BACKGROUND:Household waste segregation and collection infrastructure are foundational to environmental sanitation and infection prevention. Evidence on prevalence patterns and policy translation from eastern India remains limited. MATERIALS AND METHODS:A community-based mixed-methods descriptive study was conducted among 219 households (urban = 110; rural = 109) in eastern India. Quantitative data were collected using interviewer-administered questionnaires and observational checklists assessing segregation practices, storage systems, and collection infrastructure after pilot validation. Waste quantification was undertaken in a subsample using color-coded bag weighing. Urban-rural comparisons were analyzed using Chi-square tests and independent t -tests, whereas thematic analysis was applied qualitatively. RESULTS:Overall segregation compliance was significantly higher in urban households. Use of dustbins for kitchen waste was 75% in urban areas compared with 65% in rural areas ( P < 0.001), whereas indiscriminate dumping was reported exclusively in rural households (20%). Formal municipal collection coverage was substantially greater in urban settlements, whereas rural households relied on roadside dumping, burning, and informal disposal systems. Rural households generated significantly higher organic waste (2.38 ± 0.60 kg/day vs. 1.38 ± 0.50 kg/day; P < 0.001). CONCLUSION:Marked urban-rural disparities exist in household waste segregation and collection infrastructure. Strengthening decentralized waste systems, behavior change communication, and municipal outreach is essential. Integrating segregation monitoring into national sanitation missions and primary health platforms can translate household action into policy-responsive environmental health gains.
Summary Uniform reporting of health economics data for taxable lifestyle commodities such as alcohol would include sales as well as consumption mapping, which is a challenging task given a component of choice as well as of intensity. This is challenging, particularly for a country such as India, where states are socioculturally diverse and have independent alcohol sales policies, leading to varying levels of its consumption. There is also a gap in the description of risky behaviors of alcohol use, leading possibly to inadequate data collection and a subsequent reporting bias. Furthermore, there is a reported disparity between the overall alcohol sales and the consumption data. This may have a significant impact on the data reporting/projection by global agencies, leading to biased implications for the external perception of health in the Indian context, while also influencing the related trade and taxation parameters. To depict the need for consumption mapping and digital interventions in this context, an example of underage drinking in India through a Strengths, Weakness, Opportunities, and Threats analysis was undertaken. Overall, adopting digital interventions, including mobility mapping for consumption and geospatial mapping of sales hot spots, may facilitate better data collection, a possible solution for bridging the information gap between sales and consumption.
BACKGROUND:Anemia is one of the most common nutritional deficiencies among pregnant women, often causing adverse maternal and fetal outcomes. While oral iron has been the primary strategy for managing anemia, however, issues related to compliance and absorption have limited its effectiveness. Intravenous iron sucrose has emerged as a potential alternative, but its cost-effectiveness remains underexplored. OBJECTIVES:The present study was undertaken to assess the cost-effectiveness of intravenous iron sucrose compared to oral iron for moderately anemic pregnant women in India. MATERIALS AND METHODS:A decision-tree model was developed to estimate the costs and outcomes of anemia in maternal and fetal/newborn populations. The analysis adopted an abridged societal perspective, considering health system costs and out-of-pocket expenditures. Indirect costs were included in the sensitivity analysis. Deterministic and probabilistic sensitivity analyses were undertaken to assess the robustness of findings. RESULTS:The use of intravenous iron sucrose has an incremental cost-effectiveness ratio (ICER) of Indian National Rupee (INR) 30,397 per disability adjusted life year averted and INR 7489 per quality-adjusted life year gained. These ICERs are below the threshold of 1-time gross domestic product per capita, indicating that intravenous iron sucrose is a cost-effective therapy. The results were sensitive to extreme variations in treatment adherence rates. CONCLUSION:Intravenous iron sucrose proves to be a cost-effective strategy for managing moderate anemia in pregnancy compared to oral iron and should be considered as first-line therapy. Furthermore, adherence to therapy is a crucial factor influencing the success of intravenous iron. Therefore, concerted efforts aimed at improving treatment adherence are recommended.
BACKGROUND:Acute blood flow restriction (BFR) training has been recognized for its potential benefits in increasing muscle strength and hypertrophy. However, the specific effects of acute BFR on muscle activation in the lower leg during exercise, such as deep squats, under different weight-bearing conditions have yet to be explored. This study aimed to investigate the effect of acute BFR on muscle activation in the lower leg during the deep squat and discuss its importance in clinical nursing. METHODS:Twenty-five female participants performed deep squats under low-intensity (LI), LI-BFR, high-intensity (HI), or HI-BFR. While the LI groups used bodyweight squats, the HI groups used 75% of one repetition maximum. A pressurized band was tied to the upper third of the thigh with the restrictive pressure determined by the thigh dimension. Electromyography signals of the biceps femoris, semitendinosus (SEM), gluteus maximus (GM), lateralis, vastus medialis (VMO), and rectus femoris (RF) were collected and the standardized values of the root mean square (RMS) of each muscle were calculated. RESULTS:The RMS values were lower in the LI-BFR than in the LI group and changes were significant for the GM, VMO, RF ( P < 0.05), SEM, and vastus lateralis ( P < 0.01). The RMS values were also lower in the HI-BFR than in the HI group and changes were significant for the lateral femoral ( P < 0.05), RF ( P < 0.05), and medial femoral muscles ( P < 0.01). The RMS standard values of the lower extremity muscles were higher in the HI than in the LI groups ( P < 0.01). Following the increase in intensity, the elevation rate of the RMS values in the lower extremity muscles was similar under both pressurized and nonpressurized conditions ( P > 0.05). CONCLUSIONS:The results of this study highlight that increasing the load effectively enhances muscle activation in the lower extremities during deep squats, but no positive impact of acute BFR on muscle activation was observed. Under BFR conditions, there was no further increase in muscle activation beyond what was achieved with increased load alone. This clinical nursing intervention method still requires further exploration, particularly in enhancing muscle strength and function in individuals undergoing rehabilitation or experiencing muscle atrophy. At least during the training process, no observed increase in muscle activation was observed. Further research and the development of evidence-based guidelines are necessary to explore the full potential of acute BFR in clinical nursing practice.
SUMMARY:Migraine is a widespread and debilitating disorder. Recent evidence suggests a role of seasonal and circadian rhythmicity in migraine episodes. We investigated the pattern of migraine attacks over 1 year in the North Indian population. A questionnaire was provided to 120 migraine patients at the end of each of the six seasons according to the Indian calendar. The frequency, pain intensity, and duration of migraine episodes were significantly higher during the hot summer (7.92 ± 0.70, 6.63 ± 0.17, and 8.73 ± 0.99, respectively) and monsoon (8.11 ± 0.72, 6.64 ± 0.17, and 8.00 ± 0.94, respectively) compared to the cold winter months. There was a gradual decrease from summer to winter, with 77.2% of patients reporting diurnal rhythmicity to their attacks, and 34.5% of patients reporting occurrences in the afternoons, increasing from colder to hotter months. Increased incidence during summer, monsoon, and afternoons should be considered in planning prophylactic and therapeutic interventions.
BACKGROUND:Earlier studies have examined the link between government health expenditure (GHE) and economic growth using panel unit root and panel co-integration and Generalized Methods of Moments GMM in BRICS countries, yet whether the long-run impact of healthcare spending to accelerate economic growth still demands more attention and in-depth analysis. OBJECTIVES:The current study examined the effective drivers of BRICS countries' healthcare systems and investigated how health indicators affect BRICS countries' gross domestic product (GDP) and per capita income. It is important to examine how healthcare variables affect BRICS nations' health spending priorities in the short and long term. MATERIALS AND METHODS:The healthcare indicators, such as Current Health Expenditure (CHE), GHE, Crude Birth Rate, Immunization, Infant Mortality Rate, Inflation Consumer prices annual percentage, Life Expectancy at Birth, out-of-pocket expenses, Population Growth, and Total Fertility Rate were considered for the analysis. The study used Panel Data analysis with Fixed Effect and Random Effect Model for the BRICS countries from 2000 to 2019. RESULTS:The results highlight that GDP and per capita income negatively affect variable CHE. It suggests that GHE positively relates with GDP and per capita income. The results reflect that higher government health spending leads to higher real GDP and per capita income. CONCLUSION:The study highlighted that the BRICS countries' healthcare systems are best protected by investing in infrastructure, hospitals, and vaccination.
BACKGROUND:Head injury (HI) places a significant burden on survivors, leading to long-term disability. However, limited studies have investigated its prevalence in South Asian countries. OBJECTIVES:Perform a systematic review to identify community-based surveys reporting the prevalence of HI in South Asia and to conduct a meta-analysis to derive pooled prevalence estimates for the region. MATERIALS AND METHODS:A comprehensive literature search was conducted in EBSCOhost, Google Scholar, Ovid, PubMed, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quality and risk of bias were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology and Risk of Bias Tool for Prevalence Studies, respectively. The analysis was carried out using the latest version of R software (4.4.0). RESULTS:Twenty-one studies assessing general, pediatric, and older adult populations were included; the overall prevalence of the general population of HI in South Asia was estimated to be 12/1000 persons. Sri Lanka had the lowest prevalence score for HI (0.6/1000 persons), whereas India had the highest (16.1/1000 persons). Prevalence of HI in the pediatric population was 60/1000 persons and in older adults was 47.2/1000 persons. The prevalence of HI was higher in males than in females, and urban residents scored higher than rural residents. CONCLUSION:The study sheds light on the current status of HI prevalence in South Asia. Therefore, improvement in community awareness and treatment facilities is needed to be implemented to control HI fatalities.
BACKGROUND:Psychosocial stress in pregnancy can cause interference in the maternal-fetal immunological system, which can have both short- and long-term implications. The presence of a standard screening process leads to early initiation of counseling and psychiatry referral in severe conditions. OBJECTIVES:The objective of this study was to develop a specific scoring system to categorize women into different grades of psychosocial stress, thereby determining its impact on outcomes and risk of postpartum depression (PPD). MATERIALS AND METHODS:This prospective cohort study was conducted in a tertiary care hospital in South India. The study recruited 226 participants after taking the institute's ethical clearance. A novel validated questionnaire based on 25 stressors was administered antenatally, and pregnancy outcomes were documented. Receiver operating characteristic curves were used to assess the predictability of adverse maternal-fetal. P < 0.05 was considered statistically significant. Youden's index was calibrated to identify a scoring cutoff to predict adverse outcomes. RESULTS:A higher level of maternal education was associated with increased levels of maternal stress ( P < 0.001). Elevated stress scores were associated with increased risk of preeclampsia ( P = 0.05), composite adverse maternal outcomes ( P = 0.014), and fetal outcomes ( P = 0.016) later in pregnancy. The optimum cutoff stress score to identify risk of adverse outcomes was identified as 7.5, whereas the risk of PPD is increased with stress score levels above 6.5. A higher level of stress score was associated with increased risk of PPD ( P < 0.001). CONCLUSION:The novel prenatal stress scoring system is a good predictor of adverse maternal and perinatal outcomes in a low-middle-income hospital setting.
BACKGROUND:Understanding Jharkhand's healthcare landscape is crucial for devising targeted interventions and strengthening research efforts to address the pressing healthcare needs of the state. OBJECTIVE:The objective of this study was to carried out a bibliometric analysis of original research articles conducted in Jharkhand between 2013 and 2023 to assess the state of health research. MATERIALS AND METHODS:A systematic search across Medline, Embase, CINAHL, and Cochrane databases identified 6492 articles, which were screened using Covidence software after duplicate removal. Descriptive analyses using Microsoft Excel 2019 and bibliometric networks with VOSviewer software were employed. RESULTS:Among 209 identified articles, 58% belonged to the Global Burden of Disease category 1 topics. Half of the studies utilized cross-sectional study designs and were conducted in facility-based settings with 22% exclusively focused on the tribal population. The average annual publications, number of citations, and number of authors per article were 19 articles, 12, and 6, respectively, with publication peaks in 2015 and 2020. Government-affiliated corresponding authors constituted 46% of all articles, with 21% from international institutes. Ethical approval was reported in 86% of articles, and 71% of funding originated from international sources. The Central Institute of Psychiatry, Ranchi, emerged as the most productive institute while leading journals were the Asian Journal of Psychiatry and PLOS One. CONCLUSION:Enhancing the focus on interventional research, fostering local partnerships and international collaborations, and addressing the health needs of marginalized communities can lead to more effective healthcare interventions and equitable health outcomes in Jharkhand.
BACKGROUND:Ovarian cancer was one of the leading causes of cancer deaths among women. This cancer is difficult to diagnose early since there is no public screening program for early identification, which results in low survival rates. This study aimed to investigate trends in ovarian cancer mortality from 1990 to 2018 in Montenegro, using regression techniques. OBJECTIVES:Data on ovarian cancer mortality in Montenegro from 1990 to 2018 were collected. MATERIALS AND METHODS:Mortality rates were age-standardized to the World Standard Population to estimate overall and age-specific trends. To find the changes in the ovarian cancer mortality trend over time, joinpoint, linear, and Poisson regressions were used. RESULTS:Resuming the period from 1990 to 2018, 418 women in Montenegro died from ovarian cancer. The average number of deaths per year was 14.4, and the average age-standardized rate was 3.0/100,000. Joinpoint regression identified consistently increasing ovarian mortality rates with an average annual percentage change (AAPC) of 1.9% (AAPC [95% confidence interval (CI)]: 1.9 [0.6-3.3]). Moreover, the number of cases increases by an average of 3.5% per year (AAPC [95% CI] =3.5 [2.2-4.7], P < 0.001). The highest rates were recorded in the age group of 75-84 years (16.4/100,000) and the age group of 65-74 years (14.3/100,000). CONCLUSION:The explanation for the rise in ovarian cancer mortality in Montenegro is unknown. However, this study emphasizes the significance of paying greater attention to ovarian cancer and undertaking additional research to discover the underlying causes of this unfavorable trend.
BACKGROUND:Eradicating malnutrition among children by the year 2030 is a key objective of Sustainable Development Goals adopted by the UNDP. However, child malnutrition continues to pose a pressing public health concern in India, with malnutrition indicators being far above acceptable limits. The challenge of addressing the problem is further compounded by significant disparities in the levels of under-nutrition among under-five children across rural and urban areas. Understanding the extent and the contributing factors to these disparities are important for designing effective policies and targeted interventions. OBJECTIVES:The study aims to explore the rural-urban disparities in child malnutrition in India as demonstrated by the composite index of anthropometric failure, a combined measure that incorporates multiple anthropometric indicators. MATERIALS AND METHODS:The study uses the unit level data from National Family Health Survey-5, 2019-2021 and employs the Fairlie decomposition technique to determine the relative contributions of various factors, including individual, maternal and socio-economic status, to the rural-urban malnutrition gap. RESULTS:The findings reveal that mother's health and education are the key factors contributing to the gap, accounting for about 37.4% and 29.3%, respectively, of the total variance. CONCLUSION:The results emphasize the importance of targeted interventions that focus on socio-economic and maternal factors to bridge the disparities.
SUMMARY:A retrospective study was conducted to analyze the profile and outcomes of trauma patients admitted to pediatric intensive care unit in a tertiary hospital. The three-month postevent outcome was evaluated based on the Glasgow outcome scale. A total of 118 patients were enrolled. Vehicular accidents ( n = 52; 44.5%) and falls ( n = 51; 43.2%) were the main trauma modes. The incidence of unrestrained passengers in vehicular accidents was high (98%). Unsupervised play in toddlers was the main mechanism of falls. Ambulance transport was done in 48.3% of patients. Abnormal computed tomography head was seen in 72.9% ( n = 86) patients. Mortality rate was 8.5%. On multivariate analysis, Glasgow coma scale (GCS) <8 and injury severity score (ISS) >17 predicted unfavorable outcomes. Screening for head trauma is important in all sick pediatric trauma patients requiring intensive care unit. The study identifies the need for increasing awareness on child-proofing and supervision of toddlers' play and restraining passengers in high-speed vehicles to prevent serious injuries. Ensuring safe ambulance transport may improve trauma outcomes.
SUMMARY:Non-communicable diseases (NCDs) are an increasing public health concern in India. A cross-sectional study was conducted among NCD patients attending outpatient clinics in two urban and two rural health centers in the Shimla district of Himachal Pradesh to investigate urban-rural differences in the prevalence of modifiable behavioral and metabolic risk factors. Hypercholesterolemia (≥200 mg/dL) and elevated diastolic blood pressure (≥90 mmHg) were significantly more prevalent among urban participants. In contrast, rural participants had greater exposure to second-hand smoke and lower intake of fruits and vegetables. These findings underscore the need for targeted interventions tailored to the place of residence to address risk factors for NCDs.
BACKGROUND:India has undergone major demographic and epidemiological transitions over the past three decades. Although life expectancy has improved, conventional mortality indicators do not capture years lived with illness or disability. Health-adjusted life expectancy (HALE) offers a more comprehensive measure of population health by integrating mortality and morbidity. OBJECTIVE:The objective of this study was to assess trends in HALE in India from 1990 to 2021 by state, sex, and age group using estimates from the Global Burden of Disease (GBD) Study 2021. MATERIALS AND METHODS:This ecological analysis used publicly available HALE estimates from the GBD Study 2021 for all 28 states and 8 union territories of India. Percentage changes in HALE between 1990 and 2021 were analyzed by sex, age group, and geography. Estimates are presented with 95% uncertainty intervals (UI). RESULTS:National HALE increased from 15.20 years (95% UI: 13.95-16.33) in 1990-16.00 years (95% UI: 14.63-17.27) in 2021, representing a 5.25% increase. Female HALE improved slightly more than male HALE (5.36% vs. 5.28%). The largest gains were observed among individuals aged 20-24 years, whereas HALE declined among males aged ≥ 75 years. Goa recorded the highest HALE in 2021 (19.31 years), while Uttarakhand had the lowest (14.78 years). Jharkhand (22.15%), Andhra Pradesh (20.83%), Odisha (18.68%), and Telangana (18.54%) demonstrated the greatest relative increases, whereas Manipur showed minimal improvement (3.23%). Chhattisgarh exhibited the widest sex disparity in HALE change. CONCLUSION:HALE in India improved modestly between 1990 and 2021; however, substantial disparities persist across states, sexes, and age groups. Targeted public health interventions and healthy aging strategies are needed to reduce inequities and improve healthy longevity.
