Background Vision related quality of life (VRQOL) measures one’s satisfaction with their visual ability to perform daily activities. Aging leads to vision impairment that can negatively affect VRQOL and physical, psychological, and social well-being. Objective To assess vision-related quality of life (VR-QOL) and its determinants among elderly residents from rural blocks of Haryana, India. Method This cross-sectional study was performed across 52 Indian villages. The vision-related quality of life scores was assessed using National Eye Institute Vision Function Questionnaire-25(VFQ-25). Social Connectedness, Geriatric Depression Scale, Mini-Mental Status Examination, and the Katz Index of Independence were collected using validated tools. Continuous data was represented as Mean (±SD) or median (IQR) depending upon their distribution. Categorical data as frequency (%). Bivariate analysis was done using Student t-test or Rank Sum test for continuous variables (for up to 2 groups) and One-Way ANOVA was run for continuous variables (for more than 2 groups). Chi-Sq. test or Fisher’s for categorical variables and multivariable linear regression model was run to calculate the determinants of the VFQ composite score. Result Amongst the 420 participants, 58% were females and 74% were illiterates. The mean VR-QOL was 42.30 ± 11.19 in the study population. The study found higher VR-QOL scores in General Health, Distance activities, and Near activities, while lower scores were observed in Mental health, Dependency, Social functioning, Ocular pain, General vision, and Role difficulties. Both the mean VR-QOL composite score and the VR-QOL domains of General Health, General Vision, Ocular Pain, Role Difficulties, Mental Health, and Dependence were all greater for women than for men. Among the reported morbidities 26% had hearing loss, 23% were hypertensives, 9% were diabetics, 85% were dependent, 60% had depression, 14% had moderate dementia, 10% had lower tendency to connect, 8% had low vision and 35% had vertigo. VFQ scores were lower among males, non-Hindus, hypertensives and among person with history of vertigo and those living in dim light than their counterparts. Conclusion The current study shows that VR-QOL is significantly lower in male, participants with history of vertigo, hypertension, diabetes and who live in dim light. There is a need to develop strategies to address these determinants through multidisciplinary approach including chronic disease management and environmental modification and promote healthy aging of elderly population.

BACKGROUND:Folate and vitamin B12 deficiencies in pregnant women are associated with increased risk for adverse maternal and infant health outcomes, including neural tube defects (NTDs). METHODS:A population-based cross-sectional survey was conducted in two rural areas in Ambala District, Haryana, India in 2017 to assess baseline folate and vitamin B12 status among women of reproductive age (WRA) and predict the prevalence of NTDs. We calculated the prevalence of folate and vitamin B12 deficiency and insufficiency by demographic characteristics among 775 non-pregnant, non-lactating WRA (18-49 years). Using red blood cell (RBC) folate distributions and an established Bayesian model, we predicted NTD prevalence. All analyses were conducted using SAS-callable SUDAAN Version 11.0.4 to account for complex survey design. RESULTS:Among WRA, 10.1% (95% CI: 7.9, 12.7) and 9.3% (95% CI: 7.4, 11.6) had serum (<7 nmol/L) and RBC folate (<305 nmol/L) deficiency, respectively. The prevalence of RBC folate insufficiency (<748 nmol/L) was 78.3% (95% CI: 75.0, 81.3) and the predicted NTD prevalence was 21.0 (95% uncertainly interval: 16.9, 25.9) per 10,000 live births. Prevalences of vitamin B12 deficiency (<200 pg/mL) and marginal deficiency (≥200 pg/mL and ≤300 pg/mL) were 57.7% (95% CI: 53.9, 61.4) and 23.5% (95% CI: 20.4, 26.9), respectively. CONCLUSIONS:The magnitude of folate insufficiency and vitamin B12 deficiency in this Northern Indian population is a substantial public health concern. The findings from the survey help establish the baseline against which results from future post-fortification surveys can be compared.

Anemia is a public health problem in women of reproductive age in many low- and medium-income countries including India. Maternal anemia can cause low birth weight, impaired fetal growth, and preterm birth. We assessed the baseline prevalence of anemia, iron deficiency (ID), iron deficiency anemia (IDA), and inflammation using c-reactive protein (CRP) among non-pregnant, non-lactating women of reproductive age living in the Ambala District, Haryana, India prior to the start of a wheat flour fortification program. We conducted a multistage cluster probability household and biomarker survey and analyzed venous blood samples from non-pregnant, non-lactating women aged 18–49 years residing in rural areas of two subdistricts in the Ambala District. Factors of interest were: anemia, hemoglobin < 12.0 g/dL; ID, serum ferritin < 15μg/L; IDA, presence of both anemia and iron deficiency; inflammation, CRP > 5 mg/L. We used the BRINDA regression adjustment for ferritin to account for inflammation. Prevalence and 95% confidence intervals (CI) for anemia, ID, IDA, and CRP were estimated. Among 775 non-pregnant, non-lactating women of reproductive age, 54.3% (95% CI; 50.7, 58.0) had anemia, 86.9% (95% CI; 84.3, 89.2) were iron deficient, and 15.1% (95% CI; 12.5, 18.1) had inflammation. Among those with anemia, 58.2% (95 CI; 54.3, 62.0) had iron deficiency anemia. Anemia, iron deficiency, and iron deficiency anemia among non-pregnant, non-lactating women of reproductive age in Haryana are significant public health concerns. The findings from the survey helped quantify the burden of inadequate iron intake and informed the Haryana government's prevention strategy aimed at reducing micronutrient deficiencies through a wheat flour fortification program. Centers for Disease Control and Prevention.

INTRODUCTION:In 2014, the Government of India (GOI) released operational guidelines on the use of antenatal corticosteroids (ACS) in preterm labor. However, without ensuring the quality of childbirth and newborn care at facilities, the use of ACS in low- and middle-income countries is potentially harmful. This study assessed the readiness to provide ACS at primary and secondary care public health facilities in northern India.METHODS:A cross-sectional study was conducted in 37 public health facilities in 2 districts of Haryana, India. Facility processes and program implementation for ACS delivery were assessed using pretested study tools developed from the World Health Organization (WHO) quality of care standards and WHO guidelines for threatened preterm birth.RESULTS:Key gaps in public health facilities' process of care to provide ACS for threatened preterm birth were identified, particularly concerning evidence-based practices, competent workforce, and actionable health information system. Emphasis on accurate gestational age estimation, quality of childbirth care, and quality of preterm care were inadequate. Shortage of trained staff was widespread, and a disconnect was found between knowledge and attitudes regarding ACS use. ACS administration was provided only at district or subdistrict hospitals, and these facilities did not uniformly record ACS-specific indicators. All levels lacked a comprehensive protocol and job aids for identifying and managing threatened preterm birth.CONCLUSIONS:ACS operational guidelines were not widely disseminated or uniformly implemented. Facilities require strengthened supervision and standardization of threatened preterm birth care. Facilities need greater readiness to meet required conditions for ACS use. Increasing uptake of a single intervention without supporting it with adequate quality of maternal and newborn care will jeopardize improvement in preterm birth outcomes. We recommend updating and expanding the existing GOI ACS operational guidelines to include specific actions for the safe and effective use of ACS in line with recent scientific evidence.

To study the nutritional status and prevalence of RBC folate, Serum folate and vitamin D deficiency among adolescents. A cross sectional pilot study was carried out among 96 adolescents visiting outpatient department for refraction at tertiary care hospital in North India. Anthropometric data was obtained for height in centimetres and weight in kilograms. A pretested questionnaire was used to capture quantitative data. Venous blood samples were collected where red blood cell (RBC), serum folate and serum Vitamin D concentrations were measured. Anaemia was defined as normal, mild, moderate and severe as Hb > 12gm/dl, 11–11.9 gm/dl, 8–10.9 gm/dl and < 8 gm/dl respectively. Serum folate deficiency was defined as serum folate < 7 nmol/l, and RBC folate deficiency and insufficiency were defined as RBC folate < 305 nmol/l and & < 748 nmol/l, respectively. Vitamin D deficiency, insufficiency and sufficiency was defined as 25(OH)D < 20 ng/ml, 20–29 ng/ml and ≥ 30 ng/ml respectively. Descriptive statistics and inferential statistics were used. Almost 46% of adolescents were malnourished (10.4% were underweight, 35.4% were overweight or obese) and mean BMI was 19.7 kg/meter2 however it did not differ significantly across gender. As compared to boys more girls were vegetarian by diet. The mean concentrations for Hb, serum folate and RBC folate were 12.7 (95% CI: 12.4, 13.0) gm/dl, 15.1 (95% CI 12.5, 17.7) nmol/L and 492.9 (95% CI 431.9, 553.9) nmol/L, respectively. Mean concentration for Hb was significantly different across gender (p – 0.0). Around 17% of adolescents were anaemic, 60% were deficient for serum folate and 79% were deficient for RBC folate. Mean serum vitamin D levels were 18 ng/dl (95% CI: 17.0, 22.3) no significant difference found across gender. A total of 62.5% were deficient and 28% were insufficient for vitamin D (ng/ml). Around 50% of the adolescents lack adequate sleep (<8 hours) and increase vitamin D levels were associated with increase sleep duration (r-0.02, p-0.02). The nutritional status of adolescents in this study is poor and reflects a need to conduct a community-based study which can help in planning strategies to improve nutritional status during critical period of adolescence nil.

Centers for Disease Control and Prevention.