Introduction: The unexpected boom in international and domestic travel due to improved connectivity and accessibility compels us to think about the health of the travellers. Our study involved analyses of the data in the travel health clinic. Materials and Methods: A secondary data analysis of the data regarding yellow fever vaccination since January 2019 and the data regarding the travellers presenting to the travel health clinic from its inception on 19 November 2023 to 15 July 2024 was conducted. Results: The mean age of the participants was 35, with the majority of them being males. South Africa was the most common country of travel, followed by Nigeria. The common reasons for travel were occupation/business, followed by tourism. Less than 40% of the beneficiaries were only found to have normal BMI; more than three-fourths of the beneficiaries were either pre-hypertensive or hypertensive, and around 5% presented with elevated random blood sugar levels. Conclusions: The analysis in the paper provide a path for establishing travel health clinics. There is a need for health education activities on travel health services for travellers, which need to be accessible and affordable.

Health education is an important public health intervention that promotes disease prevention, awareness generation, and healthy behavioural practices within communities. Undergraduate medical students are increasingly involved in community-based health education activities; however, they often encounter several operational and communication-related challenges during field implementation. This study explored the perceptions of undergraduate medical students regarding the challenges and opportunities in imparting health education in community settings. A phenomenological qualitative study was conducted among third-year undergraduate medical students in the Department of Community Medicine and Family Medicine at All India Institute of Medical Sciences Bhubaneswar between July 2022 and October 2022. Participants were selected through purposive sampling after attending health education training and participating in community-based health education activities. In-depth interviews were conducted using a semi-structured interview guide. Data saturation was achieved after nine interviews; additional interviews were conducted to improve data richness. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using ATLAS.ti. A total of fifteen undergraduate medical students participated in the study. Participants perceived health education as an important tool for improving community awareness, preventive healthcare, and medication adherence. Interactive methods such as skits, role-plays, posters, demonstrations, and local-language communication were considered effective in enhancing community engagement. Major challenges identified included language barriers, inadequate training, limited institutional support, logistical constraints, poor community participation, and excessive workload among community mobilizers. Students emphasized that collaboration with ASHA workers and community mobilizers improved rapport building and public participation. Opportunities identified included stronger faculty mentorship, better planning, culturally sensitive communication, community-centred educational strategies, and enhanced institutional and community support. Undergraduate medical students recognized the importance of health education in improving community health; however, several communication, organisational and logistical barriers affected its implementation in community settings. Strengthening community-oriented medical education, local-language communication skills, faculty mentorship, and collaboration with community mobilizers may improve the effectiveness and sustainability of community health education programmes.

Background: Salt iodization is the most effective public health intervention to prevent iodine deficiency disorders. This study aimed to estimate the proportion of households using adequately iodized salt at the consumer level and assess knowledge and practices regarding iodized salt usage and storage. The study also assessed the association between salt storage practices, awareness about iodized salt, and iodine levels in salt. Methods: A cross-sectional study was conducted in the urban slums of Bhubaneswar from May to July 2022. The required sample size was calculated to be 95 households, selected through systematic random sampling proportionate to the size of each ward. The multibus interface (MBI) kit was used for spot testing of iodine. Data analysis was performed using SPSS version 26.0. Results: The proportion of households using adequately iodized salt was 91.6%. About 13.7% stored salt in open containers, 65% near the fire/gas, 21.1% stored salt for more than four weeks, and 7.4% had moisture in their salt. About 53% of households added salt in the beginning of cooking and 81% of respondents had poor knowledge about iodized salt. Storing salt in open containers or sacks was significantly associated with inadequate iodine levels in salt (p value: 0.01). Conclusions: While the consumption of adequately iodized salt meets the target level of 90%, poor awareness and improper storage practices are still prevalent. Education on proper storage, handling, and the importance of iodized salt is crucial to increase community awareness and improve iodine levels in salt.

Background: Street food safety remains a significant concern, with outbreaks of foodborne diseases linked to unhygienic practices, but it has been rarely studied in India. Hence, this study assessed the knowledge, attitude, and practices regarding safe food handling techniques among street food vendors of urban Bhubaneswar city. Materials and Methods: We conducted a descriptive cross-sectional study involving 214 street food vendors from the Bhubaneswar Municipal Corporation (BMC) area. The wards under BMC with maximum street food stalls and vending zones were purposively selected, which comprised four wards. The participants were recruited by convenient sampling from December 2022 to April 2023. A semi-structured questionnaire and an observational checklist were used to collect data, which were analyzed using SPSS version 20. Results: The study found that most street food vendors were male (91%), with a mean age of 36.8 ± 10.39 years. Most vendors (71%) had private mobile stalls, and 32% were graduates. While 64% of vendors were aware of available vaccines for foodborne diseases, only 53% recognized the health risks associated with poor food handling practices. Regarding practices, 31.5% of vendors did not use personal protective equipment, and 28% washed utensils with water only. Despite adequate knowledge, barriers to practicing good hygiene included lack of awareness (53%), financial constraints (29%), and lack of training (28%). The COVID-19 pandemic significantly impacted vendors’ businesses, with 73% experiencing complete shutdowns. Conclusion: Street food vendors in Bhubaneswar have adequate knowledge of food safety principles but face barriers to implementing hygienic practices. Education, training initiatives, and regulatory measures are crucial to improving food safety in the informal food sectors.

BACKGROUND:The significant strides in cancer treatment is primarily directed towards achieving a cure. However, the well-being and quality of life of cancer patients during and after treatment are often overshadowed. Hence, this study assessed cancer patients' Health-Related Quality of Life (HRQOL) and found the association between HRQOL and sociodemographic factors. MATERIALS AND METHODS:A community-based cross-sectional study was done among cancer patients in the Bhubaneswar Municipal Corporation (BMC) area enrolled in the Hospital Based Cancer Registry (HBCR) of an Institute of National Importance (INI) from July 2021 to December 2022. Patients aged ≥ 18 years diagnosed with malignant solid tumors were included in the study. The list of cancer patients obtained from the Radiation Oncology department was sorted as per the inclusion criteria. The participants were selected using convenient sampling. 187 cancer patients were interviewed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30). RESULTS:The cancer patients' global health status score was 58.1 ± 17.2. Cognitive functioning achieved the highest score, while social functioning obtained the lowest score.  Among the cancer-affected individuals, breast cancer patients had the highest global health status score, while gastrointestinal cancers received the lowest score. The global health status of the study participants was significantly associated with their caste, education, socioeconomic status, stage of cancer, and health insurance availability. Physical functioning was associated with age, marital status, education, and family type. The individual's overall health status, physical well-being, emotional state, and social functioning were also significantly associated with financial difficulties. CONCLUSION:The quality of life of cancer patients was satisfactory, except in social functioning, where it was less satisfactory. Therefore, in clinical practice, the interventions should be need-based and patient-centric, which may provide complete care for cancer patients and enhance their Quality of Life.

Introduction: Millets are small-seeded cereal grains that are highly nutritious, rich in fiber, vitamins, minerals, and antioxidants, and can be grown on arid lands with minimal inputs. Odisha Millets Mission (OMM) is the unique flagship program the Government of Odisha launched in 2017-18 promoting millet consumption. The present study aimed to assess the knowledge, attitude, and practice towards millet consumption among women residing in an urban slum and to identify the barriers and facilitators in the adoption of millet in daily diet. Methodology: A community-based cross-sectional study was conducted in the Urban slum areas of Bhubaneswar. A diverse population of 316 adult women was recruited, including 32 AWWs and their helpers from our study area from August to October 2023. A self-designed, pre-tested, semi-structured questionnaire was prepared and administered to the study participants. Results: All 316 participants demonstrated knowledge about millets, with Ragi being the most commonly recognized type. Among the participants, 222 (70.3%) were currently consuming millet in household practice. A significant majority, 93.4%, believed millet was rich in minerals and vitamins. Additionally, 59% expressed a willingness to try millet-based recipes. However, only 35.6% of participants reported consuming millets daily, and for 56.4% of them, the primary reason for non-consumption was the difficulty in obtaining millets. Conclusion: Adopting millet in the daily diet is possible only through active community participation and awareness. The findings underscore the importance of raising awareness about the nutritional benefits of millet within the community.

Background: The global burden of cancer is increasing rapidly. In India, particularly, there is a low level of health awareness and significant information asymmetry. Improving awareness among the general population will bring about better health-seeking behavior and acceptance of screening methods. The study aims to assess the different aspects of cancer awareness and its determinants among the rural population. Methods: A cross-sectional study was conducted between August 2017 to August 2018. Data was collected from 1116 participants using a semistructured questionnaire. Information was collected on awareness about different cancers, sources of information, treatability, preventability, and risk factors of cancer. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 22 (Armonk, NY, IBM Corp.). The level of awareness was presented as a percentage and the Odds ratio was calculated to find out the association between level of awareness and different sociodemographic characteristics. Results: 73.5% of the study participants had heard of cancer. Oral cancer was the most common cancer known to the study participants. Television was the most common source of cancer information. Knowledge about the preventability, treatability, and risk factors of cancer was very low. Tobacco was the most common risk factor identified. Awareness of cancer was found to be significantly associated with educational status. Conclusion: Awareness about general cancers was high, but awareness about specific cancers was low. There is a need to re-look at the health education campaigns about cancer to improve awareness of the rural population. Television and the Internet should be used as an effective medium to generate awareness about cancer.

BACKGROUND:Sexually transmitted infections (STIs) are a major global public health concern and are linked with human immunodeficiency virus in many ways. There is little evidence of the pooled prevalence of STIs across both states (Andhra Pradesh and Odisha). OBJECTIVES:Hence, we aim to estimate the prevalence of STIs in Andhra Pradesh and Odisha. MATERIALS AND METHODS:The protocol was registered in PROSPERO. A comprehensive search was done in PubMed, EBSCO, Cochrane Library, and Google Scholar. Studies were selected based on inclusion and exclusion criteria. Quality appraisal was done using the Joanna Briggs Institute tool. We used a standardized data extraction form to collect information from eligible studies. We did a random-effects meta-analysis to obtain the pooled prevalence of STI in Andhra Pradesh and Odisha. We stratified meta-analyses by states, microorganisms, and study setting. RESULTS:We identified 1152 studies, of which 23 studies were included in the systematic review and 22 studies were included for meta-analysis. The pooled prevalence of Syphilis in Andhra Pradesh and Odisha was 0.01 (95% confidence interval [CI] 0.01-0.02) and 0.00 (95% CI 0.00-0.00), respectively. The pooled prevalence of Chlamydia and N. Gonorrhea in Andhra Pradesh among the general population was 0.01 (95% CI 0.00-0.03) and 0.05 (95% CI 0.01-0.24), respectively. The prevalence of Syphilis and Chlamydia among high-risk group populations in Andhra Pradesh was high in comparison with the general population. CONCLUSION:Understanding the prevalence of STIs in Andhra Pradesh and Odisha among the general population and high-risk group populations will strengthen the epidemiological data tracking and help in the effective management and control of STIs.

Background The main contributors to death and disability from chronic illnesses in developing nations are elevated blood pressure (hypertension), blood sugar (diabetes mellitus), and blood cholesterol (dyslipidaemia). Even though there are affordable treatments, the treatment gap for these conditions is still significant. Few pilot studies from industrialized nations discuss the value of peer-led interventions for achieving community-level management of blood pressure and blood sugar. This study aims to evaluate the effectiveness of peer-led intervention compared to standard care in achieving control of selected non-communicable diseases (NCDs) in Indian context at 1 year of intervention among people of 30–60 years with hypertension and/or diabetes mellitus and/or dyslipidaemia. Methods A cluster-randomized controlled trial will be conducted in villages of two rural blocks of the Khordha district of Odisha from August 2023 to December 2024. A total of 720 eligible participants (360 in the intervention group and 360 in the control group) will be recruited and randomized into two study arms. The participants in the intervention arm will receive a peer-led intervention model for 6 months in addition to standard care. The sessions will be based on the six domains of NCDs — self-care, follow-up care, medication, physical activity, diet, limiting substance use, mental health and co-morbidities. The mean reduction in blood pressure, HbA1C, and blood cholesterol in the intervention arm compared to the standard care arm will be the main outcome. Discussion The increasing burden of NCDs demands for newer strategies for management. Peer-led interventions have proven to be useful at the international level. Incorporating it in India will have remarkable results in controlling NCDs. Trial registration Clinical Trial Registry of India (CTRI) CTRI/2023/02/050022. Registered on 23 February 2023.

Long coronavirus disease (COVID) or postacute sequelae of coronavirus disease of 2019 (COVID-19) is widely reported but the data of long COVID after infection with the Omicron variant is limited. This study was conducted to estimate the incidence, characteristics of symptoms, and predictors of long COVID among COVID-19 patients diagnosed during the Omicron wave in Eastern India. The cohort of COVID-19 patients included were adults (>= 18 years) diagnosed as severe acute respiratory syndrome coronavirus 2 positive with Reverse Transcription Polymerase Chain Reaction. After 28 days of diagnosis; participants were followed up with a telephonic interview to capture data on sociodemographic, clinical history, anthropometry, substance use, COVID-19 vaccination status, acute COVID-19 symptoms, and long COVID symptoms. The long COVID symptoms were self-reported by the participants. Logistic regression was used to determine the predictors of long COVID. The median follow-up of participants was 73 days (Interquartile range; 67-83). The final analysis had 524 participants' data; among them 8.2% (95% Confidence Interval [CI]: 6%-10.9%) self-reported long COVID symptoms. Fatigue (34.9%) was the most common reported symptom followed by cough (27.9%). In multivariable logistic regression only two predictors were statistically significant-number of acute COVID-19 symptoms >= five (Adjusted odds ratio (aOR) = 2.95, 95% CI: 1.30-6.71) and past history of COVID-19 (aOR = 2.66, 95% CI: 1.14-6.22). The proportion of self-reported long COVID is considerably low among COVID-19 patients diagnosed during the Omicron wave in Eastern India when compared with estimates during Delta wave in the same setting.

The COVID-19 pandemic has created a defining situation globally, and the outpatient services were also affected due to the closure of many healthcare facilities. The study was conducted to know the spectrum of the population availing teleconsultation and their needs for consultation. A cross-sectional study conducted in AIIMS Bhubaneswar, India, from May 2021 to June 2021in which the beneficiaries availing of the COVID-19 teleconsultation service were taken as study was participants and a total of 423 participants participated in the study. The proportion of participants who availed of the services in the age group 20-39 years was 67.8%. The participants from the urban area were 81%. Very few or almost nil participation were observed in the category of semiskilled, unskilled, and unemployed occupations. The reasons for availing of teleconsultation services were, for the treatment of COVID-19 disease (45%), distressed consultation for the medication (21%), and seeking advice for testing (13%), related to COVID-19 vaccination (6%) and 9% consulted to know the prognosis of the disease. Steps should be taken to expand the teleconsultation services to the underserved rural community and the people with lower educational status.

In this retrospective observational study, we have performed a comparative analysis of the demographic, clinical and epidemiological characteristics of the HCWs affected with SARS-CoV-2 infection during first two waves in India. The overall prevalence of SARS-CoV-2 infection among HCWs was found to be 15.24% (14.20-16.33) and 23.38% (22.14-25.65) during first and second waves respectively. The second wave showed an adjusted odds ratio of 0.04(0.02-0.07) and 2.09(1.49-2.93) for hospitalization and being symptomatic, respectively. We detected significantly higher level of C-reactive protein (CRP) among admitted HCWs during the second wave (5.10 -14.60 mg/dl) as compared to the first wave (2.00 - 2.80 mg/dl). Our study found the relative risk of SARS-CoV-2 reinfection among HCWs during the second wave to be 0.68 [0.57-0.82, p < 0.001)]. Although, the prevalence of SARS CoV-2 infection and risk of being symptomatic was higher during second wave, the risk of hospitalization was less when compared with the first wave.

Background The prevalence of elder abuse in various parts of the world has been reported between 2.2 and 90.4%. According to some studies conducted in India, elder abuse prevalence ranges between 9.6 to 61.7%. Yet, elder abuse is an underreported issue. Most available evidence shows the involvement of close family members and caregivers in the abuse of older adults. Several factors associated with various forms of elder abuse need to be studied further. This study has attempted to capture the prevalence, pattern and associated factors of elder abuse in urban slums. Methods This study was a cross-sectional community-based study conducted between August 2019 to August 2020 in an urban field practice area of the All India Institute of Medical Sciences, Bhubaneswar. It covers four wards of the Bhubaneswar Municipal Corporation, served by the Urban Primary Health Centre, IRC Village, Nayapalli. A total of 360 participants aged 60 years and above were included in this study. They were interviewed using various semi-structured interview schedules. Validated study tools such as Activities of Daily Living (ADL- Barthel Index), Hindi Mental Scale Examination (HMSE), Geriatric Depression Scale (GDS), and Vulnerability to Abuse Screening Scale (VASS) were also used to assess various factors. Results Approximately one in five (19.4%) older adults reported some form of abuse. The types of elder abuse reported were physical abuse in 12 (3.3%), verbal abuse in 25 (6.9%), emotional abuse in 40 (11.1%), and financial abuse in 15 (4.2%) older adult participants. The sons and daughters-in-law of the older adult participants were the main perpetrators of abuse reported. Depression and past history of abuse were found significantly associated with any type of abuse. Conclusions The prevalence of elder abuse in this study was considerably high, with 70 (19.4%) out of the 360 participants reporting some form of abuse. Emotional abuse was the most reported, and physical abuse was the least reported type. The most common perpetrators were those on whom the older adults depended, like their sons and daughters-in-law.

Introduction:COVID-19 has affected the quality of life of all age groups. Medical education during the pandemic shifted to online mode due to lockdown restrictions. The stress felt by medical students during the pandemic has been studied less. The current study aimed to assessed the stressors and de-stressors for undergraduate medical students during the COVID-19 pandemic.Materials and methods:A cross-sectional online survey was conducted for the undergraduate medical students of a tertiary care institute of eastern India. A total of 307 medical students were included in the study by convenient and snowball sampling. A self-designed semi-structural questionnaire was created as a Google form and circulated among the students between September and October 2020. A combination of purposive and snowball sampling was adopted. Responses regarding stressors and de-stressors were recorded on a Likert scale. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22. Categorical variables were presented as percentages and descriptive statistics were performed.Results:A total of 307 students responded and 64.5% of them were men and 35.5% were women. 47.6% of the students experienced stress due to changes brought about by COVID-19. Risk of parents getting infection (63.2%), fear of not easily returning home (53.1%), lack of clinical exposure (52.7%), and financial impact (47.9%) were the major stressors perceived by the students. Connecting with family and friends through social media (47.5%), gaming (45.0%), online streaming platform (51.2%), spending time with family members (54.4%) were the coping strategies adopted by these students.Conclusion:Higher level of psychological stress perceived by the undergraduate students needs psychological intervention. Academic revamp and adaptation of coping strategies are required for the medical under-graduates.

BACKGROUND:Child marriage is a breach of the basic fundamental rights of a child and is a major concern for policy makers in many countries. OBJECTIVE:The present study intended to identify the direct and indirect socio-demographic factors associated with child marriage among 15-17 years old girls in India. PARTICIPANTS AND SETTING:The study used National Family Health Survey-4 data. The sample comprised of 1459 married girls and an equal number of unmarried girls aged 15-17 years at the time of the survey. METHODS:Multivariable logistic regression was performed to identify the factors associated with child marriage. A hypothetical path model was constructed and tested. The path models were refitted after removing the insignificant path coefficients, and finally, the significance of direct as well as indirect effects were obtained. RESULTS:Path analysis revealed that mother's education was the only factor that had both significant direct and indirect effects on child marriage (p < 0.001). Religion had only significant indirect effect (p = 0.047) through girls' education. Besides mother's education, the factors that showed significant direct effects on child marriage were wealth index (p = 0.012), caste (p = 0.009) and education of the girl (p = 0.009). CONCLUSIONS:Education of both mothers and the girls, wealth index and caste had significant direct effects on child marriage whereas significant indirect effect was exerted by mothers' education and religion. Therefore, these factors should be given primary focus while formulating strategies to curb child marriage in countries like India.

Primary health care institutions (PHCIs) are an essential foundation for the national response to COVID-19 disease in India. With the soaring number of confirmed cases, the health system is currently under unprecedented stress. In this scenario, there is a pressing need for empowering PHCIs in COVID-19 preparedness and response. The World Health Organization's (WHO) "Health system building block" approach is a classic model, which can work as a road map for the national health system in the process of empowering PHCIs against COVID-19 as well as other upcoming global and regional public health emergencies.

INTRODUCTION:Coronary artery disease (CAD) is the most common cause of morbidity and mortality especially in the developing countries. Coronary artery measurements (CAM) are the most important factor affecting the procedure and outcome of coronary angioplasty (PCI) as well as coronary by-pass operations (CABG). In this study, we aimed to establish a database for the normal CAM as well as for gender difference among the Indian population using quantitative coronary angiography (QCA) with an objective of assessing normal coronary vessel morphology of patients with normal coronaries.MATERIALS AND METHODS:Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals of four states in India. Informed consents were obtained. Post CABG, post PCI patients and patient being diabetic for ≥5 years were also excluded from the study.RESULTS:Ten segments from right and left coronary arteries were taken for diameter measurements. These coronary diameters were indexed to body surface area (BSA) (mean diameter mm/m2 BSA). Among, 4000 patients, 933(23.3%) [M:F-521:412] had normal coronaries and 3067 (76.7%) were diseased.DISCUSSION AND CONCLUSION:The dimensions of the coronary artery segments of Indians were smaller (in BSA indexed and non-indexed data), compared to studies from other continents which can be due to their smaller BSA.

Cancer awareness is the key to early detection and better health-seeking behaviour. Cancer is quite common in both developing as well as developed countries, but awareness is yet poor among the general population. Poor awareness may lead to poor uptake of screening modalities and delay in diagnosis. One factor that has been consistently shown to be associated with late diagnosis and treatment is a delay in seeking help for cancer-like symptoms. This paper reviews the literature on cancer awareness among the general population and attitude towards screening modalities. The poor awareness level among the Indian population shows the need for health education and sensitisation regarding cancer and its different aspects. This will be helpful in the successful implementation of health programmes related to cancer.