042375   SETHI P, SHARMA M K, AHUJA S (Dr. RML Hospital, New Delhi) : Role of early physiotherapy to enhance functional ability in a patient with bipolar latissimus dorsi myocutaneous flap transfer at the elbow: A case report. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Elbow flexion is often lacking in patients with neuro- vascular injuries post trauma to the arm. Option for functional reconstruction is often limited in such patients due to delayed presentation and unavailability of suitable nerves and blood vessels. Many a times the only available option is regional (Latissimus dorsi) or Free (gracilis) functional muscle transfer. Physiotherapy in the form of exercises and electrical stimulation, muscle re-education form an important part of post-operative protocol which helps in regaining the functional ability after bipolar latissimus dorsi transfer. A 17 year old male met with a road traffic accident which led to injury to his right arm because of which his radial, ulnar, median and musculocutaneous nerve got injured. Patient was unable to flex the elbow because of this injury. Surgeons performed bipolar latissimus dorsi myocutaneous flap transfer at the elbow and after the surgery patient was referred for the postoperative rehabilitation. A case of post-bipolar latissimus dorsi transfer with reduced strength and range of motion has been presented. Pulsed short wave diathermy at the axilla for 15 minutes. Electrical stimulation over the transferred latissimus dorsi, lumbricals, flexor carpi radialis, flexor carpi ulnaris, flexor digitorum profundus and superficialis for 10 minutes each. Tapping was done over the transferred latissimus dorsi muscle with range of motion exercises. The subject was treated 1 hour per day, 3 days a week for 3 months. Right shoulder/elbow/wrist muscular strength measured by manual muscle test, Right shoulder/elbow/wrist active and passive range of motion, Functional ability measured by Disabilities of arm, shoulder and hand scale. Physiotherapy can effectively improve the range and strength of the elbow muscles thus improving the functional capacity. Elbow and arm function post operatively can significantly improve through various physiotherapeutic interventions.

2 illus, 6 tables, 7 ref

040535   EKINCI A, DEMIR E, EKINCI H (Otorhinolaryngology Faculty of Medicine Dep, Hitit Univ, Çorum, Turkey, Email: draekinci@hotmail.com) : Serum prolidase and oxidative stress levels in patients with recurrent aphthous stomatitis: A prospective, controlled study. Indian J Dermatol Venereol Leprol 2020, 86(1), 18-23.

Recurrent aphthous stomatitis is a common disease characterized by single or multiple, self‑healing, well‑circumscribed, periodic ulcers occurring in the oral cavity. Although the relationship between recurrent aphthous stomatitis and oxidative stress has been extensively reviewed in the past, its relationship with prolidase enzyme levels has not been previously investigated. The aim of this study is to investigate plasma antioxidant status and prolidase enzyme levels in patients with recurrent aphthous stomatitis. The serum total oxidant status, total antioxidant status, oxidative stress index, prolidase and paraoxonase levels of 34 recurrent aphthous stomatitis patients (mean age 35.1) and 34 healthy controls (mean age 37.7) were compared in this study. Total oxidant status was significantly higher in the recurrent aphthous stomatitis group (P < 0.005). The mean total oxidant status value was 5.19 mmol/L in the recurrent aphthous stomatitis group, while it was 2.90 mmol/L in the control group. Oxidative stress index was significantly higher in the recurrent aphthous stomatitis group (P= 0.016*). The mean oxidative stress index level was 0.28 AU in the recurrent aphthous stomatitis group, while it was 0.18 AU in the control group. When control and patient groups were compared, there was no significant difference between groups with regard to the total antioxidant status (P = 0.343). The total antioxidant status levels were 1.09 and 1.14 mmol/L in control and patient groups, respectively. There was no statistically significant difference between PON1 levels of recurrent aphthous stomatitis and control groups (P = 0.218). Mean PON1 levels were 326 U/L in the recurrent aphthous stomatitis group and 381 U/L in the control group. Prolidase levels were not significantly different between recurrent aphthous stomatitis and control groups (P = 0.955). The mean prolidase level was 219.79 U/L in the recurrent aphthous stomatitis group and 219.26 U/L in the control group. The limitation of this study is the small size of both patient and control groups and exclusion of pediatric patients., Similar studies performed in pediatric patient populations with a comparison to adults may be useful in providing meaningful results. We detected that the total oxidant status and oxidative stress index was higher in patients with recurrent aphthous stomatitis as compared to healthy controls. We could not demonstrate a significant difference in total antioxidant status, PON1 and prolidase values.

2 tables, 30 ref

042374   JOSE P M, KUMAR R V V (Musculoskeletal and Sports Dep, The Oxford Coll of Physiotherapy, Hongasandra, Bangalore) : Effect of combined pallof press and kegels training for urinary incontinence in multigravida women and quality of life. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Urinary incontinence has become one of the main health issue faced by women after pregnancy. It’s mainly due to inadequate care and neglect to the pelvic floor muscles in regaining strength leading to muscle weakness and Urinary incontinence. Traditional Kegel’s focus only on pelvic floor muscles while core stability and abdominal strength also plays important role in preventing the occurrence of urinary incontinence.Aim and objective: The aim of the study was to find out the effects of combined Pallof press and Kegel’s exercise for urinary incontinence in multigravida women and quality of life. 30 women(group A-15,group B-15) of age group between 30 - 40years, participated in simple experimental study for a duration of 8 weeks. Subjects were assessed by RUIS - Revised urinary incontinence scale and IIQ7 –Incontinence impact questionnaire. The critical value of U at p<0.5is 64 which means its statistically significant in controlling incontinence and critical value is not significant for IIQ7. Urinary incontinence occurrence frequency is high in women without core stability and abdominal strength. The study also revealed group of Kegel’s exercise’s alone still faces the occurrence of urinary incontinence more than those practiced both pallof press and kegels. If the core muscles doesn’t have adequate strength and stability Kegels can’t alone control the issue in a successful and satisfactory way. Subjects who practiced both Kegel’s & Pallof press exercise shows less frequency of Urinary incontinence.

3 illus, 2 tables, 11 ref

040534   SARKAR R, BANSAL A, AILAWADI P (Dermatology Dep, Maulana Azad Medical Coll, Bahadur Shah Zafar Marg, Delhi - 110 002, Email: rashmisarkar@gmail.com) : Future therapies in melasma: What lies ahead?. Indian J Dermatol Venereol Leprol 2020, 86(1), 8-17.

Melasma is a common, acquired, symmetrical hypermelanosis. It negatively impacts the patient’s quality of life and responds poorly to treatment. Although earlier classified as epidermal and dermal, melasma is now thought to be a complex interaction between epidermal melanocytes, keratinocytes, dermal fibroblasts, mast cells, and vascular endothelial cells. Factors influencing melasma may include inflammation, reactive oxygen species, ultraviolet radiation, genetic factors, and hormones. With a better understanding of the pathogenesis of melasma and the realization that targeting melanin synthesis alone is not very effective, treatments focussing on newly implicated factors have been developed. These include agents targeting hyperactive melanocytes, melanosomal transfer to keratinocytes, defective skin barrier, the mast cells, vasculature, and estrogen receptors as well as drugs with anti‑inflammatory and antioxidant activity. Many of these newer agents are botanicals with multimodal mechanisms of action that offer a better safety profile when compared with the conventional drugs. There has also been a focus on oral agents such as tranexamic acid, flutamide, and ascorbic acid.   It has been suggested that the “triple therapy of the future” may be a combination of hydroquinone, an antiestrogen and a vascular endothelial growth factor inhibitor, as the “ideal” skin‑lightening agent.

6 illus, 2 tables, 102 ref

040533   SARKAR S, PANDA S, KIM B, RAYCHAUDHURI S K, GHOSH A, RAYCHAUDHURI S P (Dermatology Dep, California Univ, California, United States) : Risk of tuberculosis with anti‑tumor necrosis factor‑alpha therapy in patients with psoriasis and psoriatic arthritis in Indian population. Indian J Dermatol Venereol Leprol 2020, 86(1), 1-7.

Anti‑tumor necrosis factor‑alpha (TNF‑α) immunotherapy has revolutionized the treatment of inflammatory diseases, such as psoriasis and psoriatic arthritis. However, a major concern is that patients receiving this therapy have an increased risk of infection, particularly of reactivation of latent tuberculosis (TB). There were an estimated 10.4 million new cases of tuberculosis in 2016, worldwide, and India has one of the largest TB case burden with an estimated incidence of 2.79 million cases of TB in the same year. Anti‑TNF agents like etanercept and infliximab are available in India approved for psoriasis and psoriatic arthritis. But long‑term use of these agents possesses a risk of reactivation of latent TB. In this review article, we assessed the risk of TB with anti‑TNF therapy especially in patients with psoriasis and psoriatic arthritis in India. At the end of the article, we have also suggested a recommendation for screening of latent tuberculosis and its management, before starting anti‑TNF‑α therapy.

1 illus, 2 tables, 43 ref

042373   SANJAY P, KANITKAR A, SZTURM T, GAONKAR N, ANKOLEKAR B (Dharmasthala Manjunatheshwara Univ, Dharwad, Email: sanjaytparmar777@gmail.comand) : A computer game- assisted repetitive task practice based upper extremity therapy program for children with spastic unilateral cerebral palsy: A single case study. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

A case study is to provide evidence of the feasibility, acceptance, and benefits of a computer game-assisted repetitive task practice platform (G-RTP) in Upper extremity (UE) motor function of a child with Cerebral Palsy (CP). 4 year old left spastic CP was provided an individualized game-assisted therapy of 16 weeks. Outcome measures included PDMS-2, QUEST, computerized assessment of a broad range of object manipulation tasks. Findings demonstrated the feasibility and acceptability of the G-RTP program for use by children with UE motor impairment. The findings are positive and support a future definitive RCT needed to prove the efficacy and applicability.

2 illus, 3 tables, 26 ref

042372   CHETALI P (PES Modern Coll of Physiotherapy, Pune, Maharashtra) : Effect of secondary motor task on performance of stair descent in people with idiopathic parkinson’s disease. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

In people with Parkinson’s disease (PD), dual tasking is difficult because of the impaired motor functions of the basal ganglia. It causes postural instability, reduction in gait speed, decreased stride length, increased festination and freezing. So it can also influence performance on stair ambulation. This creates a need to study the effect of dual tasks on stair ambulation, especially stair descent. 30 subjects were selected from various hospitals in Delhi. After taking the informed consent, the subjects were made to descend down the stairs under two conditions: stairs descent only and stairs descent with secondary motor task. The time taken in both the activities was recorded along with the scores on Observational Stair Parameter Scoring System (OSPS). Time taken by the subjects and the scores on OSPS for performing secondary task was more than the normal stair descent. The performance of stair descent with secondary task became more difficult than descent without the secondary task.

2 illus, 20 ref

042371   KUTTY N N, SIDDEEQUE S, TAMPHAIBEMA H, AZHARUDDIN , OTHAYOTH N, BINEESH C P (Physiotherapy Dep, Cooperative Institute of Health Sciences, Kannur-670 105, Kerala, Email: nithyankutty@yahoo.co.in) : Effect of muscle energy technique with deep friction massage on pain, disability and internal rotation range of motion of hip joint in individuals with piriformis syndrome. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Piriformis Syndrome (pseudo sciatica) is caused by pressure of an injured or irritated piriformis muscle which leads to neuritis of branches of the sciatic nerve; mimics the signs and symptoms of low back pain. Due to high incidence of low back pain in our society, P.S frequently goes unrecognized or misdiagnosed in clinical settings. Patients with piriformis syndrome were screened for inclusion and exclusion criteria after detailed assessment. 30 patients who meet the inclusion criteria were grouped into 2groups (15 patients in each group). Control group received UST and piriformis muscle stretching and experimental group received MET with DFM. Treatment period was about 30-40min each session in regular period of 6 days for a week for both groups. Oswestry Disability Index, Visual Analogue Scale, Standard Goniometer Statistical analysis of intergroup significance by Mann Whitney U-test for IR ROM (sig.0.000 < p = 0.05) and independent sample t-test for VAS (t = 2.895 > table value, t = 2.048) and ODI (t = 4.842 > table value, t = 2.048) reveals that experimental group shows significant difference between pre test and post test values of IR ROM, VAS and ODI than that in the control group. Experimental group who received MET along with DFM shows greater improvement on pain, disability and IR ROM in individuals with piriformis syndrome than those in the control group who received U.S.T and piriformis muscle stretching.

43 ref

042370   VED N, GONDALIYA P, AGGARWAL N (RK Univ, Rajkot, Gujarat, Email: nidhi.ved@rku.ac.in) : A study to compare the effect of inverse ratio breathing and diaphragmatic breathing on pulmonary functions in obese female – An interventional study. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Obesity has becomes a major public health concern in many parts of the world. Obese individual have alteration in respiratory mechanics, decreased chest wall and lung compliance, decreased respiratory muscle strength and endurance, decreased pulmonary gaseous exchange and limitation in exercise capacity. In Inverse ratio breathing, the ratio of inspiration to expiration becomes 2:1, While diaphragmatic breathing involves slow and rhythmic breathing. To compare the effect of inverse ratio breathing and diaphragmatic breathing on pulmonary functions in obese female. This study was carried out in and around Rajkot city. Subjects who fulfil exclusion and inclusion criteria were selected by purposive sampling and were assigned to group A and group B by simple random sampling .They were explained about the study, its usefulness and written consent were taken.30 subjects were divide into two Groups :Group A: 15 subjects were given diaphragmatic breathing, Group B: 15 subjects were given inverse ratio breathing. Data were analysed using SPSS 20 software by applying Paired and Unpaired t-test. Pre-treatment and post-treatment FVC, FEV1 and FEV1/FVC ratio were analysed, it was statistically significant (P value < 0.05) in both the group but when comparison was done between two groups, it was statistically non-significant (P value > 0.05). FVC, FEV1 and FEV1/FVC ratio. Inverse ratio breathing and Diaphragmatic breathing both were effective in improving pulmonary functions in Obese female after performing breathing techniques for consecutive 3 days (once a day). But there was no significant difference between the two Groups in improving pulmonary function in obese female. 

3 illus, 4 tables, 19 ref

042369   SINGH N, ARORA S (Occupational therapy DIRD Dep, GGSIP Univ, Delhi) : Comparison of handwriting legibility and visual motor integration in different age groups. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Comparison of handwriting legibility and visual motor integration in different age groups was performed on adults and old age person . Three group were formulated of 20-39, 40-59 and 60-79. Handwriting Assessment Battery for Adults and Bender Visual Motor Gestalt Test were assessed for all three groups. It was analysed that Handwriting Legibility decreases with age. The most affected factors were Word Legibility and Letter Legibility. Whereas Visual motor integration is maximum in 40-59 and least in Group 60-79.

3 tables, 8 ref

040531   TAYAL M, MUKHERJEE A, CHAUHAN U, UNIYAL M, GARG S, SINGH A, BHADORIA A S, KANT R (Interventional Radiology Div, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, Email: dr.mohit@live.in) : Evaluation of remote monitoring device for monitoring vital parameters against reference standard: A diagnostic validation study for COVID 19 preparedness. Indian J Community Med 2020, 45(2), 235-9.

Vital parameters including blood oxygen level, respiratory rate, pulse rate, and body temperature are crucial for triaging patients to appropriate medical care. Advances in remote health monitoring system and wearable health devices have created a new horizon for delivery of efficient health care from a distance. This diagnostic validation study included patients attending the outpatient department of the institute. The accuracy of device under study was compared against the gold standard patient monitoring systems used in intensive care units. The statistical analysis involved computation of intraclass correlation coefficient. Bland–Altman graphs with limits of agreement were plotted to assess agreement between methods. P <0.05 was considered statistically significant. A total of 200 patients, including 152 males and 48 females in the age range of 2–80 years, formed the study group. A strong correlation (intraclass correlation coefficient; r > 0.9) was noted between the two devices for all the investigated parameters with significant P value (<0.01). Bland– Altman plot drawn for each vital parameter revealed observations in agreement from both the devices. The wearable device can be reliably used for remote health monitoring. Its regulated use can help mitigate the scarcity of hospital beds and reduce exposure to health‑care workers and demand of personal protection equipment.

2 illus, 2 tables, 19 ref

042368   MEHTA N, VIJAYAKUMAR R V (Musculoskeletal Disorders and Sports Dep, The Oxford Coll of Physiotherapy, Bangalore) : Latent trigger point therapy for smartphone users. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Multi-touch smartphones are used for a wide variety of tasks, including accessing the Internet, social media, etc. Trigger points (TrPs), causes referred pain in characteristic areas for hand and forearm muscles. Latent TrPs cause stiffness and limitation of ROM but no pain. Self Myofascial release (SMFR) is a simple and effective technique in which the therapy is done by the patient themselves often using a tool. Objectives: To find out the effectiveness of Self Myofascial Release therapy and Educational booklet among college students with latent trigger points. Methodology: 120 subjects, male and female having latent TrPs with mean age 22.3 (±2.36), fulfilling the selection criteria were included. Subjects were examined to find out latent trigger point PPT with help of Pressure Algometer on muscles of hand. Subjects were instructed SMFR therapy via tennis ball (2 mins, twice a day for 2 weeks) on the affected muscles. Post test examination of PPT was taken. Result: The mean age was calculated to be 22.3 (±2.36) were analyzed. Right hand Adductor Pollicis muscle and Left hand 1st dorsal interrosei muscle was found to be most affected (p < .00001) and Opponens pollicis on both sides were least affected. Educational booklet was given for creating awareness and was found to be helpful. Conclusion: Smartphones with greater dimensions promotes predominant usage of thumb while typing. SMFR and Educational booklet appears to be effective in reducing pain and addictive behaviour among Smartphone users.

2 illus, 4 tables, 11 ref

040530   DHIKALE P T, SHRIVASTAVA S R, SRINIVASAN S (Community Medicine Dep, Shri Sathya Sai Medical Coll and Research Institute, Tamil Nadu - 603 108, Email: drshrishri2008@gmail.com) : Perspectives about professionalism among undergraduate students in a medical college in India: A qualitative study. Indian J Community Med 2020, 45(2), 230-4.

Professionalism has been recognized as an important competency of a doctor by various regulatory bodies. The purpose of the study was to explore the perceptions of medical undergraduate students and to assess their attitude on professionalism. It was a qualitative study in which four focus group discussions were conducted, one for each year of course. Atotal of seven themes emerged after the qualitative analysis of the data, namely qualities of a good doctor, need of teaching professionalism, ways of learning professionalism by medical students, ways of teaching professionalism, assessment of professionalism, factors promoting professionalism, and factors hindering professionalism. The students perceived that a good doctor should be committed to excellence, responsive and accountable to patients, profession and community, selfless, healthy, good communicator, ethical and law abiding, practice integrity, and social justice. The students preferred to learn professionalism by role modeling by faculties and case‑based scenario discussions. Medical undergraduate students should be briefed about the need and importance of professionalism through small‑group discussions involving narratives, case scenarios, and role modeling by faculty. Professionalism of both students and faculties should be assessed and appropriate action taken.

20 ref

042367   MUHAMMAD JABIR C T , PADMAKUMAR S (Yenepoya (Deemed to be Univ), Mangaluru, Karnataka, Email: principalypc@yenepoya.edu.in) : Relationship between anthropometric parameters and jumping ability among male undergraudate college students- A cross sectional study. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Vertical Jump (VJ) is a key skill for many athletes. Whether its basketball, volleyball, football or tennis, it is very important in many sports. There are very limited studies on the topic and those available are mainly conducted on sports specific events and athletes. In this study, the subjects selected were non-sports healthy individuals. The purpose of this study was to investigate the relationship between anthropometric parameters and jumping ability among undergraduate college students. Undergraduate college students (n=62) aged between 18-25 years were included in the study. Twenty six parameters of International Society for Advancement of Kineanthropometry(ISAK) were selected along with lower limb Manual Muscle Testing(MMT) and Range Of Motion(ROM) prior to the study. The participants were evaluated for their jumping ability. Data was analyzed using Pearson’s correlation .Level of significance was set at p <0.05. Out of the 58 parameters, 1 parameter showed excellent negative correlation (weight), 17 parameters showed good negative correlation, 12 parameters showed moderate correlation, 16 parameters showed poor negative correlation and 12 parameters showed poor positive correlation. There exist a significant relationship between the anthropometric parameters and jumping ability. The most significant parameter affecting jumping height was found to be Weight, which gave an excellent negative correlation and the other parameter were muscle girth and skin fold.

11 ref

040529   SHRIVASTAVA S R, SHRIVASTAVA P S (Community Medicine Dep, Shri Sathya Sai Medical Coll and Research Institute, Tamil Nadu - 603 108, Email: drshrishri2008@gmail.com) : Estimation of the prevalence of tobacco consumption among rural women in South India using mixed methods analysis. Indian J Community Med 2020, 45(2), 225-9.

Tobacco consumption is a public health problem in Tamil Nadu. The current study was done to estimate the prevalence of tobacco consumption among rural women and to identify the sociodemographic characteristics with high prevalence of tobacco consumption. It was a community‑based cross‑sectional descriptive study conducted among women ≥18 years of age. Mixed methods were employed to obtain the comprehensive picture about the substance use among women. Multistage random sampling method was used to interview 210 women using a semi‑structured and pretested schedule. This was followed by key informant interviews, in which nine women were interviewed. Frequency distributions and Chi‑square test were employed to study the association. In addition, manual content analysis was done to identify the reasons for the initiation of tobacco consumption and the measures to curb the practice. The prevalence of tobacco consumption among the women was estimated as 15.2 %. Women in the lower socioeconomic status group showed a higher prevalence of tobacco consumption than the middle and high socioeconomic status group. All 32 (100 %) women were consuming tobacco products in the smokeless forms. Further, 28 (87.5 %) women were not willing to quit tobacco consumption. The prevalence of tobacco consumption among the women was estimated to be above expectation of the national figures. Lower socioeconomic class and poor educational status were found to be major determinants for tobacco consumption among rural women.

2 tables, 30 ref

040528   RAJESH G, BINNAL A, PAI M B H, NAYAK S V, SHENOY R, RAO A (Oral Medicine and Radiology Dep, Manipal Coll of Dental Sciences, Mangalore, Karnataka, Email: dr_almas123@yahoo.co.in) : Insights into disaster management scenario among various health care students in india: A multi institutional, multi professional study. Indian J Community Med 2020, 45(2), 220-4.

The frequency of occurrence of disasters is on the rise all over the world. Workforce shortage can be a major impediment toward efficient disaster management. Incorporation of other health‑care workers along with conventional medical personnel might be critical for efficient and effective management of disasters. The objective of this study was to assess various aspects pertaining to disaster management among various health‑care students in India. Final‑year students pursuing medicine, dentistry, nursing, physiotherapy, pharmacy, Ayurveda, and homeopathy at various institutions in Mangalore, India, were the study participants. Participants’ willingness to partake in disaster management and knowledge, attitude, behavior, and perceived effectiveness pertaining to disaster management was ascertained by a questionnaire method. Their previous history of training and familiarity with standard operating procedures was assessed. A total of 437 students belonging to seven health‑care institutions participated in the study. Overall, 98.40 % of the participants were willing to partake in disaster management. The mean knowledge, attitude, behavior, and perceived effectiveness scores were 49.19 %, 81.75 %, 47.28 %, and 66.20 %, respectively. Step‑wise multiple linear regression analysis revealed that course (β = 0.247, P < 0.001), attitude (β = 0.154, P = 0.001), and behavior (β = 0.284, P < 0.001) were significant predictors of perceived effectiveness. Participants in the present study revealed that they were willing to partake in disaster management. The participants also reported poor behavior and knowledge scores but appropriate attitude scores. The present study highlights the need for curriculum changes and policy implications for effective integration of various sectors for disaster management, particularly in developing nations such as India, which have a definite scarcity of resources.

1 illus, 2 tables, 33 ref

040527   VIJAY J, SHARMA S, KAPIL U, BHADORIA A S (Community and Family Medicine Dep, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, Email: ajeetsinghbhadoria@gmail.com) : Iodine deficiency during preconception period of adolescent girls residing in a District of Rajasthan, India. Indian J Community Med 2020, 45(2), 215-9.

In India, iodine deficiency (ID) still remains a serious concern even after five decades of enormous efforts. ID during the preconception period of adolescent girls may negatively affect future neonates, resulting in neonatal hypothyroidism. Hence, the present study was conducted to assess the prevalence of goiter and associated factors among adolescent girls in a poor socioeconomic district of Rajasthan. A cross‑sectional study was conducted during January–March 2015 in Tonk district of Rajasthan. A total of 1912 adolescent girls were selected from thirty schools using population proportionate to size sampling. Adolescent girls were clinically examined for thyroid using palpation method. Casual urine (n = 344) and salt samples (n = 370) were collected from a subgroup of girls for the estimation of urinary iodine concentration (UIC) and iodine content in salt, respectively. The overall goiter prevalence was 15.3 % (95 % confidence interval 13.6 %–16.9 %) and the median UIC was 266 µg/l (interquartile range: 150–300 µg/l) among 1912 adolescent girls (age, 15.7 ± 1.4 years). Around 16.8 % of the families of adolescent girls were consuming salt with inadequate iodine (< 15 ppm). Goiter prevalence was statistically significantly different with respect to age groups (P = 0.03). There was no statistically significant difference in goiter prevalence with respect to iodine content of salt (P = 0.98) and UIC (P = 0.41). The median UIC increased with an increase in consumption of iodine content of salt from inadequacy to adequacy (P = 0.15). Adolescent girls, residing in an underdeveloped district, are in the transition phase from mild ID (goiter prevalence 15.3%) to iodine sufficiency (median UIC 266 µg/l).

1 illus, 16 ref

042366   DESAI M, KAPDULE P (D.Y Patil Univ, Nerul, Navi-Mumbai, Maharashtra, Email: manasi.desai@dypatil.edu.) : The prevalence of musculoskeletal problems in architects. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Architects are required to work on a computer for several hours a day which mainly requires sitting in prolonged static postures, along with bending and flexing the neck which might put strain on the back, cervical and wrist area.^[1]The purpose of the study was to identify the prevalence of common musculoskeletal problems in Architects. A community based cross-sectional survey was conducted on 106 architects working for more than 2 years by administering the Extended Nordic Musculoskeletal Questionnaire to quantify the musculoskeletal pain and activity limitations in 9 body regions. A Self-Designed Questionnaire was administered aiming at getting information regarding the various musculoskeletal problems faced by architects, various postured attained and activities performed throughout the day. Out of total architects investigated, 80 % architects experienced musculoskeletal pain. Neck, lower back and shoulders were the most commonly affected body regions. The results showed that the work-related risk factors like arms below shoulder activities (77.4 %), frequent bending (41.5 %), arms above shoulder activities (25.5 %), twisting (17.9 %) and awkward postures were highly associated with musculoskeletal disorders. The study concluded that there was 80 % prevalence of musculoskeletal problems in Architects. Neck was the most commonly affected body region followed by low-back, shoulder and upper back. Majority of architects required to work on computer in continuous sitting and also required to perform arm activity below shoulder level and bending constantly which may have contributed to the high prevalence of work-related musculoskeletal disorders in this population. The study also concluded that the implementation of ergonomic intervention strategies at the workplace may eliminate ergonomic hazards and minimize the risk of work-related musculoskeletal disorders.

19 ref

042365   JEEVANNAVAR J S, APPANNAVAR S, KULKARNI S (A Constituent Unit of Shri Dharmasthala Manjunatheshwara Univ, Dharwad, Karnataka) : Obstetric brachial plexus palsy – A retrospective data analysis. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Obstetric brachial plexus palsy is the condition seen during birth due to any injury to the nerves. There are mainly 3 type’s brachial plexus injuries (BPI), namely Erb’s palsy, Klumpke’s palsy and total plexus palsy. The injury can cause paralysis of upper limb and may lead to deformity. Thus this study aimed at analyzing the prevalence and influences of few physical factors noticed during the clinical practice. Retrospective data of 28 children with obstetric brachial plexus injury (OBPI) was subjected to statistical analysis. The collected data included age, gender, weight, side of affection, type of delivery and the instrumentation used. Statistical analysis of the data showed that there was more affection in boys than girls. The frequency of non instrument assisted deliveries was higher in the sample included. There was only one child born through LSCS. Right sided brachial palsy was more in frequency as compared to left sided and bilateral plexus injury. Erb’s palsy was most commonly reported than Klumpke’s palsy and total plexus palsy. The mean weight of boys was relatively higher than the girls. The study concluded that gender and birth weight of the new born along with mode of delivery and instrument assisted deliveries influenced the occurrence of OBPI.

8 ref

040526   MITTAL N, SINGH N, NAVEEN KUMAR P G N (Banaras Hindu Univ, Varanasi - 221 005, Uttar Pradesh, Email: drnidhiconsendo@gmail.com) : Prevalence of dental caries among smoking and smokeless tobacco users attending dental hospital in Eastern region of Uttar Pradesh. Indian J Community Med 2020, 45(2), 209-14.

The relationship of tobacco use to dental caries is still unclear. The aim of this study is to assess the relationship between smoking and smokeless tobacco usage and prevalence of dental caries and its pattern in the Varanasi population. In this study, 472 elderly dentate and consenting individuals were included. Individuals were examined with the aid of mouth mirror, No. 23 explorer, and cotton rolls. The age of the study group ranged from 16 years to 75 years. Individuals were categorized as smoking tobacco users, smokeless tobacco users, and the combination of these two. Frequency and dosage of tobacco usage was recorded. Dental caries was measured using decayed, missing, and filled teeth (DMFT) index. Oral hygiene practices such as mode, material, and frequency of brushing were also recorded. Data were assessed using SPSS 17.0 using Chi‑square, t‑test, ANOVA test, and binary regression. Caries rate was similar in both males and females (2.57 and 2.70), and the difference was not statistically significant. Caries was higher in individuals with habits when compared to those who were not having habits. There was no statistically significant association between individuals who were smokers, using smokeless tobacco, frequency, mode, and material of brushing with caries pattern. Among smokers, DMFT increased with frequency and duration of smoking, and it was statistically significant; however, in smokeless tobacco users, this was not the case. There was a positive correlation with DMFT and frequency of smoking. The study has shown that tobacco habit is a risk factor for increased caries activity, and it is higher in smokers as compared to smokeless tobacco chewers.

5 tables, 40 ref

042364   JEEVANNAVAR J S, SHEIK K M, SANJEEV J S (S. D. M. Univ, Dharwad, Karnataka, Email: drjyotisj@gmail.com) : Comparison of endurance between trained university level cricketers, untrained university level cricketers and non-cricketers. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Endurance plays a significant role for sustaining the physical demand for the various formats of cricket. In relation to cricket, endurance is the ability of a player to sustain maximum speed, agility, and power in each play for an entire game. This study intended to check the levels of endurance among the various groups of trained university level cricketers, untrained university level cricketers and non cricketers. The study included 3 groups consisting of 10 individuals in each group. Group A – Trained cricketers playing club level and/or university level cricket; Group B – Untrained cricketers playing club level and/or university level sport. Group C – non-cricketers. The participants who met the inclusion and exclusion criteria performed the Yo-Yo intermittent recovery test. The levels completed, Vo₂max, Speed and distance covered obtained through the test were compared across the 3 groups for statistical significance. The performance of the participants in Group A was significantly better than those in both Groups B and C at a p value of <0.05 across all the components of the test. Participants in Group A were significantly better in distance covered, Vo₂max and levels completed, than those in Group B, at a p value of 0.003, 0.003 and 0.002 respectively. Participants in Group A were significantly better than those in group C in distance covered, speed, Vo₂max, levels completed at a p value of 0.001, 0.002, 0.001 and 0.001 respectively. When Vo₂max was correlated with distance the results showed r=0.987 at p <0.0001. This study showed that participants in Group A had better Vo₂max, completed more Levels and covered more distance as compared to participants in Groups B and C. A correlation of Vo₂max with distance covered showed that as Vo₂max improves, the distance covered will improve. The results of the study conclude that regular Training would influence the performance.

1 illus, 1 table, 9 ref

040525   DASGUPTA A, PODDER D, PAUL B, BANDYOPADHYAY L, MANDAL S, PAL A, MANDA M (Preventive and Social Medicine Dep, All India Institute of Hygiene and Public Health, Kolkata - 700 073, West Bengal, Email: dr.debayan2014@gmail.com) : Perceived stress and coping behavior among future nurses: A cross sectional study in West Bengal, India. Indian J Community Med 2020, 45(2), 204-8.

Demanding clinical and academic environments have been potential sources of stress among nursing students. Inability to cope effectively often potentiates this stress. If not intervened early, this may have a detrimental effect on health and may eventually affect the future workforce in rendering care. The objective of this study was to explore the levels and sources of perceived stress and coping behavior among undergraduate nursing students in West Bengal. This descriptive cross‑sectional study was conducted in two nursing training institutions in West Bengal, from July to September 2018, using a validated pretested self‑administered questionnaire comprising demographics, Perceived Stress Scale (PSS), and coping behavior inventory (CBI). Students having at least 6 months of clinical exposure were invited to participate. Of 256 eligible students, 182 returned completed questionnaires, giving an overall response rate of 71 %. Descriptive statistics, Pearson’s correlation, and multiple regression analysis were performed using SPSS 16.0 software. Stress from assignments and workload” and “problem‑solving” was the most prominent stressor and coping behavior (Factor rank 1) respectively among students. Statistically significant correlation was observed between overall mean PSS and CBI score (r = 0.306, P < 0.01). Years of education, self‑decision to join, increased screen time, staying at hostel significantly predicted stress (R² = 0.248, F = 9.640, P < 0.01), and coping behavior (R² = 0.223, F = 10.077, P < 0.01) among students. Stress from academics and clinics were high among nursing students. As they are the future carers, it is apt to intervene early to mitigate their stress and enhance their coping skills during professional training and practice.

1 illus, 4 tables, 26 ref

040524   SINGHAL R R, TALATI K N, GANDHI B P, SHINDE M K, NAIR P A, PHATAK A J (H M Patel Academic Centre, Karamsad ? 388 325, Anand, Gujarat, Email: ajaygp@gmail.com) : Prevalence and pattern of skin diseases in tribal villages of Gujarat: A teledermatology approach. Indian J Community Med 2020, 45(2), 199-203.

The prevalence and pattern of skin diseases are influenced by the overall ecosystem of the region. There is a dearth of research about prevalence, health‑care seeking, compliance, and treatment outcome in skin diseases among scheduled tribes. The aim of this study is to understand the magnitude of skin diseases in tribal area of Dahod, Gujarat using a simple “Store and Forward” technique of teledermatology. A cross‑sectional study was conducted in 10 randomly selected villages of Dahod and Jhalod blocks of Dahod district of Gujarat during June–August 2017. Trained surveyors visited households randomly in different localities (called Faliya) of each village ensuring representativeness. Survey responses were captured on mobile‑based MAGPI portal, and images of skin conditions were capture on smart phones, and de‑identified images were transferred over WhatsApp. A total of 781 households were approached in 10 villages and 2214 participants consented. Among them, 549 were identified with suspected skin diseases, but 520 consented for photograph. The skin diseases were more prevalent among males, children, and elderly. Of 520, 44 (8.5 %) could not be assess due to poor quality photograph and 35 (6.7 %) did not have any clinically significant condition. Thus, of 2214 participants, 441 (20 %) had skin diseases, and infections and eczema were major conditions constituting two‑third of the skin diseases in the study population. The treatment‑seeking behavior and compliance to treatment was poor. Considering the high prevalence of skin diseases in tribal villages of Dahod, Gujarat coupled with limited availability of trained dermatologist, new innovative avenues like teledermatology should be explored.

2 tables, 25 ref

040523   VENKATESAN J, JANUMPALLY R, GIMKALA A, MEGAVARAN V, MYKLEBUST H, RAO G V (Emergency Medicine Learning Centre Dep, GVK Emergency Management and Research Institute, Hyderabad, Telangana, Email: jyothi_v@emri.in) : Importance of “telephone cardiopulmonary resuscitation” in out of hospital cardiac arrest in India. Indian J Community Med 2020, 45(2), 194-8.

Out‑of‑hospital cardiac arrest (OHCA) is a major cause of mortality in developing countries such as India. Most cardiac arrests happen outside the hospital and are associated with poor survival rates due to delay in recognition and in performing early cardiopulmonary resuscitation (CPR). Community CPR training and telephone CPR (T‑CPR) in the dispatch centers have been shown to increase bystander CPR rates and survival. The aim of this study is to identify the significance of T‑CPR in OHCA and to discuss its implementation in the health system to improve OHCA outcomes in India. A descriptive research study methodology was adopted following a literature search. The search criterion “Cardiovascular diseases” resulted in 162, “Out‑side hospital cardiac arrest” in 50; For a comprehensive overview, these publications were evaluated looking for data on T‑CPR incidence, criteria for detecting OHCA by emergency medical dispatchers, sensitivity and specificity, and BCPR. This current research stresses the scale and seriousness of the implementation of T‑CPR in OHCA in India.

3 illus, 27 ref

040522   SENGUPTA A, SAHOO M, KHAN A, SHAIKH R, KHAN R (Ramakrishna Sarada Sevashram?Vivekananda Tribal Hospital, Navi Mumbai - 400 706, Maharashtra, Email: senguptaamit@hotmail.com) : Maternal health status in tribal India: A 5 year intervention program and its outcome. Indian J Community Med 2020, 45(2), 189-93.

There is poor penetration of evidence‑based maternal health care provided under national health programs in resource‑poor underserved regions. A well‑planned locally acceptable community‑driven comprehensive health promotion strategy and quality health care delivery mechanism is necessary to improve the situation. The main objective was to find the gaps in the existing system and promote health literacy and health‑seeking behavior. 80,000 tribal population living in isolated conflict zone of Bastar district was covered for 5 years between 2012 and 2017. An integrated health‑care plan was developed with community leaders, panchayat, and the local government to promote and provide quality evidence‑based maternal health care. Available resources were mobilized and health technologies introduced. Regular home visits, point of care diagnostics, identification of high‑risk mothers and their timely referral, and behavioral change communication increased the trust of the community. It resulted in higher demand for evidence‑based health interventions. The adolescent pregnancy rate (9 g % (third trimester) improved. Supervised births and high‑risk referrals increased from 19.5 % (2014) to 58 % (2017) and 8.5 % (2014) to 13.1 % (2017), respectively. Although significant improvement was noted, key indicators continued to remain below rural Bastar (National Family Health Survey‑4). Promotion of existing good practices, behavior change, health technologies, and evidence‑based emergency care improved the maternal health status of the secluded and underserved tribal community, but persistent effort is needed to enable women access the quality maternal health services provided under National Health Mission.

3 tables, 20 ref

040521   NAIK S S, MOHAKUD N K, MISHRA A, DAS M (Pediatrics Dep, KIIT Deemed Univ, Bhubaneswar, Odisha, Email: nirmal.mahakud@kims.ac.in) : Quality assessment of maternal death review: a pilot study in 10 high priority Districts of Odisha state, India. Indian J Community Med 2020, 45(2), 184-8.

Maternal death review (MDR) is a strategy that helps in identifying gaps in the care of a pregnant mother. The objective is to assess the quality of MDR, causes of maternal mortality, and finding corrective action in 10 high‑priority districts of Odisha. : MDR was undertaken by our team in 4‑month timeline (August to November 2014). It included the development of tools, desk reviews, training of staffs, and data handling. The maternal deaths were estimated from the Annual Health Survey. It was compared to estimated maternal death of each district to get the under reporting/over reporting districts. Areport was generated on MDR process indicators and program indicators after completion of the assessment. Only 129 (52 %) of the 247 deaths found suitable for community‑based MDR. The proportion of maternal death reported versus estimated was 247 versus 367. Correct diagnoses were reported in 120 cases. The classification of deaths was not mentioned in 74 cases. Maximum deaths (55 %) were in 18–25 years of age group (the most common cause being anemia). Majority (50 %) of the deaths occurred during the postnatal period and majority (67 %) at the health facility. Only 61 (47 %) had received antenatal check‑ups. Facility‑based MDR showed, Type 1 delay (denotes about seeking care) being the most common (53 %). Inaccurate and incomplete information available was also found to compound the above problems in addition. The present study could contribute to a larger extent to address some of the gaps in the MDR process in the Odisha state.

2 tables, 23 ref

044474   SRIVASTAVA A, YADAV D S, RAO H M, ARUN A, SIDDIQUE R (Conservative Dentistry and Endodontics Dep, D.A. Pandu Memorial R V Dental Coll, Bengaluru, Karnataka, Email: ankitasrivastava50@gmail.com) : Evaluation of push‑out bond strength of BioRoot RCS and AH Plus after using different irrigants: An in vitro study. J Conserv Dent 2020, 23(1), 26-31.

The aim of this study was to compare push‑out bond strength of root canal spaces filled with AH‑Plus and BioRoot RCS after using different irrigants. Eighty single‑rooted teeth were decoronated and endodontically treated by crown‑down technique using ProTaper Universal rotary files progressively till F4 (40/0.06). Samples were divided into two groups according to the sealer (n = 40): Group A = BioRoot RCS, Group B = AH Plus, further subdivided into four subgroups according to irrigation protocol (n = 10): Group 1A, 1B – 0.9 % saline, Group 2A, 2B – 5.25 % NaOCl + 17 % EDTA, Group 3A, 3B– 17 % EDTA +2 % chlorhexidine, and Group 4A, 4B – 17 % EDTA + 3 % green tea extract. Samples were obturated with sealers and prepared for push‑out test with root slices of 2 mm thickness using universal testing machine. Data were statistically analyzed using two‑way ANOVA, Bonferroni’s post hoc analysis, and independent Student’s t‑test. BioRoot RCS exhibited significantly higher push‑out bond strength (n < 0.001). The interaction between irrigants and sealer showed higher bond strength for BioRoot RCS when 17 % EDTA+ green tea was used. Within the limitation of the study, it was concluded that bond strength of a sealer was influenced by the irrigants used.

2 illus, 5 tables, 22 ref

040520   DASH S, GUPTA S, EPARI V, PATRA P Y (Physiology Dep, Siksha “O” Anusandhan Univ, Bhubaneswar - 751 003, Odisha, Email: sandhyagupta.physio@gmail.com) : Association of vitamin d levels in coal miners: A case–control study. Indian J Community Med 2020, 45(2), 181-3.

Coal miners working underground are likely to be at greater risk of developing Vitamin D deficiency due to reduced sunlight exposure. To date, only three studies have been reported, with no significant risk of Vitamin D deficiency among coal miners. None were conducted in the tropical region, where sunlight is ample. The present study estimated Vitamin D levels among underground coal miners in a tropical region and determined their associated factors. Serum calcium, 25‑hydroxyvitamin D, and bone turnover markers among underground and surface workers were estimated in a matched case–control study. Binary logistic regression analysis was performed using case/control as the dependent variable to estimate odds ratios and 95 % confidence intervals of variables which significantly (P < 0.1) differed among the cases and controls. The mean Vitamin D level among both coal miners(22.12 ng/dl) and surface workers(23 ng/dl) were low. No significant difference was noted for all biochemical parameters after adjusting for other covariates except the parathyroid hormone (PTH), which was marginally higher among the surface workers. Even in the absence of statistically significant evidence of low Vitamin D level in underground workers compared to surface workers, there was indirect evidence (of differences in PTH) to indicate that Vitamin D level is lower in underground workers probably because of poor sunlight exposure.

2 tables, 11 ref

044473   PATNANA A K, CHUGH A, CHUGH V K, KUMAR P (Dentistry Dep, All India Institute of Medical Sciences, Jodhpur, Rajasthan, Email: arun0550@gmail.com) : The incidence of nickel titanium endodontic hand file fractures: A 7 year retrospective study in a Tertiary Care Hospital. J Conserv Dent 2020, 23(1), 21-5.

The present retrospective cross‑sectional study aims to evaluate the incidence and factors associated with nickel‑titanium hand file fractures in root canal‑treated teeth in a tertiary care hospital of western India. The diagnostic records of intraoral periapical (IOPA) radiographs were analyzed to check for file fractures in the root canal‑treated teeth. As a part of standardized departmental protocol, Hand ProTaper Universal file system (Dentsply, India) was used for chemomechanical preparation for root canal treatment. The file fractures were analyzed with reference to age group, type of teeth, curvature of the canal, site of file fracture in the canal, length of file fracture, level of file fracture, distance of the file fracture from the apex, and obturation status of the file‑fractured tooth. Chi‑square test was applied to assess the significance difference between the tested groups. A total of 19,810 IOPA X‑rays were screened and 2728 root canal‑treated teeth were found and of these 2728 cases, 109 file‑fractured teeth were observed.  The total incidence of file fractures was 3.9/100 root canal‑treated cases, and mandibular molars with severely curved canals (>25 °) had shown the maximum incidence of file fractures.

1 illus, 4 tables, 23 ref

040519   GANIGA R, M. PAI R, PAI M M M, SINHA R K (Amity Univ Haryana, Manesar - 122 413, Haryana, Email: rajesh.sinha@manipal.edu) : A preliminary study of real time capturing and sharing of routine health data among the public health professionals. Indian J Community Med 2020, 45(2), 176-80.

Electronic health record (EHR) has the potential to make available the real‑time data of the patient to the healthcare professionals by connecting all levels of the public health system, irrespective of their geographical boundaries. This study aims to test the capturing and sharing of real‑time patient data at primary, secondary, and the tertiary level. The cloud‑based EHR system developed earlier was used to capture real‑time data of the patient visiting a primay health center (PHC) in Udupi District of Karnataka. About 100 patient records including laboratory and pharmacy data have been captured into the EHR system. The confidentiality of patient data is assured. The result of the study indicated no errors while capturing and sharing the patient data in real time. The system also evidenced the availability of vital statistics about the patient visiting PHCs. The system also allowed the professionals at referral level to view patient data for providing quality healthcare. EHR plays a vital role in capturing, storing, and sharing patient data for providing quality healthcare and it should be made mandatory by the central health agencies in the provision of patient care and reporting of notifiable communicable diseases at all levels.

4 illus, 22 ref

044472   QUTIESHAT A S, AL-HIYASA A S , ISLAM M R (Conservative Dentistry Dep, Jordan Univ of Science and Technology, Irbid- 221 10, Jordan, Email: asqutishat@just.edu.jo) : The effect of adding graphene oxide nanoplatelets to Portland cement: Potential for dental applications. J Conserv Dent 2020, 23(1), 15-20.

The potential of graphene‑based materials to improve the physiomechanical properties of Portland cement‑based materials without compromising biocompatibility is of interest to dental researchers and remains to be discovered. This study investigated the effects of adding graphene oxide nanoplatelets (GONPs) on the surface microhardness and biocompatibility of Portland cement. Three prototype Portland cement powder formulations were prepared by adding 0, 1, and 3 wt % GONPs in powder form to Portland cement. Prototype cement specimens were in the form of disks, with a diameter of 10 mm and a thickness of 2 mm. In experiment 1, surface microhardness was measured using the through indenter viewing hardness tester, 20 surface hardness values were obtained from all specimens. In experiment 2, Balb/C 3T3 fibroblasts were cultured with the material disks and the viability of cells was evaluated using the 3‑(4,5‑dimethylthiazol‑2‑yl)‑2,5‑diphenyltetrazolium bromide assay. The data were analyzed using the analysis of variance followed by Dunnett test (α = 0.05) or Tukey test (α = 0.05).  In response to material disks, the addition of 1 wt % GONPs had a proliferative effect on cells at day 3 and day 7 with a significant difference from the control. The addition of 3 wt % GONPs showed a remarkable increase in surface microhardness; however, it exhibited initial cytotoxicity. The addition of 1 wt % GONPs to Portland cement improved surface microhardness without compromising biocompatibility; therefore, it has a greater potential for dental applications. The results of this work give other researchers leads in future assessments of this prototype material. 

2 illus, 24 ref

040518   NEBHINANI M, KUMAR A, PARIHAR A, RANI R (All India Institute of Medical Sciences(AIIMS), Jodhpur - 342 005, Rajasthan, Email: mamta_rajput45@yahoo.co.in) : Stress and coping strategies among undergraduate nursing students: A descriptive assessment from Western Rajasthan. Indian J Community Med 2020, 45(2), 172-5.

Nursing is a very challenging profession, which requires very stringent training since initial years of nursing education. Throughout the training period, students are exposed to various stressful situations. Inability to cope up with varied stressors may lead to psychological distress and impede students’ pursuits of nursing career. The aim of the present study is to assess stress and coping strategies among nursing students of Western Rajasthan. Two hundred and twenty‑one undergraduate nursing students were recruited for the study through total enumeration. Standardized Student Nurse Stress Index and brief cope scale were used to assess stress and coping strategies. Nearly 82.4 % of the students reported moderate level of stress. Interface worries (mean score 17.88 ± 4.9) and academic load (mean score 17.6 ± 4.78) were the major source of perceived stress. Students considered attitude of other professionals toward nursing, lack of free time, and fear of examination as most likely reasons of their distress. Active coping was the most commonly used coping strategies. Level of stress was found to have significant association with the interest of students in nursing. Interface worries and academic‑related concerns emerged as major source of stress. A positive trend was evident in the use of adaptive coping strategies over succumbing meekly. However, there is a great need to plan and implement stress management programs so that these budding health professionals could be better equipped and trained to face various challenges of the profession.

1 illus, 3 tables, 20 ref

044471   YARED G, RAMLI G A (Orthodontics Dep, Lebanese Univ, Beirut, Lebanon, Email: ghassanyared@gmail.com) : Ex vivo ability of a noninstrumentation technique to disinfect oval‑shaped canals. J Conserv Dent 2020, 23(1), 10-4.

Oval‑shaped canals represent a challenge in endodontics. Infected tissue may remain in their recesses. This concern may be more critical with minimally instrumentation techniques. The present study evaluated the disinfection ability in oval‑shaped canals of a noninstrumentation technique using ultrasonic agitation and intracanal heating of sodium hypochlorite (NaOCl) compared to rotary canal preparation and ultrasonic agitation with and without heating of NaOCl. Sixty extracted mandibular incisors were included. The teeth had pulp necrosis and apical periodontitis and oval‑shaped canals. They were divided into three groups depending on the treatment protocol: (1) IHAN: intracanal heating and ultrasonic agitation of NaOCl only, (2) R‑IHAN: Rotary preparation followed by IHAN, and (3) R‑passive ultrasonic agitation (PUA): Rotary preparation and ultrasonic agitation of NaOCl. Root canal samples were taken before (S1) and after (S2) the endodontic procedures were completed and cultured anaerobically. Wilcoxon tests were performed to compare colony‑forming units (CFUs) before and after the endodontic procedures for the three groups. The percentage of variation of CFUs was compared among the three groups using Kruskal–Wallis tests, followed by Mann–Whitney U‑tests. All S1 samples were positive. All S2 samples showed bacterial growth in R‑PUA compared to 17 in R‑IHAN. None of the S2 samples in IHAN were positive. Bacteria reduction was significant in each group (P < 0.001). The percentage of bacteria reduction was highest for IHAN and lowest for R‑PUA (P < 0.001). Intracanal heating and ultrasonic agitation of NaOCl without instrumentation completely eliminated bacteria from infected oval‑shaped canals.

1 table, 27 ref

040517   SINGH A, JADHAV S, ROOPASHREE M R (Symbiosis Institute of Health Sciences, Pune - 411 004, Maharashtra, Email: anktsngh15@gmail.com) : Factors to overcoming barriers affecting electronic medical record usage by physicians. Indian J Community Med 2020, 45(2), 168-71.

Hospitals are adopting electronic medical records (EMRs) in larger numbers; however, the barrier to derive its full utility is the low acceptance by physicians. This study is done with an objective to identify the factors to overcome the barriers preventing the adoption of EMR by physicians. This study is cross sectional in natures and a self-administered questionnaire is developed based on the Technology Acceptance Model. The four identified factors are positive attitude toward EMR, reliability, difficulty to use, and adaptability, these factors together, have explained 62.54 percent variance in the data set. The physician’s acceptance for EMRs can be improved by focusing on the identified four factors, which are “positive attitude toward electronic medical records,” reliability of electronic medical records,” “difficulty level of use,” and “adaptability of electronic medical records.”

4 tables, 15 ref

040515   AGRAWAL N, TIWARI A (Community Medicine Dep, Shri Shankara Institute of Medical Sciences, Durg - 490 023, Chhattisgarh, Email: dranjanatiwari3@gmail.com) : Determinants of home delivery among mothers in urban and rural Vadodara District, Gujarat, India. Indian J Community Med 2020, 45(2), 159-63.

Maternal health is severely affected by home deliveries because it contributes to maternal mortality, especially if home births are not made safer. The present study aimed to assess the determinants of home delivery among mothers in urban and rural Vadodara district, Gujarat. This community‑based, cross‑sectional study was carried out during April 2017–July 2017. The mothers who delivered at home and hospital in urban and rural Vadodara district between April 15 and March 16 were included in the study. A semi‑structured questionnaire was used for interviewing all the mothers. Information regarding sociodemographic and obstetrics characteristics of mothers was recorded. The study finding was presented in the form of frequencies and percentages, and the association was found with Chi‑square test. P ≤ 0.05 was considered statistically significant. The present study was carried out among 138 mothers, of them, 71.7 % were in the age group of 20–25 years. The mean age of mothers was 24.5 ± 4.4 years. The analysis of sociodemographic and obstetric factors revealed that mothers age more than 25 years, mothers from nuclear family, illiterate mothers, late antenatal care registration by mothers, mothers not registered in Janani Suraksha Yojna/Chiranjeevi Yojana scheme, and prior experience of home delivery by mothers were significantly associated with home delivery (P < 0.05 each). This study highlighted that several sociodemographic and obstetrics determinants related to mother were associated with home delivery in the study setting. Taking these findings into consideration, it is recommended that appropriate maternity services should be designed with a special focus on poor, uneducated, and multiparous women as well as it should ensure early registration of pregnancy for every pregnant woman. Institutional delivery should be encouraged and advocated among mothers having all previous deliveries at home.

1 table, 24 ref

040514   UPADHYAY R, GOHEL B M, CHUDASAMA R K (Community Medicine Dep, PDU Government Medical Coll, Rajkot, Gujarat, Email: drbmgohel@gmail.com) : Determinants of myocardial infarction in Saurashtra region, Gujarat: A case–control study. Indian J Community Med 2020, 45(2), 154-8.

Myocardial infarction (MI) is a multifactorial noncommunicable disease. The study was conducted with an objective to assess the role of various sociodemographic and clinicoepidemiological determinants of MI. The cases and controls were selected in the ratio of 1:1 and were group matched for age, sex, and type of residence. Cases of MI were selected from the intensive coronary care unit of the medicine department at a tertiary care hospital, Rajkot, for 1 year. Controls were selected from the general population of Rajkot district. Information was collected in pretested pro forma using the interview technique. total of 406 cases and equal number of controls were enrolled in the study. Several risk factors identified for MI included illiteracy, upper socioeconomic class, family history of MI, Type A personality, hypertension, diabetes mellitus, obese or overweight, high waist–hip ratio, low intake of leafy vegetables, low intake of fruits, and history of acute life event for the past 1 year. On applying logistic regression model, these factors were also identified as independent determinants for MI. The findings confirm the role of conventional risk factors for MI and also highlight the role of sociodemographic factors such as illiteracy, higher social class, low intake of leafy vegetables and fruits, and history of acute life event.

3 tables, 27 ref

040513   NISHA B, MURALI R (Community Medicine Dep, Saveetha Medical Coll and Hospital, Thiruvallur - 602 105, Tamil Nadu, Email: drnishacm2014@gmail.com) : Impact of health education intervention on breast cancer awareness among rural women of Tamil Nadu. Indian J Community Med 2020, 45(2), 149-53.

The most common cancer among Indian females is breast cancer. Limited access to early detection and treatment is responsible for more than half of the deaths, primarily in rural areas, where organized mammography screening is neither affordable nor feasible. Therefore, imparting awareness on breast health and breast self‑examination (BSE) is highly recommended. This study aimed to assess the impact of a health education interventional program on breast health awareness and BSE among rural women of Tamil Nadu. A quasi‑experimental study was conducted among 266 women. Apreinterventional survey was done using a pretested validated questionnaire. Amultipronged breast health education intervention was administered and its effectiveness was measured after 3 months using the same tool. There was a statistically significant (P = 0.0001) improvement in the knowledge of breast health, perceived susceptibility, and reasons for practice and proficiency of BSE practice of the interventional group from pre‑ to post‑test. After the interventional program, 71.8 % of increase in knowledge about breast health and BSE was observed. In addition, 64.7 % of the women practiced BSE compared to 7.14 % pretest. This study highlights the awareness needs by the women and application of extensive strategies to increase the acceptance of cancer screening programs.

1 illus, 3 tables, 16 ref

040512   GUPTA S, TANEJA N, KAPOOR S K, KUMAR A (Public Health Dep, Amity Univ, Noida - 201 304, Uttar Pradesh, Email: drnehataneja12@gmail.com) : Comparison of mental health status of married and unmarried girls of late adolescent age in an urban slum of Delhi. Indian J Community Med 2020, 45(2), 145-8.

Late adolescence age (16–19 years) is organized around central task of achieving an identity. In India, age at marriage for girls has been legally declared as 18 years, but many girls are married much before this age. Early marriage for girls can have profound psychological and emotional impacts. The aim was to study the impact of marriage on mental health of married girls of late adolescent age and to compare them with unmarried girls of the same age. A comparison study was conducted among girls of late adolescent age in an urban slum of North East Delhi. Background information was collected through oral questionnaire method. The mental health of the study participants was assessed using validated tool “General Health Questionnaire‑12” and “Symptom Checklist‑90.” Education and economic status of participants and parents were significantly associated with early marriage. Majority of married girls were found to be associated with risk of developing mental health disorders.

3 tables, 21ref

040511   MATHUR M R, SINGH A, MISHRA V K, PARMAR P, NAGRATH D, WATT R G, TSAKOS G (Non-Communicable Diseases and Health Policy Dep, Public Health Foundation of India, Gurgaon - 122 002, Haryana, Email: manu.mathur@phfi.org) : Socioeconomic inequalities in clustering of health compromising behaviours among Indian adolescents. Indian J Community Med 2020, 45(2), 139-44.

The simultaneous occurrence of health‑compromising behaviors can accentuate the risk of noncommunicable diseases(NCDs). This study aimed to examine the existence and patterns of clustering of four NCD risk behaviors among adolescents and its association with social position. In addition, socioeconomic inequalities in the occurrence of clustering of NCD risk behaviors were also assessed. A cross‑sectional study was undertaken among 1218 adolescents (14–19 years old) in the city of New Delhi, India. An interviewer‑administered questionnaire was used to assess health‑compromising behaviors(tobacco and alcohol use, fruit/vegetable intake, and physical inactivity). Clustering was assessed using pairwise correlations, counts of clustering of health‑compromising behaviors, comparison of observed/expected ratios, and hierarchical agglomerative cluster analysis. Multivariable logistic regressions were used to test the associations of clustering with social position (education and wealth). The relative and slope indices of inequalities in the presence of clustering of behaviors according to education and wealth were estimated. Three major clusters of health behaviors emerged: (a) physical inactivity + lower fruit and vegetable intake, (b) tobacco + alcohol use, and (c) lower fruit and vegetable intake + tobacco + alcohol use. Pronounced clustering of health‑compromising behaviors was observed with lower educational attainment and wealth. The presence of clustering of health‑compromising behaviors was considerably higher among adolescents with lower educational attainment and wealth. The area of residence has an important influence on socioeconomic inequalities in clustering of NCD risk factors.

6 tables, 24 ref

042362   BAXI G, SINGH P, BASU S, KHA M U , PALEKAR T (Dr. D. Y. Patil Coll of Physiotherapy, Sant Tukaram Nagar, Pimpri, Pune 411 018, Email: poojassinghdpu@gmail.com) : Immediate effects of kinesio taping on lung functions, chest expansion and dyspnoea in COPD patients. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Dyspnoea is a major symptom of COPD and an independent predictor of mortality. It is caused by mechanical alterations adapted by shortened or deconditioned musculature.There is insufficient evidenceregarding the efficacy of kinesio taping on the symptoms posed by respiratory conditions like COPD.This study investigates the immediate effects of kinesiology taping done for pectoralis major and rhomboid major, on chest expansion and lung functions along with dyspnoea. By convenient sampling, 30 stable COPD patients with mild to moderate stage affection as per GOLD criteria, and having complaints of dyspnoea were randomly divided in two groups. Group A received kinesio taping along with conventional physiotherapy, group B was the control group where only conventional physiotherapy exercises were given twice a day for 3 days. Eligible patients were assessed for their lung functions, chest expansion and dyspnea. Data analysis within the groups as well as between the groups was done using the WINPEPI and PRIMERsoftware.Between groups comparison for lung functions showed significant improvement (p<0.05)for FEV1, FVC and PEFR. Pre and post comparison ofrespiratory rate and SpO2 between the groups showed significant improvement (p<0.05). There was a significant improvement in the experimental group which suggest that kinesio tape application is beneficial in improving lung function and reducing rate of perceived exertion.

2 illus, 2 tables, 15 ref

042361   BR G, KRISHNANUNNI S (Cardiovascular and Pulmonary Physiorapy Dep, KAHER’s Institute of Physiorapy, Belagavi, Karnataka) : Effect of fast tempo vocal and instrumental music on cardiovascular parameters, perceived exertion and stress rate during high intensity interval training in asymptomatic subjects: A randomized clinical trial. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

ACSM defines physical activity as bodily movement that is produced by contraction of skeletal muscle. Music is said to be a sensory modality that can have effect on exercise. purpose of study was to study outcome of music with faster tempo and instrumental type, on cardiovascular, RPE, mood, stress and enjoyment thus improving observance to HIIT in asymptomatic subjects. By random sampling method 40 subjects, male and female (20-30 years) with minimum to moderate amount of physical activity were selected and a two week trial with treadmill was done. Participants were be divided into 2 groups for HIIT: group A with fast vocal music and group B with instrumental music. Mood and stress was assessed pre and post using Abbreviated Profile Of Mood State (POMS) and Perceived Stress Scale (PSS) respectively, RPE was taken over time using Borg scale respectively, enjoyment was assessed post HIIT using Physical Activity Enjoyment Scale (PACES ). Statistical significance was found in heart rate in vocal group, mood and enjoyment in both groups with a p value of < 0.005. present study of 2 weeks concluded that vocal and instrumental music had significant effect on heart rate, stress, enjoyment, mood during high intensity interval training.

5 tables, 18 ref

040508   KUMAR B, PAUL U K, PAL D K (Urology Dep, IPGMER and SSKM Hospital, Kolkata - 700 020, West Bengal, Email: urologyipgmer@gmail.com) : Perception of doctor–patient relationship in the present time from the viewpoint of doctors: A qualitative study at a tertiary health care center in Eastern India. Indian J Community Med 2020, 45(1), 100-3.

Doctor–patient relationship has gone through some troubled times in the recent past. Quality data regarding this is lacking in the Indian setting. The study aim was to find the perception of doctors regarding doctor–patient relationship. The study was conducted at a tertiary health‑care center in West Bengal. It was a qualitative study including in‑depth interviews and focus group discussions(FGDs). The study comprised of in‑depth interviews (IDI) of thirty residents and three FGDs, involving 33 residents. Data analysis was performed manually by deductive approach. Descriptive “codes” of the text information were done. The consolidated criteria for reporting qualitative research guidelines were followed. Doctor–patient relationship was perceived as of mutual trust and respect. Overburdened doctors, impatient patients, unrealistic expectations from the treatment, and lack of infrastructure were some of the agreed‑upon factors for the strained relationship. A combined corrective effort is needed to salvage the current situation. A healthy doctor–patient relationship is instrumental in the holistic picture of health care. Doctors, patients, administration, and media have shared causation to the problem and have equal responsibility for its amendment.

15 ref

040507   SIVAPRAGASAM R, RAJINI S, RAJALAKSHMI S, PRIYANGA K, RAJESH V, PRIYADHARSHINI R (Community Medicine Dep, Sri Lakshmi Narayana Institue of Medical Sciences, Puducherry - 605 502, Email: sivapragasam66@gmail.com) : A community based cross sectional study about the quality of life in postmenopausal women in rural Puducherry. Indian J Community Med 2020, 45(1), 96-9.

The aim of this study was to assess the quality of life (QOL) of postmenopausal women, in the rural areas of Puducherry and to find the associated factors. A cross‑sectional study was done in the rural field practicing area of SLIMS, Puducherry. The sample size was 172 based on the previous study, and simple random sampling technique was used. The women who were receiving hormonal treatment, having chronic illness and those who refused to participate were excluded from the study. The sociodemographic information and menopause‑specific QOL questionnaire were used, and data were analyzed using the SPSS 21. In this study, mean age of the postmenopausal women was 61 ± 7.5 years, 42.4 % belonged to socioeconomic status (SES) Class IV. The prevalence of one or more symptoms of vasomotor, psychological, and sexual domains were 23.8 %, 87%, and 68 %, respectively. We found an association between SES and both vasomotor and psychological symptoms. Furthermore, age and psychological symptoms were associated. The menopause‑related symptoms had a negative effect on the QOL of postmenopausal women. The study can help in creating awareness and also in helping in educating women for early identification of the frequent menopausal symptoms.

3 tables, 15 ref

042360   GOHIL D, SWAMI A, BAXI G, TAI Z, EDGAONKAR R, PALEKAR T (Dr. D. Y. Patil Coll of Physiotherapy, Pune) : Effectiveness of instrument assisted soft tissue mobilization in management of athletes with gleno-humeral internal rotation deficit. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Athletes involved in overhead sports show limited ROM for internal rotation and increased external rotation. This condition of Gleno-humeral internal rotation deficit (GIRD) increases risk of shoulder injuries in athletes and need active management. Current interventions include static stretching, muscle energy techniques and warm-up exercises. Instrument assisted soft tissue mobilization (IASTM) has been hypothesized to lengthen the tissue and improve range by breaking adhesions in soft tissues, there is lack of research showing its effects in athletes with GIRD. This study explores the effectiveness of IASTM in athletes with GIRD following a three week protocol. Thirty athletes with GIRD were enrolled in the study by purposive sampling. They received intervention of IASTM with M2T Blade for posterior shoulder musculature and capsule, on alternate days for three weeks. Pre and post-intervention measurements for gleno-humeral ROM for internal rotation, external rotation and horizontal adduction using goniometry; and Apley’s scratch test were noted. Statistical analysis was done using ANOVA test. IASTM significantly improved ROM for internal rotation from 40.1±5.76 to 74.17±8.28 (p<0.001). There was significant improvement in horizontal adduction ROM from 90.47±10.12 to 105.5±8.02 (p<0.001). No significant difference was found for external rotation. Statistically significant changes were found on Apley’s scratch test as well (p<0.001). Three weeks intervention of IASTM using M2T Blade is effective in improving ranges and flexibility of athletes with GIRD.

3 tables, 21 ref

044466   MASTHI N R R, JAHAN A (Community Medicine Dep, Kempegowda Institute of Medical Sciences, Karnataka, Email: dr.afrazjahan@gmail.com) : Junk food addiction across generations in urban Karnataka, India. J Commun Dis 2020, 52(1), 65-71.

Junk food consumption is progressing from being just an unhealthy life style habit to a full-fledged addiction. Objectives: To assess the health problems related to junk food habits; To assess the burden of addiction to junk food using a novel junk food addiction scale and to describe the alternate diets followed. Methodology: A cross-sectional study was conducted among people across three generations: Generation X, Millenials and Generation Z residing in urban Karnataka, India. Using convenient sampling, a sample size of 500 subjects were selected. Addiction to junk food was assessed by a novel Junk Food Addiction Scale developed for the study. Result: All 500 study subjects had consumed either junk/street/fast/instant food any time in the past 1 year. A total of 211 (42.2%) subjects reported acute health problem and 182 (36.4%) chronic health problems following junk food consumption. The burden of junk food addiction was found to be 80 (16%) [CI (95%): 13.32-18.68] of which majority 70 (14%) had mild addiction. The prevalence of different fad diets followed for 3 months or more was 137 (27.4%).Conclusion:Junk food addiction was observed in more than one tenth of the subjects. Majority had mild addiction and observed equally between Millennials and Generation Z. Obesity, habits and gadgets had independent effects on junk food addiction. More than one forth subjects followed fad diets.

28 ref

042359   DAS D, VENKATESAN.R (Musculoskeletal and Sports Dep, The Oxford Coll of Physiotherapy, Begur Road, Hongasandra, Bangalore) : Dynamic sitting exercise versus spinal extension exercise on pain, lumbar mobility and quality of life in adults with mechanical low back pain. Indian J Physiother Occup Ther 2020, 14(1), 10.5958/0973-56.

Now-a-days it is seen that busy work schedule and unhealthy environment leads to discontinuity in exercising despite of awareness and knowledge of its effectiveness on problems like low back pain. There are many factors including improper posture, over loading, immobility, trunk muscles weakness leads to mechanical low back pain in adults. Exercises of various types have been used in managing low back pain. Hence there is a need to find out a single functional and effective exercise for such problems so that they can be done anytime during work and without any equipment which is also economical. Thirty adults aged between 20-30 years participated in this comparative experimental study. After underwent physical screening for selection criteria mechanical low back pain followed by simple randomization participants were divided into group A and group B. Group A and group B received dynamic sitting and spinal extension exercise respectively for thrice a week for six weeks. Pre and post values were assessed using outcome measures Visual Analog Scale for pain, MMST used for lumbar mobility and Short Form-36 Health Survey Questionnaire for quality of life. In comparison of post test scores of outcome measures evidenced that the reduction of pain score, improvement in lumbar mobility and quality of life scores. There were significantly improvement among the adults with mechanical low back pain treated with Dynamic sitting exercise (DSE) than treated with Spinal extension exercise (SEE). 6 weeks of dynamic sitting and spinal extension exercise can prevent in pain and improvement in lumbar mobility and quality of life in adults with mechanical low back pain.

2 illus, 1 table, 22 ref

040506   YUVARAJ B Y, MANE V P, ANILKUMAR L, BIRADAR M, NAYAKA V, SREENIVASAMURTHY R (Community Medicine Dep, Koppal Institute of Medical Sciences, Koppal - 583 231, Karnataka, Email: vijaymane01@gmail.com) : Prevalence of consumption of smokeless tobacco products and exposure to second hand smoke among women in the reproductive age group in a rural area of Koppal, Karnataka. Indian J Community Med 2020, 45(1), 92-5.

Tobacco use is one of the most important causes of death and disease globally. Nearly one-third of the population in India uses tobacco, and smokeless form is culturally acceptable even among women. (1) To estimate the prevalence of consumption of smokeless tobacco (SLT) products among women in the reproductive age group in the study setting. (2) To determine the various factors associated with the consumption of SLT. (3) To estimate the prevalence of exposure to second-hand smoke among the study participants. A cross‑sectional study was conducted in the field area of primary health center Irkalgad, Koppal in March 2018. A cluster sampling technique was used and a total of 829 women were included. Data were collected using pretested and semi-structured questionnaire and analyzed using the Epi info software version 3.5.4 (Centers for Disease Control and Prevention” (CDC), Atlanta, Georgia, United States of America). The prevalence of consumption of SLT products was 17.85 %, and the most common product consumed was tobacco with betel quid. Tobacco consumption was found to be significantly associated with age, literacy, marital, and employment status of the study participants. The present study concludes that SLT consumption is high among women in the reproductive age group in the study setting and identifies multiple determinants for effective planning of interventions.

2 tables, 20 ref

040505   CHERIAN V, DUGG P, KHAN A M (Community Medicine Dep, Medical Sciences and GTB Hospital Univ Coll, New Delhi -110095, Email: khanamirmaroof@gmail.com) : Prevalence of pet dog ownership in an urban colony of East Delhi and awareness regarding canine zoonotic diseases and responsible pet ownership among dog owners. Indian J Community Med 2020, 45(1), 89-91.

India has lowly prioritized pet‑associated zoonosis as a public health priority because data regarding the same and the susceptible population involved are sparse. To find the proportion of pet dog ownership in a settled urban colony of East Delhi and to assess awareness regarding canine zoonotic diseases and responsible pet ownership. This was a cross‑sectional descriptive study of 700 participants in an urban colony of East Delhi. The proportion of pet dog owners was 5.4 %. Only one‑third (34.2 %) of the respondents were aware that pets are a source of disease. Amajority of pet owners (86.8 %) identified rabies as a disease caused by the bite of only stray dogs. The proportion of responsible pet owners was 39.4 %. Only one‑tenth of surveyed households had registered their pet with the local municipal authorities, despite such registration being a compulsory requirement by law. This study provides us with a better understanding of the lacunae in awareness of zoonotic diseases and its preventive measures among pet owners. All pet owners have a responsibility to ensure that their pets are healthy and free from disease.

1 table, 19 ref

044464   SHARMA S N, SINGH R, KUMAWAT R, SINGH S K (Ministry of Health & FW, 22 - Sham Nath Marg, Delhi, Email: drsns.nvbdcp@gmail.com) : Guidelines for vector surveillance and its control at international airports and ports in India. J Commun Dis 2020, 52(1), 38-60.

International Health Regulations (IHR) were brought into consideration during 1969 to which all the member states were required to notify to WHO any specific disease outbreaks/ public health emergencies of international concern within 24 hours through focal point, maintain sanitary standards at international borders and PoE as prescribed under IHR. In May 2005, the Fifty-eighth World Health Assembly adopted the new International Health Regulations (IHR, 2005), which came into force in July 2007. In the IHR, state parties are requested to designate airports, and ports that shall develop core capacities requirements, and where justified for public health reasons, may also designate ground crossing. To prevent the threat to Yellow Fever, Zika, Dengue/DHF, KFD, CCHF, Plaque etc., although efforts are being made to address the issue of prevention and control of vector borne diseases, yet lot is to be done in terms of infra-structure strengthening, capacity building, proper planning, implementation and strict monitoring and supervisions at all levels at the grassroot level. An attempt has been made in this regard to address the issue of vectors of Dengue/DHF, Zika, Yellow Fever and Rodents, flies and cockroaches. The guidelines regarding vector surveillance and control may be used as a basis for at PoEs i.e. International airports/ seaports. The development of a management plan for preparing and performing vector surveillance and applying public health measures within the framework of the 2005 IHR is the need of hour and should be a main focus. The primary aim of developing these guidelines is to assist public health authorities at PoE in strengthening core capacities and managing vector surveillance and control programmes by providing technical guidance and skills  on the optimal use of resources, planning, monitoring, and decision-making.

14 illus, 3 tables, 10 ref

040504   SATHIYANARAYANAN S, KUMAR P, RAO C R, KUMAR A, KAMATH A, KAMATH V (Community and Family Medicine Dep, All India Institute of Medical Sciences, Mangalagiri ? 520 008, Andhra Pradesh, Email: sathiya@aiimsmangalagiri.edu.in) : Prevalence of maternal measles antibody and its associated factors among infants in coastal Karnataka, India. Indian J Community Med 2020, 45(1), 83-8.

The current recommendation in India to commence first dose of measles immunization is at 9 months of age. The effectiveness of measles vaccination is greatly impacted by the level of maternal measles antibody (MMA) during infancy. To find the prevalence of MMA and to study the maternal and infant factors associated with persistence of MMA among the infants in a Indian rural community. Dried blood spot sample was collected before vaccination among infants aged 9 months and above when they came for first dose of measles vaccine to assess measles‑specific maternal IgG antibody titers by enzyme immunoassay. Maternal and child factors influencing persistence of MMA were collected by interviewing the mothers. Association between various factors affecting seropositivity was tested using univariate logistic regression analysis and strength of association is reported as risk ratio with 95 % confidence interval. Based on the qualitative estimation among all the recruited children (250) in the study, 4 (1.6 %) infants showed the presence of MMA whereas 25 (10 %) of children had MMA on quantitative estimation. The effect of maternal factors, child nutrition, and sociodemographic factors on the presence of MMA was not found to be statistically significant. The prevalence of persistent MMA (IgG titer ≥200 mIU/ml) among the infants aged 9–12 months was 10 %. The choice of vaccinating infants at the end of 9 months for the first dose of measles vaccine is justified as the remaining (90 %) of infants were susceptible for measles infection at this age.

2 illus, 3 tables, 37 ref