042575   KAUR H, LAMBA C D , SACHDEVA J , RUTTEN L , KHURANA A , OBERAI P, MANCHANDA R K, RAIZADA S , CHAUDHURY S , RAMANAN V E (Central Council for Research in Homoeopathy, Janakpuri - 110 058, New Delhi, Email: dr.harleenkaur@gmail.com) : Optimising the use of polar symptoms in Homoeopathy: Introduction to a pilot study of prognostic factor research in chronic cough. Indian J Res Homoeopathy 2020, 14(3), 200-10.

Polar symptoms represent the most challenging rubrics in the homoeopathic repertories, despite their frequent use. The study objective was to assess the relationship between 27 polar cough symptoms, 3 non-polar cough symptoms and 30 general polar symptoms and successful response to specifi c homoeopathic medicines. A multi-centre, explorative, prospective, observational study was conducted at ten centres under the Central Council for Research in Homoeopathy. Two hundred and sixteen patients were enrolled with chronic cough, lasting >8 weeks. The patients were enrolled as per four underlying diagnoses of chronic upper airway cough syndrome (CUACS), gastro-oesophageal refl ux disease (GERD), asthma and related syndromes, and non-asthmatic eosinophilic bronchitis (NAEB). 30 general polar symptoms, 27 polar cough symptoms and 3 non-polar cough symptoms were assessed at the baseline. During enrollment and follow-up consultations, two validated questionnaires (Leicester Cough Questionnaire chronic and EuroQuol (EQ)-5D-5L) were fi lled for assessing the effect of treatment . If the Physician Assessment Score was >2, the causal relationship between improvement and prescribed medicine was further assessed using Modifi ed Naranjo Algorithm. At the fourth follow-up, three medicines with >10 cases having good result were identifi ed: Phosphorus (n = 20), Pulsatilla (n = 19) and Sulphur (n = 13). For this introductory article, we compare some results with the existing data, refl ect on discrepancies between the existing data and research outcome and refl ect on future use, especially in respiratory tract infections (RTIs). In improving the homoeopathic method and its practical use, priority should be given to polar symptoms, especially related to RTIs.

4 illus, 4 tables, 26 ref

042574   SHUKLA P, NAYAK C, BAIG M Q , MISRA P ( Homoeopathic Materia Medica Dep, Homoeopathy Univ, Sanganer, Jaipur, Rajasthan, Email: drpurnimashukla2019@gmail.com) : Effects of pre-defined homoeopathic medicines to mitigate adverse dermatological effects of radiotherapy and vomiting of chemotherapy in breast carcinoma: A randomised, double-blind, placebo-controlled, pilot trial in the context of usual care. Indian J Res Homoeopathy 2020, 14(3), 189-99.

Radiotherapy and chemotherapy are used in breast cancer, but they cause an array of adverse effects including dermatological changes and vomiting. The objective of the study was to examine whether Usual Care (UC) plus pre-defi ned homoeopathic remedies can produce different effect beyond UC plus placebo in dermatological adverse effects of radiotherapy and vomiting of chemotherapy in breast carcinoma. In this double-blind, randomised, placebo-controlled, parallel-arm trial, 88 females suffering from dermatological adverse effects due to radiotherapy (n = 41) or vomiting due to chemotherapy (n = 47) were randomised to receive either UC + Homoeopathy (verum; n = 44) or UC + Placebo (control; n = 44). The outcome measures were the number of responders showing any reduction of grades of Acute Radiation Morbidity Scoring Criteria (ARMSC) of the Radiation Therapy Oncology Group and Common Toxicity Criteria (CTC) for vomiting, measured at baseline and after 7 and 14 days. Relative Risk (RR) with 95% Confi dence Intervals (CIs) was assessed; Chi-square tests were run to report P values. A protocol-compliant sample (n = 80; 8 dropped out, verum: 4, control: 4) was analysed. The number of responders as per the ARMSC score after 7 days (11/18 vs. 1/19, RR = 3.3, 95 % CI = 1.7–6.3, P = 0.001) and 14 days (16/18 vs. 1/19, RR = 9.4, 95 % CI = 2.5–35.2, P < 0.001) was statistically signifi cant, favouring verum over control. Similar results were obtained according to the CTC scoring after 7 days (15/22 vs. 2/21, RR = 3.3, 95 % CI = 1.7–6.3, P < 0.001) and 14 days (21/22 vs. 4/21, RR = 15.1, 95 % CI = 2.2–102.4, P < 0.001). Pre-identifi ed homoeopathic medicines appeared superior to placebo, warranting further evaluation. 

3 illus, 6 tables, 27 ref

042573   SHINDE V H, RUTTEN L , KHURANA A , MANCHANDA R K , BAWASKAR R S (Regional Research Institute for Homoeopathy, Navi Mumbai - 400 614, Maharashtra, Email: drvhsb@gmail.com) : Prevalence of homoeopathic polar symptoms: A Follow-up pilot study conducted in Mumbai in 2017. Indian J Res Homoeopathy 2020, 14(3), 179-88.

Prospective assessment of homoeopathic symptoms is different from eliciting symptoms in daily practice. In prognostic factor research, we apply symptom questionnaires with Likert scales to assess symptoms in different intensities. In former research, we tested a 5-point Likert scale, which rendered a rather high prevalence for some symptoms even the strongest intensity, not useful in daily practice. A longer, 7-point Likert scale might render more useful outcome. To study if a longer Likert scale perform better in homoeopathic prognostic factor research. A 7-point Likert scale questionnaire with 30 polar symptoms was tested on 300 patients. Responses to various domains of temperature, climate, diurnal, infl uence of sleep, eating and desires/aversions were elicited. The outcome was compared with the former 5-point Likert scale. The mean prevalence of all symptoms in the highest intensity with the 7-point Likert scale is (much) lower than in the 5-point scale, and for some symptoms, more useful. For a few symptoms, the prevalence remained high, even in the highest intensity. A longer Likert scale performs better in homoeopathic prognostic factor research, but not for all symptoms. The fi lling out of this questionnaire by patients should be guided by homoeopathic practitioners who are properly trained in prospective assessment of homoeopathic symptoms.

3 illus, 2 tables, 7 ref

042572   KHURANA A , MITTAL R , RATH P , MOORTHY K , TANEJA D , SINGH U , MISHRA K , MANCHANDA R K (Central Council for Research in Homoeopathy, Janak Puri, New Delhi, Email: renumittal8@gmail.com) : Ferrum phosphoricum 3X and Ferrum metallicum 3X in the treatment of iron deficiency anaemia in children: Randomized parallel arm study. Indian J Res Homoeopathy 2020, 14(3), 171-8.

Anaemia in children has signifi cant adverse health consequences and is a major public health problem.The objective of this study is to identify effi cacy of Ferrum phosphoricum 3X (FP) and Ferrum metallicum 3X (FM) in changing haemoglobin (Hb) levels in school-going children, 12–14 years of age with Iron Defi ciency Anaemia (IDA). School children were screened for Hb levels using a portable haemoglobinometer at Noida, Kottayam, Guwahati and Imphal. Children with Hb levels ≤11.9 g % and ≥8 g % were investigated for IDA by measuring serum ferritin level and other parameters. Children enrolled were divided into two categories, i.e., mild (Hb 11–11.9 g %) and moderate anaemia (Hb between 8 and 10.9 g %). Children in both the groups were randomised into FP and FM groups and prescribed accordingly for 3 months. Hb levels were repeated after 3 months. 2,878 children were screened and 792 (27.5 %) were identifi ed to have Hb between ≤11.9 g % and ≥8 g %. 102 (mild anaemia: FP-30; FM-29, moderate anaemia: FP-21, FM-22) were enrolled after investigations and consent. Signifi cant increase in Hb was seen in children with moderate anaemia in FP group (9.95 ± 0.749–10.97 ± 1.51). Increase in Hb in other groups was not signifi cant. Percentage of children with low iron reserves and having true IDA was <4 %. FP has a potential to improve Hb levels in children with no side effects. 

1 illus, 5 tables, 13 ref

042571   MOORTHI S K, RADHIKA P, MURALEEDHARAN K C (National Homoeopathy Research Institute in Mental Health, Kottayam - 686 532, Kerala, Email: drjaiguru@gmail.com) : Psychological implications during the outbreak of COVID‑19 and its homoeopathic management. Indian J Res Homoeopathy 2020, 14(2), 136-42.

Coronavirus disease 2019 (COVID‑19) is rapidly spreading across the globe and is creating dread among all people irrespective of their socioeconomic status. To tackle the rapid spread of the disease, social distancing has been found to be the only measure. However, such distancing creates a lot of mental stress, as evident from previous studies. The objective of the study was to assess the psychological implications during quarantine and isolation and to find the homoeopathic remedies that may be suitable. We have tried to collect the mental symptoms from the available literature and from the recent studies in China on COVID-19. Based on these, repertorisation outcome was analysed to evolve a group of medicines that can be used in the scenario. Based upon the symptoms collected from the previous studies, repertorisation outcome [Figure 1] was analysed to evolve a group medicine which can be used in the scenario. The medicines Arsenic album, Calcarea carbonica, Lachesis, Ignatia and Pulsatilla obtained the highest marks in the analysis. The symptoms of these medicines were collected after referring the Hering’s Guiding Symptoms of Materia Medica³¹ and Desktop Guide to Keynotes and Confirmatory Symptoms by Roger Morrison³² and are presented in the paper. We hope that these medicines will prove to be beneficial for prescription to those suffering from the psychological impacts of COVID‑19. 

1 illus, 32 ref

042570   NAYAK D, VARANASI R (Central Council for Research in Homoeopathy, New Delhi, Email: drdnayak@gmail.com) : Homoeopathic nosodes, a neglected approach for epidemics: A critical review. Indian J Res Homoeopathy 2020, 14(2), 129-35.

Nosodes are the homoeopathic medicines prepared from diseased products of biological origin. These are commonly used in clinical practice for the prophylaxis and treatment of ailments including infectious diseases. This review aims at the usage of nosodes for the management of epidemics. The homoeopathic research literature was searched to find examples of the use of nosodes in different ways and to evaluate their role and position in homoeopathic practice with special reference to epidemic diseases. Research evidence for use of the nosodes as prophylactics and for the treatment of various infectious and non‑infectious diseases is emerging. Nosodes such as Meningococcinum, nosoLEP and Malaria officinalis have been used successfully in controlling meningitis, leptospirosis and malaria, respectively. The use of nosodes as isopathy is somewhat acceptable in the mainstream medicine due to its similarity to vaccination. Although it is feasible to use nosodes in a short span of time and can be administered easily, the method of preparation and the safety issues are of much concern and therefore, should be used with utmost care. The safety issues outlined by the World Health Organization should be satisfied before their application in public health. The challenge for the future is to refine the method of preparation and to develop a harmonised way of preparing the nosodes, which is conducive to all the homoeopathic pharmacopoeias across the globe. Nosodes prepared as per the homoeopathic principles have potential to be used as prophylactics in epidemics, but only if there is sufficient experimental evidence of its effectiveness and safety.

1 illus, 46 ref

042569   MATHUR M, KAPOOR A (Practice of Medicine Dep, Nehru Homoeopathic Medical Coll and Hospital,, Faridabad ? 121 003, Haryana, Email: drmohitmathur@gmail.com) : A review on immunomodulatory response of homoeopathic medicines through cytokine induction as evidenced in in vivo and in vitro studies. Indian J Res Homoeopathy 2020, 14(2), 122-8.

This review discusses the importance of inter-individual variations in Homoeopathy and role of immune modulation through cytokine induction behind these variations in symptoms. To analyse the effects of homoeopathic drugs in modulation of cytokine synthesis to find the individualised immunological mechanisms of these drugs. The PubMed database was searched for studies which analysed effects of homoeopathic medicines on cytokine synthesis. Full texts of shortlisted studies after scrutiny of abstracts, were analysed for study design, homoeopathic medicines used, cytokines analysed and results. The PubMed search yielded 21 studies. After analysis of abstracts of 21 studies, 10 were shortlisted, which included 7 in vivo and 2 in vitro studies. One study had both in vivo and in vitro interventions. Majority of in vivo studies used rat and exposure to immunological challenge before administration of homoeopathic medicine. The cytokines studied were interleukin (IL)-1α, IL-1β, interferon-gamma, tumour necrosis factor alpha, IL-2, IL-4, IL-5, IL-6, IL-10 and IL-12. The two in vitro studies evaluated effects of Saussurea lappa and Mercurius solubilis on lymphocytes and macrophage culture, respectively. Out of 10 studies analysed, 8 showed homoeopathic medicines can modulate cytokine synthesis either by increasing or decreasing the cytokine synthesis, in a statistically significant manner. The studies were heterogeneous regarding the antigenic challenge given to stimulate immune cells and only 50 % of studies clearly mentioned random allocation of animals in groups. Though majority of studies showed that homoeopathic medicines can modulate cytokine synthesis, the mechanism of cytokine modulation remained unexplored.

34 ref

042568   VARANASI R, NAYAK D (Central Council for Research in Homoeopathy, New Delhi, Email: varanasiroja@gmail.com) : Homoeopathy in the management of infectious diseases: Different facets of its use and implications for the future. Indian J Res Homoeopathy 2020, 14(2), 110-21.

Infectious diseases are a major challenge to humanity and public health at large. The aim of this study is to conduct a systematic narrative review of the clinical research evidence for homeopathy in the management of infectious diseases. A comprehensive search of major biomedical databases: Cochrane Database of Systematic Reviews, Pubmed, Core‑Hom, AYUSH Research Portal) and other individual journal sites were conducted. Relevant research published between 1999 and 2019 was categorised by study type, clinical condition and causative pathogen. The literature search of two decades (1999–2019) gathered 86 articles: Meta‑analysis (n = 1), systematic reviews (n = 4), randomised controlled trials (n = 30), comparative cohort/observational studies (n = 16), cohort/observational studies (single arm) (n = 25), case series (n = 7) and case reports (n = 3). The review demonstrated the beneficial evidence of homeopathy in infectious diseases is large. Both controlled and uncontrolled studies reported positive results, early recovery, reduction of hospital stay, less use of antibiotics and satisfaction of patients. Prophylactic studies on dengue, chikungunya, Japanese encephalitis/acute encephalitis syndrome and leptospirosis have shown the potential role of homeopathy in preventing the disease outbreaks. Homoeopathy as an add‑on treatment for these conditions has shown added benefits in reducing mortality, morbidity and sequelae. Homoeopathy has a possible and viable role as standalone and as an integrative medicine for different infectious diseases. Homoeopathy offers beneficial role in combating infections. Due to the heterogeneity of approaches, more studies in different research settings are warranted to add to the existing evidence and validating it for enhancing the self‑healing power of the body against infections.

108 ref

042567   CHAUDHARY A, KHURANA A (Central Council for Research in Homoeopathy, Janakpuri, New Delhi, Email: anupriyaccrh@gmail.com) : A review on the role of Homoeopathy in epidemics with some reflections on COVID‑19 (SARS‑CoV‑2). Indian J Res Homoeopathy 2020, 14(2), 100-9.

While the world is grappling with the current pandemic of COVID-19, medical fraternity and policy makers are still trying to find ways to control its spread in the absence of any definite treatment protocol. The escalating medical costs of infrastructural requirements in health care as well as development of vaccine are but a few challenges being faced. Alternative approaches to handle the situation require to be explored. This article reviews the role homoeopathy has played in controlling epidemics afflicting the mankind in the past while summarizing the scope of this approach in the current COVID-19 pandemic. A literature search was conducted using various bibliographic databases like PubMed etc, google search engines to collect all relevant research and review articles, reports, archived texts, you tube recordings, webpages etc. in English language published uptil March 2020. Scientific evidence in various epidemics clearly showcase that Homoeopathy can be used both therapeutically and /or as prophylactic with success using approaches like Genus epidemicus, nosodes etc. Its greatest successes have been recorded in the prevention & treatment of flu like illnesses. Homoeopathy has stood the test of time over centuries as a notable approach in controlling morbidity as well as mortality in epidemics. Administration of the homoeopathic “Genus epidemicus” as a prophylactic for general public or adjuvant homoeopathic treatment in symptomatic cases can be an inexpensive, safe and feasible approach to manage and alleviate the compounding fear and panic that COVID-19 is creating across the globe. National polices & strategies to tackle the pandemic need to be revisited. 

84 ref

044627   DEVEGAPPANAVAR G (Karnataka State Rural Development and Panchayat Raj Univ, Gadag– 582 101, Karnataka, Email: gulappa.md07dmr@gmail.com ) : Occupational health: Farmers knowledge on pesticide usage and it’s harmful effects on human health in rural areas of South India. J Ecophysiol Occup Health 2020, 20(1&2), 108-13.

An estimated 1.3 billion workers are engaged in agricultural production worldwide. This represents half of the total world labor force. Almost 60% of them are in developing countries. Pesticides can enter the human body by three common ways: Through the skin (contact), the mouth (ingestion) and the lungs (inhalation). The state of the chemical, i.e. solid, liquid or gas, affects the chances of pesticide penetration into the body. During the usage of pesticides farmers reported problems such as eye irritation, headache, dizziness, breathing difficulty, skin rashes and all of these symptoms at least once during their exposure to pesticides. A field based cross sectional study was conducted in the rural areas of Karnataka state, Gadag district, to assess the farmer’s knowledge, attitudes and practices about pesticide usage and its harmful effects on human health. A pre-tested semi-structured questionnaire was used to obtain the data from January to February 2020. Data was collected at the rural settings by visiting their house and agriculture fields. Totally 265 farmers were interviewed, out of that more than half of them have good knowledge about pesticide usage but only few of them have knowledge about the harmful effects of pesticide on their health. In our study findings majority of the farmers are not aware about the health hazards due to usage of pesticides, they showed good attitude and poor practices about pesticide usage.

6 tables, 24 ref

042566   TANEJA D, KHURANA A (Central Council for Research in Homoeopathy, Janak Puri, Delhi, Email: drdivyataneja@gmail.com) : An online cross‑sectional survey on knowledge, attitudes, practices and perspectives of homoeopathic practitioners towards COVID‑19. Indian J Res Homoeopathy 2020, 14(2), 90-9.

In the light of pandemic of coronavirus disease (COVID‑19), identification of level of epidemic preparedness and understanding of homoeopathic practitioners is required to utilise their services in mainstream healthcare effectively. The objective of this study was to identify knowledge, attitudes and practices of homoeopathic physicians about COVID‑19. An online cross‑sectional survey was undertaken in the midst of the epidemic in India when services of homoeopathic doctors were under consideration. The ten knowledge questions were scored and analysed to identify differences with sociodemographic variables. Responses to the ten questions on attitudes and practices were analysed to identify differences in the domains, differing significantly in knowledge scores. Out of 3901 responses received over 2 days, 3595 were included for analysis. Knowledge scores significantly differed with qualification (graduates – 8.60 ± 1.38, post‑graduates – 8.84 ± 1.29 and other qualifications – 8.56 ± 1.31) and years of practice (10 years – 8.84 ± 1.30). Gender was not identified as a variable to affect knowledge scores significantly. Attitudes and practices were also identified to be more favourable in participants with more than 10 years’ experience. Homoeopathic physicians have largely been able to maintain a high level of currency of knowledge, purely on their own accord. Specific aspects related to patient care and practices need to be further enhanced. Practitioners affirmed that homoeopathic medicines need to be validated on a group of patients before mass treatment/prevention can be identified for which immediate access to patients is required. 

1 illus, 11 tables, 22 ref

042565   GOLDEN I (National Institute of Integrative Medicine, PO Box 695, Gisborne, Victoria 3460, Australia, Email: admin@homstudy.net) : Proposed checklist for standardising homoeoprophylaxis interventions. Indian J Res Homoeopathy 2020, 14(2), 80-9.

Results from large homoeoprophylaxis(HP) interventions support the effectiveness of HP, but their variable methodology means that meaningful summaries of the combined data are difficult to produce. The aim of this article is to develop possible ways of standardising and improving the quality of data from HP interventions. Evidence collected from some large HP interventions is summarised. A previously suggested pre‑ and post‑intervention checklist intended to help standardise the evidence from HP interventions is critically examined. Asummary of HP evidence from large interventions shows that there is a growing body of data suggesting a level of HP effectiveness between 85 % and 90 %. However, the type and quality of the evidence is variable. A previously developed checklist for researchers to use is modified and examples are given from actual interventions. There is a growing body of evidence supporting claims that HP interventions are effective. The evidence base needs to be improved in a range of ways. Requiring a standardised checklist to be completed by researchers before and after an intervention offers one method to improve the quality and consistency of evidence collected. HP has much to offer governments, health officials and citizens globally. It is safe, relatively effective, flexible, easily delivered and highly cost‑effective. Yet, it is supported by very few governments. The quantity of evidence is growing, but the onus is on proponents to strengthen the quality of the evidence base supporting HP to the point where the inevitable critics of Homoeopathy are silenced. 

10 tables, 21 ref

040801   CHOPRA A, KAUR A, SINGH S, KAUR R, RALLAPALI A V (Public Health Dentistry Dep, Sardar Kartar Singh Sarabha Hospital and Dental Coll, Ludhiana, Punjab, Email: dr.amandeepchopra@gmail.com) : Childhood sexual abuse perceptions and experience among college students of Panchkula. Indian J Sex Transm Dis AIDS 2020, 41(1), 30-4.

Child sexual abuse (CSA) is a global public health and human rights concern. Hence, the present study was conducted to assess childhood sexual abuse perception and experience among college students of Panchkula. self-administered anonymous questionnaire which assessed perception and experiences of childhood sexual abuse was given to a convenient sample of 1000 college students. Using descriptive statistics and Chi-square test, perception and the experience of childhood sexual abuse were calculated. The study showed that 18 % (boys = 20 %, girls = 16 %) of the students were exposed to CSA, with boys more often affected than girls. The student’s perception about abuse was not very clear. Myths and cultural beliefs justified abuse. Although preliminary in nature, the present findings are among the first to demonstrate the nature of CSA among students of Panchkula. Further, the study revealed that CSA manifests both as contact and noncontact forms. More boys than girls are exposed to most forms of abuse.

1 illus, 1 table, 22 ref

042564   MANCHANDA R K, KHURANA A , FISHER P, ARYA B S , MEHRA P , SAHA S, KOLEY M , BHATIA M (Central Council for Research in Homoeopathy, Janakpuri, New Delhi, Email: rkmanchanda@gmail.com) : Homoeopathic drug proving researches (1996–2018): A scoping review. Indian J Res Homoeopathy 2020, 14(1), 24-49.

A systematic review on homoeopathic pathogenetic trials (HPTs) from 1945 to 1995 was published in 2007, and the basic question whether the effect produced by homoeopathic drugs in healthy human volunteers is equivalent to placebo or otherwise remained unanswered. There is a need to take up another review of HPTs conducted in the last two decades, to assess the changes in the methodologies adapted and to assess whether the effects produced in apparently healthy volunteers is due to homoeopathic medicines in high dilutions or not. Objective: To seek, collect, review and describe HPTs published during 1996–2018. A comprehensive literature search, both electronic and manual, was done using search terms ‘homoeopathic drug proving’ and ‘homoeopathic pathogenetic trial’ with time constraint of 1996–2018 in English language. As per the inclusion and exclusion criteria, the papers were selected for extraction of data in the predefined extraction form. One hundred and forty‑seven eligible records (74 peer‑reviewed [PR] and 73 non‑peer‑reviewed [NPR]) of HPTs of 214 drugs were identified and subjected to the extraction of data. Majority of the drug proving records were contributed by the Central Council for Research in Homoeopathy which included 86 records (24 PR and 62 NPR) with the data of 24 and 63 drugs, respectively, and by Riley, one book (NPR) with data of 68 drugs. Heterogeneity was encountered in all aspects – design, conduct, participants and outcome reporting. This preliminary study is the basis for data recovery and for the forthcoming program of systematic review and meta‑analysis, which may include the HPTs published in other languages. 

1 illus, 4 tables, 23 ref

040800   KUMARI S (Transfusion Medicine Dep, Gian Sagar Medical Coll and Hospital, Patiala, Punjab, Email: sonu4068@yahoo.co.in) : Prevalence and trends of hepatitis B virus, hepatitis C virus, human immunodeficiency virus 1, 2 and syphilis infections among blood donors in a regional transfusion center in Punjab, India: A 3 years study. Indian J Sex Transm Dis AIDS 2020, 41(1), 22-9.

Accurate estimates of the risk of transfusion-transmitted infectious diseases are essential for monitoring the safety of blood supply and evaluating the potential effects of new screening tests. The aim was to determine changes over time in blood donor population infection rates of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV‑1, 2) and syphilis. Changes in rates of HBV, HCV, HIV-1, 2, and syphilis infections were evaluated by comparing yearly prevalence rates for blood donors over 3 years, that is, between January 1, 2012 and December 31, 2014. Serological tests were done according to the standard operating procedures and manufacturer’s instructions and included the following: tests for hepatitis B surface antigen; antibodies to HCV and HIV-1, 2 and rapid plasma reagin test for syphilis. Nearly 2.54 of the total screened blood donors were reactive for one of the four transfusion transmitted infections (TTIs) with higher prevalence in replacement (3 %) than voluntary donors (2.3 %) and in male (2.54 %) than female (2.3 %) donors. TTI tend to be more (54.7 %) in younger population of 18–30 years. HCV infection is the most common of all TTI (50 %). The rising prevalence rates of HIV; HBV; HCV and syphilis among different groups suggests that blood transfusion is still very unsafe in this community and emphasis should be laid on donor education and donor self-exclusion, implementation of strict donor screening criteria, pre-donation counseling, and more sensitive screening methods. Furthermore, donors with a history of sexually transmitted infections should be totally excluded from all donations.

3 illus, 4 tables, 32 ref

044626   GOYKAR P, KADAM N (Krishna Institute of Medical Sciences, Karad- 415 110, Maharashtra, Email: dr.namratakcpt@gmail.com) : Effectiveness of early physiotherapy interventions for weight gain in low birth weight neonates. J Ecophysiol Occup Health 2020, 20(1&2), 95-9.

Prematurity is a leading cause of death in Indian scenario. There are lack of studies done on early physiotherapy interventions in neonates. Early care interventions in premature newborns show positive effect. Growth retardation and demineralisation of bones in newborn are thought to be caused by prolong immobilisation or lack of physical activities. In this study we are going to give combination of massage, passive movements, facilitatory techniques, joint compression and kangaroo mother care, which has not been done before. Indeed this made us to study the effectiveness of early physiotherapy intervention on weight gain in low birth weight neonates. To determine the effectiveness of early physiotherapy intervention on weight gain in moderate premature neonates (32–37 weeks), very premature (28–32 weeks) and extremely premature neonates (less than 28 weeks). Individuals fulfilling the inclusive criteria were selected. Written consent was taken from parents and care taker of neonates. Total 20 low birth weight neonates were taken. They were differentiated into moderate premature, very premature and extremely premature neonates. The weight was measured and breast feeding frequency was noted before treatment. Then the neonates were given massage, passive movements, proprioception stimulation by individual joint compression, oral stimulation and kangaroo mother care. This was given for 25-30 minutes each session for two times per day for 7 days. After that again weight and breast feeding frequency was checked to see progression. Later evaluation and interpretation was done using statistical analysis. The early physiotherapy intervention is effective in low birth weight baby for improving weight in pre mature neonates. On the basis of result it can be concluded that the early physiotherapy is effective in improving weight, breast feeding frequency in low birth weight neonates. Hence, early physiotherapy interventions should be considered to decrease the morbidity and mortality rate of LBW neonates.

11 ref

040799   SHAH I, MULLANFIROZE K (Pediatrics Dep, B. J. Wadia Hospital for Children, Mumbai - 400 056, Maharashtra, Email: irashah@pediatriconcall.com) : Profile of HIV and multidrug‑resistant tuberculosis in orphans living in orphanages in Mumbai, Maharashtra, India. Indian J Sex Transm Dis AIDS 2020, 41(1), 17-21.

The aim was to study the clinical profile of HIV‑infected orphans living in orphanages in Mumbai, Maharashtra, India and determine the prevalence of multidrug-resistant (MDR) tuberculosis (TB) in them. Seventy-four HIV-infected orphans from two orphanages (orphanage A taking antiretroviral therapy [ART] as per our prescription, whereas orphanage B taking ART from an ART center) were included in the study. Detailed history and examination was carried out in each patient. CDC class prior to ART, age at presentation, CD4 count/percent, opportunistic infections (OIs) prior to and after ART, co-infections with hepatitis B virus (HBV) and hepatitis C virus, growth, ART regimes, and treatment failure were noted in each patient. Of 18 HIV-infected children in orphanage A, boys constituted 11 (61.1 %) and girls were 7 (38.9 %), whereas orphanage B had all girls (n = 56). TB was the most common OI in orphanage A prior to the start of ART seen in 15 (83.3 %), whereas it was seen in 18 (32.1 %) in orphanage B. In contrast, TB was seen in eight (14.2 %) orphans in orphanage B after the start of ART, of which two (3.5 %) were MDR-TB and another two (3.5 %) were suspected to have MDR-TB, whereas one (5.5 %) in orphanage A had MDR-TB. Age of presentation was 4.7 ± 3.2 years for orphanage A and 12.9 ± 2.5 years for orphanage B. On ART, malnutrition was seen in one child in orphanage A as compared to nine in orphanage B. ART was started at 6.1 ± 3.1 years in orphanage A and 10.1 ± 2.8 years in orphanage B. Zidovudine, lamivudine (3TC), and nevirapine (NVP)/efavirenz (EFV) constituted the baseline ART regimen in 13 (72.1 %) orphans in orphanage A, whereas stavudine (d4T) + 3TC + NVP constituted the baseline ART in 17 (30.3 %) orphans in orphanage B. Three (5.3 %) orphans had HBV co-infection in orphanage B. Children in orphanage A came to us at a younger age, in more advanced stage of disease, and were more malnourished. Orphanage A was started on ART earlier in life. The prevalence of TB was higher in orphanage A prior to ART. MDR-TB was seen in both orphanages, with prevalence ranging from 3.5 % to 5.5 %.

1 table, 13 ref

042563   CHAUDHURI B K, CHAUDHURI B (Jadavpur Univ, Kolkata, West Bengal, Email: sspbkc23@gmail.com) : Proposed interaction mechanism between medicine and the diseased cell in diluted homoeopathic medicine. Indian J Res Homoeopathy 2020, 14(1), 15-23.

High‑diluted homoeopathic medicines practically contain no medicinal molecules. The disease‑curing mechanism of homoeopathic medicines has not yet been adequately understood. Acceptable knowledge of this mechanism is essential for further development of homoeopathic science. The purpose of this article is to provide a phenomenological model to understand the interaction mechanism between homoeopathic medicines and the diseased cell (DC), which cure diseases with a view to build a conceptual framework that would facilitate subsequent clinical and theoretical investigations. We have proposed the formation of hydrogen bonded nano and micro clusters (NAM) during the preparation (succession) of homoeopathic medicines. NAM are composed of effective ionic charge (such as O⁺ , H⁺ and other ions) distribution patterns(CDPs). During the electrostatic interaction between CDP around NAM and that around DC, H⁺ ion (proton) or other ion tunnelling takes place, which normalises the highly disordered (higher entropy) state of the CDP around DC to bring it to the normal state. NAM is DC dependent. The entropy change around the DDP leads to information change, which is transmitted to the brain through neurotransmitters to complete the disease remediation process. Proton or ion tunnelling from NAM to DC is quantum mechanical in nature. A novel phenomenological model demonstrating the interaction between DC and homoeopathic medicines (NAM) has been proposed that cures the disease. Ion tunnelling, entropy and related information change (cells signalling) taking place during the healing process appeared to be associated with biological phenomena, yet to be fully developed.

6 illus, 31 ref

040798   GOPINATH H, KARTHIKEYAN K (Dermatology Dep, All India Institute of Medical Sciences, Guntur - 522 503, Andhra Pradesh, Email: hima36@gmail.com) : Genital scabies: Haven of an unwelcome guest. Indian J Sex Transm Dis AIDS 2020, 41(1), 10-6.

The itch mite Sarcoptes scabiei var. hominis has been a menace to humanity for ages. Diagnosing scabies can be a challenge in view of the varied presentations of the disease. The male genitalia are an important area of predilection of the mite. Examination of this often overlooked area is essential as it may reveal both characteristic and atypical manifestations of scabies. Genital involvement also attains special relevance in view of the possible sexual transmission of the mite. In addition to the morbidity caused by itching, patients may have to deal with myths, stigma, and embarrassment.

5 illus, 1 table, 58 ref

040797   GAUTAM M M, SINGH V, NADKARNI N J, PATIL S P (Dermatology Dep, Dr. D Y Patil Hospital and Research Centre, Navi Mumbai, Maharashtra) : Anogenital lichen sclerosus. Indian J Sex Transm Dis AIDS 2020, 41(1), 1-9.

Lichen sclerosus (LS) was first described by Hallopeau in 1887. It is a chronic inflammatory condition most commonly involving the anogenital region with a relapsing course and a potential for destruction, functional impairment, atrophy, and malignant changes. LS affects both sexes with a female preponderance of 5:1. The exact prevalence of the disease is difficult to predict as the lesions are asymptomatic in the initial phase and later when the complications arise patients might visit the surgeon, pediatrician, gynecologist, or urologist. The etiology of LS has a complex interplay of genetic factors, autoimmunity, infections, and trauma. Physical examination to assess the extent of the disease and decide the line of management is the most crucial step in the management. Corticosteroids, calcineurin inhibitor, retinoids, phototherapy, and surgery can be helpful. Self-examination and long-term follow-up are necessary.

6 illus, 27 ref

040795   SINGHAVI H R, SINGH A, BHATTACHARJEE A, TALOLE S, DIKSHIT R, CHATURVEDI P (Tata Memorial Centre, Mumbai, Maharashtra, Email: atanustat@gmail.com) : Alcohol and cancer risk: A systematic review and meta analysis of prospective Indian studies. Indian J Public Health 2020, 64(2), 186-90.

Alcohol increases risk of cancer of oral cavity and pharynx, esophagus, colorectal, liver, larynx, and female breast. The objective of this study was to determine the relationship of alcohol and cancer in India by meta-analysis. Systematic Medline searches were performed to identify all the published literature associating alcohol and cancer in India. Initially, we retrieved 1509 studies, but after applying inclusion and exclusion criteria, only 29 studies were found eligible for our meta-analysis. Our meta‑analysis shows that alcohol consumption increases the risk of cancer with the odds ratio (OR) of 2.32 (95 % confidence interval [CI]: 1.50–3.47) in case–control studies and relative risk of 1.52 (95 % CI: 0.97–2.51) in cohort studies. It also shows that risk of oral cavity cancer increases by two times (OR: 1.92, 95 % CI: 1.54–3.96) in the population consuming alcohol. Publication analysis showed that studies included in the meta-analysis had wide variation, suggesting good representation all over the country. The result from our meta-analysis supports our hypothesis that alcohol consumption increases the risk of cancer, implying immediate cessation of the habit for cancer risk reduction.

1 illus, 31 ref

040794   RAJKUMARI B, KEISAM A, HAOBAM D S, THOUNAOJAM T (Jawaharlal Nehru Institute of Medical Sciences, Imphal - 795 001, Manipur, Email: avinashkeisam@yahoo.co.in) : Evaluation of vaccination coverage of measles rubella campaign in Imphal East District, Manipur: A cross sectional study. Indian J Public Health 2020, 64(2), 173-7.

In India, the measles‑rubella (MR) vaccination campaign was conducted with the purpose of vaccinating all children of 9 months–15 years of age with a single dose of MR vaccine. However, it encountered various challenges which may hamper with the coverage. This study was conducted to evaluate the recently conducted MR campaign in Manipur pertaining to its coverage and factors for not vaccinating. The cross‑sectional study was conducted in Imphal East district of Manipur during May and June 2018 among 1551 children from two communities. The study tool was adapted from the rapid convenience monitoring tool of the WHO. Descriptive statistics were generated, and multivariable logistic regression analysis was performed with vaccination status as dependent with selected independent variables. Among the study children, 38 % were in the age group of 5–10 years, males constituting 51.3 %. Only two‑third (68.8 %) of the children had received the MR vaccine, coverage among Muslim children was 40.4 % only, and 6.5 % of the respondents reported some forms of adverse events following immunization. Children from the Meitei community were (odds ratio: 14.35, 95 % confidence interval: 10.22–20.16) significantly more likely to receive the MR vaccination as compared to children belonging to the Muslim community (P = 0.001). Vaccination coverage of only 68.8 % highlighted the need for increased sensitization and involvement of local and religious leaders in generating necessary awareness for improved coverage of the campaign.

3 tables, 25 ref

040793   KANT S, KAUR R, AHAMED F, SINGH A, MALHOTRA S, KUMAR R (All India Institute of Medical Sciences, New Delhi - 110 029, Email: ravneetk08@gmail.com) : Effectiveness of intravenous ferric carboxymaltose in improving hemoglobin level among postpartum women with moderate to severe anemia at a secondary care Hospital in Faridabad, Haryana – an interventional study. Indian J Public Health 2020, 64(2), 168-72.

Postpartum anemia is associated with postpartum anxiety, depression, poor cognitive interaction, and delayed infant development. Oral iron is the currently recommended therapy but is associated with gastrointestinal complaints and poor compliance. Parenteral iron dextran may cause serious side effects, whereas iron sucrose requires repeated visits. Intravenous ferric carboxymaltose (FCM) is given as an infusion in a single setting, which is logistically convenient both to patients and health system. It can be particularly beneficial for postpartum women who are usually discharged from health facility 48 h after delivery. The objectives of this study were to estimate the change in mean hemoglobin (Hb) level 6 weeks after administration of intravenous FCM and to document any adverse events following administration among postpartum women. A prospective, interventional follow‑up study was conducted from August to December 2018. One hundred eligible postpartum women with Hb level of 5–9.9 g/dl were administered a calculated dose of intravenous FCM based on Ganzoni’s formula with Hb target of 12 g/dl. Hb and serum ferritin were measured at baseline and at 6 weeks after FCM infusion and compared for mean increase. There was a significant increase in Hb and serum ferritin levels after administration of FCM. The mean (95 % confidence interval) increase in the Hb and serum ferritin after 6 weeks was 4.2 (3.9–4.5) g/dl and 137.3 (113.6–161.0) ng/ml, respectively. No major adverse events were reported. Administration of FCM was safe and effective in the treatment of moderate‑to‑severe anemia among postpartum women.

3 tables, 18 ref

040792   SINGH M, RAINA S, PARASHAR M, GUPTA E, GOSWAMI S, GANDHI M K (Community Medicine Dep, Dr. RP Government Medical Coll, Kangra, Himachal Pradesh, Email: ojasrainasunil@yahoo.co.in) : Is calorie intake the fundamental driver of noncommunicable diseases in India – a systematic review. Indian J Public Health 2020, 64(2), 161-7.

Nutrition epidemiology initially focused on few nutrients thought to be responsible for noncommunicable diseases (NCDs). The database of Indian Nutrition Survey is based majorly on calorie intake. The objective was to compare the change in the average calorie intake from 1990 to 2012 with the emerging epidemic of diabetes and hypertension (HTN) in India since 1990. A comprehensive search was made in National Library of Medicine’s PubMed database and Google Scholar from March to August 2018, on the above‑mentioned subjects. Reports of national surveys (National Sample Survey Office and National Nutrition Monitoring Bureau) were included for average calorie intake among different states from year 1990 onward. Region‑wise search depicted by national nutrition surveys resulted in 277 and 587 abstracts on the prevalence of HTN and diabetes mellitus, respectively. There were 51 full‑text articles and abstracts on the prevalence of HTN and diabetes from the above regions. The average calorie intake per capita per day in the four zones of country in rural areas decreased from 1990 to 2012. An increasing trend in the prevalence of diabetes from rural areas was observed from 1994 to 2012. The per capita average calorie intake per day in urban areas from 1999 through 2011 in all zones except the eastern part of country was on rise. There was no consistent trend in the prevalence of HTN in any of the zones. It is not just an increase in calories, but a trade‑off between the demand for calories and the demand for healthy lifestyles determines the prevalence of NCDs.

1 illus, 3 tables, 54 ref

040791   WU Y, DING W, WANG Z, KOENIG H G, SHOHAIB S A (Epidemiology and Statistic Dep, Ningxia Medical Univ, Yinchuan - 750 004, China, Email: wzhzh_lion@126.com) : The relationship between parental religiosity and school age children’s dietary behavior in Ningxia province, China: A cross sectional study. Indian J Public Health 2020, 64(2), 154-60.

Studies have shown parental religious involvement was associated with better health behaviors of their children. However, the relationship between parental religiosity and child dietary behaviors remains unclear. This study aimed to examine the relationship between parental religious involvement and the dietary behaviors of school‑aged children in mainland, China. Participants were selected from a northwest province of China using a multi‑stage sampling process from July 2017 to October 2017. The frequency of parental religious activities and the importance of religion in life, along with the dietary behaviors of children, were collected using a questionnaire. Dietary pattern analysis coupled with multivariable linear regression was employed to test the association between parental religious involvement and children’s dietary behavior. The regression model indicated no significant relationship between parental religious behaviors and children’s dietary behaviors in the overall sample. However, the frequency of mother’s religious attendance was inversely related to children’s consumption of vegetables(β = −0.40, P< 0.05) in the Hui subsample (vs. Han) when stratifying analyses by ethnicity. These findings suggest among those of Hui ethnicity, parental religious involvement may impact children’s dietary behavior in a way that may affect their future health habits.

3 tables, 38 ref

040790   ANURADHA S, MAKKAR A M, NANDI P K, RAJESHWARI K (Maulana Azad Medical Coll, New Delhi - 110 002, Email: drsanuradha@gmail.com) : Quality of life and its determinants among people living with HIV attending an antiretroviral treatment Center in Delhi, India. Indian J Public Health 2020, 64(2), 148-53.

With universal access to antiretroviral treatment (ART), the management of people living with human immunodeficiency virus (PLHIV) encompasses holistic, comprehensive care. Despite being a vital goal of care, quality of life (QOL) assessment of PLHIV in India is neglected. This study assessed the QOL and its determinants among PLHIV accessing services through ART centers. The cross‑sectional study was conducted from November 2015 to February 2017 among 109 PLHIV attending an ART center in New Delhi. Sociodemographic and clinical profile characteristics were ascertained. QoL was evaluated using the medical outcomes study HIV health survey questionnaire; physical health summary (PHS), and mental health summary (MHS) scores were calculated. Depression was evaluated with the becks depression inventory and social support using the multidimensional scale of perceived social support. Chi‑square test, Student’s t‑test, and analysis of variance were used as test of significance. The overall QOL was: PHS‑48.04 ± 8.27 and MHS 42.43 ± 8.79. PHS scores were significantly higher among PLHIV with older age (P = 0.04), higher formal education (P = 0.022), early HIV disease (P = 0.006), higher CD4 counts (current, peak and nadir: P =0.024, 0.008, and ≤ 0.001, respectively), receiving ART (P = 0.05), with better social support (P = 0.012) and without depression (P ≤ 0.001). Similarly, MHS scores were better in PLHIV with greater formal education (P = 0.009), early HIV disease (P = 0.046), without depression (P ≤ 0.001). Depression and social support mechanisms emerged as two key determinants of QOL. Older age, higher education, less advanced disease, and ART were predictive of better QOL.

3 tables, 16 ref

040789   KASSA M D, GRACE J M (Biokinetics Dep, KwaZulu-Natal Univ, Durban, South Africa, Email: kassam@ukzn.ac.za ) : Frequency, intensity, time, and type principle of physical activity as a medical disability prevention program in Ethiopia: A mixed method study. Indian J Public Health 2020, 64(2), 141-7.

Despite the recognized benefits of physical activity (PA), the extent of its recognition and applications as a medical disability (MD) prevention program by practitioners working in Ethiopian health‑care settings is unknown. The objective of the study was to explore health‑care professionals’ knowledge base and characteristics on the utilization of the frequency, intensity, time (duration), and type principle (FITT) of PA as an MD prevention program in the Ethiopian public health‑care system. A mixed‑method research design was used with data collected from 13 public referral hospitals in Ethiopia. In Phase I, quantitative data were collected from 312 health professionals (99 physicians and 213 nurses) using a survey. In Phase II, qualitative data were collected by interviewing health officers (n = 13 physician–hospital managers) and conducting one focus group discussion (n = 6 national health bureau officers). A quarter (28 %) of practitioners working in referral hospitals are using PA as an MD prevention program. Higher specialization (adjusted odds ratio [AOR] = 20.203, P < 0.001), many service years (AOR = 0.041, P = 0.014), young age (AOR = 19.871, P < 0.001), and being male (AOR = 0.269, P < 0.001) were associated with using PA as a MDs prevention program. Applying the FITT principle of PA for the prevention of MD among practitioners was very poor. Training of health‑care professionals to use PA as a program for MDs prevention is required at the undergraduate level as well as specialized courses on qualification.

3 tables, 26 ref

040788   PAN T, DASGUPTA A, PAUL B, BANDYOPADHYAY L, AUGUSTINE A T V, SUMAN S (PSM Dep, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, Email: dr_bobbypaul@rediffmail.com) : Bone health and its association with vitamin d and other covariates: A community based study among women in a rural area of West Bengal. Indian J Public Health 2020, 64(2), 135-40.

Low bone mineral density (BMD) is implicated in the pathogenesis of osteoporosis and osteopenia, and primarily manifest as fragile bones. This is a rapidly emerging global health problem with increasing prevalence in India. The objective of this was to assess the status of bone health and find its determinants among women aged 40 years and above in a rural population of West Bengal. A community‑based cross‑sectional study was conducted from May 2017 to April 2018 among 260 women aged 40 years and above residing in the selected villages of Singur through multistage random sampling. Each respondent was interviewed using a structured schedule. Serum Vitamin D and calcium levels were investigated. BMD was assessed through calcaneal quantitative ultrasound. Osteoporosis was diagnosed among those with T‑score ≤−2.5, while those with 25(OH) Vitamin D <30 ng/ml were classified to have Vitamin D insufficiency (VDI). Individuals with BMD T‑score <−1 were considered to have low BMD. Inferential statistics were employed to find the associates of poor bone health. Out of 260 participants, 34 (13.1 %) were screened positive for osteoporosis and 77.7 % had low BMD. Approximately 75 % had VDI. On multivariable analysis, VDI (adjusted odds ratio [95 % confidence interval] = 4.13 [2.12, 8.37]) was a significant predictor of low BMD after adjustment for poor education, decreasing diet score, menopause, presence of comorbidity, underweight, and overweight explaining 43.6 % of the variance. Serum Vitamin D levels are implicated to play a crucial role in bone metabolism; however, its effect on the body in accordance with other important hormones should be explored.

2 illus, 2 tables, 27 ref

040787   TAQI M, SARKAR S, KHAN M M A (Geography Dep, Government PG Coll, Bhaderwah - 182 222, Jammu and Kashmir, Email: taqizaik@gmail.com) : Analyzing the disparities in the coverage of maternal and child health services: A District level cross sectional analysis of Jammu and Kashmir. Indian J Public Health 2020, 64(2), 130-4.

Improving overall coverage of maternal and child health (MCH) services is essentially required if India in general and Jammu and Kashmir state in particular have to attain the Sustainable Development Goals by the year 2030. Thus, the disparities in coverage of MCH services need to be assessed and addressed. The objective of this study was to examine the variation in coverage rates for a key set of interventions in MCH services and to assess the relationship between coverage gap and socioeconomic development across the districts of Jammu and Kashmir. Data from the National Family Health Survey‑4 (NFHS‑4), 2015–2016, Census of India 2011, and Digest of Statistics Jammu and Kashmir were used to construct two composite indexes of coverage gap and socioeconomic development at district level. Cronbach’s alpha was used to assess the internal consistency of indicators used in the two indexes. The overall coverage gap in the state was 28.17 %, and the size of coverage gap was largest for family planning interventions (55.8 %), followed by treatment of sick children (26.95 %) and maternal and newborn care (18.75 %), and was smallest for immunization (10.5 %). There is a moderate negative correlation between coverage gap and socioeconomic development (r = −0.63, P = 0.01). Coverage of MCH services and socioeconomic development has a significant disparity in the districts of Jammu and Kashmir. Resource‑rich and more urbanized districts are much ahead of the poor and less urbanized districts in terms of the usage of MCH services.

1 illus, 3 tables, 25 ref

040785   FAUK N K, MERRY M S, AMBARWATI A, SIGILIPOE M A, ERNAWATI, MWANRI L (Flinders Univ, Adelaide - 5001, Australia, Email: nelsen_klau@yahoo.com) : A qualitative inquiry of adherence to antiretroviral therapy and its associated factors: A study with transgender women living with HIV in Indonesia. Indian J Public Health 2020, 64(2), 116-23.

Successful antiretroviral therapy (ART) mainly depends on sustaining high rates of adherence. In the context of Indonesia, none of the previous studies have looked at determinants of HIV adherence among transgender populations. This study aimed to explore factors associated with the adherence to ART among HIV‑positive transgender women in Yogyakarta, Indonesia. Face‑to‑face in‑depth interviews with 29 transgender women, also known as Waria, living with HIV were conducted from December 2017 to February 2018. Participants were recruited using purposive and snowball sampling techniques. Data were analyzed thematically using a qualitative data analysis framework. Factors associated with ART adherence among transgender participants were divided into three major levels as follows: (i) individual factors, (ii) social factors, and (iii) structural factors. Feeling tired and lazy due to work, falling asleep before taking medicine, schedule to take the medicine, healthy physical condition of other HIV‑positive friends who did not take antiretrovirals, and the lack of finances to travel to health facilities were the influencers of the participants’ ART adherence. These findings indicate the need for the development of HIV/AIDS‑related health service supporting system in health‑care facilities and the dissemination of knowledge and information of HIV/AIDS and its related service for HIV‑positive transgender women and other people living with HIV and general populations in other parts of the country and other similar settings globally.

2 tables, 34 ref

040783   WAHABI H A, MASSIS A, FAYED A A, ESMAEIL S A (Clinical Dep, Princess Nourah Bint Abdulrahman Univ, Riyadh, Saudi Arabia, Email: fayedam_200@hotmail.com) : Effectiveness of health education in reducing secondhand smoke exposure among pregnant women visiting the antenatal clinic in Saudi Arabia: A randomized controlled trial. Indian J Public Health 2020, 64(2), 102-8.

Pregnant women’s exposure to secondhand smoking (SHS) is associated with detrimental effects on the pregnancy outcomes. The objective of the study was to compare the effectiveness of face‑to‑face counseling, based on health belief model (HBM), combined with a written educational pamphlet, and health education using written pamphlet only, in improving pregnant women’s perception, behavior to avoid SHS and change in exposure to SHS. A randomized controlled trial was conducted in 2016. The intervention group received face‑to‑face health counseling on SHS, while the control group received only written educational pamphlets. Outcomes were the change in the perception of mother on the four constructs of the HBM and the change in mothers’ behavior of avoidance of SHS exposure. A total of 100 women were recruited for the study, of whom 93 (47 intervention and 46 control) women completed the study. All women identified their spouse as a source of SHS exposure. Following the intervention, the intervention group had significantly higher scores in the perception of susceptibility (21 ± 4 vs. 16 ± 7, P < 0.01) and severity (15 ± 3 vs. 12 ± 4, P < 0.01) and reduced perception scores of barriers to avoid SHS exposure (11 ± 4 vs. 9 ± 5, P = 0.03), compared to the control group. However, there was an insignificant change in the exposure to SHS after the intervention in both the groups; where 25 (53.2 %) women in the intervention group and 31 (67.4 %) in the control group (P = 0.16), continued to being exposed to SHS. Counselling of pregnant women, based on HBM, has insignificant effect in reducing their exposure to SHS; however it is effective in improving their knowledge and perception about SHS exposure.

1 illus, 3 tables, 24 ref

044625   CHINTAMANI R, RAYJADE A, YADAV T (Musculoskeletal Sciences Dep, Krishna Institute of Medical Sciences Univ, Karad– 415 539, Email: radds2009@gmail.com) : Effect of hydrokinesia in elderly subjects with backward disequilibrium: A systematic review. J Ecophysiol Occup Health 2020, 20(1&2), 82-94.

Water based exercise are significant in improving both static as well as dynamic balance. Elderly subjects already are known to have decreased balance. Changes in the musculoskeletal system are one of the major causes of decreased balance. Physiotherapy regimen is important in improving both static and dynamic balance in elderly. Aquatic therapy is painless and easy way to improve balance in geriatric. However, despite its widespread knowledge of importance of aquatic therapy in improvement of balance, the efficacy of aquatic therapy in elderly is limited.  The aim of this systematic review is to analyze the importance of aquatic therapy on fall perspective in elderly population. The authors searched Google Scholar and PubMed from 1996 to 2017. Only downloadable randomized controlled trials (15), randomized clinical trials (14) and experimental studies (3) were included in the study. The duration of treatment varied significantly in comparison to various studies. Subgroup analysis was performed on factors considered for measuring of fall risk parameters in elderly subjects. The result of the present study shows strong evidence to support the water based exercises in which Hydrokineitic therapy showed significant reduction in kinesiophobia and fall risk rate. Hence the therapy can be considered effective for geriatric population.

32 tables, 36 ref

044624   RAZAGH S, ALISHIRI G H, GOOSHK H S (Islamic Education Dep, Kharazmi Univ, Tehran, Iran, Email: ghalishiri@gmail.com) : The role of prayer in physical health (prayer therapy). J Ecophysiol Occup Health 2020, 20(1&2), 75-81.

Health has various dimensions: 1. physical health, 2. mental health, and 3. spiritual health that the spiritual health affects the physical and mental health and it is influenced by them at the same time. Prayer is the highest order of worship is the religion of Islam and can have physical, spiritual and spiritual effects on the individual. The prayer affects the individuals’ purity, Wudu¹ and observance of one’s health directly affects one’s own health. Its physiological effects, such as bowing, strengthen the abdominal muscles, digestive system, the spine, neck, hands legs and thighs. Prostration is considered as the most important part of prayer in the treatment of lumbar discs, strengthening of the neck and increasing blood flow to the brain, which in turn contributes to the relaxation and reduction of anxiety. In this study, while addressing the principles and states of prayer, they are adjusted with the physicians’ recommendations, some of the results of which were that prayer is very effective in spiritual and body health. The results of medical research confirm that prayer can be referred to as the spirit and body exercise. There is a significant relationship between those parts of prayer and its components with more medical effects e.g. purity, the presence of the heart, long prostrations, and night prayer that are focused by the religion. The Quran and narrations refer to the multifaceted nature of prayer and its principles. Each principle is like the rings of a chain that provide the worldly and here after health of the human being.

27 ref

040782   RANE T M, MAHANTA T G, RYAVANKI S P, GOGOI B, BORUAH M (Community Medicine Dep, Tezpur Medical Coll, Dibrugarh - 786 001, Assam, Email: drtulikagoswami@gmail.com) : Home based newborn care voucher initiative in Assam: An evaluation. Indian J Public Health 2020, 64(1), 66-71.

An innovative home-based newborn care (HBNC) voucher system has been introduced in Assam to improve home visits of accredited social health activists (ASHAs), make them more accountable, and empower the community. This study aimed to evaluate the effectiveness of HBNC voucher initiative in Assam. A mixed methodology study was conducted in 2018 including 4 districts of Assam. A quantitative study was done among a sample of 836 lactating mothers by interviewing them through house-to-house visits. A qualitative study was done by in-depth interview of various health-care service providers. Of 836 lactating mothers, 65 % received HBNC voucher; 45.6 % received at the time of discharge, and 5.3 % during antenatal care. The purpose of HBNC vouchers as a tool of validating ASHAs’ home visits was explained to only 14.5 % of lactating mothers. Examination of newborn (44.6 %), counseling on breastfeeding (57.1 %), counseling on care of baby (39.2 %), and counseling on immunization (49.2 %) were the services commonly provided by ASHA during HBNC visits. Voucher system improved incentive payment system, but uninterrupted supply was a problem area as stated by ASHAs. Auxiliary nurse midwives and ASHA supervisors told that voucher system had improved ASHA home visits, payment system, and increased identification of danger signs of newborns. HBNC voucher system as an innovative approach was found to be effective. Coverage of services varied among different districts. Uninterrupted supply of the vouchers, periodic resensitization of health workers on its use, and increasing awareness among the community is needed to be sustained.

3 tables, 19 ref

040781   AGRAWAL R, NEGI R, KAUSHAL S K, MISRA S K (Community Medicine Dep, S.N. Medical Coll, Lucknow, Uttar Pradesh, Email: rudreshnegi@gmail.com) : Out of pocket expenditure and its associated factors in neonates admitted to neonatal intensive care unit of tertiary care government Hospital of Agra District, Uttar Pradesh. Indian J Public Health 2020, 64(1), 60-5.

Neonatal health remains a thrust area of public health, and an increased out-of-pocket expenditure (OOPE) may hamper efforts toward universal health coverage. Public spending on health remains low and insurance schemes few, thereby forcing impoverishment upon individuals already close to poverty line. To determine catastrophic health expenditure (CHE) in neonates admitted to the government neonatal intensive care unit (NICU) and factors associated with of out-of-pocket expenditure. This cross-sectional study was conducted in a governmental NICU at Agra from May 2017 to April 2018. Asample of 450 neonatal admissions was studied. Respondents were interviewed for required data. OOPE included costs at NICU, intervening health facilities, and transport as well. SPSS version (23.0 Trial) and Epi Info were used for analysis. Of the 450 neonates analyzed, the median total OOPE was Rs. 3000. CHE was found among 55.8 % of cases with 22 % spending more than their household monthly income. On binary logistic regression, a higher total OOPE of Rs. 3000 or more was found to be significantly associated with higher odds of residing outside Agra (adjusted odds ratio [AOR] = 1.829), delay in first cry (AOR = 1.623), referral points ≥3 (AOR= 3.449), private sector as first referral(AOR= 2.476), and when treatment was accorded during transport(AOR= 1.972). OOPE on neonates amounts to a substantial figure and is more than the country average. This needs to be addressed sufficiently and comprehensively through government schemes, private enterprises, and public–private partnerships.

3 tables, 33 ref

040780   DARIVEMULA S B, NAGOOR K, JOHN K R, KAHN P S, CHITTOORU C S (Community Medicine Dep, Apollo Institute of Medical Sciences, Chittoor - 517 127, Andhra Pradesh, Email: nagoorkhadervali@gmail.com) : Morbidity profile of children from birth to 18 years of age referred for intervention to the District early intervention Centre in a District Hospital, Andhra Pradesh. Indian J Public Health 2020, 64(1), 55-9.

The “Child Health Screening and Early Intervention Services” program aims at early detection and management of the four dimensions prevalent in children‑defects at birth, diseases in children, deficiency conditions, and developmental delays, including disabilities. The objective of the study was to assess the morbidity profile of children from birth to 18 years of age screened in the district early intervention center (DEIC). A record‑based descriptive study was done in the DEIC in Chittoor, Andhra Pradesh. The data were retrieved for 1‑year from April 2017 to March 2018 into the excel sheet, and the combined master sheet was prepared for analysis. The analysis was done with SPSS 21.0 Version. A total of 10571 children were screened and referred to the DEIC during the period. Out of them, 5679 (53.7 %) were male and 4892 (46.3 %) were female. Among all the four types of morbidities screened, majority 4847 (45.9 %) were having the childhood diseases, 4177 (39.5 %) had developmental delays including disabilities, 1067 (10.1 %) had different deficiencies, and 361 (3.4 %) had birth defects. Among the adolescent health issues, 119 (1.1 %) were screened and sent for the early intervention to the district hospital. A huge number of children were screened and referred to the DEIC every year for intervention. The health sector has to focus more on the resources like workforce, training of peripheral health workers at regular intervals about the different morbidities screened, that would help in identifying the morbidities at the earliest possible time and receive the intervention at the best center.

3 tables, 11 ref

040779   DASGUPTA A, BANERJEE R, PAN T, SUMAN S, BASU U, PAUL B (All India Institute of Hygiene and Public Health, Kolkata - 700 039, West Bengal, Email: rajarshi0110@gmail.com) : Metabolic syndrome and its correlates: A cross sectional study among adults aged 18–49 years in an urban area of West Bengal. Indian J Public Health 2020, 64(1), 50-4.

The prevalence of metabolic syndrome (MetS) is increasing dramatically of late, across all ages irrespective of gender, socioeconomic status, and ethnicity. People with MetS have twice the likelihood of developing and dying from cardiovascular disease and more than seven times the risk of developing diabetes. This study was undertaken to determine the prevalence of MetS among adults who were in their first three decades of adulthood and to find out the risk factors of MetS among them. This was a community based cross‑sectional study among 388 subjects aged 18–49 years selected by multistage random sampling in an area of Kolkata, India, from November 2016 to October 2018 over 2 years. Data collection was done using a structured questionnaire along with anthropometry, blood pressure measurement, and relevant blood tests. Physical activity was classified by the International Physical Activity Questionnaire Short‑Form questionnaire. Data were analyzed using the Statistical Package for the Social Sciences(version 16.0), and descriptive statistics were calculated as frequency and percentage. Logistic regression was done to determine the strength of association between MetS and different risk factors. The prevalence of MetS was 44.6 % (35.4 % in males and 55.6 % in females), and female gender, poor economic status, sedentary lifestyle, poor diet, and addiction of tobacco were found to be the risk factors of MetS in the final model using multivariable logistic regression. This research revealed the high prevalence of MetS in the community. The effective primordial and primary level of prevention along with prevailing secondary or tertiary level of prevention should have been employed to curtail the epidemic of MetS.

3 tables, 12 ref

044622   NASSER A A, HAMAD R, MOHAMMED H, AKONDI B R (Medical Education Dep, Suez Canal Univ, Ismailia- 41111, Egypt, Email: dr.asmaashraf@gmail.com) : Prevalence of b-blockers misuse for exam stress and anxiety management among health professions students in Jeddah, Saudi Arabia. J Ecophysiol Occup Health 2020, 20(1&2), 62-9.

Excessive stress can affect students’ learning performance and well-being. An optimal level of stress could enhance learning and achievement, whereas excessive stress may affect academic achievement and result in mental and physical health problems. This research aims to assess the prevalence of Beta-Blockers misuse especially propranolol and to determine the stress causative factors among health professions students.  A descriptive cross-sectional study has been conducted at Jeddah, Saudi Arabia. Data collected through an online, modified and valid questionnaire through Google documents were sent to all health professions students. The total number of participants is 430. Results: The prevalence of propranolol misuse is 40 % (172) among health professions students in Jeddah city and 89 % (153) of them were among the age group 20-30 years. The most causative stimulants to use propranolol among the medical students especially was for reducing the educational stress and anxiety (70 %) and they reported that they frequently used propranolol before oral/poster presentation (42 %) and entering the practical exams (OSCE/OSPE) (26 %) and oral exam (19 %) in comparison to the theoretical written exam (p-value < 0.01).  This study concludes that there is a high rate of propanol misuse among health professions students in Jeddah city especially among male medical students. All users were aware of the potential side effects of propranolol, however; the stress-relieving effect and feeling of propranolol increased its use prior to practical, oral and presentations exams.

4 illus, 1 table, 15 ref

044621   TARIQ R, TARIQ A, TARIQ K, SHAHID A, SHAHID M, HUSSAIN A (Public Health Dep, Punjab Univ, Lahore, Pakistan, Email: rukiyatariq17@gmail.com) : Overweight and obesity among 25–60 years women in Lahore, Pakistan. J Ecophysiol Occup Health 2020, 20(1&2), 57-61.

To observe association of factors such as nutritional factors, physical activities and systemic factors with overweight and obesity among 25 to 60 years old women. Study Design: A quantitative household survey. The survey was carried out in all ten towns of Lahore, Pakistan from 4th January 2016 to 4th May 2016. The research investigated 3239 women (25 to 60 years of age) through multistage sampling technique; from which two neighboring localities were randomly selected; found 1106 women were overweight and 449 were obese whereas, 1684 females were normal weights who were excluded from the research study. Factors were found significantly associated with overweight and obesity. Among nutritional factors such as fast food and snacks have p-value 0.000, whereas, daily food intakes have p-value 0.001. Physical activities such as housework activities have p-value 0.000; whereas, both regular exercise and time spent on TV/Computer per day have p-values 0.001. Systemic factors such as systemic diseases have p-value 0.001 whereas family history of overweight and obesity and women using medications both have p-value 0.000. The study concluded that overweight and obesity was positively associated with nutritional factors, physical activities and factors such as genetics, use of medications and systemic diseases among women 25-60 years.

3 tables, 20 ref

040778   TITORIA R, UPADHYAY M, CHATURVEDI S (British Columbia Univ, Vancouver, BC, Canada, Email: drreenat@gmail.com) : Quality of routine immunization service: Perception of clients. Indian J Public Health 2020, 64(1), 44-9.

Immunization prevents over 2–3 million deaths each year worldwide. In India, even though vaccines are offered free of cost at public health facilities the coverage remains low. Limited scrutiny has been conducted at health service and client interface for routine immunization (RI) services, which may have been affecting the acceptance of vaccines. This emphasizes the importance of assessing the level of satisfaction and perceived quality of clients regarding RI services. This study aimed to assess the perceived quality and level of overall general satisfaction with RI services of clients. In addition, determine the association of factors influencing clients perceived quality and overall general satisfaction with RI services. A community‑based cross‑sectional study was conducted in an urbanized village of Delhi from November 2015 to April 2017. A total of 279 RI visits were covered in the study, and the clients were interviewed at their residence using a pretested tool. The dissatisfaction toward the domains of perceived quality of RI services was reported to be 3.2 % for vaccine availability, 9.7 % for vaccine information, 3.2 % for staff behavior, 6.1 % for doctor behavior, and 7.5 % for infrastructure. Multivariable‑regression analysis indicated that distance to health facility, literacy and age of the client, doctor behavior, staff behavior, and infrastructure had an effect on overall general satisfaction of client toward RI services. The client’s perception is multidimensional; improvement in one domain is likely to strengthen the other. By understanding the client’s perspective toward quality of RI service, the healthcare mangers may improve the level of overall satisfaction.

4 tables, 18 ref

040777   BASAK M, BISWAS R, BHATTACHERJEE S, DAS D K, MITRA S (Community Medicine Dep, Coochbehar Government Medical Coll and Hospital, Coochbehar, West Bengal, Email: docbromi@rediffmail.com) : Prevalence and pattern of childhood injuries in Siliguri City, West Bengal, India. Indian J Public Health 2020, 64(1), 39-43.

Children are vulnerable to injuries, and childhood injury is a complex phenomenon precipitated by a set of factors. In India, the magnitude and nature of childhood injury are not clearly known owing to the absence of a proper injury surveillance system. However, in recent days few studies demonstrated a substantially high burden of childhood injury. To find out the prevalence, pattern, and the factors associated with injury among children of 0–14 years in the Siliguri city of West Bengal. A cross‑sectional study was conducted among 780 children aged 0–14 years residing in the Siliguri Municipal Corporation area selected through cluster sampling technique (30 clusters [wards] with a cluster size of 26). Relevant data were collected by interviewing the mothers of children as respondents and was analyzed using SPSS software, binary logistic regression was applied to test the association between injury and other risk factors. Of total 780 children, 165 had reported a total of 220 injury events with an overall period prevalence of 21.2 % and a mean of 0.28 injury events per child. Majority of injuries were superficial in nature (53.2 %); due to fall (56.4 %), extremities were mostly involved (62.3 %), and 12.8 % cases were moderate‑to‑severe grade. Under‑five children were most vulnerable. Injury was significantly related to socioeconomic status, presence of siblings, outdoor activities, and the presence of supervising person during travelling. Childhood injury is still highly prevalent in the area with its unique pattern and few preventable risk factors requiring a multifaceted comprehensive approach.

2 tables, 22 ref

040776   DUGG P, CHHABRA P, SHARMA A K (Community Medicine Dep, DY Patil Univ, Navi Mumbai - 400 706, Maharashtra, Email: dr.preetidugg@gmail.com) : Contraceptive use and unmet need for family planning among HIV Positive women: A hospital based study. Indian J Public Health 2020, 64(1), 32-8.

For women living with HIV who do not want to become pregnant or who wish to delay pregnancy, contraception has the added public health benefit of reducing the number of infants who might acquire HIV. The unmet need for contraception must be addressed to prevent unintended pregnancies among HIV‑positive women and consequently mother‑to‑child transmission of HIV. The objectives of this study were to assess the contraceptive usage and its various determinants and to find out the unmet need for family planning among HIV‑positive women. This was a cross‑sectional descriptive hospital‑based study conducted among 235 HIV‑positive women attending the ART center of a medical college. Data were collected using a questionnaire‑containing sociodemographic details, obstetric history, treatment information, contraceptive usage, and their fertility desires. Data analysis was performed using MS Excel and the SPSS version 20.0 using frequencies, Chi‑squared test, and multiple logistic regression. The mean (standard deviation) age of the study participants was 28.8 (5.5) years. Majority (96.6 %) of them were married and were illiterate (34.4 %). The prevalence of unmet need for family planning was found to be 17 %, and the prevalence of consistent contraceptive use was 74.5 %. The most common family planning method used by women was male condom. Not having HIV‑positive children, HIV‑negative partner, and discussing contraceptive with partner were observed to be significant predictor of consistent contraceptive use on multiple logistic regression. There is a need to boost family planning counseling and address the unmet need and contraceptive use among HIV‑infected women.

1 illus, 3 tables, 33 ref

040774   KUMAR G, GUPTA S (National Institute of Health and Family Welfare, New Delhi - 110 067, Email: gaurav_ucms@yahoo.co.in) : Assessment of cold chain equipments and their management in government health facilities in a District of Delhi: A cross sectional descriptive study. Indian J Public Health 2020, 64(1), 22-6.

Cold chain equipments(CCEs) at health facilities(HFs) are an essential part of the immunization supply chain (ISC). The CCEs in government HFs of Delhi were never assessed using the World Health Organization-United Nations Children’s Fund (WHO‑UNICEF) Effective Vaccine Management (EVM) tool except that of state vaccine store during National EVM assessment 2013. The objective of the study was to assess the CCEs and their management in government HFs using the WHO‑UNICEF EVM tool in a district of Delhi. The assessment was done during December 2017–March 2018 in one randomly selected district of Delhi. Sample size and site selection were done using the WHO EVM site selection tool. A total of 29 HFs were assessed along with District Vaccine Store. Questions on CCEs in EVM tool 1.0.9 were used for data collection. Out of 56 electrical CCEs, 8.9 % were nonfunctional, 48.2 % were noncompliant with WHO standards, 5.4 % were not chlorofluorocarbon free, 4.7 % did not have temperature monitoring device, and 18.8 % did not have stabilizer. Eighty‑six percent of passive containers were compliant with the WHO standards. The storage capacity of electrical vaccine storage equipment was insufficient in 3.4%, passive container capacity in 65.5 %, and ice packs preparation and storage capacity in 24.1 % of HFs. There was no planned preventive maintenance of CCEs and no standard operating procedures for emergency event management. There was a shortage of vaccine storage, ice packs preparation and storage, and passive container capacity. Many CCEs used in ISC of assessed sites were noncompliant to the WHO standards. There was no PPM of CCEs and no guidelines for emergency event management.

2 illus, 1 table, 21 ref

040773   MISHRA G D, KUMAR D, PATHAK G A, VAISHNAV B S (Physiotherapy Dep, KM Patel Institute of Physiotherapy, Anand - 388 325, Gujarat, Email: daxagm@charutarhealth.org) : Challenges encountered in community based physiotherapy interventions for urinary incontinence among women in rural areas of Anand District of Gujarat, India. Indian J Public Health 2020, 64(1), 17-21.

It is necessary to understand the way women think about their health. There is a “culture of silence” among women regarding urinary incontinence (UI). Physiotherapy is proven effective mode of therapy in case of UI. This study aimed to explore the attitude of the women toward UI, to understand the related sociocultural factors and health‑seeking behavior, and to ascertain the challenges encountered in community‑based physiotherapy interventions. A qualitative study was conducted among women who refused to participate in a physiotherapy intervention for UI in the rural community of Gujarat, India. Fourteen in‑depth key informant interviews were conducted using an interview guide. The responses were noted and compiled into a composite interview script. Interviews were not recorded due to nonavailability of consent. Interviews were reviewed by investigators and content analysis was carried out. Key themes were identified after multiple iterations. Most of the women were unaware of the UI and believed that it may be due to their gender or due to aging. Physiotherapy interventions were disregarded due to various reasons such as shy nature, lack of priority and privacy, dependency, self‑neglect, and influence of social and cultural norms. Cultural and social systems were more important determinants of health seeking than health systems themselves particularly when sensitive issue such as UI in women of rural Western India was concerned.

1 table, 21 ref

044619   SOLEMAN S R, ANDINI S A, EDI L C ( Public Health Dep, Islam Indonesia Univ, Yogyakarta– 555 84, Indonesia, Email: sani.rachman@uii.ac.id) : Lead exposure on blood pressure and lipid parameters alteration among people around bus terminal in yogyakarta. J Ecophysiol Occup Health 2020, 20(1&2), 45-9.

Lead is generated as residual progress of vehicle or factory process. The excessive amount of lead has several impacts on human health system namely on cardiovascular, respiratory, endocrine and metabolic system through damaging enzymatic process and Reactive Oxygen Species (ROS). The aim of this study is to search the correlation of lead exposure on blood pressure and lipid parameters alteration among people around bus terminal in Yogyakarta. This study is a cross sectional research design. According to calculation of sample size, 71 respondents had fulfilled the inclusion criteria such as: Agree to be respondents, 6 hours fasting prior to take data, age >18 years old and had history of staying nearby bus terminal for more than one year. The variables divided into two, independent variable is lead exposure and dependent variables are SBP and DBP meanwhile lipid parameters such as LDL, HDL and TG. Those variables were analyzed by linier regression. Based on linier regression was obtained that SBP (p value 0.004, r 0.33 and R square 0.11), DBP (p value 0.001 r 0.37 and R square 0.138), LDL (p value 0.002 r 0.35 and R square 0.128), HDL (p value 0.001, r 0.37 and R square 0.139) and TG (p value 0,002, r 0.36 and R square 0.130). The result of study was found that lead exposure contributed on blood pressure and lipid parameters alteration among people around bus terminal in Yogyakarta.

3 tables, 22 ref

040772   JACOB O M, KANT S, HALDAR P, KAUR R, DADHWAL V, PRAKASH S (All India Institute of Medical Sciences, New Delhi - 110 029, Email: skant76@gmail.com) : Intravenous iron sucrose and change in hemoglobin, ferritin, and oxidative stress markers among moderately anemic pregnant women attending a secondary care level hospital in Northern India. Indian J Public Health 2020, 64(1), 11-6.

Intravenous iron is associated with oxidative stress, and very few studies have assessed change in oxidative stress markers post infusion. The study aimed to measure the change in levels of hemoglobin (Hb), serum ferritin, and select oxidative stress markers (malondialdehyde [MDA], superoxide dismutase [SOD], and ferric reducing ability of plasma [FRAP]) 4 weeks following the administration of intravenous iron sucrose (IVIS) among moderately anemic pregnant women who were attending a secondary‑level health‑care facility, Haryana, North India. An observational study was conducted (May 2016 to Jan 2018) among pregnant women receiving intravenous iron sucrose i.e., IVIS (300 mg per dose) diluted in 300 mL of normal saline over 20–45 min and were followed up for a period of 4 weeks after the last dose of IVIS (end line). The study outcomes were measured in the levels of Hb, serum ferritin, MDA, SOD, and FRAP from the baseline to the end line. The mean (95 % confidence interval) change in the Hb and serum ferritin level 4 weeks after the last dose of IVIS was an increase of 2.5 (2.1–3.0) g/dL (P < 0.001) and 63.0 (44.7–81.3) ng/mL (P < 0.001), respectively. There were no significant changes (baseline to end line) in mean (standard deviation [SD]) MDA level and mean (SD) FRAP level. The mean (SD) SOD level declined significantly (2.2 [0.4] U/mL to 1.6 [0.5] U/mL [P < 0.001]). No life‑threatening adverse events were encountered during the study. IVIS was well tolerated and effective in treating moderate anemia in pregnancy. Body iron store was replenished following IVIS administration. There was no increase in oxidative stress following IVIS therapy.

1 illus, 2 tables, 36 ref

040771   KUMAR R, SARKAR M, KUMAR A, CHAKRAVARTY J, KANSAL S (Banaras Hindu Univ, Varanasi - 221 005, Uttar Pradesh, Email: dr.madhutandra.sarkar@gmail.com) : Factors affecting disclosure of HIV Positive serostatus among people living with HIV/AIDS attending an antiretroviral therapy center of Eastern India. Indian J Public Health 2020, 64(1), 4-10.

HIV serostatus disclosure plays an important role in reducing the risk of HIV transmission. However, its negative effects may include rejection, assault, separation, divorce, stigma, and discrimination. This study was undertaken to find out the proportion of HIV‑positive serostatus disclosure to any family member and different factors influencing disclosure among people living with HIV/AIDS (PLWHA). A cross‑sectional study was conducted among all patients aged 18–49 years with confirmed HIV infection registered at the antiretroviral therapy center of a tertiary care hospital in eastern part of Uttar Pradesh, India, for the duration of 1 year, from July 2017 to June 2018. Most of the respondents were aged 30–49 years (79.9 %), male (63.2 %), married (85.4 %), rural residents (60.4 %), Hindu (96.5 %), literate (84 %), employed/driver (61.8 %), and belonged to lower/lower middle class (62.6 %). The rate of disclosure of HIV‑positive status to any family member was quite high in this study (238/288 or 82.6 %), among which 92.9 % (221/238) to the spouse only. The number of sexual partners before disclosure, educational status, and socioeconomic status of the respondents were found to be independent predictors of disclosure of HIV‑positive status to any family member (P < 0.05). This study indicates the need of giving more emphasis on creating awareness regarding the importance of HIV serostatus disclosure to any family member, especially to spouse, and encourage all PLWHA in the community to disclose their status. Effective strategies also need to be evolved that will target those not likely to disclose their status to anybody.

4 tables, 24 ref

044618   MINHAS U, KUMAR D, ALI A, YADAV D, KESARWANI R, GUPTA S P, KUMAR R (Biochemistry Dep, Allahabad Univ, Allahabad– 211 002, Uttar Pradesh, Email: rbotany@gmail.com) : Health status of cycle rickshaw pullers in Allahabad (India). J Ecophysiol Occup Health 2020, 20(1&2), 41-4.

Occupation is one of the most important extrinsic factors which have the major impact on health. Pedalling the tricycle rickshaw is a most stressful job. Rickshaw Pullers are extensively exposed to the air pollutants in conjunction with strenuous exercise. In the present study demographic details along with nutritional status, hygiene status and morbid conditions were obtained from fifty Rickshaw Pullers (RPs) in Allahabad.

1 illus, 4 tables, 5 ref

044617   ALSHAMMARY N F, SALAMA K F, ZAFAR M (Jubail General Hospital, Al Jubail City, Saudi Arabia, Email: dr.lofan@gmail.com) : Heat stress among steel workers in al Jubail, Saudi Arabia. J Ecophysiol Occup Health 2020, 20(1&2), 34-40.

Workers working in the steel industry has commonly exposed to heat which lead to health risk. The objective of this study was to assess heat stress among steel production workers. It is a cross sectional study, 186 workers were selected through simple random sampling. There are two groups of workers staff and line production. The Wet Bulb Global Temperature (WBGT) index was measured from Heat Stress Monitor (Casella Micro herm WBGT) and Heat Strain Score Index (HSSI). Spearmen correlation for determine the correlation between WBGT and HSSI and association between risk factors and HSSI determined through logistic regression. The mean and SD values of the wet bulb global temperature was 32.46 (2.01) and these values exceed Threshold Limit Values (TLV by American Conference of Governmental Industrial Hygienists (ACGIH) standard and HSSI scores showed that 24.3 % of the exposed workers were in red dangerous zone (severe heat strain). The WBGT and HSSI values are positively correlated (r = 0.85) (P = 0.001). Risk factors associated with heat stress after adjustment are age 19-35 years (OR 6.07, CI 1.78-21.90), years of experience >10 years (OR 4.67. CI 1.23-18.42), ever smoking (OR 1.58, CI 1.08-4.57) and overweight (OR 1.56, CI 1.20-12.48). The finding of this study showed that heat stress is common hazard among steel workers and the heat conservation planning intervention action should be conducted to reduce exposure.

6 tables, 20 ref

040765   KSHIRSAGAR R R, VAIDYA S A, JAIN V (Quality Assurance Dep, Oriental Coll of Pharmacy, Navi Mumbai - 400 705, Maharashtra, Email: vandana.jain@ocp.edu.in) : Development and validation of a novel RP-HPLC method for the simultaneous quantification of ascorbic acid, gallic acid, ferulic acid, piperine, and thymol in a polyherbal formulation. Indian J Nat Prod Resour 2020, 11(4), 307-11.

A novel, accurate, precise, and linear RP-HPLC method for the simultaneous estimation of ascorbic acid, gallic acid, ferulic acid, piperine, and thymol in a polyherbal formulation was developed and validated as per ICH guidelines. A good chromatographic separation was achieved using gradient profile with the help of Shim-pack RP-HPLC column (250 mm*4.6 mm, 5 µm) and a mobile phase consisting of acetonitrile and 1 % acetic acid was used. The column temperature was maintained at 28 °C throughout the run with a wavelength of 272 nm using UV-Visible detector. The retention time of ascorbic acid, gallic acid, ferulic acid, piperine, and thymol was found to be 3.9, 6.7, 21.5, 44.6, and 45.9 min respectively. The linearity of ascorbic acid, gallic acid, ferulic acid, piperine, and thymol was found to be in a range of 10-100, 5-50, 1-10, 5-50, and 2-20 µg/mL, respectively with correlation coefficient >0.99. The high recovery values (98-102 %) indicate satisfactory accuracy. The % RSD values were found to be less than 2 % in the precision study which reveals that the method is precise. Hence the developed method can be used for quality control and quantitative analysis of extracts and commercial containing these selected phytoconstituents.

8 illus, 2 tables, 12 ref