Unintentional injury and its determinants among adolescents

Background: Globally, unintentional injury has been a documented public health problem among adolescents having debilitating consequences and accountable for economic burden. The study was undertaken to estimate the prevalence of unintentional injury, identify the determinants and consequences among adolescents. Design and Methods: This cross-sectional study recruited 222 adolescents using systematic random sampling from a site covered under UHTC Srinagar Garhwal, Uttarkhand. Binary and multivariate logistic regression was used to compute crude and adjusted odds ratio [95% CI] for establishing an association between risk factors and unintentional injury. Descriptive measures (causes, consequences, etc.) describing injuries were presented in tabular, graphical form in proportions. Results: 73.1% of the adolescents suffered from unintentional injury. The risk factors associated (statistically insignificant) with  Unintentional Injury was  males (AOR =1.019, 95% CI =.524-1.979) , living in nuclear family (AOR = 1.540, 95% CI =.766-3.093) , smoked tobacco (AOR = 2.797, 95% CI :.227-34.4377) , visually impaired (AOR =1.629 95% CI :.548 - 6.458) and living in house with overcrowding(AOR =1.66,95% CI:.818-3.395) . 5 % of those affected with unintentional injury had disability. Conclusions: Health education addressing causes, risk factors, consequences of unintentional injury among adolescents, parents, school, and district health authorities should be mandated for the formulation of policy to prevent unintentional injuries

Assessing attitude towards condom use among truck drivers at transhipment location, Meerut District, India, using multidimensional condom attitude scale

Background: In India, unsafe sex has been documented among truck drivers. This study explores the factors influencing their attitude of trucker towards condom use.Methods: A cross-sectional study design was adapted for this study in which 25 factors were chosen to assess attitude toward condom use on 7 point validated Likert scale UCLA Multidimensional Condom Attitude Scale on 5 subcomponents –Reliability, Pleasure, Stigma associated with condom use, embarrassment about negotiation and use of condom and about purchasing condom. Hundred truck drivers were recruited using convenient sampling and Mann-Whitney U and Kruskall Wallis Test were used to validate the subcomponents among those practicing unsafe sex. Results: Positive attitudes regarding reliability and effectiveness of condom were significantly higher among adult entrants and those resting more than 10 hours during journey whereas positive attitude regarding pleasure associated with condoms and stigma towards it is significantly higher among truck drivers travelled long distances and resting more than 10 hours. Conclusion: Adolescent entrants, those who have not travelled long distances and not rested more than 10 hrs requires improvement in the attitude towards condom use. Keywords: Unsafe sex; condom use; India

Exploring unsafe sexual practices among truck drivers at Meerut District, India: a cross-sectional study

Background: Despite implementation of HIV prevention programmes for truck drivers in India, unsafe sex behavior among truck drivers has been documented. Objective: The objective of this study was to assess knowledge about HIV Transmission and modes of prevention, pattern of condom use with high risk partners and explore the practice of unsafe sex and its risk factors among truck drivers. Methods: This exploratory cross-sectional study design was conducted on a recruited convenient sample of 100 truck drivers above 18 years from March to May 2015. Binary logistic regression was used to compute unadjusted odds ratio [95% Confidence Interval] for establishing association of risk factors with unsafe sex. Results: Overall, only 7% had complete knowledge about HIV/AIDS transmission and prevention. 54% of truck drivers have sex with a high risk partner (commercial sexual worker or men having sex with men) and thirty-eight percent reported unsafe sexual practices due to inconsistent condom use with them. The various risk factors found significantly associated with unsafe sex were mean age of first intercourse (OR= 0.92, 95% CI: 0.75 \u2013 0.97), access to pornography (OR = 4.4, 95% CI: 1.8 \u2013 10.7) and conuming psychoactive substance before sex (OR = 4.06, 95% CI: 1.09 \u2013 15.02). Conclusion: Socio-demographic, occupational factors, pornography access and consuming psychoactive substances seems to influence the sexual behaviour of truckers

A cross-sectional study on COVID-19 vaccine hesitancy at peri-urban areas in Kanpur, Uttar Pradesh, India

Vaccination is a potential public health solution for the prevention of infection. It reduces the severity of symptoms in case of COVID-19. Despite the availability of vaccines, some people are hesitant to be vaccinated. The objectives of the study were to measure the proportion of vaccine hesitancy among the peri-urban population and identify its determinants. An adult population of 303 from two peri-urban areas in the field practice area of Urban Health Training Centre, Rama Medical College were interviewed from 22nd February 2021 to 25th March 2021. Epicollect 5 was used for collecting data and STATA 16 was used for analysis. Multivariable logistic regression was applied to compute the adjusted odd ratio (95% confidence interval) to find out the determinants of vaccine hesitancy. Three Cs model guided tools of data collection and analyses. More than one fourth (28%) of the participants were vaccine-hesitant whereas 34.6% of participants had no confidence in the vaccine. Other reasons were complacency (40.6%) and convenience (35.9%). Vaccine hesitancy was significantly associated with gender [AOR = 2.40 (1.12-5.16)] and trust in government [AOR = 0.18 (0.08-0.45)] but no association with age group, political affiliation and source of information about the vaccine.  It is important to build the trust of people in vaccines, make it convenient and resolve the issues that are making them complacent. The health system needs to involve non-governmental organisations to reach out to those for whom there are issues of availability and approach

A dosemetric and radiobiological impact of VMAT and 3DCRT on lumbosacral plexuses, an underestimated organ at risk in cervical cancer patients

Background: The purpose of this study was to evaluate dosimetric and radiobiological difference between volumetric modulated arc therapy (VMAT) and 3-dimensional conformal radiotherapy (3DCRT) in organ at risk (OAR) lumbosacral plexus (LSP) in cervical cancer patients. Materials and methods: 30 patients of cervical cancer who were treated using 3DCRT or VMAT along with chemotherapy followed by brachytherapy were enrolled. LSP was delineated retrospectively. Dosimetric and radiobiological difference was evaluated. Patients were followed for radiation induced lumbosacral plexopathy (RILSP). Results: Median follow-up was 12 months (3–16 months). 53.3% of patients were treated by 3DCRT and 46.7% by VMAT. The mean (±SD) LSP volume: 119.03 ± 15 cm3. The mean volume percentages (%) of the LSP: V5, V10, V20, V30, V40, V50, V55, and V60 were 100%, 99.8%, 99.2%, 94.3%, 84.03%, 59.7%, 0%, 0%, respectively. All patients received doses to the LSP in excess of 50 Gy, one patient received 55 Gy. A statistically significant difference was observed in the median value of V20, V30, V40, V50, D50, P2, P4, P7, P8, P9, and P10 across two different techniques of radiotherapy — VMAT and 3DCRT. None of the patients presented with RILSP. NTCP value was less in VMAT plans compared to 3DCRT, which is also statistically significant. Conclusion: RILSP is a rare and often refractory complication of pelvic radiotherapy. Advance radiotherapy technique with proper OAR delineation and constraint can prevent the occurrence of RILSP. VMAT has potential benefits for the probability of dose reduction in LSP. Further studies are required focusing on dose distribution in LSP–OAR and radiotherapy modality

COVID-19 vaccination: Is it a matter of concern?

Background: COVID-19 vaccination is still a matter of concern among the public since its inception. Primary care physicians being in prime position can share accurate and ample information about COVID-19 vaccination so we estimated proportion and determinants of adverse events following immunization (AEFI) with Covishield vaccine, vaccination and reasons of non-vaccination. Methods: A cross-sectional study was conducted from January to April 2021. Data collection was done by using data capture tool Epicollect-5. Regression analysis was performed to evaluate the association of AEFI and vaccine acceptance with various demographic variables. Results: Of 520 subjects, 408 got vaccinated, and of these 125 (30.6%) developed AEFI. Females without AEFI had lower median age than females having AEFI. Only religion (aOR = 5.311; 95%CI: 1.216–23.1) was significantly associated with AEFI. Education (aOR = 0.399; 95%CI: 0.199–0.799), marital status (aOR = 0.459; 95%CI: 0.245–0.858), and religion (aOR = 3.874; 95%CI: 1.96–7.648) were significantly associated with vaccination. Most common local AEFIs were inflammation (46; 36.8%) followed by lump (10; 8%) at the site of injection. Most common systemic AEFI were fever (87; 69.6%), feeling unwell (65; 52%), generalized weakness/fatigue (30; 20%), tiredness (26; 20.8%), flu-like symptoms (12; 9.6%), dizziness (10; 8%), headache (8; 6.4%) and gastrointestinal events (7; 5.6%). Conclusion: Most of the AEFI were mild and transient, resolved without any medical management. This study warrants active reporting of AEFI, public release of safety, and efficacy data. Primary care physicians can play a pivotal role by targeted awareness campaigns and trust-building activities to alleviate fear and anxiety related to vaccine

Difference between Capillary Blood Glucose of Free Flap and the Patient: A Novel Objective Marker of Free Flap Vascular Compromise during Postoperative Monitoring

Background Defining cut-off values of flap glucose levels in diagnosing free flap vascular compromise, without taking patients' glucose levels into account, does not hold good in all circumstances, especially in cases of high fluctuations in patients' capillary blood glucose and in diabetic patients. The aim of our study was to establish the role of capillary blood glucose measurements of the flap in relation to patients' fingertip, as an objective tool for postoperative free flap monitoring. Methods A total of 76 free flaps underwent postoperative monitoring with reference test (clinical parameters) and simultaneously with our index test (difference between capillary blood glucose of free flap and the patient), in non-diabetic and diabetic patients. Patients' demography and flap characteristics were also recorded. An ROC curve was plotted to determine diagnostic accuracy and cut-offs of the index test in diagnosing free flap vascular compromise. Results Our Index test has a cut-off value of 24.5 mg/dL with 68.75% sensitivity and 93% specificity, with an accuracy of 91.54%. Conclusion The difference between capillary blood glucose of free flap and the patient is simple, feasible, and inexpensive, and can be done by any health care professional and does not require any specialized facilities or training. It has an excellent diagnostic accuracy to detect impending free flap vascular compromise, especially in non-diabetics. Although in diabetics, this test becomes less accurate. Being an observer-independent objective test, the difference in capillary blood glucose of patient and flap measurement can be used as a highly reliable tool for postoperative free flap monitoring