An Epidemiological Investigation of Cholera Outbreak in a Residential School for differently abled children and adolescents in Central India

Background: Migration, inadequate sanitation, congestion, and disease ignorance make cholera a major public health issue in emerging nations like India. The increase in diarrhea and dehydration cases at an NGO Residential School for differently abled children and adolescents in Indore, M.P., India, demanded quick investigation to avert future morbidity and mortality. Objectives: To investigate diarrhea and dehydration outbreak at an NGO Residential School for differently abled children and adolescents in urban Indore, M.P., India; determine the etiological agents, outbreak’s severity and recommend control strategies. Materials and Methods: A cross-sectional study with pre-defined case definition, followed line-listing and collection of stool, food, and water samples. Symptomatic cases were referred and treated. A comprehensive epidemiological report with recommendations and inclusive action plan was submitted to the district health authorities. Results: Out of 94 suspected cases, 31 tested positive for cholera. Most affected individuals (72.34%) were aged 10–19 years, with an equal male-to-female ratio. The case fatality rate was 4.3%, while attack rate was 32.98%. Contaminated drinking water and poor hygiene were identified as the main causes of the outbreak. Conclusion: Contaminated water and poor hygiene were identified as key factors responsible for cholera outbreak. Water treatment and hygiene education helped control the outbreak. Periodic supervision suggested to prevent future outbreaks

Bagasse dust related morbidities and its determinants among workers at sugarcane factory of District Saharanpur

Introduction: India’s sugarcane factories are growing by creating job opportunities for thousands of workers with varying educational, professional and socioeconomic backgrounds. These factories are a source of several hazards that severely harm the workers’ health. Aims & objectives: To find prevalence of morbidities due to bagasse dust exposure among sugarcane factory workers and various factors associated with them. Material and methods: Cross sectional study was conducted in randomly selected Government sugarcane factory of District Saharanpur, among 343 factory workers for a period of one year. Pretested semi structured questionnaire was used to collect data. Collected data was analysed using appropriate statistical tests. Result: Overall prevalence of bagasse dust related morbidities was 29.2%. Maximum workers suffered from chronic cough (21.6%), chronic cough with breathlessness (2.3%), and chronic cough with phlegm (1.7%), chronic phlegm (1.5%), breathlessness (1.2%), wheeze (0.9%). These morbidities were significantly higher among those belonging to socioeconomic class III (37.4%)., working in processing section (68.4%) and those working for > 8 hours/day (38.7%). Conclusion: Occupational hazards have deleterious effect on the individual health and safety, and on organizational effectiveness. These are preventable to a larger extent. Regular training should be conducted to educate workers to adopt proper safety measures

Study to assess psychological distress among undergraduate Medical and Engineering students of Delhi

Background: Undergraduate students, especially those in medical and engineering fields, face significant academic pressures coupled with other stressors which makes them susceptible to mental distress, including anxiety, depression, and sleep disturbances. Objective: To assess and compare mental distress among undergraduate medical and engineering students and factors affecting it. Materials and Methods: A comparative cross-sectional study was conducted among 300 students (150 each from medical and engineering colleges of Delhi, India. Data was collected using a structured online questionnaire, which included demographic details and the Kessler Psychological Distress Scale (K10) to assess mental distress. Results: We observed that 61.3% of participants were likely to have some sort of stress disorder, with higher prevalence in medical students (62.7%) than in engineering students (60%). Longer sleep latency was significantly associated with moderate to severe stress disorders (p < 0.001). Association of gender with mental distress was also found to be significant (p value= 0.022). Conclusions: Medical students were more prone to severe stress disorders compared to engineering students. Prolonged sleep latency was a strong predictor of psychological distress. Early intervention and mental health support are essential for improving student well-being

Redefining Assistive Technology: A Shift from Disability to Functional Impairments in Policy and Practice

Achieving the Sustainable Development Goals (SDG) and ensuring inclusive universal health coverage (UHC) with the goal of “leaving no one behind” has sparked a global dialogue on Assistive Technology (AT) or Assistive Products (AP).(1) This conversation has driven innovation and transformed lives, yet the unmet needs for AT are significant globally. The WHO-UNICEF Global Report on Assistive Technology (GReAT) 2022 reported that in low- and middle-income countries (LIMCS), as low as 3% of the population needing AT has access to these life-changing tools.(2) Further, it is estimated that by 2050, two billion people will require AT, yet 90% of them, particularly in LMICs, will lack access.(3) The International Organization for Standardization (ISO) has defined “assistive product as any product (including devices, equipment, instruments, and software), specially produced or generally available, used by or for persons with disability for participation; to protect, support, train, measure or substitute for body functions/structures and activities; or to prevent impairments, activity limitations or participation restrictions.(4) For ease of understanding, the authors use AT as the umbrella term in the rest of the article for Assistive technology or aids or products or services

Rethinking the “Evidence Pyramid”: A shift From Positivism to Pragmatism - Evidence Pie

The evidence pyramid ranks study designs by their reliability in establishing causal relationships, with systematic reviews and RCTs at the top due to their ability to minimize bias. However, these studies may have limited external validity, as they often use controlled environments that don\u27t reflect real-world conditions. Observational and quasi-experimental studies offer better external validity but have lower internal validity. The pyramid\u27s structure is based on a positivist paradigm, which emphasizes on the objective truth and empirical methods. However, newer research methodologies recognize the complexity of real-world data and promote social justice and empowerment. The evidence pyramid\u27s overfocus on internal validity may underappreciate external validity, and it often overlooks the importance of qualitative research. With increasing importance of value based medicine, the subjective experiences of patients To address these issues, we have proposed the Evidence Pie model, where all study designs contribute to evidence, with quality of the evidence being determined by rigor rather than design type. This simplistic, single-layered model aims to integrate diverse evidence types for more practical, context-sensitive decision-making

Exploring Quality of Life and Caregiver Burden in Palliative care

Background: The increasing prevalence of non-communicable diseases in India has led to a growing need for palliative care. This study aimed to explore and analyse the factors contributing to the quality of life and burden experienced by caregivers of palliative patients in a metropolitan setting. Methodology:  A qualitative phenomenological approach was employed, grounded in the interpretivist paradigm. Seven in-depth, semi-structured interviews were conducted with primary caregivers of palliative patients at a tertiary care hospital and Palliative Care Hospital. Purposive sampling was used, and data saturation determined the sample size. Interviews were audio-recorded, transcribed, and translated. Data analysis followed a hybrid approach, combining inductive and deductive methods. Results: Seven major themes emerged from the analysis. Caregivers reported significant deterioration in their quality of life, disruption of daily routines, and emotional distress. They faced challenges including physical and mental exhaustion, lack of respite, and financial constraints. Coping mechanisms included seeking emotional support and spiritual practices. Despite hardships, caregivers found satisfaction in witnessing improvements in their loved ones\u27 conditions. They expressed concerns about future care arrangements and suggested better communication with healthcare professionals and respite opportunities. Conclusion: The study revealed that caregiving for palliative patients significantly impacts caregivers\u27 quality of life and emotional well-being. While caregivers experience multiple challenges, they also find satisfaction in their role. To improve the caregiving experience, healthcare systems should focus on enhancing communication between healthcare professionals and patients, and providing respite options for caregivers. These findings can inform strategies to support caregivers and improve palliative care services in metropolitan settings

Practices and Knowledge about Safe Pesticide use- a Cross sectional Study amongst Farmers of a district in Odisha, India

Background: With agriculture being the second largest workforce sector in the world, the knowledge and practices on safe pesticide use among farmers is of paramount importance. Aim & Objectives: The study aimed to investigate the farmers’ knowledge and practices on safe use of pesticides. Methodology: A community based cross-sectional study was conducted among 421 farmers from December 2020 to September 2022 in the second populous district of the state. Data was collected using a semi structured questionnaire using demographic and occupational data, knowledge & practices on safe pesticide use. Data was entered into Microsoft excel and analysed using Epi Info statistical software. All categorical data was presented using frequency and percentages & continuous data in mean±SD. Results: The mean age was 40.53±6.7 years (18 to 65 years). Maximum (62.94%) were in the age-group of 40-60 years; 83.37 % were males and 79.33% literate. All the farmers used pesticides, 47.50% of them had an experience of >15 years in farming and 68.65% were using pesticides since 5-15 years. The overall knowledge was poor (68.4%).Conclusion: The overall knowledge on safe use of pesticides was poor, their practices still poorer. Most of them had not attended any training on integrated pest management

Road Safety Awareness and Attitudes Among Undergraduate Students in a City of Western India

Background: Road traffic injuries (RTIs) pose a major global public health challenge, causing significant morbidity, mortality and disability annually. India, despite having only 1% of the world’s vehicles, contributes significantly to global road fatalities. Factors such as poor road conditions, inadequate driver training, lax enforcement of traffic laws, and risky driving behaviors exacerbate the issue. Young adults, due to their mobility and risk-taking tendencies, are particularly vulnerable. This study aimed to assess the awareness, attitudes, and behaviors of undergraduate students in Ahmedabad regarding road safety. Methods: A cross-sectional study was conducted among undergraduate students across five academic disciplines in Ahmedabad during the 2021–2022 academic year. A multistage random sampling method was employed, selecting colleges from different administrative zones. A structured questionnaire was administered online via Google Forms. The sample size was determined at 440 students, with additional considerations for non-response. Descriptive statistical methods, including Chi-square tests, were used to analyze the data. Results: The study included 446 respondents (51.3% males, 48.7% females) with a mean age of 20.84 years. Most students drove both two- and four-wheelers (52.2%), while 30.7% drove only two-wheelers. A majority (90.3%) held valid driving licenses. Risky behaviors such as underage driving (14.1%), use of mobile phones while driving (56.8% Bluetooth, 8.5% handset), and non-compliance with protective gear (39.5% always, 9.9% never) were noted. Over speeding and distracted driving were identified as significant accident contributors. A substantial proportion of respondents (59.2%) supported stricter enforcement of traffic laws. Conclusion: The findings highlight critical gaps in road safety awareness and behavior among undergraduate students. While most students recognize the dangers of reckless driving, non-compliance with safety measures remains prevalent. Strengthening road safety education, promoting responsible driving behaviors, and enforcing stricter regulations are essential to reducing RTIs among young adults

Prevalence and determinants of anxiety among school-going adolescents of Kanpur Nagar

Background: Adolescence is a time of significant physical, hormonal, and behavioral transformations, as well as psychosocial adversity. These transformations can affect mental health because of school pressure, shifting interpersonal relationships, and societal demands. Anxiety disorders occur in almost a quarter of adolescence all over the world, more in females. Aim & Objective: The proposed study aims to explore prevalence and determinants of anxiety disorders among school-going adolescents in Kanpur Nagar. Setting & Design: School Based cross-sectional study. Methods & Material: Multistage random sampling from eight schools in Kanpur Nagar, selecting one section from each class (IX-XII).Pretested questionnaire, self-report method, with consent and assent obtained from participants and parents. Includes bio-social characteristics, lifestyle and behaviour, and Beck’s Anxiety Inventory (BAI). Data analyzed using SPSS with descriptive and inferential statistics (t-tests, ANOVA, with Pearson’s chi-square test applied). Results: Among the participants, 53% are female and 47% are male. The participants are distributed across grades, with 26.1% in 9th, 25.5% in 10th, 25% in 11th, and 23.4% in 12th. Sleep duration also demonstrated a significant correlation (p=0.01), as participants sleeping less than 6 hours per day exhibited higher levels of severe anxiety (20.5%). Conclusions: A nearly equal gender distribution (53% female, 47% male) and wide representation across religion, caste, school type, and socio-economic status strengthen the generalizability of findings. Statistically significant associations were found between anxiety levels and gender, religion and educational class with 12th-grade students and females experiencing higher levels of severe anxiety. Lifestyle factors also played a crucial role: students engaging in regular physical activity reported lower anxiety, while inadequate sleep correlated with higher anxiety levels.

Navigating Risks: Exploring Sexual and Reproductive Health and Contraceptive Awareness among Adolescent Girls in in District Dehradun

Background: Adolescence brings about significant changes in the life, making it crucial to develop lifelong healthy habits. However, societal norms often restrict open discussions on sexual and reproductive health (SRH). In India, access to accurate SRH information and healthcare remains limited for many adolescents. Aim & Objective: To study trend in risk taking behavior related to sexual & reproductive health of adolescent girls and to find out awareness about and use of contraception in the study population. Settings and Design: A cross-sectional study was conducted in two randomly selected intercolleges in district Dehradun. Methods and Material: A total of 400 unmarried school-going adolescent girls (classes 9th–12th) were surveyed with a focus on SRH. Statistical Analysis Used: Percentages and chi-square test. Results: The mean age of respondents was 15.62 (±1.557) years. Teachers were the primary source of SRH information, but only 26.2% respondents had attended sex education classes. While most had heard of HIV/AIDS, knowledge about other sexually transmitted infections was low. Awareness of condoms and oral contraceptive pills was higher than other methods and improved with age. Conclusion: The study highlights inadequate access to accurate SRH information and the need for comprehensive education programs to promote informed decision-making