Objective The adoption of Multi arterial grafting (MAG) in coronary artery bypass surgery is lower in diabetics despite high prevalence of multi vessel coronary artery disease due to procedural complexity and risk of sternal wound infections. We propose randomized controlled study to evaluate safety, graft patency at 1-year, and long-term survival at 5 years in MAG compared to single arterial grafting (SAG). This interim analysis reports 1-year mortality, morbidity, and graft patency. Methods A total of 950 diabetic patients with multivessel coronary artery disease were enrolled between February 2022 through January 2025 at 15 hospitals across 7 states in India and randomized to SAG (n=477) or MAG(n=473) groups in a multicenter, prospective, randomized trial. Major adverse cardiac and cerebrovascular events and graft patency assessed by CT coronary angiography at 1 year were analyzed (CTRI/2020/09/027692). Results One-year composite outcome (SAG: n=7 [1.5%] vs MAG: n=7 [1.5%], p=0.98) & mortality (SAG: n=4 [1.27%] vs MAG: n=6 [0.84%], p=0.51) was low and comparable. Myocardial infarction occurred in one patient in each group. Stroke rates were comparable (SAG: n=2 vs MAG: n=1). One patient with SAG required repeat revascularization (PCI). Sternal wound infection occurred in 7 SAG patients (1.5%) and 11 MAG patients (2.3%) (p=0.36). Sternal reconstruction was required in only 3 MAG patients (0.6%). 350 patients underwent protocol CT graft angiography for graft assessment (SAG: n=170, MAG: n=180). Although, overall graft patency did not differ between SAG and MAG groups, vein graft patency after covariate adjustment was higher with MAG. The Off-pump CABG, RIMA grafts, RCA and LCx territory grafting are associated with lower overall graft patency. Conclusions Interim results from the trial demonstrate similar safety and 1-year clinical outcomes for SAG and MAG. We show superior venous graft patency with MAG after adjustment, but requires further studies to validate this finding.

BACKGROUND:Low diet diversity is the major contributor to micronutrient inadequacy among children, underscoring a need for a rapid assessment tool to assess micronutrient adequacy. OBJECTIVE:This study aimed to (i) develop a context-specific diet diversity score (DDS) tool (ii) evaluate the performance of the DDS scoring system against mean probability of adequacy for 10 micronutrients, 5 biomarkers of micronutrient status and (iii) identify an optimal DDS cut-off by applying minimum portion size threshold to support its potential use as a practical screening tool. METHODS:A cross-sectional study was conducted among 6-10-year-old children (n = 76) in two villages of Ghatkesar sub-district, Telangana. Portion sizes of commonly consumed fruits and vegetables were standardized. Data on household demographics, anthropometry, and biomarkers of micronutrient status were collected using a pretested questionnaire and standardized protocols. Three non-consecutive 24-hour-dietary-recalls were obtained using the weighment method. DDS was developed based on the nutrient content of consumed foods; minimum intake thresholds of 0.1 g, 5 g and 10 g was applied while scoring. Mean probability of adequacy (MPA) for 10 micronutrients was estimated using ICMR-EAR values. Correlations of DDS with MPA and biomarkers were examined, and sensitivity and specificity were assessed using ROC curves, considering MPA ≥ 70% as adequate. RESULTS:The DDS included 13 food groups. Mean DDS (5 g threshold) was 8.67 ± 1.50 and correlated significantly with MPA (r = 0.58), and hemoglobin (t = 2.07). A DDS-5 g cut-off of ≥10 predicted MPA > 70%, with an AUC of 0.89. CONCLUSION:The DDS showed good predictive performance for micronutrient adequacy, but requires further field validation before programmatic use.

BACKGROUND:Hospitalized patients with gastrointestinal (GI) diseases are predisposed to malnutrition and sarcopenia due to inflammation, malabsorption, and reduced intake, resulting in prolonged hospitalization and increased mortality. AIMS:To determine the prevalence of malnutrition and sarcopenia among adult hospitalized GI patients using the Global Leadership Initiative on Malnutrition (GLIM) criteria, computed tomography (CT)-derived body composition, and handgrip strength (HGS), and to evaluate their associations with length of hospital stay and 1-year mortality. METHODS:A single-center prospective observational study of 847 consecutively hospitalized adults with medical GI diseases. Malnutrition was classified using GLIM criteria, and sarcopenia was assessed via CT-derived skeletal muscle index (SMI), and HGS. Asian cutoffs were applied, and follow-up at 1 year post-discharge. RESULTS:GLIM-defined malnutrition was identified in 65% of patients, low HGS in 54%, and low SMI in 44%. Overall, 28% had both low SMI and low HGS, consistent with sarcopenia. Low SMI was significantly associated with low HGS (P < 0.001). Compared with well-nourished patients, GLIM-malnourished patients had higher odds of low HGS (58.3% vs. 45.3%; OR 1.68, 95% CI 1.26-2.24; P < 0.001). One-year mortality was higher among malnourished patients (7.5% vs. 3.1%; P = 0.018). In forward stepwise multivariable logistic regression, GLIM-defined malnutrition remained independently associated with 1-year mortality after adjustment for age, primary diagnosis, and length of hospital stay (OR 2.56, 95% CI 1.14-5.76; P = 0.023). CONCLUSION:GLIM-defined malnutrition and sarcopenia are highly prevalent and associated with poor outcomes. Findings support integration of body composition, and HGS into routine nutritional assessments.

The management of acute type A aortic dissection (ATAAD) remains a challenge in cardiac surgery, with significant variability in practices influenced by surgeon experience, institutional resources, and patient demographics. This survey aims to evaluate the current trends in ATAAD management among Indian cardiac surgeons. A nationwide survey was conducted among Indian cardiac surgeons, collecting data on preoperative, intraoperative, and postoperative practices, as well as surgeon demographics and institutional case volumes. The survey questionnaire was distributed to 380 active Indian cardiac surgeons. Key trends and factors influencing decision-making were analyzed. Two hundred surgeons responded to the survey questionnaire. In patients over 80 years of age, the management was conservative, with 73.49

In India, the prevalence of secondhand smoke (SHS) exposure is 29.5% in general and 11.2% at home. The youth may expose themselves to SHS without knowing the risk factors and consequences involved. This study is intended to determine the prevalence of SHS exposure and the measures adopted by the youth to avoid exposure. A cross-sectional study was conducted among 338 youth in an urban area in Hyderabad. A modified Global Youth Tobacco Survey questionnaire was used for data collection on SHS exposure and avoidance. The total prevalence of SHS exposure was 35.21%. The mean days of SHS exposure/week were 1.419 (standard deviation -1.806) days. Belonging to the age group 18–21 years, and male gender were significant predictors of SHS exposure. Education of the head of family was a significant predictor of SHS avoidance behavior. Creating awareness among young adults regarding the deleterious effects and preventive strategies of SHS exposure, thereby making them responsible for the health of their family can be a protective long-term strategy.

In the realm of evidence-based medicine, the importance of available data in ensuring better and ethical patient care is increasing. Medical record keeping (MRK), is crucial to research and the fast-growing field of clinical research and development. This study explored the perspectives of various hospital stakeholders – including doctors, staff, and members of the Ethical Committee (EC) – regarding the markers that define a proficient center based on good MRK practices. Using a Likert scale, 318 respondents from different affiliations (public, private, or both) assessed 10 specific markers. Comparing roles and affiliations, the study revealed significant differences in 7 out of the 10 markers; particularly in areas such as institutional support, training, presence of registered Ethics committees, documentation standards, recruitment procedures, and internal quality assurance. When comparing public and private sector affiliates, differences persisted in 9 markers. Notably. The representation from the public sector was limited (19.8

Background: Bile acid and salts depletion from high output bile in post- gastrointestinal surgical patients can lead to fat malabsorption causing malnutrition, fat-soluble vitamin deficiencies, dehydration, acute kidney injury and electrolyte abnormalities. Bile reinfusion is a method for restoration of bile salts in the gut. However, there are no studies which describe feeding delivery and nutritional adequacy during bile reinfusion. Methods: Patients undergoing gastrointestinal surgery and who have high bile output >500ml were included. Patients were started on oral, tube feeding and/or parenteral nutrition. Results: Twenty post- gastrointestinal surgical patients with a mean age of 48±13.5years and body mass index of 23.94±4.0kg/m2 had high output bile and in whom reinfusion was initiated. An average volume of 531±438ml/day of bile was reinfused for 9±4.99days along with oral diet or tube feeding and/or parenteral nutrition. Of the 20patients, 2 were exclusively on tube feeding, 5 on tube feeding and oral, 7 on oral and supplemental parenteral nutrition, and 6 on tube feeding with supplemental parenteral nutrition. Adequacy of energy and protein were categorized as ≥70% and <70%. Adequacy of protein and energy of ≥70% was achieved among 13patients (p=0.004, p=0.012). Although the adequacy was not statistically significant due to the small sample size, 18patients were discharged in clinically good condition and 2patients did not survive. Conclusions: The improvement in the patient’s nutrition, as in this study, is probably a significant contributing factor towards a positive postoperative outcome. Clinical benefits of this technique include fluid and electrolyte balance and optimal utilization of remaining absorptive capacity for enteral and/or oral nutrition.

Emerging foodborne pathogens in recent times are been a major public health concern for consumers. Food establishments such as street foods, which cater to larger sections of the population in developing countries, have become potential vehicles for emerging foodborne pathogens. The present study aimed to identify high-risk/emerging pathogens in street-vended foods from the south Indian city –Hyderabad. A cross-sectional study was carried outon 150 Chinese fast food samples, and 150 Bhelpuri- (mixed of puffed rice vegetables and sauces) samples, collected by stratified random sampling method. Foodborne pathogens/hygiene indicators were analyzed using USFDA-BAM (United States Food and Drug Administration-Bacteriological Analytical Manual) methods. Enteropathogens such as spp. and spp. were identified in 45.3% (68/150) and 20% (30/150) respectively in Bhel puri samples. Among Chinese fast foods, was detected in 90-92% of samples. About 40% samples were observed positive for in Chinese fried rice. Among the isolates of (n=20), 50% were resistant to Co-Trimoxazole and Amoxicillin. and were identified in the food samples. Periodic evaluation and monitoring of street foods are very essential to estimate the risk and toxicity of foodborne pathogens.

BACKGROUND:Non-communicable diseases are important causes of morbidity and mortality throughout the world. METHODS:A community-based cross-sectional study conducted in 10 Indian states using multi-stage random sampling procedures. Information was collected on socio-economic and demographic particulars, anthropometric measurements such as height, weight and waist circumference, fasting blood glucose and blood pressure was measured. One day 24-h dietary recall was done for foods and nutrient intakes. Bivariate and multivariate step-wise logistic regression analyses was done. RESULTS:The prevalence of overweight/obesity among rural adults was 23.4 % (95 % CI: 22.9-23.9), while age adjusted prevalence of pre-diabetes was 8.4 % (95 % CI: 8.1-8.7) and diabetes was 6.8, (95 % CI 6.7-7.1), respectively. The prevalence of diabetes was lowest in Uttar Pradesh, West Bengal and Odisha (3-4%) and higher in Kerala and Tamil Nadu (12-15 %). The odds of diabetes was 5.5 times more among elderly, 1.3 times higher among Christians and among high income groups, and 2 times among overweight (CI: 1.50-2.50), obese (CI: 1.61-2.76) and abdominal obesity (OR; 1.57; CI: 1.29-1.91) and 1.6 times more among hypertensives. The odds of diabetes were high among those consuming the lower tertiles of carbohydrates, pulses, milk and milk products and folic acid. CONCLUSION:the age-adjusted prevalence of diabetes and pre-diabetes was 6.8 % and 8.4 % respectively and the odds of diabetes was high among elderly, among high socio-economic groups, overweight/obese subjects and among hypertensives. Also, knowledge about symptoms of diabetes was low. There is a need to improve awareness for early diagnosis and treatment for control of diabetes and hypertension.

Studies on the effects of coronavirus disease 2019 (COVID-19) on pregnant mothers and their newborns, specifically in relation to their micronutrient status, fatty acids (FAs), and inflammatory status are sparse. We hypothesized that COVID-19 infection would adversely affect the transfer of nutrients, and FAs from mothers to their fetuses via the umbilical cord and maternal-fetal distribution of inflammatory cells. This study aimed to determine the effect of COVID-19 on micronutrients, inflammatory markers, and FAs profiles in pregnant mothers and their newborns' cord blood.This was a cross-sectional study of 212 pregnant mothers in the third trimester and their newborns, recruited after testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serostatus. Peripheral blood of mothers and cord blood were collected at birth and analyzed for vitamin B12 (Vit B12), folic acid, 25(OH)D3, FAs, and peripheral blood mononuclear cells. Student's t-test or analysis of variance (ANOVA) was used to express statistical significance. Non-normal data were tested using the Mann-Whitney U test and Kruskal-Wallis test, with proportions compared with the chi-square test.Vit B12 levels were significantly low and adrenic acid levels significantly high in COVID-19 seropositive mothers while 25(OH)D3 was significantly low in seropositive cord blood. Irrespective of COVID-19 serostatus, folate, vit B12, saturated FA levels were significantly high in cord blood indicating their increased transfer from mothers to the fetus. However, monounsaturated (MUFA) and polyunsaturated fatty acid (PUFA) levels were significantly lower in cord blood. Irrespective of COVID-19 serostatus, CD4+ T helper cells (percentage of lymphocytes) were significantly higher in cord blood, while NK cells, NK-T cells, and CD8+ T-cytotoxic cells-percentage of lymphocytes-were significantly lower in cord blood when compared with corresponding mother's blood.The results indicate that while COVID-19 did not impede the transfer of essential nutrients such as MUFA and PUFA from mother to fetus, or affect maternal-fetal immune cell responses, it did appear to affect the levels of vit B12, vitamin D, and adrenic acid. · COVID-19 did not impede essential fatty acids transfer through cord blood.. · COVID-19 affected maternal-fetal immune responses.. · COVID-19 affected vitB12, vitamin D and adrenic acid levels..

Multiple sclerosis (MS) is a complex neurological disorder. Neurofilament light chain (NfL) is a marker of axonal injury. It is potentially a significant biomarker in MS. Its detection from neuron-derived extracellular vesicles (NDEVs) using enzyme-linked immunosorbent assay (ELISA) warrants further exploration. NDEVs displayed typical extracellular vesicle traits and neuronal markers. NfL levels rose significantly in SPMS/PPMS patients (3.41 ± 0.979 pg/mL, p < 0.001) compared to RRMS patients (1.16 ± 0.549 pg/mL). NfL’s potential to distinguish MS patients from controls and among disease types was confirmed (AUC = 0.6531 and 0.9938, respectively). Additionally, our study revealed that Disease-Modifying Therapies (DMTs) treatment correlates with reduced NfL levels (mean: 1.302 pg/mL) compared to untreated MS patients (mean: 2.446 pg/mL), as shown by an unpaired t-test (p = 0.0095). NfL levels were significantly associated with MS progression and EDSS deterioration, explaining 68.7 and 37.5

The health and quality of life, of older persons are commonly affected by physiological and psychological changes and concurrent to the changes that occur in their food choices and consumption patterns due to various biological and psychological reasons. Numerous age-related illnesses and ailments can be prevented, mitigated, or alleviated by proper diet and nutrition. Cross-sectional research was done to examine the food choices, and well-being of the elderly. Using stratified random sampling, 114 homebound senior individuals (>60 y) from high, medium, and low socioeconomic strata (SES) in Kolkata were recruited. Data were gathered by the administration of pre-coded questionnaires, including a semi-quantitative food frequency questionnaire, WHO-SRQ depression' and WHOQOL-BREIF-26 for measuring Quality of Life, and a Lifestyle questionnaire to assess the general lifestyle of participants (physical activity, social activities, etc.). The data were analysed using descriptive statistics, correlations, the chi-square test, and the non-parametric ANOVA test. The results show that dietary preferences, quality of Life, and lifestyle were significantly associated with gender, socioeconomic position, and marital status. The intake of green leafy vegetables was the same across all three SES groups, however the consumption of fruit was lower among low-SES, women, and widows. These groups also had much greater rates of depression than their peers. Dietary diversity was positively connected to healthy lifestyle, and depression was inversely associated. The study reveals that older adults limit themselves to fewer food groups for biological, environmental and psychological reasons. There is a need dietary education and psychosocial support to improve their health and quality of life.

PURPOSE:The purpose was to study the choroidal thickness and its profile, derived from different point locations in healthy Asian Indian subjects using RTVue XR 100 optical coherence tomography (OCT) and to determine its correlation with age, refractive error, and axial length. METHODS:In this cross-sectional study, 300 eyes of 150 healthy subjects, with no ocular pathology, were scanned in a single session, using a line scan protocol of RTVue XR 100 OCT. Choroidal thickness was measured at the subfoveal region, and six measurements were obtained on either side of the fovea (temporal and nasal) at 500 μm interval apart, up to 3000 μm. The correlation between subfoveal choroidal thickness and age, refractive error, and axial length was assessed. RESULTS:Three hundred eyes of 150 healthy subjects were included in the analysis. Median age of the study participants was 55 years (interquartile range [IQR]: 44-61). The median subfoveal choroidal thickness was 235 μm (IQR: 210-263). The choroidal thickness was minimum at nasal 3000 μm from the fovea, while it was maximum in the subfoveal region. The point zones which were near the fovea showed thicker choroidal thickness than the outer zones, both nasally and temporally (P < 0.00001 at all locations), and at all point locations the choroid were thicker temporally than nasally (All P < 0.00001). Subfoveal choroidal thickness showed negative correlation with age (coefficient = -0.62, P = 0.03) and axial length (correlation = -8.52, P = 0.02). A decrease in subfoveal choroidal thickness of 0.62 μm/year was found by regression analysis. CONCLUSION:Our study provides normative database and topographic profile of choroidal thickness in the normal Asian Indian eyes using RTVue XR 100 OCT.

Background: Early menarche has emerged as a significant global concern due to its myriad health implications. Divergent findings characterize existing research on its determinants, prompting the necessity for this study to elucidate the discordance among them and to broaden the spectrum of predictors of early menarche. The primary objective of this study is to determine the mean menarcheal age and to study the influence of various factors, including socio-demographic characteristics, body mass index (BMI), and lifestyle habits, on the onset of menarche in our study population. Methodology: This was a questionnaire-based cross-sectional study carried out in the southwestern region of Karnataka between 2016 and 2017. A total of 700 high school girls aged between 14 and 16 years were recruited for the study via a simple random sampling technique. Results: The mean menarcheal age was found to be 12.67 ± 1.19 years, with 33% experiencing it before the age of 12. Factors accelerating menarche included high BMI, excessive exposure to audio-visual media, lack of exercise, non-vegetarian diet, and late sleeping habits, as determined by stepwise logistic regression analysis. Conclusions: Findings emphasize the significance of monitoring menarcheal trends and identifying modifiable factors influencing its onset. There is a need for educational programs focusing on the holistic health of girls.

Endometriosis is a benign gynaecological condition causing chronic pelvic pain, impaired fertility and dysmenorrhoea. It is difficult to describe the lesion distribution due to the complexity of the disease, inconsistent pattern and sometimes even absent progression. To describe clinical characteristics and locations of lesions in women with endometriosis using #ENZIAN classification. This was a retrospective observational cohort study of 154 patients with endometriosis who underwent laparoscopic or robotic endometriosis excision between April 2021 and September 2022 by a single surgeon in a multidisciplinary endometriosis centre. Clinical criteria such as age, demographics, menstrual history, previous endometriosis surgeries, size and location of endometriomas, along with clinical symptoms such as dysmenorrhea, dyschezia, infertility, dyspareunia, urinary frequency and rectal pain were documented. The #ENZIAN [2021] classification was used to assess the distribution of disease. Mean age of the patients was 32.25 ± 6.107 years, and mean BMI was 23.9 ± 3.36 kg/m2. 47.2

Background: Allograft dysfunction (AGD) is a common complication following solid organ transplantation (SOT). This study leverages the potential of urinary extracellular vesicles (UEVs) for the non-invasive detection of AGD. Aim: We aimed to assess the diagnostic value of T-cell and B-cell markers characteristic of T-cell-mediated and antibody-mediated rejection in UEV-mRNA using renal transplantation as a model. Materials and methods: UEVs were isolated from 123 participants, spanning healthy controls, functional transplant recipients, and biopsy-proven AGD patients. T-cell and B-cell marker mRNA expressions were evaluated using RT-qPCR. Results: We observed significant differences in marker expression between healthy controls and AGD patients. ROC analysis revealed an AUC of 0.80 for T-cell markers, 0.98 for B-cell markers, and 0.94 for combined markers. T-cell markers achieved 81.3 % sensitivity, 80 % specificity, and 80.4 % efficiency. A triad of T-cell markers (PRF1, OX40, and CD3e) increased sensitivity to 87.5 % and efficiency to 82.1 %. B-cell markers (CD20, CXCL3, CD46, and CF3) delivered 100 % sensitivity and 97.5 % specificity. The combined gene signature of T-cell and Bcell markers offered 93.8 % sensitivity and 95 % specificity. Conclusion: Our findings underscore the diagnostic potential of UEV-derived mRNA markers for T-cells and Bcells in AGD, suggesting a promising non-invasive strategy for monitoring graft health.

A targeted food safety training program for street food handlers is very essential to provide safe food for consumers. An in-depth assessment of knowledge and specific food safety practices of vendors is a prerequisite for incorporating a novel approach in training programs. The present study is a cross-sectional study conducted on 400 street food vendors (Panipuri-150, Bhelpuri-150, Fruit juice vendors-50, Chinese fast food-50) in south Indian city-Hyderabad, by stratified random sampling technique from 5 zones. A validated pre-tested questionnaire was administered by interview mode, and practices were recorded through the observational checklist. Scores have been allotted for a knowledge-based questionnaire with 18 items of which 5 are exclusive on knowledge and 13 questions on knowledge and subsequent practices recorded via observation checklist with different weights. Among all the street vendors, panipuri vendors (20.5±1.94) secured high scores and bhelpuri vendors (14.04±1.20) secured the least scores for knowledge whereas practice scores were relatively the same for all types of vendors. The average percentage for knowledge (17.40±3.56) scores was 68.1% and for practices (8.28±2.54) 38% for all the vendors. Very few vendors know the importance of practices like separating raw from cooked foods (22%), cooking food thoroughly (21.7%), and safe storage of cooked food (8.5%). Only about 13.7% of vendors thought that it is important to use soap for washing hands and only 4 % of the vendors practiced. The present study helps in identifying knowledge and knowledge-practice gaps in street food vendors for developing targeted food safety training programs.

Aim Study the effect of coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the placenta and in turn study its effects on pregnancy and newborn outcomes. Methods In this cross-sectional study, which was conducted in the term pregnant women who underwent delivery, their placentas were collected after delivery along with the mothers’ blood and cord blood. Results Among the 212 pregnant women recruited, the prevalence of marginal cord insertion (MCI) in the placentas after delivery, was found to be 23% (n=48). Among these 48 cases (n=48) with MCI, 58.33% (n=28) were COVID-19 positive. The placentas with MCI had significantly lower minimum placental circumference (probability value/p value=0.04) and significantly longer umbilical cord (p-value=0.05). COVID-19 antibodies transfer from the mother to the umbilical cord (C/M antibodies ratio) was observed to be lower, albeit insignificantly. Both the weight of newborns (p value=0.03) and their COVID-19 antibodies levels (p-value=0.05) were observed to be significantly lower in the MCI group. Univariate analysis shows that a body mass index (BMI) ≥ 23 of the mothers was significantly associated with abnormal MCI. Conclusion The prevalence of MCI was observed to be high in COVID-19-affected mothers in our study. MCI was associated with lower placental size, newborn weight, lesser transfer of COVID-19 antibodies from the mother to the fetus across the umbilical cord, and lower antibody levels in the cord blood when compared to maternal blood.

Background: Out of Pocket Expenditure (OOPE) are expenditures directly made by households at the point of receiving health care. In Telangana State the average OOPE per delivery in public health facility is Rs. 3846. The study helps to know the OOPE among mothers undergoing institutional deliveries and emphasise on the expenditure even after utilising the government financial assistance. Objectives: To estimate the OOPE among women undergoing institutional delivery and to find its association with government financial assistance utilization and socio-demographic factors. Methodology: A community based cross sectional study was done among 200 mothers who delivered recently residing in an urban slum under our health and training centre. Ethical clearance was taken before the conduct of study. Results: The median direct out of pocket expenditure among mothers in our study was Rs.500 i.e., 6.6 $ (0 to 1600). OOPE was present among 68.5% of mothers. Availability of government financial assistance, age and occupation of the mother and type of delivery was found to be significantly associated with p value <0.05. Conclusion: The financial assistance definitely reduced the burden of OOPE among the mothers. The implementation of such schemes is important and needs to be evaluated time to time to ensure proper reach of its benefits to the community.