Zydus Medical College and Hospital, Dahod

This study explored sickle cell disease (SCD) in the tribal population of Eastern Gujarat, India. The objectives included determining the incidence and gender-wise distribution of SCD cases. A hospital-based analytical study was conducted with 600 tribal participants. Data were gathered from medical records between June 1 and June 27, 2019. Ethical approval and participant consent were obtained. The study included patients diagnosed with SCD and excluded those who had undergone surgery, were females in their menstrual cycle, or were non-SCD patients. Data analysis was performed using SPSS 22.0 software. The highest incidence of SCD was observed in males aged 10 years-20 years and females aged 21 years-30 years. In whole study population, the incidence was 25.67%. Significant differences (P < 0.05) were found between male and female patients in red blood cell (RBC) count, hemoglobin (Hb) levels, white blood cell (WBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and packed cell volume (PCV). SCD patients showed lower RBC count, Hb concentration, PCV, and RBC indices but higher WBC counts. Significant gender differences were noted in several parameters. Due to limitations in data recording, mortality could not be thoroughly assessed. The study indicates that malnutrition, stemming from poverty, is a concern, and balanced diets are essential for reducing the incidence and morbidity of SCD.

Background: Taboo in a social or religious setting means a custom prohibiting or restricting certain practices. Many foods related myths are common in society which leads to poor pregnancy outcome. It is important to make the community aware about it and educate them regarding this. Being a tribal community, taboos are more prevalent and this was the main aim to do the study regarding food taboos. Study: The type of the study is Qualitative research method; The study was done in a tribal community in the eastern part of Gujarat. The subjects were taken on the basis of convenience sampling. Focus group discussion (FGD) was done and data was generated. The data was recorded in notes and audio recordings, which were further analyzed. Results: The study was conducted in a tribal area with 80 participants. Out of which 37 were pregnant mothers and 43 were mothers with babies aged 0 to 6 months. The most common foods avoided were Papaya, pineapple, chicken, eggs, onion, garlic, eggplant, Jaggery, Guwar, urad daal, and various other food items. Discussion: This study shows that many foods are considered hot and cold and they are restricted during pregnancy and postpartum. There is a strong notion in the community that consumption of certain foods is associated with poor outcomes of pregnancy and the health of the baby. Conclusion: The food taboo followed in these communities can lead to potential nutritional deficiencies which in turn can lead to adverse effects in the child and the mother. A need for education regarding proper nutritional practice is necessary at this level.

Background Sickle cell disease (SCD) with vaso-occlusive pain crisis (VOC) has a major impact on healthcare resource utilisation and poses a significant financial burden for the patients. This study examines the economic implications of managing VOC in individuals with SCD in India, from the perspectives of patients, healthcare system and society.Methods This cross-sectional, observational study included 1000 patients with SCD across 14 centres enrolled from November 2021 to June 2022. Data were collected systematically using a structured electronic case record form. Employing a cost-of-illness approach, the study assessed the economic impact of SCD and VOC management, including assessing patient/caregiver costs, healthcare provider costs and societal burdens extrapolated to the larger SCD population in India.Findings Patients incurred substantial out-of-pocket expenses, with a median (IQR) annual expenditure of INR 22 080/US$267 (IQR: INR 36 990/US$447.7), representing 14.65% (26.53) of their annual household income. Overall, catastrophic healthcare expenditure (CHE) for total annual average SCD care with VOC management was experienced by 624 patients (62.40%). Moreover, 334 patients (33.4%) experienced CHE of >25% of the annual household income. Patients with SCD with VOC had significantly higher median annual healthcare expenditures and used a higher median percentage of their yearly household income on healthcare compared with those without VOC (19.82% vs 6.08%; p<0.001). Cost incurred by healthcare providers for VOC management in different healthcare facilities (outpatient department/emergency department/intensive care unit) was similar across different reimbursed facilities (government tertiary care hospitals, non-governmental organisation-operated healthcare centres and government-subsidised healthcare setups). The estimated societal burden for VOC management in 1 year for 1000 patients visiting different healthcare facilities was around INR 35 119 074 (~US$0.42 million).Interpretation These findings highlight the considerable economic strain on both patients and healthcare providers in SCD and VOC management, which is similar to the other non-communicable diseases emphasising the urgent need for targeted interventions to improve financial hardships among patients.Funding The study was funded by Novartis Healthcare Private Limited.

Background:Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods:A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results:The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions:High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.

Background and Aim: Among all the rotator cuff tendon injuries, supraspinatus tear is very common and it is mostcommon in older individuals. Before the arthroscopy came into high demand, the open repair of supraspinatustear was the preferred method of surgery. Recently, the miniopen technique of repair has also gained popularitybecause of certain factors like better repair strength, requires less expertise and facilitates early active mobilization.Present stud was performed to compare functional and clinical outcomes of arthroscopic and mini-open repair.Material and Methods: The present analysis is the randomized control study done on the patients diagnosedwith rotator cuff tears and was planned with supraspinatus repair with the use of arthroscopic and mini opentechnique. As per the inclusion and exclusion criteria total of 128 patients were included in the study. The includedpatients were equally divided into two groups: 64 patients who underwent mini-open repair and 64 patientswho underwent arthroscopic repair. Follow up was done after 12 months postoperatively and the results wereevaluated using University of California Los Angeles (UCLA) shoulder score.Results: For arthroscopic repair group, UCLA shoulder score were: 26 patients got excellent result, 30 patients gotgood result and only 8 patients got fair result. In the other group UCLA shoulder score were: 22 patients in whomexcellent results were obtained good results were obtained in 32 patients and in 10 patients we got fair results.Conclusion: The arthroscopic procedure decreased postoperative pain, faster regains normal ROM and quickerreturn to function and in turn early return to work compared to mini-open procedure. The arthroscopic procedurebetter in addressing intra-articular and other associated problems than mini-open technique.