. Results The prevalence of self-medication in the area was 60 % (240). The most widely used drugs for self-medication were analgesics (159; 66.25%) and antipyretics (142; 59.16%). Common ailments for which self-medication was used frequently were fever, body aches, common cold, and cough. It was observed that female participants were twice more likely to self-medicate as compared to male participants (Odds Ratio (OR): 2.04; Prevalence (p) = 0.014, Confidence Interval (CI) 95% = 1.15-3.62). Additionally, those having education above the high school level had more chances of self-medicating than those educated less than high school (OR: 1.25; p≤0.014, CI 95%=1.05-1.50). The commonest reasons for resorting to self-medication as per the findings of the present study are that it saves time and the condition was not serious enough to warrant a physician's consultation.

Status of Respectful Maternity Care Among Women Availing Delivery Services at a Tertiary Care Center in Central India: A Cross-Sectional Study.

Introduction There are numerous reports of disrespectful, abusive, or neglectful treatment during childbirth from health facilities worldwide. Although India has substantially increased the number of hospital deliveries and reduced the maternal mortality ratio, the quality of intrapartum and immediate postpartum care for delivering mothers has not been given much importance. Therefore, assessing mistreatment and quality of care during childbirth is vital for promoting respectful maternity care.  Methods A descriptive hospital-based cross-sectional study was carried out in a tertiary care center in central India. A convenience sampling method was used, and a total of 150 consecutive consenting women aged 18-49 years who delivered in the study setting were included. Data was collected using a predesigned and pretested questionnaire based on seven major categories per the Respectful Maternity Care (RMC) Charter. Results All the 150 women in the present study, i.e., 100%, experienced at least one form of disrespect during their labor, childbirth, or postnatal period at the hospital. The mean scores for domains of non-confidential care (0.59), non-consented care (0.95), abandonment or denial of care (1.21), and physical abuse (1.26) are low. Conclusion The findings of the present study shed important light on the current state of respectful maternity care in the study area. Though mothers are noticing and reporting positive changes in maternity care practices, respectful maternity care still has a long way to go.

Infectious causes of acute encephalitis syndrome hospitalizations in Central India, 2018-20.

BACKGROUND: We enhanced surveillance of hospitalizations of all ages for acute encephalitis syndrome (AES) along with infectious aetiologies, including the Japanese encephalitis virus (JEV). METHODS: From October 2018 to September 2020, we screened neurological patients for AES in all age groups in Maharashtra and Telangana States. AES cases were enrolled at study hospitals along with other referrals and sampled with cerebrospinal fluid, acute and convalescent sera. We tested specimens for non-viral aetiologies viz. leptospirosis, typhoid, scrub typhus, malaria and acute bacterial meningitis, along with viruses - JEV, Dengue virus (DENV), Chikungunya virus (CHIKV), Chandipura virus (CHPV) and Herpes simplex virus (HSV). RESULTS: Among 4977 neurological hospitalizations at three study site hospitals over two years period, 857 (17.2%) were AES. However, only 287 (33.5%) AES cases were eligible. Among 278 (96.9%) enrolled AES cases, infectious aetiologies were identified in 115 (41.4%) cases, including non-viral in 17 (6.1%) cases - leptospirosis (8), scrub-typhus (3) and typhoid (6); and viral in 98 (35.3%) cases - JEV (58, 20.9%), HSV (22, 7.9%), DENV (15, 5.4%) and CHPV (3, 1.1%). JEV confirmation was significantly higher in enrolled cases than referred cases (10.2%) (p < 0.05). However, the contribution of JEV in AES cases was similar in both children and adults. JE was reported year-round and from adjacent non-endemic districts. CONCLUSIONS: The Japanese encephalitis virus continues to be the leading cause of acute encephalitis syndrome in central India despite vaccination among children. Surveillance needs to be strengthened along with advanced diagnostic testing for assessing the impact of vaccination.

COVID-19 and subsequent lockdown: Adverse effects on psychological health of Indian women.

CONTEXT: COVID-19 pandemic and subsequent lockdown have led to adverse psychological outcomes in general population. Stress is mounting at an unbelievable pace and one gender is taking the brunt more than the other. While it's easy to understand the predicaments of working women and how stressful they are during the lockdown, what escapes the notice is the condition of homemaker women who face a lot of challenges as their workload has increased due to lack of house help. Hence the study was conducted to assess anxiety and stress related to problems arising out of COVID-19 and the subsequent lockdown among Indian women. METHODS AND MATERIAL: Cross-sectional study was carried out among women across India using snowball sampling technique. Data was collected by a semi-structured online questionnaire based on GAD-7 and PSS scales. It was done using STATA 10.1 and Spearman's correlation coefficient, Kendall's Tau, etc., were applied. RESULTS: Majority of study participants mentioned either improvement or no change in their personal relations. Anxiety was present in 55.97% and moderate stress in 90.53% of the female participants. Mean GAD and PSS scores were 5.91 and 21.91 respectively. Anxiety and stress were found to be significantly related to getting help in the household work and occupational status. Watching movies and trying different recipes were the main destressors. CONCLUSIONS: More than half of the women are having anxiety and almost all have some form of stress due to COVID-19 pandemic and the subsequent lockdown.

Independent association of meteorological characteristics with initial spread of Covid-19 in India.

Whether weather plays a part in the transmissibility of the novel Coronavirus Disease-19 (COVID-19) is still not established. We tested the hypothesis that meteorological factors (air temperature, relative humidity, air pressure, wind speed and rainfall) are independently associated with transmissibility of COVID-19 quantified using the basic reproduction rate (R0). We used publicly available datasets on daily COVID-19 case counts (total n = 108,308), three-hourly meteorological data and community mobility data over a three-month period. Estimated R0 varied between 1.15 and 1.28. Mean daily air temperature (inversely), wind speed (positively) and countrywide lockdown (inversely) were significantly associated with time dependent R0, but the contribution of countrywide lockdown to variability in R0 was over three times stronger as compared to that of temperature and wind speed combined. Thus, abating temperatures and easing lockdown may concur with increased transmissibility of COVID-19 in India.